Overview
- The BMJ cohort tracked 606,434 U.S. veterans with type 2 diabetes for up to three years and found GLP-1 agonist users had a 14% lower risk of developing any new substance use disorder versus patients on other diabetes drugs.
- Risk reductions varied by substance, including opioids (25%), cocaine (20%), nicotine (20%) and alcohol (18%), according to the study summaries.
- Among people with existing substance use disorders, GLP-1 use was associated with fewer severe outcomes, including lower risks of overdose (39%), emergency care (31%), hospitalization (26%), suicidal thoughts or attempts (25%) and death (50%).
- Analyses used electronic health records and compared GLP-1 agonists such as semaglutide and tirzepatide with SGLT2 inhibitors including empagliflozin and dapagliflozin, which may limit generalizability beyond the veteran population.
- Scientists cite a plausible mechanism involving GLP-1 receptors in brain reward pathways, but emphasize that current first-line, substance-specific treatments should remain standard as randomized controlled trials and mechanistic studies are planned.