Overview
Ozempic and similar semaglutide medications / GLP-1 agonists are being prescribed off-label for addictive disorders
These medications are typically used for treatment of type 2 diabetes and weight management, and anecdotally patients who are on them talk about how the medications decrease cravings for food
They also report less cravings for alcohol, tobacco
Currently multiple RCT’s underway to understand effects of GLP-1 receptor agonists on SUD
Mechanism
GLP-1 receptor activation attenuates alcohol’s ability to activate mesolimbic dopamine system
Agonists also decrease dopamine release in nucleus accumbens, a region of the brain implicated in reward and addiction in a variety of SUD’s
Evidence thus far
Has been studied in smoking cessation, alcohol use disorder, and opioid use disorder
One study of those with OUD found that GLP-1 medication reduced opioid cravings by 40% over 3 weeks
One study found that people with OUD or AUD who took GLP-1’s had 40% lower rate of opioid overdose, and 50% lower rate of alcohol intoxication compared to those who were not on the medications
References (read more about it here)
1. Bajaj S. Opioid cravings were reduced by anti-obesity drug in small study. STAT. February 18, 2024. Accessed January 7, 2026. https://www.statnews.com/2024/02/17/opioid-cravings-glp1-weight-loss-liraglutide-penn-state/
2. Freet CS, Evans B, Brick TR, et al. Ecological momentary assessment and cue-elicited drug craving as primary endpoints: study protocol for a randomized, double-blind, placebo-controlled clinical trial testing the efficacy of a GLP-1 receptor agonist in opioid use disorder. Addict Sci Clin Pract. 2024;19:56. doi:10.1186/s13722-024-00481-7
3. Hendershot CS, Bremmer MP, Paladino MB, et al. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder. JAMA Psychiatry. 2025;82(4):395-405. doi:10.1001/jamapsychiatry.2024.4789
4. Klausen MK, Thomsen M, Wortwein G, Fink‐Jensen A. The role of glucagon‐like peptide 1 (GLP‐1) in addictive disorders. Br J Pharmacol. 2022;179(4):625-641. doi:10.1111/bph.15677
5. Lüthi H, Lengsfeld S, Burkard T, et al. Effect of dulaglutide in promoting abstinence during smoking cessation: 12-month follow-up of a single-centre, randomised, double-blind, placebo-controlled, parallel group trial. eClinicalMedicine. 2024;68:102429. doi:10.1016/j.eclinm.2024.102429
6. Wium‐Andersen IK, Wium‐Andersen MK, Fink‐Jensen A, Rungby J, Jørgensen MB, Osler M. Use of GLP‐1 receptor agonists and subsequent risk of alcohol‐related events. A nationwide register‐based cohort and self‐controlled case series study. Basic Clin Pharmacol Toxicol. 2022;131(5):372-379. doi:10.1111/bcpt.13776
7. Five things to know about GLP-1s and addiction. News Center. Accessed January 7, 2026. https://med.stanford.edu/news/insights/2025/04/ozempic-addiction-glp-1s-mounjaro-lembke.html
8. The association between glucose‐dependent insulinotropic polypeptide and/or glucagon‐like peptide‐1 receptor agonist prescriptions and substance‐related outcomes in patients with opioid and alcohol use disorders: A real‐world data analysis - Qeadan - 2025 - Addiction - Wiley Online Library. Accessed January 7, 2026. https://onlinelibrary.wiley.com/doi/10.1111/add.16679