The latest findings note that those prescribed Ozempic and GLP-1 equivalents have stronger chances of not becoming dependent on excessive drinking, opioids and other substance use and nicotine. For anyone researching addiction treatment options, the findings represent the latest and most specific data point in a fast-moving area of research.
Researchers at The University of Texas at El Paso’s School of Pharmacy, analyzed more than 142,000 patient cases. Around 20,000 of them had prescriptions for GLP-1 medications to manage type 2 diabetes or obesity. Researchers then compared substance use disorder rates between GLP-1 users and similar patients not on the medications.
The Research Findings
The striking results reverberated across every substance category studied. Patients taking GLP-1 medications experienced the following:
- 74% lower odds of alcohol use disorder
- 75% lower odds of cocaine addiction
- 69% lower odds of opioid dependency
- 68% lower odds of nicotine use disorder
All patient data came from the NIH’s All of Us Research Program, one of the largest and most diverse health databases in the country.
GLP-1s May Affect Substance Use Disorders
GLP-1 medications were originally developed to treat obesity and diabetes by regulating blood sugar and appetite. But emerging research points to a broader neurological effect. These drugs appear to influence dopamine signaling and the brain’s reward pathways, which are the same circuitry implicated in addiction.
“Our findings add to growing evidence that GLP-1 medications may influence more than appetite and blood sugar regulation,” noted lead author Dr. Tadesse Abegaz. GLP-1 seemed to affect the brain’s part in cravings and seeking rewards, which, Abegaz relayed, might explain the “lower rates of substance use disorders observed in our study.”
This fits with a pattern across multiple studies. Earlier research drawing on work from researchers at NIDA and NIAAA found that GLP-1s may modulate the neurobiological pathways underlying addictive behaviors, with early clinical trials showing encouraging signals for alcohol, opioids, and tobacco.
A large-scale analysis of 600,000+ U.S. veterans found GLP-1 users had a 14% overall risk of developing any substance use disorder with risk reductions up to 25% for opioids and 50% decline in drug-related deaths among those with disorders. The UTEP findings included different and broader patient populations using NIH data to add meaningful weight to that picture.
Clinical Use Possibilities
Despite the significant associations found, the UTEP team carefully avoids speculation about addiction treatment at this stage.
The research team doesn’t support prescribing these medications for addiction treatment right away. Co-author Dr. Gabriel Frietze pointed out that their study was observational in nature with a specific clinical population. He stated that further randomized clinical trials should be conducted before any GLP-1 medications can hit the market.
The study doesn’t establish cause and effect, and GLP-1 medications haven’t been approved or validated as a standalone addiction treatment. The research team’s planned follow-up will track individuals beginning GLP-1 therapy over time. They’ll evaluate whether substance use behaviors shift after treatment starts and whether those changes connect to improvement in any concurrent mental health conditions.
Applying the Findings to Treatment Seekers
GLP-1 medications aren’t currently part of approved addiction treatment protocols, and current guidelines have not changed. However, people who qualify for a GLP-1 drug on other grounds — such as obesity or type 2 diabetes — may want to discuss with their prescribing physician how that medication fits into their overall care picture, including any prescriptions taken for substance misuse.
Ongoing behavioral therapy and counseling remain the foundation of effective addiction treatment, regardless of what the GLP-1 research ultimately shows.
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