Overview
- Analyzing records for more than 600,000 U.S. veterans with type 2 diabetes, researchers found a 14% lower overall risk of developing new substance use disorders after starting a GLP-1 receptor agonist.
- Substance-specific reductions among those without prior diagnoses included alcohol (18%), cannabis (14%), cocaine (20%), nicotine (20%), and opioids (25%).
- Compared with SGLT2 inhibitors, GLP-1 use in veterans with existing substance use disorders was linked to 31% fewer substance-related emergency visits, 26% fewer hospitalizations, 39% fewer overdoses, 25% fewer suicidal events, and roughly half the deaths.
- The BMJ cohort used a target-trial emulation over up to three years, comparing new GLP-1 prescriptions to SGLT2 drugs to reduce bias in observational analyses.
- Authors note limits to generalizability due to a predominantly older male VA population and emphasize that randomized trials are needed to test causality and clinical use.