Cardiology in reviewJun 1, 2026

New Evidence and Future Possibilities for Using GLP-1-Based Drugs in Treating Substance Use Disorders

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jun 2, 2026

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) may reduce substance use in individuals with addiction disorders.

GLP-1 receptors are found in brain regions that regulate reward, suggesting a role in substance use disorders.
Preclinical studies indicate that GLP-1RAs can reduce drug usage and inhibit relapse behaviors for alcohol, nicotine, and opioids.
Initial clinical findings show semaglutide may decrease alcohol and cigarette consumption, though results are inconsistent and based on small samples.
Subgroup analysis hints that GLP-1RAs could be more effective in people with obesity and metabolic disorders.
Current evidence for opioid use disorder is limited to animal studies, showing effects similar to established treatments.
Future research should focus on larger clinical trials and long-term safety assessments to clarify the role of GLP-1RAs in treating addiction.

Simplified

Substance use disorders (SUDs) are the leading causes of both global mortality and morbidity, and alcohol, nicotine, and opioids account for most of this burden. Existing pharmacotherapies are only moderately effective, have inconsistent compliance and regular relapse, and therefore, new treatment modalities are required. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), which have been licensed to treat type 2 diabetes and obesity, have emerged as potential therapeutic candidates for SUDs due to their central action on neural reward circuits. GLP-1 receptors are expressed in mesolimbic regions, and preclinical studies show decreases in drug use, suppression of nucleus accumbens efflux of dopamine, and inhibition of relapse-like behaviors in models of alcohol, nicotine, and opioids. Early clinical findings, particularly those from semaglutide, indicate reductions in both alcohol and cigarette consumption, although the results remain inconsistent and are limited by small sample size. Subgroup analysis and observational findings suggest that GLP-1RAs may have potentially larger effects in individuals with obesity and metabolic disease, which could also be due to metabolic modes of action. In opioid use disorder, evidence is currently limited to animal models but demonstrates comparable efficacy to established therapies. Collectively, GLP-1RAs represent an emerging and mechanistically novel therapeutic option for SUDs. Future research should prioritize large-scale randomized controlled trials, patient stratification, and long-term safety assessments to define their potential role as adjunct or standalone treatments in addiction medicine.

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Disclosure: The authors have no conflicts of interest to report.

PubMed

New Evidence and Future Possibilities for Using GLP-1-Based Drugs in Treating Substance Use Disorders

Abstract

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Abstract

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