Burnie Academy Academy
GLP-1 medicines, craving, and addiction: emerging, not approved

GLP-1 medicines, craving, and addiction: emerging, not approved

Early research hints that GLP-1 medicines like semaglutide, liraglutide, and exenatide may quiet the brain's reward pathways and reduce alcohol craving, smoking reward, and possibly some behavioural addictions. This is promising but preliminary: small trials, animal data, and large observation studies. No GLP-1 medicine is approved to treat alcohol use disorder, smoking, or gambling, and larger trials are still running. This honest guide explains what the science shows and what it does not.

13 Jul 2026 · Burnie Academy
glp-1 addiction alcohol smoking

You may have heard that weight-loss injections like semaglutide and liraglutide seem to calm cravings, not just for food but also for alcohol and cigarettes. There is real biology behind this idea, and early research is genuinely interesting. But the honest truth matters here: this is emerging science, not settled medicine. No GLP-1 medicine is approved to treat alcohol use disorder, smoking, or gambling. The human trials so far are small, much of the evidence comes from animal studies and large observation studies, and bigger trials are still running. This guide gives you the plain picture, what the studies actually show, and what they do not show, so you do not jump to a dangerous conclusion about using these drugs to quit a habit.

The baseline: why GLP-1 and addiction are even talked about together

GLP-1 receptor agonists were built for blood sugar and weight, but scientists noticed the GLP-1 system also touches the brain's reward pathways, the same circuits that drive wanting for alcohol, nicotine, and other rewards. In animal studies, GLP-1 medicines reduced alcohol intake, drug taking, and drug cue relapse, and they dampened dopamine signals in reward areas like the nucleus accumbens and the ventral tegmental area. A 2023 review in Frontiers in Pharmacology put it plainly, that the GLP-1 pathway plays a role in the complex mechanisms regulating alcohol and drug consumption. A 2024 IUPHAR review adds that several clinical trials are underway to test GLP-1 receptor agonists in people with substance use disorders. A 2025 systematic review of 41 studies found preclinical data convincing but clinical evidence still preliminary. So the biology gives a real reason to look, and scientists are looking, but the proof in humans is not finished.

Alcohol use disorder (most studied, still emerging)
This is where the most human evidence sits, and it is still early. A 2022 randomised trial of once-weekly exenatide in 127 adults with alcohol use disorder did not reduce heavy drinking days overall, but brain scans showed it calmed alcohol-cue reactivity in reward areas, and in an obese subgroup it did cut heavy drinking. A 2025 phase 2 trial of low-dose semaglutide found it reduced alcohol consumed in a lab test and weekly craving versus placebo, with the authors saying this justifies larger trials. Two large observation studies, one in Nature Communications of over 83,000 obesity patients and one Swedish nationwide cohort in JAMA Psychiatry, both linked GLP-1 use to lower alcohol use disorder risk. But observation studies can show a link, not proof of cause, and no GLP-1 is approved for alcohol use disorder.
Smoking and nicotine (small trials, helps weight after quitting)
Evidence for smoking is thinner. Animal studies show GLP-1 medicines reduce nicotine self-administration and nicotine-driven dopamine release. A small pilot trial of exenatide plus nicotine patches found higher quit rates than patches alone, while another trial of dulaglutide plus varenicline did not improve abstinence. A 2024 systematic review concluded GLP-1 medicines give a compelling rationale for larger trials and have a standout feature: they reduce the weight gain that often follows quitting smoking, which existing approved quit-smoking medicines do not do. Still, no GLP-1 is approved for smoking cessation.
Gambling and behavioural addiction (mostly theory, no trials)
This is the most speculative corner. The same reward-pathway biology suggests GLP-1 medicines might ease behavioural addictions like gambling, shopping, or gaming, because these share the brain's dopamine wanting system. But the honest gap is this: there are no randomised trials of GLP-1 medicines for gambling disorder, and most talk comes from animal drug studies, self-reports, and social-media observation, not controlled tests. Treat any story that GLP-1 'cures' gambling as unproven.

GLP-1 medicines cure addiction, so you can use them to quit drinking or smoking.

Verdict

Not proven, and not approved. The honest position is emerging, not established. No GLP-1 medicine, including semaglutide, liraglutide, or exenatide, is approved to treat alcohol use disorder, smoking, or gambling anywhere. The human trials so far are small and short: the exenatide alcohol trial did not meet its main goal overall, the semaglutide alcohol trial was a 9-week phase 2 study in 48 people that the authors themselves say only justifies larger trials, and the smoking trials are small and mixed. The big positive signals come from observation studies, which can show a link but cannot prove the drug caused the change. A 2025 systematic review is clear that preclinical data are convincing but clinical evidence remains preliminary. Larger trials, including a NIDA-sponsored semaglutide study, are still running. So do not use a GLP-1 to quit drinking or smoking on your own, and do not skip proven treatments. Approved medicines and counselling exist for alcohol and smoking, and an addiction specialist, not a weight-loss prescription, should guide that care.

The bottom line

The idea that GLP-1 medicines could help with alcohol, smoking, and maybe behavioural addiction is real science with a real biological basis, and early studies are genuinely promising. But promising is not proven, and not approved. The alcohol trials are small and short, the smoking trials are mixed, and the gambling evidence is mostly theory and observation. The strongest signals come from large observation studies that show a link but cannot prove cause, while a 2025 systematic review is clear that clinical evidence remains preliminary and larger trials are needed. No GLP-1 medicine is approved for any addiction. So the honest message is: this is a space to watch, not a treatment to start on your own. If you struggle with alcohol, smoking, or gambling, talk to a doctor or an addiction specialist about proven care. Burnie can help you log your food and see your daily calorie deficit, but decisions about medicine, addiction treatment, and your safety belong with your doctor.

Track your food the honest way

Burnie helps you see your estimated calorie deficit with familiar Indian foods — no fake precision, no guilt trips.

Get Burnie on the App Store

Android public availability is being expanded.