Researchers report that GLP‑1 receptor agonists, originally developed for type 2 diabetes and now commonly used for weight loss, may help prevent and treat substance use disorders across many drugs. A team at Washington University School of Medicine in St. Louis analysed electronic health records for 606,434 US veterans with type 2 diabetes. The cohort was divided into 524,817 people without a pre‑existing substance use disorder and 81,617 with a pre‑existing disorder. Patients were followed for up to three years from the start of a GLP‑1 agonist—most commonly semaglutide, liraglutide, or dulaglutide—or an SGLT2 inhibitor.
Among those without a prior disorder, GLP‑1 use was associated with a 14% reduced risk of any substance use disorder, with declines of 18% for alcohol, 14% for cannabis, 20% for cocaine and nicotine, and 25% for opioids; the authors say this corresponds to seven fewer new diagnoses per 1,000 GLP‑1 users. In patients with an existing disorder, GLP‑1 use was tied to fewer severe harms after three years: a 30% reduction in emergency visits, 25% fewer hospitalisations, 40% fewer overdoses, and 50% fewer drug‑related deaths, equal to 12 fewer serious harm events per 1,000 users.
The team notes that GLP‑1 receptors are present in brain regions that influence reward and craving, which could explain effects across different substances. Senior author Ziyad Al‑Aly said the drugs “are likely acting against the craving itself. It blunts that craving that pulls people toward whatever they’re addicted to.” The authors argue these findings support testing GLP‑1 medications in clinical trials aimed at addiction outcomes, including overdose and drug‑related death. The research was funded by the US Department of Veterans Affairs; funders had no role in the study design, analysis, or publication decisions.
Difficult words
- agonist — drug that activates a specific receptoragonists
- cohort — group of people in a study
- overdose — taking too much of a drug causing harmoverdoses
- craving — strong desire to use a substance
- hospitalisation — admission to hospital for medical carehospitalisations
- electronic health record — digital record of a patient's medical historyelectronic health records
- substance use disorder — medical condition involving harmful use of drugs
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- If GLP‑1 drugs reduce cravings and overdose risk, what are the possible benefits and risks of using them to treat addiction? Give reasons.
- What practical challenges might health systems face if GLP‑1 medications are tested and approved for addiction treatment?
- What additional evidence or types of clinical trials would you want to see before these drugs were widely used for substance use disorders?
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