SUD
Loren Bonner
Motivated by the growing public health challenges from opioid and alcohol use disorders, researchers may have found one more area where GLP-1 receptor agonists are benefiting patients: curbing addiction.
At least from the literature, it seems like GLP-1s can’t go wrong for health outcomes. The drugs, initially prescribed to patients for diabetes, have shown promising effects on weight and appetite regulation. In a study published October 16, 2024, in AddictionAddiction, researchers have now found that patients with GLP-1 prescriptions demonstrated lower rates of opioid overdose and alcohol intoxication compared with those individuals who didn’t have such prescriptions.
“This adds a layer of potential benefits to [GLP-1s] beyond metabolic effects, indicating they could one day be integrated with existing treatment strategies for addiction,” said Fares Qeadan, PhD, lead study author. “These findings suggest that [GLP-1s] might be valuable adjuncts in treating substance use disorders, offering a new tool to mitigate severe outcomes, such as overdose and intoxication in opioid and alcohol use.”
However, he said further clinical research is necessary before GLP-1s can be recommended for this purpose. As an observational study, the research establishes associations but not causality, underscoring the need for randomized clinical trials to confirm the results.
Researchers used EHR data from roughly 136 health systems in the United States, covering over 100 million patients and spanning 2014 to 2022. The study included 503,747 patients with a history of OUD and 817, 309 patients with a history of alcohol use disorder who were 18 years old or older.
Reward pathways
Qeadan and the research team wanted to see if GLP-1s could offer protective effects against severe outcomes in opioid and alcohol use disorders. This class of medications seems to have an influence on the reward and craving pathways associated with addiction—as seen with the benefits GLP-1s have on weight and appetite regulation.
“The standout finding was the significant association between [GLP-1] use and lower rates of severe outcomes like opioid overdose and alcohol intoxication,” said Qeadan, who is from the Parkinson School of Health Sciences and Public Health at Loyola University Chicago. “While we expected some protective effect based on initial literature, the strength of these associations was surprising. Additionally, we observed that the protective association was slightly stronger in patients with alcohol use disorder, which may hint at differences in how these medications interact with the brain’s reward pathways for various substances.”
GLP-1s influence the brain’s reward system—especially in regions that process motivation, pleasure, and craving, like the nucleus accumbens. They appear to modulate dopamine signaling pathways, which are also heavily involved in addiction, said Qeadan.
“By dampening the reward response, [GLP-1s] might reduce cravings and the reinforcing effects of addictive substances, making it easier for patients to manage substance use,” he said.
Neuroimaging studies could also help clarify how these drugs interact with brain reward pathways specifically related to addiction.
Future research
“Our findings align with preliminary studies and animal research that suggest [GLP-1s] can impact addictive behaviors,” said Qeadan. “This is consistent with the existing knowledge of how GLP-1s modulate appetite and craving, which are central to both substance use and obesity.”
He said future research should focus on clinical trials to determine the causal effects of GLP-1s on substance use outcomes, optimal dosing, and treatment duration for addiction.
“With further research, [GLP-1s] may expand pharmacists’ roles in supporting patients with substance use disorders, underscoring the importance of interdisciplinary approaches in modern health care,” said Qeadan.
Examining the potential impacts of GLP-1s on other types of addiction, such as nicotine or stimulants, could broaden their applicability in addiction treatment.
“For pharmacists, these findings highlight the evolving scope of [GLP-1s] beyond metabolic disorders, as well as the potential for new roles in addiction management,” said Qeadan “It’s an exciting time in pharmacotherapy, as real-world data increasingly informs our understanding of drug effects in broader contexts.” ■