Researchers identified a strong association between GLP-1 medications and reduced rates of multiple substance use disorders, raising new questions about how these drugs may affect the brain’s reward system.
What if some of the world’s most popular weight loss drugs are affecting more than appetite?
A new study suggests that GLP-1 medications, a class of drugs that includes Ozempic, may be linked to substantially lower rates of several substance use disorders. The findings add to growing interest in the possibility that these medications influence the brain’s reward system, an effect that could extend beyond eating behavior.
Researchers at The University of Texas at El Paso analyzed health data from more than 142,000 people with type 2 diabetes or obesity. Roughly 20,000 of those patients had been prescribed a GLP-1 medication. The team compared them with similar individuals who were not taking the drugs to determine whether rates of substance use disorders differed between the groups.
Their findings, published in Frontiers in Psychiatry, revealed a consistent pattern: GLP-1 users were significantly less likely to be diagnosed with alcohol, opioid, nicotine, or cocaine use disorders.
“Our findings add to growing evidence that GLP-1 medications may influence more than appetite and blood sugar regulation,” said lead author Abegaz. “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.”
Significant Associations Observed Across Multiple Disorders
Compared with similar patients who were not taking GLP-1 medications, users showed:
- 74% lower odds of alcohol use disorder
- 69% lower odds of opioid use disorder
- 68% lower odds of nicotine use disorder
- 75% lower odds of cocaine use disorder
The researchers stressed that the findings show an association, not proof that GLP-1 medications prevent substance misuse or addiction.
“We do not support prescribing these medications for addiction treatment at this time, Frietze said. “Because this was an observational study in a specific clinical population, randomized clinical trials are needed before GLP-1 medications can be recommended for treating addiction.”
Researchers Plan Further Investigation
The team said the results are encouraging and plans to further investigate how GLP-1 medications may influence substance use disorders.
“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 the substance use behaviors occur after treatment begins and whether these changes related to improvements in mental health and quality of life.
He added, “Ultimately, this work will help inform whether GLP-1 medications could become part of future treatment strategies for substance use disorders.”
Reference: “Association between GLP-1 receptor agonist use and substance use disorders among individuals with type 2 diabetes or obesity: a nested case-control study in the All of Us research program” by Tadesse M. Melaku Abegaz, Muktar Ahmed, Akshaya Srikanth S Bhagavathula and Gabriel Frietze, 18 February 2026, Frontiers in Psychiatry.
DOI: 10.3389/fpsyt.2026.1766770
Patient data for this study was provided by the National Institutes of Health All of Us Research program, one of the nation’s largest and most diverse health databases.
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