GLP-1s may help reduce addiction to cigarettes, alcohol and opioids, research suggests

Evidence continues to mount suggesting that GLP-1 drugs can help people reduce smoking, drinking and opioid use.

As the drugs – which include semaglutide and tirzepatide – have grown in popularity, anecdotal reports have emerged of people who say they no longer feel the urge to drink alcohol or use drugs while taking GLP-1. Peer-reviewed studies have followed.

“An accumulating body of studies shows the positive potential of GLP-1 in drug addiction,” said Christian Hendershot, director of clinical research at the USC Institute for Addiction Science in Los Angeles.

Most of this research has focused on people with alcohol use disorders. The new study, published Wednesday in the BMJ, casts a much wider net, looking at the effects GLP-1s have on other drug use disorders, including cannabis, cocaine, nicotine and opioids.

For the study, researchers analyzed patient records for more than 600,000 people in the Department of Veterans Affairs database. The average age was about 65 and men made up 90% of the population in the study.

All patients had type 2 diabetes and took GLP-1 or another diabetes drug called a sodium-glucose cotransporter-2 inhibitor, or SGLT2.

Using the data, researchers simulated seven clinical trials, testing what effect GLP-1 appears to have on people with existing substance use disorders, and whether they appear to prevent substance use disorders from developing.

In a randomized clinical trial, people are recruited and given a drug or a placebo, and are followed for the duration of the study. The process takes years. So-called controlled simulated experiments, which use the same methods to analyze data already collected, can provide information very quickly.

“I consider it the strongest form of conclusive evidence, but it’s still something we want to confirm with randomized trials,” Fares Qeadan, associate professor of biostatistics at the Loyola Parkinson School of Health Sciences and Public Health in Chicago, told NBC News by email. Qeadan wrote an editorial published alongside the study.

The new results showed that among people with pre-existing substance use disorders, there were fewer emergency room visits, hospitalizations and deaths related to their drug use nationwide. That means that GLP-1 drugs may not only be a promising treatment for alcoholism, but also for other substance use disorders.

The fact that the results were consistent for all types of drugs – alcohol, opioids, stimulants – “really raises the idea that these drugs really work on the causes of all these drugs,” said Dr. Ziyad Al-Aly, an epidemiologist at Washington University in St.

“Here’s a trial with 600,000 people that doesn’t just teach opioids or nicotine or alcohol, but all of them. So it’s impossible for it to be coincidence or chance,” Al-Aly said.

About 50 million people in the United States live with a substance abuse problem, but few receive treatment, according to the National Institute on Drug Abuse.

A drug that treats many substance use disorders is needed, said Alex DiFeliceantonio, an assistant professor at Virginia Tech’s Fralin Biomedical Research Institute. The Food and Drug Administration has approved various medications to treat alcohol, opioid and nicotine use disorders, but none for marijuana, stimulants such as cocaine or sedatives such as benzodiazepines.

“Even with the drugs we have for alcohol use disorder and opioid use disorder, the relapse rates are really high,” said DiFeliceantonio, who was not involved in the study.

A new study also suggested that using GLP-1 drug in addition to another type of drug can help prevent a person from developing a drug use problem, although some experts say that this finding is weaker than the data showing that drugs can help treat existing diseases.

“Most people talk about this from a medical perspective,” said Hendershot, who was not involved in the new research. He added that the average age in the study was 65 years. “Most people would have had a substance use problem before that point.”

However, research has shown that GLP-1 drugs can reduce the likelihood of substance use disorders, he said.

Researchers are still looking at how this can curb drug and alcohol use. The theory is that GLP-1 drugs act on the reward signaling part of the brain.

“In obesity, when people take GLP-1 agonists, they describe the silencing of food noise, that constant chatter in their mind saying, ‘I’m thinking about what I’m going to eat,'” Al-Aly said. “I think the same thing happens with that anxiety about needing something. It’s quiet.”

Hendershot said that a number of clinical trials are already underway to test this idea more rigorously. Those results, which he said will be published in the next few years, will provide a definitive answer on whether GLP-1 drugs can help treat drug and alcohol addiction. However, medication probably won’t work for everyone.

“Substance use disorders are complex conditions. There are different reasons why people develop substance use disorders and why some treatments may be more effective for some than others. It is difficult to develop any drug, especially for substance use disorders, that works for everyone,” he said.