GLP-1 drugs – Ozempic and Wegovy – linked to lower use of risky substances

A University of Texas at El Paso study has found that people with type 2 diabetes or obesity who used glucagon-like peptide-1 receptor agonists had lower odds of alcohol, opioid, nicotine and cocaine use disorders, although researchers said clinical trials were needed before the drugs could be considered for addiction treatment

A study led by researchers at The University of Texas at El Paso, USA, has found that the use of diabetes and weight loss medicines such as Ozempic was associated with a lower risk of alcohol, opioid, nicotine and cocaine use disorders.

The research examined patient data from more than 142,000 people with type 2 diabetes (T2DM) or obesity. Of these, around 20,000 had been prescribed glucagon-like peptide-1 (GLP-1) receptor agonists. The investigators compared people who had used these drugs with clinically similar patients who had not received them, then assessed whether either group was more or less likely to develop substance use disorders.

GLP-1 receptor agonists were originally developed to treat T2DM and obesity. They act partly by imitating a gut hormone involved in appetite regulation, insulin secretion and blood glucose control. In recent years, medicines in this class, including semaglutide – which is the active ingredient in both Ozempic and Wegovy – have attracted intense scientific and public interest because of their effects on body weight and cardiometabolic risk.

The El Paso team said emerging evidence suggested that GLP-1 medicines might also affect brain systems involved in reward, reinforcement and craving. These neural pathways are relevant not only to eating behaviour but also to the use of addictive substances such as alcohol, opioids, nicotine and cocaine.

“Our findings add to growing evidence that GLP-1 medications may influence more than appetite and blood sugar regulation,” said Dr Tadesse Abegaz, lead author and researcher at the UTEP School of Pharmacy.

“These medications appear to affect brain pathways involved in reward and craving, which could help explain the lower rates of substance use disorders observed in our study,” he added.

The study reported that people who took GLP-1 medicines had respectively reduced chances of:

• • alcohol use – 74 per cent lower
  • opioid use – 69 per cent lower
  • nicotine use – 68 per cent lower
  • cocaine use – 75 per cent lower

when compared to patients who did not receive the medicines.

The authors emphasised that the findings showed association rather than causation. The study did not prove that GLP-1 medicines directly prevented substance misuse or addiction, nor did it not support their immediate use as addiction treatments. Observational studies can identify patterns in real-world clinical data but they cannot fully exclude other confounding differences between patient groups which may explain the results.

“We do not support prescribing these medications for addiction treatment at this time,” said Dr Gabriel Frietze of the UTEP School of Pharmacy.

“This was an observational study in a specific clinical population [consequently] randomised clinical trials are needed before GLP-1 medications can be recommended for treating addiction,” he explained.

The researchers said the results were nevertheless promising and warranted further study. The possibility that GLP-1 medicines could reduce craving or alter reward-related behaviour has become an active area of investigation, particularly as these drugs become more widely used for diabetes, obesity and weight management.

“Our next goal is to conduct prospective research that follows individuals initiating GLP-1 therapy over time,” Abegaz said.

“We aim to evaluate whether changes in substance use behaviours occur after treatment begins and whether these changes are related to improvements in mental health and quality of life.

“Ultimately, this work will help inform whether GLP-1 medications could become part of future treatment strategies for substance use disorders,” he concluded.

Patient data for the study was provided by the US National Institutes of Health ‘All of Us Research Program’, one of the largest and most diverse health databases in the USA. The programme was designed to support biomedical research by collecting health information from participants across a broad range of backgrounds, which may help researchers to assess health patterns across more representative populations.

For further reading please visit: 10.3389/fpsyt.2026.1766770