Medications such as semaglutide (marketed as Ozempic/Wegovy) could aid treatment of alcohol and other substance use disorders, according to a peer‑reviewed review in the Journal of the Endocrine Society. Early animal and human data suggest these GLP‑1 receptor agonists act on brain reward circuits; lead author Lorenzo Leggio urged caution, saying, “Early research in both animals and humans suggests that these treatments may help reduce alcohol and other substance use.”
A new Endocrine Society–linked review examines whether glucagon‑like peptide‑1 receptor agonists (GLP‑1RAs)—drugs developed for diabetes and, more recently, obesity—might help address alcohol and other substance use disorders (SUDs). GLP‑1RAs curb appetite and influence satiety pathways in the brain, which overlap with circuits implicated in addiction, the authors note. The article was published online October 9, 2025, in the Journal of the Endocrine Society. (academic.oup.com)
The public‑health need is substantial. In the United States, only about 14.6% of people with a past‑year substance use disorder received any substance use treatment in 2023, according to the federal government’s National Survey on Drug Use and Health. (samhsa.gov)
Evidence to date is mixed but encouraging in places:
- Alcohol use disorder (AUD): In a 127‑person randomized clinical trial, once‑weekly exenatide did not reduce heavy drinking days overall versus placebo, but exploratory analyses suggested reductions in heavy drinking days and total alcohol intake among participants with obesity; neuroimaging also showed attenuated alcohol cue reactivity. Separately, a small randomized trial found that low‑dose semaglutide reduced laboratory alcohol self‑administration, drinks per drinking day, and weekly craving in adults with AUD. (pmc.ncbi.nlm.nih.gov)
- Opioid use disorder: Preclinical studies in rodents report that GLP‑1RAs, including liraglutide and exendin‑4, reduce heroin and fentanyl seeking and curb reinstatement of drug‑seeking—a laboratory model of relapse. (pubmed.ncbi.nlm.nih.gov)
- Tobacco use disorder: Animal data show GLP‑1–pathway interventions lower nicotine self‑administration and relapse‑like behavior, and mitigate withdrawal‑related hyperphagia and weight gain. Early human work includes a pilot randomized trial where exenatide, added to nicotine patches, increased short‑term abstinence and reduced post‑cessation weight gain; in the semaglutide AUD trial, a smoking subsample recorded greater relative reductions in cigarettes per day versus placebo. (pmc.ncbi.nlm.nih.gov)
The review was authored by Nirupam M. Srinivasan (University of Galway), Mehdi Farokhnia and Lisa A. Farinelli (National Institute on Drug Abuse/National Institute on Alcohol Abuse and Alcoholism), Anna Ferrulli (University of Milan/IRCCS MultiMedica), and Lorenzo Leggio (NIDA/NIAAA), who emphasized the need for larger, longer trials to establish efficacy, dosing, safety, and patient selection. (academic.oup.com)
In comments released with the paper, Leggio said the field is in its early days and that more research is required to translate these findings into practice. The Endocrine Society’s news release summarizing the review underscores the potential across alcohol, opioid, and tobacco use disorders while warning that current evidence remains preliminary. (sciencedaily.com)
Researchers also stress context: while some studies have ranked alcohol as the most harmful drug overall when considering harm to users and others, treatment access remains limited and uneven. Any future role for GLP‑1 drugs would complement—not replace—established behavioral therapies and approved medications. (pubmed.ncbi.nlm.nih.gov)
