New Delhi: Medications that have gained global attention for helping people lose weight and manage diabetes may be influencing something else as well — substance addiction. A large study published in The BMJ has found that drugs belonging to the GLP-1 class could lower the risk of developing addiction to substances such as alcohol, nicotine, cocaine, and opioids. The research looked at medical records from more than 600,000 people in the United States Department of Veterans Affairs (VA) health system, one of the largest healthcare networks in the country.
GLP-1 drugs work by mimicking a natural hormone called glucagon-like peptide-1, which helps regulate appetite and blood sugar levels. They are widely prescribed today for type 2 diabetes and, increasingly, for obesity. Over the past few years, however, doctors have started noticing something curious during routine consultations.
Some patients taking these medications reported that their desire to drink alcohol or smoke seemed to fade. Others said they simply felt less interested in substances they previously used regularly. These anecdotal reports caught the attention of researchers, who began exploring whether the drugs might be affecting the brain’s reward system.
To investigate further, the research team turned to the VA’s massive electronic health records database. They compared people with type 2 diabetes who were prescribed GLP-1 medications with another group who were treated with a different class of diabetes drugs known as SGLT-2 inhibitors. Both groups were followed for up to three years after starting treatment.
When researchers examined outcomes, they noted a consistent trend—people who were taking GLP-1 drugs were less likely to develop substance disorders during a follow-up period than those who relied upon alternative medication.
The reductions were seen across several substances. The risk of alcohol-use disorder was about 18 percent lower among people using GLP-1 drugs. For cannabis, the risk dropped by around 14 percent. Nicotine- and cocaine-related disorders were roughly 20% less common, while the odds of opioid-use disorder were lower by 25%.
The study also looked at people who were already struggling with substance-use disorders. In this group, people taking GLP-1 medication appeared to have a much lower risk of dying from substance-related causes. The research stated that the risks could be easily reduced to almost half.
Researchers say the consistency of these findings is striking, particularly because the substances involved affect the brain in different ways. One possible explanation is that GLP-1 drugs may influence the brain circuits linked to reward, motivation, and cravings—pathways that are closely tied to addictive behaviour.
Still, scientists caution that results should not be interpreted as proof that medication can directly prevent addiction. But because the study relied on medical records rather than controlled clinical trials, it could only indicate an association, not cause and effect.
Experts say larger, carefully designed trials will be needed before GLP-1 drugs can be considered a treatment option for substance-use disorders. Even so, the findings add to the growing list of unexpected health effects linked to these medications.
Originally developed to control blood sugar and later embraced for weight management, GLP-1 drugs may yet prove to have a wider impact on human health than researchers first imagined.
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