Injections that reduce weight and treat diabetes could also cut the risk of dying from substance-use disorders.Credit: Jill Connelly/Bloomberg/Getty
Blockbuster GLP-1 medications might help people to avoid becoming addicted to drugs, including alcohol, cocaine and opioids, a massive study1 suggests. It also found that, for those already dealing with addiction, the treatments are linked to a 50% reduction in the risk of dying from substance abuse.
The findings, published today in The BMJ, come from an analysis of electronic health records from more than 600,000 people in the database of the US Department of Veterans Affairs (VA), which provides care for millions of military veterans. The study is the latest suggesting that GLP-1 drugs — which mimic a hormone called glucagon-like peptide 1 and are mainly prescribed to treat obesity and type 2 diabetes — can also play a part in curbing addiction.
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The study’s large number of participants is unique and allowed researchers to evaluate the effect of GLP-1 drugs on the risk of several substance-use disorders. “The consistency of effect across multiple substances, which have different mechanisms of action, was quite a revelation,” says Ziyad Al-Aly, a co-author and a clinical epidemiologist the VA St Louis Health Care System in Missouri.
The observational study confirms what physicians are seeing in their clinics and the results of some small clinical trials2. But larger clinical trials are still needed to demonstrate whether the drugs could truly help people with substance-use disorders, specialists say.
“We have our patients telling us, ‘I don’t feel like I want to smoke any more. I don’t really have the interest in drinking any more,’” says Daniel Drucker, an endocrinologist at the University of Toronto in Canada. “There’s no question this is real and there are responders. But, so far, we don’t have a really robust, randomized, controlled clinical trial.”
Treasury of data
Intrigued by people’s reports of reduced alcohol cravings while taking GLP-1 drugs, Al-Aly turned to the VA’s database of electronic health records. “It’s a colossal data system and it creates a great opportunity,” he says.
Al-Aly and his colleagues used the database to compare two groups of people with type 2 diabetes: the treatment group, which had been prescribed GLP-1 drugs, and the control group, which had been prescribed a different class of diabetes medication, called sodium-glucose cotransporter-2 (SGLT-2). They were followed for up to three years after they began taking either medication.
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Among the GLP-1 users with no history of addiction, the risk of developing a substance-use disorder over the three-year period was 18% lower for alcohol, 14% lower for cannabis, 20% lower for cocaine, 20% lower for nicotine and 25% lower for opioids than among those in the control group.
