New research out of the Karolinska Institutet in Stockholm, Sweden, reveals new information about the effectiveness of GLP-1 drugs against substance use disorders (SUDs).

In the past, we have reviewed studies that show GLP-1 drugs such as Ozempic and Wegovy reduce alcohol consumption and cravings. Now we’re getting studies that explain exactly how this mechanism works.

The Swedish study, which will be published in August in The Lancet: Psychiatry, is an observational study that covers the period from 2005 to 2024. It followed patients with type 2 diabetes both while they were using GLP-1 drugs and when they discontinued use of the drugs.

What they looked for in this study was hospitalizations for issues related to alcohol use disorder (AUD). Check out the sample sizes for this study:

• 167,026 individuals diagnosed with type 2 diabetes
• 1,559 had at least one AUD-related hospitalization since 2008
• 2,008 had at least one SUD-related hospitalization since 2008
• 41,109 patients were prescribed GLP-1 drugs during the period covered

The results have some very interesting nuances. First, GLP-1 drugs were “associated with lower rates of hospitalisations related to alcohol use disorder and substance use disorder.” Second, the rate of hospitalization for AUD remained diminished for six months after treatment was discontinued. Third, the rate of hospitalization for AUD rebounded between the 6th and 12th month after discontinuation.

Dr. Leonardo Vando explained the significance of the Swedish finding in an article for The Clinical Trial Vanguard. GLP-1 drugs reduce the onset of AUD and SUD, so that people taking the drugs are much less likely to require hospitalization for these addictions. They also continue to protect against AUD for a limited period after use is discontinued.

Dr. Vando writes, “GLP-1 receptor agonists are not arriving at addiction pathways through some indirect metabolic detour, they are landing on the same circuitry that drives compulsive substance use.” He suspects “two different mechanistic processes” to explain the persistence of protection for AUD patients and not for SUD patients.

Dr. Vando goes one layer deeper, and looks at GLP-1 drugs’ impact on the factors driving AUD: “The comorbid conditions driving drinking (metabolic stress, sleep disruption, chronic pain) are still partially controlled post-discontinuation.” Does this mean GLP-1 drugs reduce stress, pain, and sleep problems? I’ve not seen any studies that show that.

Dr. Vando makes some interesting observations regarding the Swedish study. It lacks detail about drinking quantity, cravings scores, or relapse severity. He continues:

GLP-1 trials examining addiction outcomes need the same rigor around cessation windows, pre-specified follow-up at 90, 182, and 365 days post-discontinuation, with drinking quantity and craving endpoints, not just hospitalization rates.

Dr. Vando also argues that the Swedish study supports the theory that people should not be yanked off GLP-1 drugs due to an inability to pay. “A patient whose GLP-1 prescription lapses because their insurer stops covering it is facing metabolic destabilization and, potentially, a six-month window of elevated addiction risk simultaneously.”

Every new study on GLP-1 drugs leads to interesting new questions, such as how harmful the cessation of GLP-1 drugs might be, and whether GLP-1 drugs work because they attack the underlying motivators for substance abuse: pain and stress. We look forward to examining those issues in future posts on AddictionNews.

Written by Steve O’Keefe. First published July 29, 2026.

Sources:

“Association of GLP-1 receptor agonists with alcohol use disorder-related and substance use disorder-related hospital admissions during treatment and after discontinuation: a Swedish register-based within-individual observational study,” The Lancet: Psychiatry, August 2026.

“GLP-1 Agonists Are Quietly Reducing Addiction Hospitalizations, But Only While Patients Take Them,” The Clinical Trial Vanguard, July 21, 2026.

“Examining the consequences of discontinuing GLP-1 medications on addiction-related hospitalizations,” MedicalXpress, July 21, 2026.

Image courtesy of Wikimedia Commons, used under Creative Commons license.