Study Finds Ozempic-Class Drugs May Reduce Addiction Risk

A large study published in The BMJ found that people taking GLP-1 drugs - the class of medications that includes Ozempic - were less likely to develop substance use disorders than those not taking them. The research analyzed data from more than 600,000 veterans over a period of up to three years, according to NPR. Participants were originally prescribed GLP-1 drugs for Type 2 diabetes, not addiction treatment.

Among people without a prior history of substance use disorder, those taking GLP-1 drugs showed approximately 14% overall lower risk. Per substance (alcohol, nicotine, cannabis, cocaine, opioids), the reduction was 15-20%, per NPR and CNN. The breadth of that finding across multiple, chemically different substances was what drew attention from researchers outside the study.

Who Conducted the Research and How

The study was led by Dr. Ziyad Al-Aly, a clinical epidemiologist at WashU Medicine and the VA St. Louis Health Care System. His team compared health outcomes among veterans who were and were not prescribed GLP-1 medications, tracking diagnoses, hospitalizations, overdoses, and other clinical events, according to NPR. The VA patient population is predominantly older and male, though a separate analysis of women and younger men found similar patterns.

For participants who already had a documented substance use disorder, the results were more pronounced. Those taking GLP-1 drugs showed a 25% to 50% lower risk for emergency department visits, drug-related hospitalization, overdose, suicidal ideation, and death, according to NPR. Al-Aly described the consistency across substances as suggesting a shared biological mechanism - one centered on the brain’s dopamine-driven reward system, which GLP-1 drugs appear to dampen.

The Biological Explanation Researchers Propose

GLP-1 drugs appear to reduce dopamine activity in what researchers call the mesolimbic system - the part of the brain associated with reward, motivation, and stress response, according to NPR. Addiction researchers have long described this system as the one “hijacked” by addictive substances. The hypothesis is that by moderating that dopamine signal more broadly, GLP-1 drugs may reduce the pull of multiple addictive substances, not just one.

That would make GLP-1 drugs fundamentally different from existing addiction medications, which are designed to address a single substance. Dr. Lorenzo Leggio, an addiction researcher at the National Institutes of Health who was not involved in the study, told NPR that the prospect of a single medication addressing multiple substance disorders simultaneously could significantly change how treatment is structured for the estimated 50 million Americans with substance use disorder.

What Researchers Say Is Still Unknown

Despite the scale of the study, experts emphasized that it is observational - meaning it identifies associations rather than proving cause and effect, according to CNN. People starting GLP-1 drugs may differ from those who are not in ways that influence outcomes beyond the medication itself, including increased clinical engagement and motivation to change behaviors. Randomized controlled trials, which randomly assign participants to treatment and control groups, are needed to confirm whether the drugs themselves are producing the effect.

Dr. Klara Klein, an endocrinologist at the UNC School of Medicine, told NPR that GLP-1 drugs have not been tested in people who do not have obesity or Type 2 diabetes - the populations currently approved for the medications. Several large clinical trials focused specifically on addiction are underway or in planning, with results expected in the coming year. Until those findings are available, widespread use of GLP-1 drugs for addiction treatment is not recommended by the researchers involved in the study.

References: GLP-1s like Ozempic transformed weight loss and diabetes. Is addiction next? | GLP-1s may have potential to treat addiction, evidence suggests