GLP-1 Weight-Loss Drugs Could Address a Range of Addictions

“There are a smattering of studies here and there, small studies that look at one type of substance use—for example, alcohol—but there really is not a single human study that comprehensively evaluates two things: 1) the risk of new onset substance use disorders across all major substances, and 2) harm reduction, or the question of do these drugs really reduce the risk of drug overdoses, drug deaths, drug-related hospitalizations, emergency room visits, and suicides,” says Al-Aly.

He and his team analyzed health records from more than 600,000 people in the Department of Veterans Affairs system, who represented a broad swath of the population, although most were men. All of the participants were diagnosed with diabetes and prescribed either a GLP-1 drug like Ozempic or Mounjaro, or a different group of diabetes medications known as SGLT2 inhibitors, such as Farxiga or Jardiance. While GLP-1 drugs work in the brain, the SGLT2 drugs do not, acting instead on the kidneys to remove excess sugar. That’s why previous studies suggested that GLP-1 drugs could have benefits in treating addictions—as weight loss drugs, they suppress the reward signals in the brain, in the mesolimbic system, that reinforce cravings and so-called food noise that many people with obesity report. Addictive substances such as nicotine, alcohol, cocaine, and opioids tap into the same brain region to reinforce cravings for and dependence on those substances.