Weight-loss drugs like Ozempic may reduce opioid overdose rates

New popular weight-loss and anti-diabetes drugs may reduce the rate of opioid overdose or alcohol intoxication in people with substance use disorders, according to a new study.

The research, published in the monthly scientific journal Addiction, found that among people with opioid use disorder, those with a prescription for drugs like Ozempic (semaglutide) or Saxenda (liraglutide) had a 40 per cent lower rate of overdose.

Among those with alcohol use disorder, individuals who were taking the blockbuster weight-loss and type 2 diabetes drugs had a 50 per cent lower rate of alcohol intoxication.

The study adds to growing evidence that this class of drugs – known as glucose-dependent insulinotropic polypeptide (GIP), or glucagon-like peptide-1 (GLP-1) receptor agonists – may help people with substance abuse.

How was the study carried out?

Researchers analysed electronic health records from a large US database encompassing over 136 health systems. It included more than 500,000 people with opioid use disorder and more than 800,000 with alcohol use disorder.

Of those, there were roughly 8,100 people and 5,600 people, respectively, who had a prescription for a GIP/GLP-1 receptor agonist.

These drugs, marketed as Ozempic, Victoza, and Trulicity among others, work by mimicking a hormone in the intestine. They can trigger insulin and make people feel full after eating.

“The advantage of this study is there’s a ton of data, it goes back to 2014,” said Alexandra DiFeliceantonio, associate director of Virginia Tech’s Center for Health Behaviors Research in the United States.

“But, it’s not a controlled trial [so] there could be other factors driving the effects that you can’t account for without an experimental manipulation. That being said, studies like these are important,” DiFeliceantonio, who was not involved in the study, said in an email.

She was the co-author of a study published last year that found that people with obesity taking semaglutide (Ozempic or Wegovy) or tirzepatide (Mounjaro) had reduced alcohol consumption based on self-reports and says there’s a lot more work to be done and medications to test in this area.

Trials under way to study potential link

Dr Lorenzo Leggio, a physician-scientist at the US National Institutes of Health (NIH) told Euronews Health that the pre-clinical research including animal studies into the link between these drugs and reducing substance use was “very robust”.

His team published a study last year, for instance, that found that semaglutide reduced binge-like alcohol drinking in mice and rats.

But “we’re missing an important piece which is the double-blind placebo-controlled randomised clinical trials,” he said, where “you are comparing the medication to placebo”.

“We only have a couple of trials which are also relatively small. But the good news is that there are many clinical trials right now under way both in the United States and in Europe,” he added. 

His team is currently enrolling participants in a trial looking at semaglutide in alcohol use disorder, for instance.

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Why is it important to look into more treatment options for substance abuse?

Despite the availability of medicines and treatments to address substance use disorders, drug alternatives could offer “new options with potentially lower stigma,” according to Fares Qeadan, an associate professor of biostatistics at Loyola University Chicago in the US and lead author of the new study on opioid overdose and alcohol intoxication.

“With further validation, these medications might broaden the toolkit for managing opioid and alcohol use disorders, ultimately helping more people avoid relapse, overdose, and severe health consequences,” he said in an email.

The burden of opioid overdose is notably higher in the US than in European Union countries. The US saw more than 100,000 drug overdoses in 2022 and 2023, compared to around 6,400 in the EU in 2022.

Alcohol use, meanwhile, is prevalent in both areas, with the EU being the “heaviest-drinking area globally,” according to the World Health Organization (WHO).

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Leggio points out that the new study looking at overdose and intoxication is clinically relevant “because people die with opioid overdose and people die with alcohol intoxication”.

“People with alcohol use disorder often have opioid use disorder and vice versa, and when you mix alcohol and opioids together that’s a very deadly combo,” he said.

Growing evidence suggests that GIP and GLP-1 receptor agonists “may impact brain regions involved in reward and motivation, which also play a crucial role in addiction,” according to Qeadan, who said that they “appear to modulate satiety and craving pathways that overlap with neural circuits related to substance use behaviours”.

“Future research should focus on identifying the specific mechanisms through which GLP-1 and GIP receptor agonists impact addiction and overdose outcomes,” he added, such as trials tracking patient cravings and substance use behaviours.

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“Additionally, studying long-term outcomes and exploring these drugs’ effectiveness across diverse populations, particularly those at high risk of relapse, would be critical for shaping future treatment guidelines,” he said.