GLP-1 Medications and Addiction: Emerging ResearchGLP-1 Medications and Addiction: Emerging Research
Glucagon-like peptide-1 (GLP-1) receptor agonists are medications widely used to treat Type 2 Diabetes and increasingly obesity. Examples include medications such as semaglutide and liraglutide.
Recent research has begun exploring whether these medications may also influence brain pathways involved in addiction and substance use disorders.
What the research found
A large study published in The BMJ in 2026 analysed electronic health records from over 600,000 patients with Type 2 Diabetes treated within the US Veterans Affairs healthcare system.
Researchers compared patients who started a GLP-1 receptor agonist with those starting another diabetes medication class known as SGLT-2 inhibitors.
Over a follow-up period of up to three years, patients taking GLP-1 medications were found to have lower rates of several substance use disorders, including:
- Alcohol use disorder
- Cannabis use disorder
- Cocaine use disorder
- Nicotine dependence
- Opioid use disorder
Overall, GLP-1 receptor agonist use was associated with a lower combined risk of developing substance use disorders compared with the alternative medication group.
Findings in patients with existing substance use disorders
The study also examined outcomes in patients who already had a substance use disorder.
In this group, GLP-1 receptor agonists were associated with reduced risk of several serious outcomes, including:
- Emergency Department visits related to substance use
- Hospital admissions related to substance use
- Drug overdose
- Suicidal ideation or attempts
- Substance-related mortality
Why might this happen?
GLP-1 receptors are present in areas of the brain involved in reward, motivation, and impulse control.
Laboratory and animal studies suggest that GLP-1 medications may influence dopamine signalling in the brain’s reward pathways, which could potentially reduce the reinforcing effects of substances such as alcohol, nicotine, and opioids.
This has led researchers to explore whether these medications might one day play a role in addiction treatment research.
Important limitations
Although the findings are interesting, the study was observational. This means it cannot prove that GLP-1 medications directly prevent substance use disorders.
Other factors – such as health behaviour, underlying health conditions, or healthcare engagement – may also influence the results. In addition, the study population consisted largely of US veterans, which may limit how widely the findings apply to other populations.
What this means
GLP-1 receptor agonists remain medications primarily prescribed for Type 2 Diabetes and metabolic health conditions. However, the study highlights a growing area of interest in medicine: the connection between metabolic health, brain function, and addictive behaviour.
Further research – including randomised clinical trials – will be needed to determine whether these medications could have a future role in addiction treatment.
Source: Cai M, Choi T, Xie Y, Al-Aly Z. Glucagon-like peptide-1 receptor agonists and risk of substance use disorders among US veterans with type 2 diabetes: cohort study. BMJ. 2026;392:e086886.