Weight loss drugs could help people avoid getting addicted to alcohol, tobacco and illegal drugs. Smaller studies had shown such results before, but for the first time this effect has been demonstrated in a very large sample — over 600,000 people. The study results were published in The BMJ journal.
Ozempic, Mounjaro, and other GLP-1 inhibiting drugs may prevent the development of new substance use disorders and alleviate existing addictions. This is shown by a large-scale study conducted among US military veterans.
The effect was observed across a wide range of addictive substances, including cocaine, opioids, alcohol, nicotine, and cannabis. This phenomenon had been noted before, but in small studies. This time, scientists used the US Department of Veterans Affairs database to identify patients with type 2 diabetes receiving treatment with two different classes of drugs: Trulicity or Mounjaro from Eli Lilly, Ozempic or Victoza from Novo Nordisk, Jardiance from Boehringer Ingelheim, and Farxiga from AstraZeneca. The results obtained were compared in emulated randomized trials.
“There is no single medication in addiction medicine that is effective against all these substances,” notes Dr. Ziyad Al-Aly, who led the study.
Furthermore, in most cases, the study participants were not taking GLP-1 drugs at the doses used for obesity treatment, as these are higher than those used for diabetes treatment.
Among 124,001 participants with no history of substance abuse who took GLP-1 drugs, the likelihood of developing a new substance use disorder over the following three years was 14% lower compared to 400,816 similar patients who were prescribed SGLT-2 inhibitors.
The researchers found that GLP-1 inhibiting drugs reduced the likelihood of developing new alcohol use disorders by 18%, cannabis use disorders by 14%, cocaine use disorders by 20%, nicotine use disorders by 26%, and opioid use disorders by 25%.
Among 81,617 patients with pre-existing substance use disorders, the likelihood of emergency department visits over the following three years was 31% lower for those taking GLP-1 drugs. These medications also reduced substance use-related hospitalizations, substance use-related deaths by 50%, drug overdoses by 39%, and suicidal thoughts or attempts by 25%.
“Doctors know that if a patient has an addiction to substance A, they should be given an antidote for substance A: for example, a nicotine patch for tobacco. But here we are dealing with a drug that acts on all addictive substances,” said Dr. Al-Aly. “This tells us that there is probably a common biological mechanism underlying all these addictions, one that is indeed treatable or influenced by GLP-1.”
According to him, GLP-1 drugs likely act on the mesolimbic system to “suppress the craving” that drives people to overconsume anything, whether it be food or other substances.
The researchers stated, however, that they do not know whether these effects will persist with long-term use of the medication or whether the brain will adapt and the GLP-1 effect will diminish.
“We are very interested in exploring this question in detail and trying to better understand this concept,” Al-Aly said.
The US Department of Veterans Affairs plans to conduct a large traditional clinical trial using semaglutide, the main component of Ozempic and Wegovy, in US veterans with alcohol use disorder.
Novo Nordisk stated that it is not currently conducting any clinical trials to evaluate the effectiveness of semaglutide in patients with substance use disorders or addiction-related diseases. Although changes in alcohol consumption are a secondary goal of its ongoing study of semaglutide in combination with other medications in patients with alcohol-related liver disease.
The Danish company also stated that it is aware of numerous studies investigating the effect of GLP-1 on reducing addictions and welcomes such unbiased research in this area.