The list of health conditions that may benefit from GLP-1 drugs – including Ozempic, Wegovy, Mounjaro, and Zepbound – continues to expand. These medications are already approved to lower the risk of heart disease, sleep apnea, kidney conditions, and liver conditions.
A recent study, published in the BMJ, reports that people taking GLP-1 drugs experienced a lowered risk of developing addictions, as well as reduced negative consequences of addictive behaviors, including hospitalizations, overdose, and death.
A Novel Approach to Addiction Treatment
Researchers led by Dr. Ziyad Al-Aly from the Washington University School of Medicine analyzed health records from over 600,000 people within the Department of Veterans Affairs system. Participants were diagnosed with diabetes and prescribed either a GLP-1 drug or an SGLT2 inhibitor – a different class of diabetes medication like Farxiga or Jardiance.
Dr. Al-Aly noted the lack of comprehensive research evaluating both the risk of new substance use disorders and harm reduction across all major substances. “There is no medicine, or no precedent in our armamentarium that actually has this property of working across addictive substances,” he said.
Among participants without existing substance use disorders, those taking GLP-1 drugs showed a 14% to 25% reduced risk of developing an addiction to alcohol, cannabis, cocaine, nicotine, or opioids over a three-year period, compared to those prescribed SGLT2 inhibitors. The greatest reduction in risk was observed for opioid dependence.
For individuals already struggling with substance use, GLP-1 medications were associated with a 29% reduction in emergency department visits, a 26% reduction in hospitalizations, a 39% reduction in overdose events, and a 50% reduction in drug-related deaths.
Uncertainties Remain
Researchers caution that more studies are needed to determine the appropriate dosage and duration of GLP-1 treatment for addiction. Dr. Al-Aly expressed concern about the potential for cravings to return if the medication is discontinued, as the drugs perform by suppressing reward signals in the brain.
Another area requiring further investigation is the brain’s potential to adapt to the medication, potentially diminishing its effectiveness over time. “I would not advise prescribing [GLP-1s] for the sole indication of addiction at this point, pending more studies and understanding,” Dr. Al-Aly stated.
Despite these uncertainties, the data suggest that GLP-1 medications could offer a new avenue for both preventing and treating addiction, particularly for individuals already prescribed the drugs for diabetes, obesity, or being overweight.
Frequently Asked Questions
What did the study examine?
The study examined the association between GLP-1 drugs and the risk of developing new substance use disorders, as well as the impact of these drugs on reducing harm related to existing addictions, such as hospitalizations, overdose, and death.
Who was included in the study?
The study analyzed health records from over 600,000 people in the Department of Veterans Affairs system who had been diagnosed with diabetes and prescribed either a GLP-1 drug or an SGLT2 inhibitor.
Are GLP-1 drugs currently recommended for treating addiction?
According to Dr. Al-Aly, GLP-1 drugs are not currently recommended for prescribing for the sole purpose of controlling addiction, pending further research and a better understanding of their long-term effects.
Given these promising, yet preliminary, findings, how might the evolving understanding of GLP-1 medications reshape approaches to addiction prevention and treatment?
