Ozempic, GLP-1s May Help Curb Substance Use Disorders, Study Finds

Significantly lower rates of alcohol, nicotine, opioid, and cocaine use disorders found among patients taking GLP-1 medications

A new study led by researchers at The University of Texas at El Paso found that use of weight loss drugs like Ozempic and other GLP-1s is associated with a lower risk of developing alcohol, opioid, nicotine, and cocaine use disorders.

The study, led by UTEP School of Pharmacy researchers Tadesse Abegaz, PhD, and Gabriel Frietze, PhD, was published in Frontiers in Psychiatry. It looked at more than 142,000 cases of patients with type 2 diabetes or obesity, of which around 20,000 were prescribed GLP-1 medications. They then examined whether GLP-1 users were more or less likely to develop substance use disorders than similar counterparts who were not on the medications.

GLP-1s are a class of medications that were originally developed for treating obesity and diabetes. But emerging evidence suggests these medications may influence dopamine signaling and other neural pathways that contribute to cravings—not only of food but other substances.

"Our findings add to growing evidence that GLP-1 medications may influence more than appetite and blood sugar regulation," says lead author Abegaz. "These medications appear to affect brain pathways involved in reward and craving, which could help explain the lower rates of substance use disorders observed in our study."

The study found that people taking GLP-1 medications had:

• 74% lower odds of alcohol use disorder;
• 69% lower odds of opioid use disorder;
• 68% lower odds of nicotine use disorder; and
• 75% lower odds of cocaine use disorder.

The team emphasizes that their findings do not establish cause and effect—GLP-1s do not specifically prevent patients from abusing substances.

“We do not support prescribing these medications for addiction treatment at this time, Frietze says. “Because this was an observational study in a specific clinical population, randomized clinical trials are needed before GLP-1 medications can be recommended for treating addiction.”

However, the team believes their results are promising and plans to continue studying GLP-1s’ effect on substance abuse.

“Our next goal is to conduct prospective research that follows individuals initiating GLP-1 therapy over time,” Abegaz says. “We aim to evaluate whether changes in substance use behaviors occur after treatment begins and whether these changes are related to improvements in mental health and quality of life.

He adds, “Ultimately, this work will help inform whether GLP-1 medications could become part of future treatment strategies for substance use disorders.”

Patient data for this study was provided by the National Institutes of Health All of Us Research Program, one of the nation’s largest and most diverse health databases.

— Source: University of Texas at El Paso

Newer Obesity Drugs Linked to Fewer Alcohol-Related Hospitalizations for People With Alcohol Dependence

Use of newer GLP-1 receptor agonists for obesity or diabetes was associated with a reduction in hospital admissions, suggesting a potential role for the treatment of alcohol-use disorder

Use of newer GLP-1 receptor agonists (semaglutide or tirzepatide) for obesity or diabetes by people with alcohol-use disorder was associated with a reduction in alcohol-related admissions to hospital, finds a study published online in the open access journal BMJ Open.

The findings suggest a potential role for the drugs semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) in the treatment of alcohol-use disorder.

While GLP-1 receptor agonists are used primarily for the treatment of type 2 diabetes and obesity, there have been reports of reduced alcohol consumption among patients taking the drugs, prompting the authors to investigate the potential impact on alcohol-related hospitalizations among adults with alcohol-use disorder.

The study compared alcohol-related hospitalizations in 40,703 adults with alcohol-use disorder and type 2 diabetes or obesity who started a newer GLP-1 receptor agonist (semaglutide or tirzepatide) or a comparator drug between January 1, 2018, and December 31, 2024. Participants were split across four trials involving clinically distinct populations—the antidiabetic medication trial, antiobesity medication trial, medications for alcohol use disorder with type 2 diabetes (MAUD-T2D) trial, and medications for alcohol-use disorder with obesity (MAUD-obesity) trial.

Compared with participants taking an active comparator drug, those taking GLP-1 receptor agonists had a lower risk of alcohol-related admission to hospital during all four trials.

Use of GLP-1 receptor agonists was associated with a 26% lower risk of alcohol-related hospital admission than other diabetes medicines during the diabetic medication trial, and a 32% lower risk of alcohol-related hospital admission than other obesity medicines during the antiobesity medication trial.

In the MAUD trials, the active comparators were drugs for alcohol-use disorder including acamprosate, disulfiram, and naltrexone. Compared with taking drugs for alcohol-use disorder, use of GLP-1 receptor agonists by adults with type 2 diabetes was associated with a 63% lower risk of alcohol-related admission to hospital during the trial, and for adults with obesity, use of GLP-1 receptor agonists was associated with a 65% lower risk of alcohol-related hospitalizations.

The authors acknowledge several limitations to their study. Most importantly, alcohol-use disorder is undercaptured due in part to stigmatization, and when documented, it may also be recorded variably with lower reporting in areas of high social deprivation. Alcohol-related outcomes may have been undercaptured as they were defined using diagnosis codes and laboratory testing for alcohol exposure, and the study captured hospitalizations from treatment initiation to discontinuation in a trial environment, so treatment effects in an average clinical setting may differ.

Finally, there may have been some confounding in relation to socioeconomic status, underlying clinical stability or alcohol-use disorder severity, and health care engagement, as newer GLP-1 receptor agonists are higher-cost therapies and patients with access to these medications may differ from comparator groups.

The risk of residual confounding was greatest in the MAUD trials, as reflected by the reduced risk of non-alcohol-related hospitalizations with use of GLP-1 receptor agonists. The authors say the results of the MAUD trials should be interpreted with greater caution, as there were also high rates of treatment discontinuation increasing the potential for bias.

Nevertheless, the authors conclude, “Initiation of newer GLP-1 receptor agonists among patients with alcohol-use disorder was associated with a lower observed risk of alcohol-related hospitalization, with similar associations across populations with type 2 diabetes and obesity.

“These findings may suggest a potential role for GLP-1 receptor agonists in the context of alcohol-use disorder.”

— Source: BMJ Open