New research suggests that GLP-1 receptor agonists, a class of drugs widely used for type 2 diabetes and weight loss, may be associated with reduced risks related to substance use disorders. The study, led by researchers at Washington University School of Medicine in St. Louis and published in The BMJ, examined electronic health records from 606,434 U.S. veterans with type 2 diabetes.
The medications studied include drugs in the same class as Ozempic, Wegovy, Mounjaro and Zepbound. GLP-1 drugs were originally developed for diabetes management and later became widely used for obesity treatment. Reports from some patients that alcohol, tobacco or food cravings declined after starting the drugs helped prompt further investigation.
Researchers compared veterans taking GLP-1 medications, most often semaglutide, liraglutide or dulaglutide, with those taking SGLT2 inhibitors, another diabetes drug class. Among 524,817 participants without a substance use disorder at the start, GLP-1 users had a 14 percent lower risk of developing any substance use disorder over three years. Lower risks were reported for alcohol, cannabis, cocaine, nicotine and opioids. The researchers estimated this equaled seven fewer new diagnoses per 1,000 users.
A second analysis involved 81,617 veterans who already had a substance use disorder. In that group, GLP-1 use was associated with fewer serious outcomes, including a 30 percent reduction in emergency department visits, 25 percent fewer hospitalizations, 40 percent fewer overdoses and 50 percent fewer drug-related deaths. Overall, this amounted to 12 fewer serious addiction-related events per 1,000 users.
The researchers said GLP-1 drugs may affect brain pathways involved in reward and craving, potentially addressing a common mechanism across substances. They called for clinical trials to test whether the medications can be used as addiction treatments. Because the study was observational, the findings show associations, not proof of cause and effect. Further research will determine clinical relevance.