A large observational study has found that GLP-1 receptor agonist medications may reduce the risk of developing multiple substance use disorders and lower the likelihood of serious harm in those already affected.
The analysis, published in The BMJ, examined electronic health records from more than 600,000 United States Veterans Affairs patients with type 2 diabetes over three years. Researchers compared patients treated with GLP-1 drugs against those receiving other blood sugar-lowering medications across seven parallel trials covering alcohol, cannabis, cocaine, nicotine, and opioid use.
Patients taking GLP-1 medications showed reduced risks of developing addiction across all substances studied: 18% lower for alcohol, 14% for cannabis, 20% for both cocaine and nicotine, and 25% for opioids. Among patients with existing substance use disorders, GLP-1 use was associated with a 31% lower risk of emergency department visits, a 39% lower risk of overdose, and a 50% lower risk of death.
Researchers suggest the drugs may act on the brain’s reward pathways, the same system that drives cravings, in a manner analogous to their known effect of reducing intrusive thoughts about food. However, as an observational study, the findings demonstrate association rather than causation.
The study’s limitations include a population that is predominantly older, white, and male, and data drawn exclusively from patients with diabetes. Experts stress that the results do not yet justify prescribing GLP-1 drugs specifically to prevent or treat addiction; randomised controlled trials are needed before clinical recommendations can be made.
Published in: The BMJ