Popular Weight Loss Drugs May Help Reduce Risk of Substance Use Disorders, Suggests New Study

GLP-1 drugs, such as semaglutide and tirzepatide, have become extremely popular as they help in managing blood sugar levels and weight loss. Emerging studies have also reported how these drugs can prevent cardiac events, protect the kidney, regulate appetite, and reduce joint pain. Now, a new study published in The BMJ, says that GLP-1 drugs may help prevent and treat substance use disorders across all major addictive substances that were studied. This suggests that GLP-1 drugs target a common biological pathway underlying addiction. The study was conducted by researchers from the Washington University School of Medicine in St. Louis.

Study Overview

For the study, the team analysed more than 6,00,000 U.S. veterans with type 2 diabetes who had an average age of 65. The team found that GLP-1 use reduced the risk of developing substance use disorders across all major addictive substances, including cannabis, cocaine, nicotine and opioids. It also reduced the risk of severe harm, including overdose and death, in people who already have such disorders.

Dr. Ziyad Al-Aly, MD, a WashU Medicine clinical epidemiologist and Chief of the Research and Development Service at the VA Saint Louis Health Care System, and senior author of the study, said, "In addiction medicine, a lot of treatments target just one thing - for example, a nicotine patch helps with smoking, but not alcohol - but there is no medication that works across addictive substances, let alone all of them.

"The revelation about GLP-1 medication is that it really works against all major substances, and it works uniformly, not because it acts against alcohol or opioids or nicotine specifically, but because it is likely acting against the craving itself. It blunts that craving that pulls people toward whatever they're addicted to."

The team used the data and conducted seven clinical trials to test the effect of GLP-1s on people without a pre-existing substance use disorder and those who already had a substance use disorder. The participants were divided into two groups.

The team looked back on their health records for up to three years, beginning when they started taking either a GLP-1 receptor agonist - most commonly semaglutide, liraglutide or dulaglutide - or another type of medication, called an SGLT2 inhibitor, to treat their diabetes.

Study Findings

From the first group, the researchers tracked 524,817 participants, who developed alcohol, cannabis, cocaine, nicotine, opioid or other substance use disorder. In second group with pre-existing substance use disorder, participants experienced drug-related emergency department visits, hospitalization, mortality, overdose, or suicidal ideation or attempt.

When they were compared to patients treated for diabetes with a non-GLP-1 medication, GLP-1 use was associated with 14% reduced risk of developing any substance use disorder. Also, the risk of developing each substance use disorder was reduced by 18% for alcohol, 14% for cannabis, 20% for cocaine and nicotine, and 25% for opioids.

Participants with pre-existing substance use disorder saw fewer hospitalisations, overdoses and deaths related to substance use. After three years, there was a 30% reduction in emergency department visits, 25% reduction in hospitalisations, 40% reduction in overdose and 50% reduction in drug-related deaths.

The results of the study were consistent across substance types; alcohol, opioids, stimulants. Dr. Al-Aly said that this "really elevates the notion that these medications are really acting on the root causes of all of these addictions." He added, "Here is a trial with 600,000 people studying not only opioids or nicotine or alcohol, but all of them. So it's unlikely to be a coincidence or chance finding."

The study only provides evidence that GLP-1 drugs can be used as a treatment for addiction. Researchers are working on how these could also curb drug and alcohol use. The theory is that GLP-1 drugs work on the reward signaling part of the brain.

"People taking these drugs for obesity often describe a quieting of 'food noise,' the persistent preoccupation with food that drives overeating," Al-Aly said. "What our study suggests is something broader: GLP-1 drugs may also quiet what I call 'drug noise,' the relentless craving that drives addiction across substances. That cross-substance signal points to a shared biology underlying addiction, and it opens the door to a fundamentally different approach: not treating one addiction at a time, but targeting that common biologic signal, that common craving across addictions. Moving beyond food noise to drug noise, GLP-1s are quieting the roar of addiction."

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.