GLP-1 medications appear to quiet cravings for some people, and at Carrara a GLP-1 prescription sits inside a residential program in Malibu, with a physician, a therapist and a plan around it.
GLP-1 addiction treatment is the off-label use of a GLP-1 receptor agonist, a type 2 diabetes and weight-management medication, to reduce cravings during recovery from a substance use disorder. GLP-1 receptor agonists (written GLP-1RA, GLP1RA or just GLP1 in the research) mimic a gut hormone that steadies blood sugar, slows digestion and signals fullness.
The addiction question arrived by accident: people taking these drugs for diabetes or weight told doctors the wish to drink, smoke or use had gone quiet. Now it’s being tested properly: the signal is real, the trials are small, and nothing is settled.
No GLP-1 medication is currently approved specifically for treating substance use disorders, so its use for addiction remains off-label. At Carrara, these medications may be considered as one component of an individualized residential treatment plan, alongside evidence-based therapies and ongoing clinical care.
GLP-1 medications appear to lower craving by turning down the brain’s reward signal, not by blocking the substance. Alcohol, opioids and stimulants drive a dopamine surge far larger than ordinary life produces; the brain learns to expect it, everyday pleasures flatten, and the pull to use sharpens.
GLP-1 receptors sit along that circuit, in the ventral tegmental area, the nucleus accumbens and the prefrontal cortex. In animal studies, activating them dampens the dopamine response to drugs and drug cues without removing ordinary pleasure. Human imaging work is early. People who respond describe the noise going quiet, not feeling flat.
Other routes are likely involved too, from gut-to-brain signaling through the vagus nerve to inflammation and the balance of glutamate and GABA in reward circuits, which is one reason the medication is paired with therapy rather than trusted alone.
Semaglutide for alcohol use disorder is where human evidence has gone furthest. Early studies showed lower craving and fewer drinks on drinking days in adults with AUD (Hendershot et al., JAMA Psychiatry, 2025) and lower rates of new and returning AUD compared to other weight medications (Wang et al., Nature Communications, 2024). Building on this, a small eight-week placebo-controlled trial in treatment-seeking adults (American Journal of Psychiatry, 2026) found oral semaglutide reduced heavy drinking days, daily craving, and alcohol-related problems.
The smoking evidence is mixed. A pilot trial of exenatide added to a nicotine patch (Yammine and colleagues, Nicotine & Tobacco Research, 2021) reported more people abstinent at six weeks than the patch alone. A larger trial of dulaglutide added to varenicline (Lengsfeld and colleagues, eClinicalMedicine, 2023) found no difference in quitting, only less weight gain. Enough to keep studying, not to prescribe on.
For opioids the evidence is observational. An analysis of US health records (Qeadan and colleagues, Addiction, 2025) found lower rates of opioid overdose among people with opioid use disorder who held a GLP-1 or GIP/GLP-1 prescription. Association, not cause; craving trials are only now under way. Nothing here replaces buprenorphine, methadone or naltrexone, the approved medications on our medication-assisted treatment page.
No medication is approved for cocaine or methamphetamine use disorder, so GLP-1 research in stimulants is watched closely and easily overstated. What exists is mostly animal work plus a handful of small human studies. A GLP-1 medication is not itself a stimulant, and stimulant treatment still rests on behavioral work, with contingency management carrying the strongest evidence. Our page on GLP-1 agonists and stimulant addiction goes further.
GLP-1 therapy may be considered once you’re medically stable and withdrawal is managed, as part of an individualized treatment plan that integrates medication with psychotherapy, wellness practices, and ongoing clinical care. Our post on GLP-1s and addiction recovery at Carrara describes the model behind the four stages below.
Medical detox with monitoring around the clock, then sleep, nutrition and the nervous system settled. No GLP-1 medication while withdrawal is being managed.
If screening supports it, GLP-1 therapy begins here, with semaglutide or tirzepatide, alongside individual psychotherapy, trauma work, CBT, DBT and somatic therapy.
The physical rebuild: strength training, breathwork, sleep and nutrition. On a GLP-1 medication this isn’t optional, because muscle can go with the weight.
An aftercare plan written while you’re still here: ongoing therapy, support, and what happens with any medication you leave on, agreed before you go.
GLP-1 therapy is considered for people whose craving has stayed loud despite good treatment. It isn’t right for everyone; candidacy is decided by medical evaluation: lab work, metabolic assessment and psychiatric screening, and if it isn’t right for you, we’ll say so.
Persistent, intrusive craving for alcohol, opioids, stimulants or nicotine that earlier treatment didn’t quiet.
Relapse after residential treatment or MAT that was otherwise done well.
Weight gain, insulin resistance or a hormonal imbalance next to the substance use, where one medication may serve both.
Arriving on Ozempic, Mounjaro or another GLP-1? Mention it when you call; every medication is reviewed at intake.
Most side effects are digestive and mild and ease as your body adjusts, but know them before you say yes. The medical team monitors your response with regular lab work and adjusts as needed. When the medication stops, craving can return, so the therapy, the medical plan and the aftercare below matter as much as the prescription.
The common one, mostly in the first weeks and after any change. Smaller meals, less fat and steady fluids help, and the team adjusts rather than asking you to push through.
Reduced appetite, constipation or diarrhea, and reflux. People arriving from heavy alcohol or opioid use often have an irritated stomach already, one reason the medication waits until after detox.
A meaningful share of the weight lost on a GLP-1 medication can be muscle unless protein and strength training are protected, which is why the gym is part of the plan and why our post on the GLP-1 wake-up call treats exercise as non-negotiable.
Pancreatitis, gallbladder problems and low blood sugar in people on diabetes medication are on the labels, with a warning about a thyroid tumor seen in rodent studies. Screening for them is part of candidacy.
A GLP-1 medication can quiet craving. It cannot do the rest of the work, which is most of it: the trauma, depression or anxiety underneath, and the life the craving grew in. An injection reaches none of that. Worth asking wherever you call: who prescribes it, when it starts, what therapy surrounds it, and whether they’ll say plainly it’s off-label.
At Carrara the prescription sits inside individual psychotherapy, psychiatric care, family therapy, and an aftercare plan written during treatment, in Carrara’s Malibu house, with six clients in residence at most. The GLP-1 protocol is physician-designed, under Senior Medical Officer Dr. Kenneth Spielvogel, MD, a physician nearly 30 years into practice with a special interest in addiction medicine. The prescription is written and reviewed by Carrara’s own medical team after an in-person evaluation, not by an outside service.
If you’ve read that GLP-1 medications quiet cravings and want to know what’s actually known, call and ask; the person who answers works for Carrara.
Private and HIPAA compliant. The decision stays yours.
Call (888) 383-5207No. Semaglutide (Ozempic for type 2 diabetes, Wegovy for weight) isn’t approved for any substance use disorder, and neither is any other GLP-1 medication; use for cravings is off-label and under study. At Carrara that means a medical evaluation, informed consent and lab monitoring first, and nothing prescribed by phone.
For some people, and the timing varies. In the 2025 JAMA Psychiatry trial, craving and drinks per drinking day fell over nine weeks; outside a trial, some people notice a change within a few weeks; others notice nothing. Nobody can predict your response, so it’s reviewed rather than assumed.
Maybe. One small trial found more people quit when exenatide was added to a nicotine patch; a larger one found dulaglutide added nothing beyond less weight gain. If nicotine is part of what you’re treating, tell admissions; it’s treated within the same plan, alongside the primary substance.
Tirzepatide (Mounjaro, Zepbound) acts on GIP receptors as well as GLP-1 and is one of the two medications used here; no completed head-to-head trial has compared it with semaglutide for cravings. Retatrutide (“reta”) is a three-receptor compound still in weight-loss trials, with no approval for any use as of this writing, so nobody should be prescribing it for addiction. Newer forms are coming; we don’t prescribe from press releases.
Sometimes, for part of it. Insurance may contribute to a portion of residential treatment, depending on your plan; whether a plan pays anything toward an off-label GLP-1 prescription is the insurer’s call and changes often, which is why admissions looks at your particular plan before you arrive. More on how insurance works with luxury rehab.
Calling about yourself, or about someone you love, you reach admissions staff employed by Carrara, not a call center. The conversation is confidential, and if GLP-1 therapy isn’t right for you, the medical team will say so and treat you well without it.
If this is an emergency, call 911. For free confidential support 24 hours a day, call or text 988.
This page is general information, not medical advice.
