News: GLP-1 drugs may treat, prevent addictions, study suggests

Initiation of GLP-1 drugs was associated with a lower risk of substance use disorders (SUD) in adults with type 2 diabetes, a recent target trial emulation using data on veterans found. When compared with SGLT2 inhibitors (used to treat type 2 diabetes, heart failure, and chronic kidney disease) in veterans, there was a 14% lower risk of developing new SUDs for patients on a GLP-1 drug.

For patients without a history of any SUD, those who started a GLP-1 drug instead of an SGLT2 inhibitor had a reduced risk of a composite outcome of all SUDs—including alcohol, cannabis, cocaine, nicotine, opioid, and other SUDs. Benefits also extended to those with preexisting SUDs, the study found.

Starting a GLP-1 drug over an SGLT2 inhibitor was associated with significantly lower risks of the following:

• SUD-related emergency department visits
• SUD-related hospital admissions
• SUD-related mortality
• Drug overdose
• Suicidal ideation or attempt

The study was designed as a target trial emulation, with eight new-user, active-comparator trials using electronic health record data. Seven of the trials focused on each incident SUD outcome, while the eighth analyzed veterans with existing SUDs. Semaglutide (Ozempic) was the most used GLP-1 drug. Nearly all SGLT2 inhibitors were empagliflozin (Jardiance). About half of patients were adherent to either drug class after three years. The comparison found that the initiation of GLP-1 drugs was associated with a significantly lower risk of developing each SUD than SGLT2 inhibitors.

"People taking [GLP-1 drugs] for obesity often describe a quieting of 'food noise,' the persistent preoccupation with food that drives overeating. 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," Ziyad Al-Aly, MD, of the VA Saint Louis Heath Care System explained, according to MedPage Today.

Researchers warned that these observational findings alone are not enough to prescribe a GLP-1 agent to specifically prevent or treat SUDs yet. However, they contribute to the growing body of clinical research testing the role of these agents in SUDs. Additionally, the findings offer actionable signals that can support patient-centered decision-making.

Editor’s note: To read the full study, click here. To read additional coverage of this study from MedPage Today, click here.