GLP-1 receptor agonists—sometimes called GLP-1 drugs—are medications like semaglutide (sold under brand names Ozempic and Wegovy) and tirzepatide (Mounjaro), developed to help regulate blood sugar and reduce body weight. They do this partly by mimicking a hormone the body naturally produces after eating, which signals fullness and reduces appetite. What researchers and patients are now discovering is that these medications seem to quiet cravings for alcohol and other substances, too. This appears to happen through the same brain reward pathways that govern both food-seeking and substance-seeking behavior. The emerging science on GLP-1 medications and addiction is still developing, but the evidence—from preclinical and human studies alike—is substantial enough to take seriously, and personal enough to pay attention to.
You didn't expect a weight loss medication to change how you think about drinking
You were prescribed it for one thing. Weight management. Blood sugar. The number your doctor kept circling in red. And then, somewhere along the way, you realized you'd passed on the drink you always had with dinner. Or the craving you'd been managing for years just ... softened.
You're not imagining it.
The research backs this up. People taking semaglutide reported wanting to drink less, and when they did drink, they drank less (Hendershot et al., 2025). Another study found that people on semaglutide were far less likely to develop a serious problem with alcohol than people taking other weight loss medications (Wang et al., 2024).
That pattern—lower rates of alcohol use disorder, reduced craving, fewer drinks consumed—is central to what makes this medication's potential for recovery from alcohol and other substances so compelling.
What this doesn't mean is that the medication has solved anything—or that you're finished. What it might mean is that a door has cracked open. The quieter the craving, the more clearly you can hear whatever is underneath it. And that, for many people, is where the real work begins.
What's actually happening in your brain when the cravings go quiet
Think of your brain as having a reward system—a network of pathways that decides what feels worth doing again. When you eat something satisfying, use a substance, or even receive approval from someone you care about, this system lights up. It registers the experience, files it as important, and pulls you back toward it.
GLP-1 receptors—the same biological targets that semaglutide activates—are present throughout this reward network, including in a region called the ventral tegmental area and another called the nucleus accumbens, which is roughly the part of the brain that decides what feels worth repeating. When GLP-1 medications activate these receptors, they seem to turn down the dopamine signal—the brain chemical that makes a substance feel worth chasing again. That's why the pull softens (Alves et al., 2025).
And it's not just alcohol. The same quieting effect has shown up with opioids, nicotine, and stimulants—all through that same system, which also happens to be the one that governs metabolic health and appetite (Marquez-Meneses et al., 2025). The reason eating and substance use both feel so hard to resist is that they run on the same track. These medications slow that track down.
Our clinical team at Wish Recovery tracks this research closely. Understanding what's happening neurologically is part of how we help clients make sense of what they're experiencing—and build a plan that doesn't depend on any single tool.
If the medication is handling the cravings, do I even need treatment?
This is a fair question. A genuinely fair one. If the urge has lessened, if the pull is softer, why add more to an already complicated life?
The honest answer is that medication quiets the volume. It doesn't change the channel.
The patterns that drove the drinking or the substance use—the emotional avoidance, the responses to stress, the things that happened that you've been living around for years—those aren't stored in the same place as the craving. They live in memory, in habit, in the body's conditioned responses. No injection reaches them.
The research community understands this, which is why the leading clinical trials don't test semaglutide alone. The SEMALCO trial—a large, carefully designed study—is built on the model of combining semaglutide with cognitive behavioral therapy, which is a structured form of talk therapy that helps people recognize and change patterns of thinking and behavior connected to substance use, for people with alcohol use disorder and obesity. The design of that trial makes the clinical consensus clear: when you combine medication with structured therapeutic support, you get something neither achieves on its own (Klausen et al., 2025). Another phase II trial is studying semaglutide in people with opioid use disorder who are already receiving medication-assisted treatment—meaning the medication is being tested as an addition to existing care, not a substitute for it (Freet et al., 2025).
Medication lowers the noise. Therapy helps you learn to live differently in the quiet. One without the other leaves something essential unaddressed. Many of us at Wish Recovery understand this ambivalence because we've walked through it personally—and we've seen what becomes possible when both are present at the same time.
What happens to the cravings if you stop taking the medication
This is the question most people don't ask out loud but carry quietly. What happens when I stop?
The weight loss research is pretty clear on this: stop the medication, and the weight tends to come back (Wilding et al., 2022; Kolli et al., 2025). The biology doesn't get reprogrammed. It just gets quieted for a while.
While addiction cravings aren't the same as body weight, the principle carries over: the medication is managing a biological signal, not rewiring it permanently. When the medication stops, the signal can return.
This isn't a reason to panic. It's a reason to build.
Substance use disorder is a chronic condition, not a temporary problem with a finish line. The window when cravings are quieter is exactly when the recovery skills, the therapy, the community, and the self-awareness that support relapse prevention need to be developed—so that when anything changes, you have something to stand on. Structured outpatient treatment isn't a backup plan for when the medication stops working. It's how you achieve the kind of recovery that holds.
Have questions about what outpatient treatment looks like day to day? We'd love to talk.
When you're managing your weight, your addiction, and the rest of your life all at once
There's a particular kind of exhaustion that comes from needing help for more than one thing at a time.
You didn't set out to be here. Managing your weight, managing your relationship with substances, wondering whether getting more help means admitting something you're not ready to put into words. That's a lot to carry. And asking for support for all of it at once can feel like too much—like it makes the problem too big, too real, too permanent.
You're not falling apart. You're paying attention. That takes more courage than most people ever acknowledge.
When treatment addresses all of it together—substance use, mental health, and the medical pieces—people do better. Better recovery. Better mental health. A better chance at keeping both (Glover-Wright et al., 2023). Dealing with more than one condition at the same time is genuinely harder. More setbacks. More days when nothing feels like it's working. Having that kind of support in one place makes getting through those days a little more possible (Mizuno et al., 2025).
Your weight is connected to your mental health. Your mental health is connected to your substance use. These aren't three separate problems requiring three separate solutions. They're one person, carrying a story that deserves to be heard all at once.
At Wish Recovery, we treat the whole person—not just the addiction, not just the diagnosis on the paperwork. Our programs, from Partial Hospitalization (PHP) to our flexible Evening and Virtual IOP options, are built for people who have a full life to return to and can't afford for treatment to require them to disappear into it. You're not a number here. You're known.
What luxury outpatient treatment actually looks like when you're also on GLP-1 medication
Picture a Tuesday. You arrive at our Northridge facility in the San Fernando Valley. The morning begins with individual therapy—a private session with a licensed clinician who knows your full history, including your GLP-1 regimen and what you've noticed since starting it. No need to re-explain your story to someone new. We've carried it with you from the start.
Group sessions follow. Ours run with a maximum of 10–12 people, so the room is small enough to be honest in. Depending on where you are in treatment, the day may include structured group therapy using techniques drawn from cognitive behavioral therapy (CBT—a method for identifying and changing patterns of thought and behavior), dialectical behavior therapy (DBT—which focuses on emotional regulation and distress tolerance), or EMDR (a trauma-focused approach that helps process difficult memories through bilateral stimulation, such as guided eye movements). Holistic sessions—yoga, meditation, sound therapy—are woven in because recovery that ignores the body isn't treating the whole person.
At noon, lunch is prepared by a private chef. Gourmet, nourishing, without ceremony about it. Recovery shouldn't feel like deprivation.
After sessions, the facility stays open. The gym, the sauna, the movie theater, the common areas. Unstructured time in early recovery is one of its most underestimated challenges—having somewhere to be, surrounded by people who understand, makes a real difference.
For clients on GLP-1 medication for weight management, our clinical team coordinates directly with prescribing physicians to determine how to best support your care without disruption. We also facilitate access to naltrexone and Vivitrol—FDA-approved medications that reduce cravings for alcohol and opioids—for clients for whom they're appropriate, at whatever dose fits their treatment plan. Medication-assisted treatment is not a shortcut. It's a clinical tool, and we know how to use it thoughtfully. Our Los Angeles treatment center is built around a simple truth: outpatient care, done right, works. People getting medication support in an outpatient setting have meaningfully better safety outcomes than those who don't (Hartung et al., 2022).
Your program is designed to fit a life that doesn't stop. Evening IOP starts at 5:30 PM for those managing work or family commitments. Virtual IOP removes geography from the equation entirely. Recovery that fits your real life is the only recovery that lasts.
Explore your treatment options with the team at Wish Recovery IOP.
The research is moving fast, and so is the conversation about what recovery can look like
As of 2026, GLP-1 medications are not FDA-approved for treating alcohol use disorder, opioid use disorder, or any other substance use condition. Their use for addiction purposes is considered off-label, which means any integration into a recovery plan requires physician oversight and individualized clinical judgment. GLP-1 medications for addiction treatment aren't something we prescribe here at Wish Recovery, but we know how to work with them. We stay current with the science, and when you're already on one of these medications, our clinical team coordinates with your prescribers to make sure your care stays connected.
And the evidence building around these medications is hard to ignore. One large study following hundreds of thousands of people with alcohol use disorder found that those taking semaglutide were far less likely to be hospitalized for AUD than people on other medications—by a wider margin than most existing treatments produce (Lähteenvuo et al., 2025). A separate review pulling together findings from dozens of studies found reductions in substance use across alcohol, opioids, nicotine, and stimulants—and confirmed that larger clinical trials are still underway to work out how best to use these medications alongside addiction treatment (Völker et al., 2026).
The promise of these medications is real, even if the full picture is still coming into focus. The potential to expand access to effective, integrated addiction treatment—where GLP-1 therapy and structured clinical support work together—is exactly the conversation that's gaining traction in medicine, in research, and in policy discussions about what recovery today can look like. Our team is licensed by the California Department of Health Care Services (DHCS), certified by The Joint Commission, and LegitScript verified—because being informed about what's emerging in evidence-based care is part of what we owe the people who come to us.
You don't have to figure all of this out tonight
Whatever brought you here—the noticing, the wondering, the late hour, the question you haven't said out loud yet—it's enough. You don't have to be ready. You just have to be willing to be curious.
Ambivalence isn't a barrier to getting help. Therapists who work with people on the edge of change have found that uncertainty is often where movement actually begins (Forman et al., 2024). The doubt you're carrying may be the first sign that something is already shifting in you.
And if anxiety and substance use are both in the picture, that's okay too. Building the desire to change and the tools to actually do it usually has to happen together—with someone who understands how those two things tangle (Buckner, 2024). That's what our clinical team does. That's what the small groups, the consistent clinicians, the whole-person approach is built for.
You can call us and just ask questions. That's enough for tonight. We've walked this path ourselves, and the compassion we bring to it comes from that. The light here stays on.
Learn how Wish Recovery's evidence-based programs and treatment team approach recovery differently.
Frequently asked questions
Can GLP-1 medications like Ozempic or Wegovy really reduce substance cravings?
Yes. People taking semaglutide—the medication in Ozempic and Wegovy—have reported craving alcohol less and drinking less when they do. That same quieting effect has shown up with opioids, nicotine, and other substances too. The research is real, it's growing, and it's consistent.
Is it safe to do an intensive outpatient program while taking a GLP-1 medication?
Yes. GLP-1 medications and outpatient addiction treatment are compatible, and the IOP setting is actually where much of the current clinical research on GLP-1 and addiction is being conducted. We work directly with whoever is prescribing your medication and build your GLP-1 use into your care from the start.
Do cravings come back after stopping semaglutide or other GLP-1 medications?
They can. The research on weight—and early signals on cravings—suggests that when people stop these medications, what they'd lost tends to start coming back. That's not a reason to stay stuck. It's a reason to build something solid while the window is open. The skills, the support, and the self-awareness you develop in treatment are what hold when anything else shifts.
What is a luxury IOP, and how is it different from standard outpatient care?
A luxury intensive outpatient program (IOP) provides the same evidence-based therapeutic structure as standard outpatient care—individual therapy, group sessions, psychiatric support—but in a setting designed to support total well-being. At our Northridge facility, that means small group sizes (no more than 12 clients), gourmet meals prepared by a private chef, access to a gym, yoga, sauna, and massage therapy, and consistent clinical relationships from day one. You don't have to sacrifice comfort to get real care.
Can I address my weight and my substance use at the same time in the same program?
Yes. At Wish Recovery, we specialize in dual diagnosis care—treating co-occurring conditions simultaneously, in the same place, with the same team. Managing weight, substance use, and the mental health factors underlying both in an integrated way produces better outcomes than treating each issue separately. Your whole story is welcome here.
References
- Hendershot, C. S., Bremmer, M. P., Paladino, M. B., et al. (2025). Once-weekly semaglutide in adults with alcohol use disorder: A phase 2, double-blind, randomized clinical trial. JAMA Psychiatry, 82(4), 395. https://doi.org/10.1001/jamapsychiatry.2024.4789
- Wang, W., Volkow, N. D., Berger, N. A., et al. (2024). Association of semaglutide with risk of incident alcohol use disorder in patients with obesity: A target trial emulation. Nature Communications, 15, 4780–6. https://doi.org/10.1038/s41467-024-48780-6
- Alves, J. M., et al. (2025). GLP-1 receptor expression and neurotransmission modulation in the mesolimbic reward pathway: Implications for addiction. Medical Sciences, 13(3), 136. https://doi.org/10.3390/medsci13030136
- Marquez-Meneses, A., et al. (2025). GLP-1 analogues and their neurobiological effects on reward circuitry: Attenuation of dopamine release in substance use contexts. International Journal of Molecular Sciences, 26(11), 5338. https://doi.org/10.3390/ijms26115338
- Klausen, M. K., Kuzev, T., Pedersen, J., et al. (2025). Does semaglutide reduce alcohol intake in Danish patients with alcohol use disorder and comorbid obesity? Trial protocol of a randomised, double-blinded, placebo-controlled clinical trial (the SEMALCO trial). BMJ Open, 15(1), e086454. https://doi.org/10.1136/bmjopen-2024-086454
- Freet, C. S., Shuler, K., Kawasaki, S., et al. (2025). Efficacy of the GLP-1 receptor agonist, semaglutide, in abstinence from illicit and nonprescribed opioids in an outpatient population with OUD: A randomized, double-blind, placebo-controlled clinical trial protocol. Addiction Science & Clinical Practice, 20(1). https://doi.org/10.1186/s13722-025-00618-2
- Wilding, J. P. H., Batterham, R. L., Davies, M. J., et al. (2022). Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity and Metabolism, 24(8), 1553–1564. https://doi.org/10.1111/dom.14725
- Kolli, R., Aoutla, S., & Siva Jyothi, N. (2025). Rebound or retention: A meta-analysis of weight regain after the discontinuation of glucagon-like peptide-1 (GLP-1) receptor agonists and other anti-obesity drugs. Cureus.https://doi.org/10.7759/cureus.94926
- Wharton, S., Batterham, R. L., Bhatta, M., et al. (2023). Two-year effect of semaglutide 2.4 mg on control of eating in adults with overweight/obesity: STEP 5. Obesity, 31(3), 703–715. https://doi.org/10.1002/oby.23673
- Glover-Wright, C., Coupe, K., Campbell, A. C., et al. (2023). Health outcomes and service use patterns associated with co-located outpatient mental health care and alcohol and other drug specialist treatment: A systematic review. Drug and Alcohol Review, 42(5), 1195–1219. https://doi.org/10.1111/dar.13651
- Mizuno, S., Shimane, T., Inoura, S., et al. (2025). Co-occurring mental and substance use disorders among residents of Drug Addiction Rehabilitation Centers (DARCs) in Japan: Characterizing dual-diagnosis profiles. Psychiatry and Clinical Neurosciences Reports, 4(3). https://doi.org/10.1002/pcn.5.70196
- Hartung, D. M., Markwardt, S., Johnston, K., et al. (2022). Association between treatment setting and outcomes among Oregon Medicaid patients with opioid use disorder: A retrospective cohort study. Addiction Science & Clinical Practice, 17(1). https://doi.org/10.1186/s13722-022-00318-1
- Lähteenvuo, M., Tiihonen, J., Solismaa, A., et al. (2025). Repurposing semaglutide and liraglutide for alcohol use disorder. JAMA Psychiatry, 82(1), 94. https://doi.org/10.1001/jamapsychiatry.2024.3599
- Völker, M. T., et al. (2026). GLP-1 receptor agonists and substance use disorders: A systematic review of preclinical and clinical evidence. Frontiers in Pharmacology, 16, 1702448. https://doi.org/10.3389/fphar.2025.1702448
- Rodriguez, P. J., Lusk, J. B., Mehta, H. B., et al. (2025). GLP-1 receptor agonists vs alternatives for alcohol use disorder: A multi-target trial emulation. medRxiv (preprint). https://doi.org/10.1101/2025.06.07.25329184
- Forman, D. P., Houck, J. M., & Moyers, T. B. (2024). Do improvements in motivational language predict alcohol use in motivational interviewing? Ambivalence matters. Journal of Consulting and Clinical Psychology, 92(7), 388–398. https://doi.org/10.1037/ccp0000889
- Buckner, J. D. (2024). Motivational interviewing-based interventions with patients with comorbid anxiety and substance use disorders. Current Opinion in Psychology, 60, 101934. https://doi.org/10.1016/j.copsyc.2024.101934
June 01, 2026
