Addiction Treatment Reform Movement:  GLP1-RA – Anti-Craving/Reduced Drinking Drug

A quiet revolution is underway in addiction treatment.

For years, people who drank too much were told there was only one answer: stop completely. But most excessive drinkers don’t actually want to quit for life – they just want to regain control. They promise themselves “just two drinks” but end up having more, feel ashamed, and fear being labeled an “alcoholic.”

Now, promising research is showing there may be another way. A class of medications originally used for diabetes and weight loss, called GLP-1 receptor agonists (or “GLP-1s” for short) is helping some people cut back on drinking without going through the pain and stigma of total abstinence.

Why This Matters for Families

This isn’t just a medical discovery. It’s a shift in thinking about addiction treatment itself. Instead of one-size-fits-all, families and advocates may soon have more than one path to support loved ones. That could mean less suffering, less stigma, and more realistic goals for recovery.

The Treatment Reform Movement

To recap an earlier blog, parents losing children to opioid overdoses began demanding evidence-based treatment.  This resulted in research centers evaluating treatment approaches, including Medication Assisted Treatment (MAT).  These advocates became aligned with other groups providing new impetus to the reform movement to improve treatment outcomes in our justice and high-income populations.

For more information on Evidence Based Practices and how to find them, see Addiction Treatment Reform Movement: Evidence Based Practices. When combined with American Society of Addiction Medicine evaluation and placement standards, treatment is being transformed by sound scientific research.

Back to Our Overserved Drinker Wanting to Return to Normal Use

Nicholas Renville CASPR – Light Bulb on Weight Loss Drugs

Nicholas Renville and Center for Addiction, Science, Policy and Research picked up on anecdotal reports that people prescribed weight loss drugs began reporting reduced drinking – they were stopping at two or three drinks and not continuing onto inebriation. The same was reported for drug use.  A light bulb went off for Nicholas and he began looking for treatment programs to conduct studies to see if this were true, eventually funding a research study at the Caron Foundation.  (Follow his work at  Recursive Adaptation)

Caron Foundation Initial Report on GLP-1

The Caron Foundation’s study found that GLP-1RAs, when combined with medication-assisted treatment (MAT), significantly reduced opioid cravings compared to a placebo.  GLP-1RAs are drugs that bind to GLP-1 receptors in the brain. This system is involved in appetite regulation, and also plays a role in the brain’s reward pathways.

GLP-1RAs are able to reduce cravings for substances by modulating these reward pathways

It was also discovered that GLP-1s may have Polysubstance Potential, meaning researchers, including Caron’s CMO, have observed that GLP-1s may have a broad impact on cravings across different substances, not just opioids. 

The research is significant because it explores the use of GLP-1s for new indications, moving beyond their original uses for diabetes and weight management. This work has the potential to lead to the first effective treatments for multiple substance use disorders, expanding the options available to patients. Caron is now integrating GLP-1 into all its treatment programs.[i]

What About Alcohol? JAMA study[ii]

Findings for Semaglutide (a form of GLP-1)

Significantly Reduced Alcohol Cravings and Drinks per Day

  • Semaglutide significantly reduced alcohol craving and drinks per drinking day, also interacting with treatment to predict reductions in heavy drinking days.

Significant Decrease in the Number of Heavy Drinking Days

  • Consequently, the proportion of participants with zero heavy drinking days increased significantly in the semaglutide group across the 2 dose phases.

No Effect on Increasing Abstinent Days

  • Semaglutide did not alter the proportion of abstinent vs drinking days

To Summarize:  GLP-1 is a good “first treatment” drug for people concerned about their alcohol or drug use.  This is, of course, not consistent with abstinence-based self-help groups or treatment centers. Another benefit is that patients can say they are using it for weight loss, freeing them from the stigma of substance use.  

Why Do People Seek In-patient Treatment? 

To Manage Cravings and Address Trauma in a Safe Environment

The in-patient environment provides a safe environment to learn a better response to cravings – the overwhelming need to take a drug or a drink. Cravings tend to be short lived and in treatment we learn how to survive cravings through behavior modification techniques.  But with GLP-1, reduced or no cravings means no need for in-patient treatment.

Another reason people lean towards in-patient treatment is they see an opportunity to address severe trauma, abuse and neglect in a safe environment. A high percentage of substance dependent individuals are also victims of trauma, physical and mental abuse, and neglect. In-patient programs provide safe spaces to intensively address the damage inflicted by our upbringing and relationships.  Unfortunately, almost all addiction treatment programs do not have the expertise or desire to treat these patients. 

Prediction:  GLP-1 as a medication assisted treatment will be vigorously opposed by abstinence-based programs.  Opponents will emphasize the cost of the drug and side effects to reduce access by the general population.  Upper income folks interested in reducing their drinking (whoops interested in weight loss) will continue to access the drug.

Looking Ahead: More Choices, More Hope

For decades, families and advocates have been told that recovery means one thing: total abstinence. But evidence-based treatments like GLP-1 medications are showing us a new possibility – one where people can safely reduce their drinking or drug use, preserve their dignity, and still be supported.

This shift won’t happen overnight. Some treatment programs will resist change, and researchers still have more to learn. But the science is moving quickly, and every new study brings us closer to a future where care is guided by evidence, not stigma.

What Families and Advocates Can Do

  • Ask providers about evidence-based options, including new medications.
  • Support policies and programs that expand access to these treatments.
  • Share accurate information to help reduce shame and misunderstanding.

With knowledge, advocacy, and compassion, families can be part of a movement that gives their loved ones real choices and real hope.


[i] AI on caron foundation glp study; and
Ozempic’s Next Magic Trick: Treating Drug Addiction https://www.caron.org/news-resources/ozempics-next-magic-trick-treating-drug-addiction

[ii] Once-Weekly Semaglutide in Adults with Alcohol Use Disorder Randomized Clinical Trial JAMA Psychiatry Published Online: February 12, 2025
2025;82;(4):395-405. doi:10.1001/jamapsychiatry.2024.4789