Written by: Jevto Kalajdžić and Bojan Rakić

In recent years, the drug Ozempic, whose active ingredient is semaglutide, has become a global phenomenon. Originally developed for the treatment of type 2 diabetes and later widely used in obesity therapy, this medication has attracted attention for reasons that go beyond blood sugar control and weight loss. A growing number of studies and clinical observations suggest that it may have an unexpected impact on addictive behaviors – ranging from alcohol and nicotine to compulsive overeating and even other forms of addiction.

At the Law Office Stevanović (AKS), which represents major pharmaceutical companies, we closely monitor these trends because they represent not only a medical innovation but also a potential shift in regulatory, insurance, and social frameworks related to public health. When a drug moves beyond its original purpose and begins to be viewed as a tool for addressing complex psychological and neurological disorders, a wide range of legal and ethical questions arises.

Ozempic belongs to a class of medications known as GLP-1 agonists. They mimic a hormone that the body naturally produces after a meal, which signals satiety to the brain. This mechanism affects appetite regulation and metabolism. However, scientific research has shown that GLP-1 receptors also exist in parts of the brain associated with the reward and motivation system. These regions play a crucial role in the development of addiction, as they regulate feelings of pleasure, drive, and repetitive behavior.

In clinical practice, some patients taking semaglutide began reporting that, in addition to reduced appetite, they experienced a diminished desire for alcohol or cigarettes. Some described their urges as quieter, less intrusive, as if the “background noise” of addiction had weakened. Although these reports were initially considered anecdotal, subsequent research has begun to confirm that there may be a genuine neurobiological basis for such changes.

Animal studies have shown that GLP-1 agonists can reduce the seeking of certain substances. In humans, preliminary results indicate reduced alcohol consumption and decreased craving intensity. However, it is important to emphasize that this research is still in its early stages and that there is no long-term data confirming a sustained therapeutic effect.

This brings us to the core question: is it possible that a drug affecting appetite regulation simultaneously influences the regulation of urges? If addiction is viewed as a disorder of the brain’s reward system, then any medication that affects dopaminergic pathways could have broader implications. However, addiction is not solely a biological phenomenon. It involves psychological, social, and often traumatic factors. A medication may ease the urge, but it cannot, by itself, resolve the underlying causes.

From a legal perspective, the potential broader use of Ozempic in addiction therapy would raise numerous questions. Would such treatment be covered by health insurance? Who bears responsibility for off-label use? Would pharmaceutical companies be required to conduct additional trials and expand official indications? Finally, would a shift in the perception of addiction – from a moral or willpower issue to a strictly neurobiological disorder – influence the criminal law and social treatment of individuals with addiction?

AKS is also exploring this dimension of the phenomenon. If a medication can quiet the urge but not erase the circumstances that led to it, then therapy must be integrated. Medical treatment, psychological support, and social reintegration remain essential components. In this context, Ozempic would not be a miracle cure, but potentially a powerful tool within a broader treatment system.

In public discourse, there is often an impression that a quick solution has been found for complex problems. Experience, however, shows that in medicine and law such solutions rarely exist. What is now happening with GLP-1 medications reminds us how complex the human brain is and how the boundaries between the physical and psychological are sometimes thinner than we think.

In the coming years, we will likely witness new studies, regulatory decisions, and expanded therapeutic indications. Until then, caution is necessary, but so is openness to innovation. If it is confirmed that semaglutide can reduce the intensity of addictive urges, this could represent one of the more significant changes in the approach to addiction treatment in recent decades.

AKS will continue to monitor the development of this topic – not only as a medical curiosity, but as a phenomenon that potentially reshapes the relationship between science, law, and society.

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"Standard Prva" LLC Bijeljina is a company registered in Bijeljina at the District Commercial Court in Bijeljina. Company’s activities are accountancy, repurchases of receivables, angel investing and other related services. Distressed debt is a part of the Group within which the company repurchases the receivables, which function and are not returned regularly.

Lawyer’s Office Stevanović is the leading lawyer’s office in the region with the seat in Bijeljina. The LO abbreviation represents Lawyer’s Office of Vesna Stevanović and Lawyer’s Office of Miloš Stevanović.

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