The blockbuster GLP-1 drugs that have reshaped the treatment of diabetes and obesity may also help prevent multiple substance use disorders and reduce the tragic outcomes they cause, according to a large new study.
An analysis published Wednesday in a medical journal examined electronic health records from more than 600,000 U.S. Veterans Affairs patients with diabetes. It found that those treated with medications such as Ozempic and Mounjaro were less likely to develop addictions to alcohol, nicotine, cocaine, opioids, and other substances compared to those treated with a different class of drugs.
In patients already struggling with addiction, the GLP-1 drugs were linked to lower risks of hospitalization, overdose, and death, the study reported. These results suggest—but do not prove—that the weight-loss medications may target the underlying source of cravings affecting more than 48 million Americans with substance use disorders.
“They’re actually working against the root cause of all these different addictions,” said Dr. Ziyad Al-Aly, the study’s lead author and a chief researcher at the VA St. Louis Health Care System.
### What You Need to Know About the New Research
Previous studies have suggested that GLP-1s, or glucagon-like peptide-1 receptor agonists, could reduce addictions by targeting the brain’s reward pathways. However, those studies were often small and limited to one substance.
This new study, one of the largest to date, analyzed data from electronic records of over 600,000 Veterans Affairs patients with diabetes over three years. The researchers compared people treated with GLP-1 drugs to those receiving other blood sugar–lowering medications.
The patients were divided into seven parallel trials assessing the risk of developing addictions to multiple substances—including alcohol, cannabis, cocaine, nicotine, and opioids. An additional trial examined the risk of specific harms among people with existing addictions when prescribed different medication types.
### Key Findings
The study found that people starting on GLP-1 drugs had lower risks of developing multiple substance addictions. Compared with other medications, those taking GLP-1 drugs had a reduced risk of addiction by:
– 18% for alcohol
– 14% for cannabis
– 20% for both cocaine and nicotine
– 25% for opioids
Among patients already diagnosed with substance use disorders, beginning GLP-1 treatment was associated with:
– 31% lower risk of emergency department visits
– 26% lower risk of hospitalizations
– 25% lower risk of suicidal thoughts or attempts
– 39% lower risk of overdose
– 50% lower risk of death
Overall, the study estimated that GLP-1 drugs likely prevented approximately seven cases of substance use disorder and 12 serious harm incidents per 1,000 users over three years.
### Study Limitations
The study was conducted within the VA health system, which predominantly serves an older, white, and male population. However, Dr. Al-Aly noted that results were consistent across more than 35,000 women included in the data.
Additionally, the research only includes people with diabetes—not the general population—and could not account for factors such as socioeconomic status or lifestyle choices that might influence outcomes. The analysis compared GLP-1s with other medications, not with no treatment.
Importantly, as an observational study, the findings show an association between GLP-1 use and reduced risk of substance use disorders and related harms—but do not prove that the drugs directly caused these reductions.
### Expert Perspectives
Dr. Lorenzo Leggio, clinical director at the National Institute on Drug Abuse, who was not involved in the study, called the findings striking.
“Even though we don’t fully understand the mechanism, somehow the GLP-1 system is tackling addiction biology and the foundational system that underlies all these disorders,” he said.
Research on diabetes and weight-loss trials has shown that GLP-1 drugs target hormones in the gut and brain controlling appetite and feelings of fullness by reducing “food noise,” or intrusive thoughts about food. Similarly, this study suggests the drugs may help dampen “alcohol or drug noise.”
Dr. Anna Lembke, an addiction medicine specialist at Stanford University, described the growing evidence for GLP-1s in preventing substance use disorders as exciting.
“We haven’t really had a new tool in our toolbox from a pharmacotherapy perspective to treat addiction in a long time,” Lembke said. She noted that some addiction specialists are already prescribing GLP-1 drugs off-label, particularly when other treatments have failed. However, she cautioned that these drugs do not work the same for everyone and have associated risks that must be carefully weighed.
### What’s Next?
Dr. Al-Aly emphasized that the new findings do not, by themselves, justify prescribing GLP-1 drugs to prevent or treat substance use disorders. Such decisions require evidence from randomized controlled clinical trials comparing the drugs against a placebo.
Several of these trials are currently underway, Leggio added.
The ultimate goal is to discover new ways to treat addictions, which remain leading causes of illness and death worldwide.
“The consequence in terms of chronic disease of these addictive drugs is actually gigantic in our society,” Leggio said.
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*The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.*
https://abcnews.com/Technology/wireStory/glp-1-medications-fight-addiction-130772959
