Popular Weight-Loss Drugs May Also Treat Addiction

Drugs best known for treating diabetes and obesity may also dampen the powerful cravings that drive addiction.

Researchers at Washington University School of Medicine in St. Louis report that medications in the GLP-1 class may help both prevent and treat substance use disorders across a wide range of addictive drugs. Their findings suggest these medications may influence a shared biological pathway involved in addiction.

GLP-1 receptor agonists, including semaglutide and tirzepatide, were originally developed to treat type 2 diabetes. In recent years, their use has expanded rapidly, especially for weight loss. Some patients taking these medications have said they feel less interest in alcohol or nicotine. Previous observational studies have also linked GLP-1 treatment to a lower risk of alcohol and cannabis use disorders, opioid overdose, and alcohol related hospitalizations.

However, earlier research typically focused on one substance at a time. Researchers had not previously examined whether GLP-1 medications might reduce the risk of substance use disorders more broadly or whether they could also lower the risk of serious outcomes such as overdose and drug-related death.

To explore these questions, the WashU Medicine team analyzed health data from more than 600,000 U.S. veterans with type 2 diabetes. They found that people taking GLP-1 medications had a lower likelihood of developing substance use disorders involving major addictive substances. The medications were also linked to fewer severe outcomes, including overdoses and deaths, among patients who already had substance use disorders.

The findings were published in The BMJ.

“In addiction medicine, a lot of treatments target just one thing — for example, a nicotine patch helps with smoking, but not alcohol — but there is no medication that works across addictive substances, let alone all of them,” said senior author Ziyad Al-Aly, MD, a WashU Medicine clinical epidemiologist and Chief of the Research and Development Service at the VA Saint Louis Health Care System. “The revelation about GLP-1 medication is that it really works against all major substances, and it works uniformly, not because it acts against alcohol or opioids or nicotine specifically, but because it is likely acting against the craving itself. It blunts that craving that pulls people toward whatever they’re addicted to.”

Quieting the roar of addiction

Treating multiple substance use disorders at the same time can be difficult. Some substances, including methamphetamine, currently have no approved medications for treatment. Al-Aly said this gap presents a major challenge for recovery.

He began to consider whether patient reports about losing interest in drinking or smoking after starting GLP-1 medications might apply to other addictive substances as well. These observations, combined with the fact that GLP-1 receptors are present in brain regions involved in reward processing, suggested that the drugs might influence cravings.

Based on this possibility, Al-Aly and his colleagues investigated whether GLP-1 medications might affect substance use disorders more broadly.

The researchers examined electronic health records from 606,434 U.S. veterans diagnosed with type 2 diabetes. Participants were separated into two groups: those who had never been diagnosed with a substance use disorder and those who already had one.

The team reviewed up to three years of medical records beginning when patients started treatment with either a GLP-1 receptor agonist, most often semaglutide, liraglutide, or dulaglutide, or a different diabetes medication called an SGLT2 inhibitor.

During the study period, researchers monitored the 524,817 participants who did not previously have a substance use disorder to see whether they developed alcohol, cannabis, cocaine, nicotine, opioid, or other substance use disorders.

Among the 81,617 participants who already had a substance use disorder, the researchers tracked serious health outcomes. These included drug-related emergency department visits, hospitalizations, overdoses, deaths, and suicidal thoughts or attempts.

Lower Risk Across Multiple Substances

Compared with people using other diabetes medications, patients taking GLP-1 drugs had a 14% lower risk of developing any substance use disorder.

The reduction was seen across several specific substances. Risk decreased by 18% for alcohol use disorder, 14% for cannabis, 20% for cocaine and nicotine, and 25% for opioids. Overall, this corresponded to seven fewer new diagnoses of substance use disorder for every 1,000 people taking a GLP-1 medication.

Among patients who already had a substance use disorder, GLP-1 treatment was associated with fewer hospitalizations, overdoses, and deaths linked to substance use.

After three years, the data showed a 30% decrease in emergency department visits, a 25% decrease in hospitalizations, a 40% reduction in overdoses, and a 50% reduction in drug-related deaths. This amounted to 12 fewer serious harm events for every 1,000 GLP-1 users.

“GLP-1s may offer a dual benefit for patients with chronic conditions like diabetes or obesity who are also struggling with a substance use disorder: one medication can treat both conditions at once,” Al-Aly said.

Population-Level Implications

Millions of Americans already use GLP-1 medications, and their use continues to rise. If these drugs truly help prevent or reduce substance use disorders, the impact could be significant at the population level.

Al-Aly said the findings support conducting clinical trials designed specifically to test GLP-1 medications as treatments for addiction. Such trials could examine whether the drugs reduce overdose rates and drug-related deaths.

“People taking these drugs for obesity often describe a quieting of ‘food noise,’ the persistent preoccupation with food that drives overeating,” Al-Aly said. “What our study suggests is something broader: GLP-1 drugs may also quiet what I call ‘drug noise,’ the relentless craving that drives addiction across substances. That cross-substance signal points to a shared biology underlying addiction, and it opens the door to a fundamentally different approach: not treating one addiction at a time, but targeting that common biologic signal, that common craving across addictions. Moving beyond food noise to drug noise, GLP-1s are quieting the roar of addiction.”

Reference: “Metabolic medicines and addiction: what GLP-1 receptor agonists might add to substance use care” by Fares Qeadan, 4 March 2026, BMJ.
DOI: 10.1136/bmj.s325

Never miss a breakthrough: Join the SciTechDaily newsletter.
Follow us on Google and Google News.