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Can GLP-1 medications impact substance use?

Sarah Carstens, LCSW, LCADC, addictions clinical director of Outpatient Services at Penn Medicine Princeton House Behavioral Health, reviews research suggesting that the benefits of the GLP-1 receptor agonists extend to the treatment of substance use and other health issues.

  • June 13, 2025

Glucagon-like peptide-1 (GLP-1) receptor agonists have been successful in treating type 2 diabetes since their first FDA approval two decades ago, and the subsequent use of these medications for weight loss has increased dramatically in recent years.

However, preliminary research now suggests they may have benefits in the treatment of other health issues, including substance use.

“The potential to have a new treatment option for substance use is very positive for the field, especially since the damage that addiction causes for individuals and families can be catastrophic” says Sarah Carstens, LCSW, LCADC, addictions clinical director of Outpatient Services at Penn Medicine Princeton House Behavioral Health.

Evolving support in clinical evidence

Clinical trials to study this potential are just getting started, but preclinical evidence suggests that GLP-1 receptor agonists may reduce alcohol and substance use.

Supporting this finding is a recent observational study of nearly two million individuals in the U.S. Department of Veterans Affairs database, which showed that compared to usual care, GLP-1 receptor agonist use was associated with a reduced risk of several substance use disorders (alcohol, cannabis, opioid and stimulant use disorders) and other health issues (Nature Medicine, 2024). The mechanisms behind this benefit are possibly related to reward processing, stress regulation, and cognitive function, and mechanisms identified with changes in gastric motility, satiety, and glucose homeostasis (Pharmacological Research, 2024).

“Clearly, more in-depth research is needed,” Carstens says “These medications have shown promise, so I’m cautiously optimistic.”

“Cautiously” is the key word. Carstens points out the following important considerations surrounding the potential use of GLP-1 receptor agonists in substance use treatment.

  • Because addiction crosses all races and ethnicities, robust research is needed across a wide demographic pool to determine whether data would be consistent in specific populations, especially since the VA study focused largely on data from older white males.
  • Many individuals who struggle with addiction are multiply marginalized, making access to these medications a potential concern that should be examined.
  • Those who struggle with addiction often turn to substances to avoid pain and negative physical consequences. Yet these medications are associated with gastrointestinal side effects that may cause physical discomfort. In addition, if weight loss occurs, nutritional deficits that exist in some people with addiction may be exacerbated. Nutritional status and medication side effects would require further examination and management in any potential substance use application.
  • There’s no “quick fix” for addiction, so GLP-1 receptor agonists cannot be viewed as a sole solution.

“If these medications turn out to be the next best thing, they can’t exist in a vacuum,” adds Carstens. “Effectively addressing addiction also means examining underlying issues, working on lifestyle changes, actively participating in treatment, and engaging in activities that further support the recovery process.”

Refer a patient

To schedule an evaluation for your patient, or to learn more about Princeton House Behavioral Health’s programs, call 888-437-1610.

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