GLP-1 and Alcohol Addiction: Can Semaglutide Reduce Drinking, Smoking and Cravings?

Last updated: October 28, 2026

Semaglutide is best known for treating type 2 diabetes and obesity. But a different question is attracting growing scientific attention: could GLP-1 receptor agonists also help people drink less alcohol, smoke fewer cigarettes or experience fewer addictive cravings?

The idea is no longer based exclusively on animal experiments or social-media anecdotes. Human clinical trials have now reported reductions in heavy-drinking days, alcohol craving and some measures of nicotine craving. Most notably, a 26-week randomized trial published in The Lancet in May 2026 found that weekly semaglutide, alongside cognitive behavioural therapy, produced a greater reduction in heavy-drinking days than placebo plus therapy in people with alcohol use disorder and obesity.

However, the evidence differs substantially by substance. Results for alcohol are encouraging, while smoking-cessation evidence remains preliminary. Research involving cannabis and opioids is also emerging, but it does not establish semaglutide as a general treatment for addiction.

The central finding: Semaglutide may help reduce alcohol consumption and alcohol-related cravings in some people. Early research also suggests it can reduce nicotine craving, but it has not yet been shown reliably to help people quit smoking. It is not currently an established, specifically approved treatment for alcohol use disorder or smoking cessation in the United States.

Important distinction: A reduction in cravings, a reduction in substance consumption and recovery from an addiction are three different outcomes. Evidence for one does not automatically establish the others.

What Is the Connection Between GLP-1 and Addiction?

GLP-1 stands for glucagon-like peptide-1, a hormone involved in regulating blood glucose, appetite and satiety. GLP-1 receptor agonists are medicines that mimic this hormone's activity.

Semaglutide is the active ingredient in medicines including Ozempic, Wegovy and Rybelsus. Their approved uses differ by product and jurisdiction, but they are primarily associated with diabetes and weight management rather than addiction treatment.

Researchers are studying whether GLP-1 signalling also influences brain circuits involved in motivation, reinforcement and reward. These circuits help shape behaviours such as eating, drinking alcohol and responding to nicotine or other addictive substances.

Alcohol and nicotine do not act on the brain in the same way as food, but each can reinforce behaviour through interacting neural systems. GLP-1 receptors in relevant brain regions may influence the response to rewarding stimuli, including cues associated with substance use.

Potential explanations for the observed effects include:

• Reduced reward-seeking: Substance-related cues may become less compelling for some people.
• Altered motivation: The urge to seek another drink or cigarette may decrease even when the substance remains available.
• Changes in physiological appetite and satiety: GLP-1 medicines influence signals related to hunger and fullness, although this does not fully explain the emerging addiction findings.
• Changes in cue reactivity: Brain and behavioural responses to reminders of a substance may be affected.

These are plausible mechanisms supported to varying degrees by experimental and early clinical research. Exactly how GLP-1 receptor activation affects human addiction, and which people might benefit, remain active research questions.

For a wider introduction to GLP-1 medicines, see our GLP-1 research and evidence guide.

Does Semaglutide Reduce Alcohol Consumption?

Evidence is increasingly encouraging, particularly for people with alcohol use disorder and obesity. Several randomized trials have reported improvements in selected drinking outcomes, although the trials differ in their participants, treatment duration, dosing and primary endpoints.

Study 1: The 2026 Lancet Trial — The Strongest Evidence So Far

Study design: Randomized, double-blind, placebo-controlled trial

A trial published on May 2, 2026, in The Lancet evaluated weekly semaglutide in 108 treatment-seeking adults with moderate-to-severe alcohol use disorder and coexisting obesity.

Participants were randomly assigned to receive semaglutide, titrated to 2.4 mg weekly, or placebo for 26 weeks. Both groups also received standard cognitive behavioural therapy.

• Participants: 108 randomized; 88 completed the full intervention.
• Primary outcome: Change in the percentage of days involving heavy drinking.
• Semaglutide group: Heavy-drinking days decreased by 41.1 percentage points from baseline.
• Placebo group: Heavy-drinking days decreased by 26.4 percentage points from baseline.
• Estimated between-group difference: 13.7 percentage points in favour of semaglutide; 95% confidence interval, 5.4 to 22.0 percentage points; p = 0.0015.

Researchers also reported greater improvements in several secondary alcohol-related outcomes, including alcohol consumption, self-reported craving and measures of harmful alcohol use. Gastrointestinal side effects were more common with semaglutide and were generally mild to moderate and transient.

Interpretation: This is an important advance because it tests semaglutide over six months in people actively seeking treatment, rather than relying only on laboratory drinking tasks or retrospective medical records.

Nevertheless, the trial was conducted at a single centre and enrolled people who had both alcohol use disorder and obesity. Its findings cannot automatically be generalized to everyone with alcohol problems, including people without obesity. It also does not establish long-term effectiveness after treatment ends.

Source: Klausen et al. The Lancet, 2026. Full trial publication.

Study 2: Oral Semaglutide — The September 2026 Trial

Study design: Phase 2 randomized clinical trial

A trial published in the American Journal of Psychiatry in September 2026 examined oral semaglutide in 50 people with moderate-to-severe alcohol use disorder. Participants received semaglutide or placebo for eight weeks, using a trial regimen that increased from 3 mg to 7 mg daily.

The results were mixed but encouraging:

• The primary endpoint, laboratory-measured alcohol cue-elicited craving, was not significantly different between groups.
• Drinks per day were also not significantly reduced relative to placebo.
• Heavy-drinking days decreased significantly more with semaglutide.
• Drinks per drinking day and naturally occurring alcohol craving also decreased significantly.
• The exploratory analysis reported fewer cannabis-use days in the semaglutide group.

Why the primary endpoint matters: The trial did not establish a significant reduction in the specific laboratory craving outcome it was designed primarily to test. Improvements in secondary outcomes support further investigation but are not equivalent to a definitive positive trial across all outcomes.

The study was small and lasted only eight weeks. Its experimental oral dosing schedule should not be interpreted as a recommendation for treating addiction outside a clinical trial.

Source: Schacht et al. American Journal of Psychiatry, 2026. Oral semaglutide for alcohol use disorder.

Study 3: The Initial Randomized Trial Published in 2025

Study design: Phase 2 randomized trial; 48 participants

A study published in JAMA Psychiatry in February 2025 investigated low-dose weekly semaglutide in adults with alcohol use disorder. Participants received semaglutide or placebo over nine weeks.

Semaglutide reduced the amount of alcohol consumed during a laboratory self-administration session. The study also reported reductions in drinks per drinking day and weekly alcohol craving, alongside a greater reduction in heavy-drinking days over time.

However, there was no significant difference in average drinks per calendar day or the number of drinking days between groups.

The results provided an early human signal, but the small sample and short treatment period meant that larger trials were necessary. The subsequent 2026 Lancet study provided more substantial evidence in a different, more clinically relevant population.

Source: Hendershot et al. JAMA Psychiatry, 2025. Once-weekly semaglutide in adults with alcohol use disorder.

What Do These Alcohol Trials Mean Collectively?

The findings have become more convincing, but they do not mean semaglutide is already a proven first-line treatment for alcohol addiction.

Earlier systematic reviews, which searched for studies available through 2025, found promising observational associations but mixed randomized-trial results. Those reviews predated the important 2026 trials described above.

The newer results strengthen the argument for continued clinical development. The next steps include larger, multicentre studies, longer follow-up, assessment of relapse after stopping treatment and research in people with alcohol use disorder who do not have obesity.

Background review: Systematic review of GLP-1 receptor agonists and alcohol use disorder, Alcohol and Alcoholism, 2025.

Does Semaglutide Help People Stop Smoking?

The evidence is much less mature than it is for alcohol use disorder. The key question is whether semaglutide reduces nicotine craving enough to help people actually stop smoking and remain smoke-free.

The 2026 JAMA Network Open Smoking Trial

Study design: Phase 2a randomized clinical trial; 24 participants

A randomized trial published in JAMA Network Open in May 2026 evaluated nine weeks of semaglutide in adults who smoked cigarettes daily but were not seeking smoking-cessation treatment.

The study compared semaglutide with placebo. The dose increased from 0.25 mg weekly to 0.5 mg weekly and then to 1.0 mg in the final week, if tolerated.

The findings were nuanced:

• Nicotine craving: Weekly craving scores decreased significantly more with semaglutide.
• Cigarettes smoked per day: The difference between groups was not statistically significant.
• Primary laboratory smoking outcomes: The prespecified treatment-by-time tests were not statistically significant.
• Additional analyses: A change-score analysis found a greater reduction in cigarette consumption during laboratory testing in the semaglutide group.

The trial included only 24 randomized participants, with 12 assigned to each group. It was not a smoking-cessation trial and did not provide nicotine replacement therapy or another cessation intervention.

Interpretation: Semaglutide may reduce the urge to smoke, but reducing craving is not the same as quitting. Larger studies that recruit people actively trying to quit and measure verified abstinence over time are needed.

Source: Hendershot et al. JAMA Network Open, 2026. Once-weekly semaglutide in adults with daily cigarette use.

An earlier 2025 alcohol-use-disorder trial also found a reduction in cigarettes smoked over time in an exploratory subgroup of participants who smoked. That finding was not the primary purpose of the study and should not be treated as proof of efficacy for nicotine dependence.

Could Semaglutide Make Quitting Easier?

There are two distinct possibilities worth testing:

1. Semaglutide might directly reduce nicotine craving or the rewarding effects of smoking.
2. It might reduce weight gain or hunger-related concerns that can make smoking cessation more difficult for some people.

Both possibilities are clinically relevant, but neither establishes semaglutide as a substitute for established smoking-cessation treatment.

For someone trying to quit smoking now, behavioural support, nicotine replacement therapy, varenicline or bupropion are better-established options, depending on individual circumstances and local availability.

Source: US Food and Drug Administration: smoking-cessation products and medicines.

Does Semaglutide Reduce Other Addictive Cravings?

Possibly in some circumstances, but the evidence is not sufficient to conclude that GLP-1 medicines treat addiction in general. Different substances have distinct pharmacology, withdrawal symptoms and patterns of reinforcement.

Cannabis

The September 2026 oral semaglutide trial reported fewer cannabis-use days as a secondary outcome. This is an interesting signal, but it came from a small trial primarily designed to study alcohol use disorder. It does not establish semaglutide as a cannabis-use-disorder treatment.

Source: 2026 randomized trial in the American Journal of Psychiatry.

Opioids

Some observational studies have linked semaglutide use with lower opioid-overdose risk among people with type 2 diabetes and opioid use disorder. These studies analyse existing medical records rather than randomly assigning participants to an addiction treatment.

Such findings can generate hypotheses, but they cannot establish that semaglutide caused the reduction. Differences in health, healthcare access, prescribing patterns and other factors may influence the results.

Source: Wang et al. JAMA Network Open, 2024. Semaglutide and opioid-overdose risk in patients with type 2 diabetes and opioid use disorder.

Other Behaviours and Compulsive Habits

There is not enough reliable clinical evidence to recommend semaglutide specifically for gambling disorder, compulsive shopping, pornography use or other behavioural addictions. Anecdotal reports of reduced urges are not a substitute for controlled trials using validated clinical outcomes.

How Strong Is the Evidence? A Practical Comparison

Alcohol use disorder

Evidence assessment: Promising, with meaningful randomized-trial support.

A 2026 six-month randomized trial found a significant benefit for heavy-drinking days when semaglutide was added to cognitive behavioural therapy in people with obesity and alcohol use disorder. More evidence is needed to establish effectiveness across broader populations and over longer periods.

Nicotine craving and smoking cessation

Evidence assessment: Preliminary.

A small 2026 randomized study found lower nicotine craving but did not demonstrate a significant reduction in cigarettes smoked per day. Long-term quit rates have not been established.

Cannabis use

Evidence assessment: Early signal.

A reduction in cannabis-use days was reported as a secondary outcome in a small alcohol-use-disorder trial. Dedicated trials are needed.

Opioid use disorder and other addictions

Evidence assessment: Insufficient for routine addiction treatment.

Observational associations and experimental research justify further investigation, but they do not establish semaglutide as a treatment for opioid dependence or other addictions.

These assessments describe the maturity of the evidence, not a formal regulatory recommendation or proof of efficacy for every patient.

Is Semaglutide an Approved Treatment for Alcohol Addiction?

In the United States, semaglutide is not approved specifically to treat alcohol use disorder or smoking cessation. Approved indications for semaglutide products concern conditions such as type 2 diabetes, obesity and certain associated health risks; the indication depends on the product and its current label.

For alcohol use disorder, three medications are approved by the US Food and Drug Administration:

• Naltrexone: Can reduce alcohol craving and heavy drinking in appropriate patients.
• Acamprosate: Can support maintenance of abstinence after stopping alcohol.
• Disulfiram: Produces an unpleasant reaction when alcohol is consumed and may help selected patients maintain abstinence.

Their suitability depends on medical history, treatment goals, other medicines and local prescribing guidance. Behavioural therapies and peer-support approaches can also be important parts of treatment.

Source: National Institute on Alcohol Abuse and Alcoholism: medications for alcohol use disorder.

Approval and availability differ across countries. Readers outside the United States should check local medicine labels and clinical guidance rather than assuming that an American approval status applies in their jurisdiction.

Should Someone Take Ozempic or Wegovy to Reduce Drinking?

The answer depends on why the medicine is being considered.

For someone who already has a medical indication for semaglutide, a possible reduction in alcohol craving may be worth discussing with the prescribing clinician. It should not be assumed that everyone will experience this effect, or that the benefit will persist indefinitely.

For someone considering semaglutide solely to treat alcohol use disorder, the evidence is not yet sufficient to recommend unsupervised use or to replace established treatment. This is especially important for people without obesity, because the populations and dosing regimens studied so far do not establish a favourable benefit-risk balance for everyone.

There is also no established basis for selecting a dose of semaglutide specifically for addiction outside a clinical trial or an appropriately supervised treatment decision. Do not copy doses from research papers or increase a prescription in an attempt to suppress cravings.

Safety: What People With Alcohol Problems Should Know

Semaglutide is a prescription medicine with known risks. Its potential effects on alcohol use do not eliminate the need to assess whether it is appropriate for an individual patient.

Common adverse effects include nausea, vomiting, diarrhoea, constipation and abdominal discomfort. Gastrointestinal symptoms can lead to dehydration, which may affect kidney function.

More serious concerns include pancreatitis and gallbladder disease. Semaglutide also carries important prescribing restrictions, including for people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 under the US label.

People with substantial alcohol consumption, previous pancreatitis, significant liver disease, gallbladder problems or other relevant medical conditions should discuss these issues with a qualified clinician before starting treatment. Alcohol-related health risks and the medicine's own risks need to be assessed separately.

Semaglutide should not be combined with other semaglutide-containing products or another GLP-1 receptor agonist unless specifically directed by an appropriate clinician.

Source: Wegovy prescribing information and important safety information.

Important alcohol-withdrawal warning: If you drink heavily or regularly and may be physically dependent on alcohol, do not suddenly stop without medical advice. Alcohol withdrawal can be dangerous and may cause seizures or delirium. A clinician can assess whether supervised withdrawal treatment is needed. Severe shaking, hallucinations, confusion or seizures require urgent medical care.

What Researchers Need to Establish Next

The 2026 findings are an important step, but several questions remain unresolved:

1. Who benefits most? Researchers need to clarify whether effects differ according to obesity, diabetes, addiction severity, sex, age or other clinical characteristics.
2. Which outcomes improve? Reduced craving, fewer heavy-drinking days, abstinence and long-term recovery are different endpoints. Studies should report them separately.
3. What happens after treatment stops? More evidence is needed on relapse, sustained improvement and the duration of any benefit.
4. Can semaglutide help with smoking cessation? Trials need to evaluate real-world quit rates and sustained abstinence, rather than craving alone.
5. How does it compare with established treatments? Research should test whether GLP-1 medicines provide additional benefit when used alongside evidence-based addiction treatment.
6. What are the long-term risks and benefits? Larger and more diverse patient populations are needed to assess safety and the balance between benefits and adverse effects.

These are important questions because a medicine that reduces the desire to drink may offer a useful additional treatment option. But reducing a symptom is not automatically equivalent to treating the underlying disorder or achieving lasting recovery.

Frequently Asked Questions

Does semaglutide reduce alcohol cravings?

Early randomized trials suggest that it may. A 2025 trial and a September 2026 oral semaglutide trial reported reductions in some measures of alcohol craving. However, the primary laboratory craving outcome in the 2026 oral trial was not significantly different from placebo. The 2026 Lancet trial also found improvements in self-reported craving alongside a reduction in heavy-drinking days. More research is needed to determine who benefits and how durable the effect is.

Can Ozempic help someone stop drinking alcohol?

Semaglutide may help some people reduce alcohol consumption, but it is not yet an established treatment specifically for alcohol use disorder. The strongest 2026 randomized evidence involved semaglutide alongside cognitive behavioural therapy in people who had both alcohol use disorder and obesity. Ozempic should not be self-prescribed or substituted for established addiction care.

Does semaglutide make alcohol taste unpleasant?

The clinical trials do not establish that semaglutide universally makes alcohol taste unpleasant. Reduced desire to drink may relate to changes in craving, reward processing, satiety or other mechanisms. Individual experiences vary, and the precise mechanisms are not fully understood.

Does semaglutide eliminate the pleasurable effects of alcohol?

That has not been established as a consistent effect in humans. Research suggests GLP-1 signalling may influence reward-related responses, but it does not show that semaglutide reliably blocks alcohol's pleasurable effects or makes drinking safe.

Can semaglutide help with nicotine addiction?

A small 2026 randomized trial found reduced nicotine craving, but it did not show a statistically significant reduction in cigarettes smoked per day. The trial also did not establish sustained smoking-cessation rates. Semaglutide should not currently be considered a replacement for evidence-based smoking-cessation treatments.

Does semaglutide reduce cannabis or opioid cravings?

The evidence is preliminary and differs by substance. One small 2026 alcohol-use-disorder trial reported fewer cannabis-use days as a secondary outcome, while observational studies have linked semaglutide with lower opioid-overdose risk in certain populations. Neither finding proves that semaglutide treats cannabis or opioid use disorder.

Can someone take semaglutide specifically for addiction if they are not overweight?

Current research does not establish that semaglutide has a favourable benefit-risk balance for every person with addiction who does not have obesity. The six-month Lancet trial specifically enrolled people with both obesity and alcohol use disorder. Any proposed off-label use requires an individualized clinical assessment.

Will the effect on alcohol cravings continue after stopping semaglutide?

There is not enough evidence to know. Longer follow-up and studies after treatment discontinuation are needed to determine how often improvements persist or relapse occurs.

Is semaglutide better than naltrexone for alcohol use disorder?

There is no established head-to-head evidence demonstrating that semaglutide is superior to naltrexone. Naltrexone is an established treatment option for appropriate patients with alcohol use disorder, whereas semaglutide remains under investigation for this use. Treatment should be selected with a clinician based on medical history, goals and the available evidence.

Conclusion: A Promising New Direction, Not a Universal Addiction Cure

The evidence for GLP-1 receptor agonists and addiction has progressed substantially. The 2026 Lancet trial provides meaningful randomized evidence that semaglutide, when combined with cognitive behavioural therapy, can reduce heavy-drinking days in adults with alcohol use disorder and obesity. A smaller 2026 oral trial adds supportive findings, although its primary laboratory craving endpoint was negative.

Evidence for smoking is less mature. Semaglutide reduced nicotine craving in a small randomized study but did not significantly reduce cigarettes smoked per day. Findings for cannabis and opioids remain early and should not be interpreted as proof of an addiction-treatment effect.

The most responsible conclusion is that semaglutide may become a useful additional option for some substance-use disorders, particularly alcohol use disorder. It is not yet a universal treatment for addiction, and people should not delay evidence-based care while waiting for more research.

For readers, clinicians and researchers, the next step is to follow larger trials that measure not only craving, but also sustained reductions in harmful use, abstinence where relevant, relapse, quality of life and long-term safety.

Medical disclaimer: This article is for educational purposes and is not a diagnosis or treatment recommendation. Semaglutide is a prescription medicine. Do not start, stop or change medication to treat an addiction without consulting a qualified healthcare professional. If alcohol or drug use feels difficult to control, professional support and evidence-based treatment are available.

Selected References

1. Klausen MK, et al. Once-weekly semaglutide versus placebo in patients with alcohol use disorder and comorbid obesity: a randomised, double-blind, placebo-controlled trial. The Lancet. 2026;407:1687–1698. https://doi.org/10.1016/S0140-6736(26)00305-3
2. Schacht JP, Sakai JT, Raymond K, Shelton R. Oral Semaglutide for Alcohol Use Disorder: A Randomized Clinical Trial. American Journal of Psychiatry. 2026;183(9):636–645. https://doi.org/10.1176/appi.ajp.20260003
3. Hendershot CS, et al. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2025;82(4):395–405. https://doi.org/10.1001/jamapsychiatry.2024.4789
4. Hendershot CS, et al. Once-Weekly Semaglutide in Adults With Daily Cigarette Use: A Randomized Clinical Trial. JAMA Network Open. 2026;9(5):e2614898. https://doi.org/10.1001/jamanetworkopen.2026.14898
5. GLP-1 receptor agonists and alcohol use disorder: a systematic review. Alcohol and Alcoholism. 2025. https://doi.org/10.1093/alcalc/agaf069
6. Wang W, et al. Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world populations. Nature Communications. 2024;15:4548. https://doi.org/10.1038/s41467-024-48780-6
7. National Institute on Alcohol Abuse and Alcoholism. Medications for alcohol use disorder. Official resource
8. US Food and Drug Administration. Wegovy prescribing information. Official prescribing information