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How Diabetes Medications Could Revolutionize Addiction Treatment

a man struggles with the loss of his appetite and getting the nutrients he needs to be healthy due to alcoholism

The past two years have revealed an unexpected overlap between metabolic medicine and addiction science. Drugs originally designed to control blood sugar, especially the glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide and liraglutide, are showing early promise for reducing substance cravings and dampening reward-seeking. Prescription use of GLP-1 drugs climbed from 0.87% of U.S. adults in 2019 to 4.03% in 2024, an almost 600% jump, largely on the back of their weight-loss reputation.

Important note: Swift River does not offer GLP-1 pharmacotherapy. The information below is purely educational so you can follow the science with confidence.

The Science Connecting Metabolism and Craving

  • Shared brain circuitry. GLP-1 receptors aren’t just in the gut and pancreas. They also populate the ventral tegmental area and nucleus accumbens, two dopamine-rich “reward nodes.” Activating them can blunt drug-induced dopamine spikes and reduce the subjective “high.”
  • Hormonal ripple effects. By slowing gastric emptying and smoothing post-meal insulin surges, GLP-1 drugs steady blood-sugar swings that can feed mood crashes and cravings.
  • Appetite and impulse control. Patients often report diminished desire for calorie-dense foods—and, incidentally, for alcohol. A phase-2 trial found weekly semaglutide cut alcohol cravings and heavy-drinking days.

What the Early Evidence Says

Substance studiedKey findingStudy typeYear
Alcohol9-week RCT: semaglutide lowered lab alcohol intake and weekly craving (48 adults with AUD)Human RCT2025
NicotineSame RCT: smokers in the semaglutide arm logged fewer cigarettes/dayHuman RCT (subgroup)2025
CocaineGLP-1 agonists curtailed relapse-like cocaine seeking in ratsPre-clinical2018-24
OpioidsExendin-4/liraglutide reduced oxycodone- or heroin-seeking in rodentsPre-clinical + reviews2021-23

No GLP-1 drug is currently FDA-approved for any addiction indication.

Potential Advantages Under Investigation

  • Craving relief that may help clients stay engaged in therapy.
  • Support for weight management, up to 65% of people gain weight in early sobriety.
  • Added cardiometabolic protection for those with obesity or diabetes.

How GLP-1 Agonists Could Fit Into Comprehensive Care

If future approvals happen, a typical protocol might look like:

  1. Thorough medical work-up (screening for pancreatitis risk, thyroid nodules, etc.).
  2. Slow titration combined with counseling, CBT, and peer support.
  3. Monthly checks on labs, cravings, mood, and weight; dose fine-tuning as needed.
  4. Personalized taper or maintenance plan once recovery is stable.

Looking Ahead

Dual agonists (GLP-1/GIP) and GLP-1+amylin combos now in trials could broaden tomorrow’s recovery pharmacology. As evidence grows, clinicians will gain fresh options to pair with time-tested therapy.

Seeking evidence-based help right now?

While Swift River doesn’t dispense GLP-1 medications, our integrated inpatient and outpatient programs blend proven therapies, medication-assisted treatment (where indicated), and whole-person care. Call 413-570-9698 today to find out how we can support your recovery journey.

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