A large observational study published in The BMJ on 4 March 2026 reports that GLP-1 medications — the class that includes diabetes and weight-loss drugs such as Ozempic and Wegovy — are associated with a lower risk of substance use disorders across every major addictive substance, and with fewer severe outcomes among people who already have such a disorder. The findings echo a growing stream of anecdotes, from online forums and clinics, that these drugs can dull cravings for alcohol, nicotine and other substances.
What the study looked at
Researchers, led by Ziyad Al-Aly of Washington University in St. Louis, drew on records from more than 600,000 US military veterans with type 2 diabetes in the Veterans Affairs health system, following them for roughly three years. Veterans prescribed a GLP-1 receptor agonist for their diabetes were compared with those taking other diabetes treatments not previously linked to reduced addiction. The scale of the dataset is what sets the work apart: where earlier research tended to examine one substance at a time, this analysis looked across the full range of substance use disorders at once.
What it found
Among veterans with no prior history of a substance use disorder, GLP-1 use was associated with a 14 percent lower risk across all substance use conditions combined, with the largest reduction — about 25 percent — seen for opioid use disorders. The signal was even stronger among veterans who already had a substance use disorder. In that group, starting a GLP-1 drug was associated with fewer substance-related emergency department visits (around 31 percent), hospital admissions (26 percent), overdoses (39 percent), instances of suicidal ideation or attempts (25 percent), and deaths (about 50 percent).
A possible mechanism
GLP-1 drugs mimic a gut hormone that increases insulin production and promotes a feeling of fullness, but receptors for that hormone also appear in the brain’s mesolimbic system — circuits that govern reward, motivation, impulse control and stress. Many patients describe a quieting of “food noise,” the persistent mental chatter about eating; researchers hypothesise that the drugs may similarly quiet a kind of “drug noise,” the recurring craving that pulls people back to a substance. Patricia “Sue” Grigson, an addiction neuroscientist at Penn State who was not involved in the study, said the breadth of the apparent effect was encouraging, while cautioning that much remains to be understood. Some scientists suggest the work hints at a common biological pathway underlying many addictions.
Limitations and what to watch
Several caveats temper the optimism. This is an observational cohort study: it can establish association but not prove that the drugs caused the lower risk, since people prescribed GLP-1 medications may differ from others in ways the analysis cannot fully capture. The population — predominantly older, male US veterans with type 2 diabetes — may not represent the general public, and results could differ in women, younger people, or those without diabetes. Importantly, GLP-1 drugs are not approved as treatments for addiction, and the study does not establish a dose, duration or safety profile for that purpose. Confirming the effect would require randomised controlled trials designed specifically to test addiction outcomes. Anyone considering these medications should do so with a clinician and for an approved indication.
The peer-reviewed results are summarised by BMJ Group, with additional reporting from Scientific American.
