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Addiction

New Weight Loss Medications May Help Treat Addiction

Research indicates meds like Ozempic can reduce opioid and alcohol use disorder.

Key points

  • Sometimes, new effective treatment medications are discovered almost inadvertently.
  • New research indicates weight loss medications like Ozempic may also reduce opioid and alcohol use disorders.
  • These medications seem to alter the brain's reward pathways similarly in both eating and substance use.
Source: Markus Winkler/Pixabay

“Once in a while you get shown the light in the strangest of places if you look at it right.” –Robert Hunter, Grateful Dead, "Scarlet Begonias"

Sometimes, new effective treatment medications are discovered almost by accident. This happened with the new generation of hepatitis C medications that have much higher cure rates, fewer and less severe side effects, and a significantly shorter course of treatment than the treatment protocol they replaced beginning a decade ago.

At the time pharmaceutical companies weren’t researching for better hep C treatments, but rather a cure for HIV. What their clinical trials revealed was that while the HIV status of study participants remained the same, hepatitis C among those also infected with that virus appeared to resolve. This unintended result led to a revolution in how hep C is treated.

A similar process may be in progress related to the potential development of new and effective medications for addiction treatment. A recently published study in the journal Addiction found that people with opioid and/or alcohol use disorder (OUD, AUD) who take Ozempic or similar medications to treat diabetes and other weight-related conditions experienced dramatically lower rates of opioid overdose and alcohol intoxication than people with OUD and AUD who don’t take such medications.[1]

Ozempic is one of several medications, called glucagon-like peptide-1 receptor agonists or GLP-1 RAs, that are prescribed to treat diabetes, obesity, and other weight-related medical conditions. GLP-1 agonists and glucose-dependent insulinotropic polypeptide (GIP) agonists currently prescribed for weight-related conditions include Semaglutide (brand names Ozempic, Wegovy) and Tirzepatide (Mounjaro).

Most prior research into using these medications to treat substance use disorders consisted of animal studies and small clinical trials. In contrast, this large-scale human study looked at the medical records of 503,747 people with a history of opioid use disorder and found that the 8,103 of those who had a prescription for a GLP-1 RA or GIP had a 40% lower rate of opioid overdose compared with those who did not have a prescription for these medications. The same study also looked at 817,309 people with a history of alcohol use disorder and found that the 5,621 who had a prescription for a GLP-1 RA or GIP had a 50% lower rate of alcohol intoxication compared with those who did not have a prescription. These protective effects were consistent across various subgroups, including patients with comorbid type 2 diabetes and obesity. Importantly, these results seem to mirror those of similar recent substantial research studies.[2] [3]

How do such medications work?

These medications function by mimicking the GLP-1 hormone that is produced in response to eating and regulate hunger and weight and interact with the mesolimbic system within the brain to reduce food cravings and overall appetite, as well as increase satisfaction after eating.[4] The mesolimbic dopamine pathway is a neural circuit that plays a crucial role in reward, motivation, and pleasure. As a result, the mesolimbic system overlaps with the brain processes that govern addictive experiences/behaviors, including chronic substance use. This overlap suggests that GLP-1 RAs and similar medications may also alter the reward-response pathways associated with substance use.[5]

However, the precise mechanisms of action related to how these medications work is a subject of some debate. One belief is that they make food or addictive substances less pleasant and, in turn, less attractive. Another is that they suppress desire, so that people have fewer cravings/urges influencing them to overindulge. Yet another line of thinking is these medications change the body’s set point—the amount of food or substance use that feels sufficient and signals that it's time to stop eating or using.

Anecdotally, those taking these medications for diabetes or to lose weight commonly describe experiencing less intense food cravings and feeling satisfied or “full” after eating much less than they would have previously. And among people on these meds who also evidence problematic substance use there are frequent reports of reduced drug cravings and decreased drug-related rewards, including reduced sensations of pleasure.

In and of itself, this new research does not demonstrate that Ozempic and similar drugs can help treat addiction. But the potential is clear, and if these findings hold up—and early data from more rigorous clinical trials is promising—such medications could be as big a game changer in addiction treatment as they have been regarding obesity. Moreover, understanding more precisely how they work could dramatically shift how addiction is viewed and treated.

Copyright 2025 Dan Mager, MSW.

References

[1] Qeadan F, McCunn A, and Tingey B. 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. Addiction. 2024. DOI: 10.1111/add.16679. https://onlinelibrary.wiley.com/doi/10.1111/add.16679

[2] Wang W, Volkow ND, Wang Q, Berger NA, Davis PB, Kaelber DC, Xu R. Semaglutide and Opioid Overdose Risk in Patients With Type 2 Diabetes and Opioid Use Disorder. JAMA Netw Open. 2024 Sep 3;7(9):e2435247. doi: 10.1001/jamanetworkopen.2024.35247. PMID: 39320894; PMCID: PMC11425147.

[3] Wang W, Volkow ND, Berger NA, Davis PB, Kaelber DC, Xu R. Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population. Nat Commun. 2024;15(1):4548. doi:10.1038/s41467-024-48780-6

[4] Hernandez NS, Schmidt HD. Central GLP-1 receptors: novel molecular targets for cocaine use disorder. Physiol Behav. 2019; 206: 93–105. https://doi.org/10.1016/j.physbeh.2019.03.026

[5] Adinoff B. Neurobiologic processes in drug reward and addiction. Harv Rev Psychiatry. 2004; 12(6): 305–320. https://doi.org/10.1080/10673220490910844

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