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GLP-1s and Addiction Care

By January 12, 2026January 29th, 2026No Comments

GLP-1s and Addiction Care:

Current Landscape and Future Directions

By Lucy Connery, MPH & Brooke Langella, MPH

       Glucagon-like peptide-1 (GLP-1) is a hormone naturally created by the small intestine that triggers insulin release from the pancreas, manages blood sugar levels, slows stomach emptying during digestion, and increases satiety (feeling of fullness) after eating. GLP-1 receptor agonists — medications such as tirzepatide, semaglutide, more commonly referred to by brand names Ozempic and Mounjaro — mimic this naturally occurring hormone and have gained popularity due to their success in treating diabetes and obesity. First approved by the FDA for type 2 diabetes, they have since altered how clinicians approach obesity treatment, swiftly changing hundreds of thousands of lives (Conley, 2025). While GLP-1s have been around since the early 2000s, these medications only recently made headlines as many people dealing with food addiction report a sharp drop in “food noise,” a term describing continuous thoughts and cravings for food (Conley, 2025). As researchers continue exploring their potential use, including high blood pressure, neurodegenerative diseases like Alzheimer’s, and even substance use disorders (SUD), it is important for the public to understand their effects and the growing implications of expanding their use.

       Researchers have begun actively exploring what types of addictions GLP-1s can help with, as they’ve been proven to go far beyond weight loss by quieting cravings and reducing urges for food, but also potentially for alcohol, smoking, drugs, and even behaviors such as sex and gambling (Dimitri, 2025). In fact, there are currently physicians prescribing GLP-1s off-label to treat SUD and other forms of addiction (Conley, 2025). The influence of how hormones affect the brain has been a focus of research for years, laying the groundwork for including GLP-1s in this subject area. The idea is that these craving-related hormones, whether the urge is for food, alcohol, or drugs, tap into the same underlying system in the brain, which begins to explain their broader potential in becoming a breakthrough approach in treating addiction (Dimitri, 2025). GLP-1s impact your dopamine responses that can keep someone continuously chasing that feeling of “more”.

        Although the potential for GLP-1s to treat SUD and other behavioral health disorders is appealing, it’s vital to look at the data available on this subject. The literature around this topic is growing, yet most publications on GLP-1s for SUD have been limited to animals (Bruns et al., 2024; Bornebusch et al., 2019). For example, there has only been one randomized controlled trial published on the effects that GLP-1s have on humans with SUD (Free et al., 2024). Preliminary findings suggest reductions in self-reported opioid craving, but definitive efficacy data remains limited. This clinical trial followed 40 participants in an inpatient facility for opioid use disorder (OUD) who reported an average of a 40% reduction in opioid cravings. These results are encouraging; however, some conflicting evidence exists in the literature. For example, Bornebusch et al. (2019) report that GLP-1s may be more effective in treating alcohol use disorder than OUD; they state that “GLP-1 receptor agonists do not reduce abuse-related effects of opioids in assays of reward, reinforcement, or withdrawal” (Bornebusch et al., 2019). While inconsistent results on how well a drug works on a particular condition are not uncommon, this reinforces the need for more clinical trials to be done with humans rather than animals.

        As research about the impacts of GLP-1s on addiction continues, one thing should be made clear to the public: GLP-1s are currently not FDA-approved to treat SUD. Ongoing research means it may be years before these medications are sufficiently understood or recognized as appropriate for addiction treatment. Without FDA approval, access to GLP-1s remains limited for people living with SUD. Typically, health insurers do not provide coverage for these medications, particularly when prescribed off-label for conditions such as SUD that currently lack FDA approval (National Association of Insurance Commissioners, 2024). In addition, most insurance companies do not cover any or all GLP-1 medications unless patients meet very specific criteria, leaving many individuals to pay hundreds of dollars a month out of pocket (KFF, 2024). This financial burden presents a significant barrier when exploring the expansion in the use of GLP-1s. At the same time, if access to and insurance coverage for these medications continue to grow, it could open the door for more people to get treatment for substance use.

        There are many FDA-approved medications for addiction treatment (MAT), but this treatment method is deeply misunderstood and stigmatized. For example, many believe that MAT is simply “replacing one drug for another”. MAT works similarly to how insulin helps people with diabetes. In both cases, the body is no longer regulating an important hormone (or substance) on its own. Medications can replace or stabilize what the body cannot produce, allowing for better symptom management and overall long-term well-being.

        Like SUD, weight management is another sensitive, stigmatized issue in the United States. GLP-1s are helping expand how the public thinks about obesity because this medication is not typically used alone; behavior change in terms of diet and exercise is needed for the drug to be effective. As such, GLP-1s and MAT are similar; both are tools that may help individuals achieve their health goals, but neither can necessarily “solve” their respective health conditions for everyone (Srinivasan et al., 2025). GLP-1s can quiet “food noise” similarly to how certain forms of MAT can curb cravings and treat withdrawal symptoms. Both medication types also commonly influence appetite and weight, as they act on overlapping hormonal and reward pathways in the brain (Srinivasan et al., 2025). The two are also similar in that some people do not respond to GLP-1 therapy or MAT (Niewijk, 2024). Instead, this drug class may help provide options for patients who have already tried other treatment methods and have been unsuccessful.

        Emerging evidence suggests GLP-1s may hold promise as an added therapeutic option, but further clinical trials in humans are necessary to determine the safety, efficacy, and role in addiction treatment. As research continues, it’s important to frame GLP-1s as a tool rather than a standalone solution to diabetes, obesity, or SUD. This drug’s ability to reduce cravings – whether for food, alcohol, or opioids – in combination with other treatment and/or prevention education may help more communities understand addiction as a chronic medical condition rather than an individual’s choice. Expanding access to stigma-free, human-centered treatment options will improve health outcomes for people living with SUD, and exploring new drug classes for treating addiction is a worthwhile venture.

References

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