Overview
- Published in The BMJ, the analysis examined 606,434 Veterans Affairs patients with type 2 diabetes, comparing new GLP-1 users with SGLT2 inhibitor users over up to three years.
- GLP-1 initiation was associated with about a 14% lower risk of any substance-use disorder, including 18% for alcohol, 14% for cannabis, 20% for cocaine and nicotine, and 25% for opioids.
- Among patients with existing substance-use disorders, GLP-1 use correlated with 31% fewer emergency visits, 26% fewer hospitalizations, 39% fewer overdoses, and roughly 50% fewer drug-related deaths.
- The authors estimated absolute benefits of about seven fewer new diagnoses and 12 fewer serious harm events per 1,000 GLP-1 users over three years.
- Researchers point to plausible effects on brain reward pathways but caution that the observational VA cohort may have residual confounding and limited generalizability, and multiple academic, NIDA and industry trials are planned or underway to test causality.