Following the recent surge in the popularity of weight loss drugs such as semaglutide and tirzepatide, researchers are noticing additional benefits these drugs bring to users, particularly their potential to mediate problematic substance abuse. Semaglutide and tirzepatide are glucagon-like peptide-1 receptor agonists (GLP-1 RA), with tirzepatide having additional glucose-dependent insulinotropic polypeptide (GIP) agonistic properties. These medications target receptors located in the mesolimbic system in the brain, which simultaneously regulates appetite and satiety as well as the development and maintenance of addictive behaviours. This led to the hypothesis that GIP/GLP-1 RA may be effective in treating substance use disorders via the same reward-response pathway. To look into the significance of this connection, a retrospective cohort study was conducted to investigate the association between GIP/GLP-1 RA prescriptions and treatment outcomes in alcohol use disorder (AUD) patients and opioid use disorder (OUD) patients respectively1. Results show that among those with GIP/GLP-1 RA prescriptions, rates of incidence of opioid overdose among OUD patients were 40% lower than those without. When comorbidities like type 2 diabetes mellitus (T2DM) and obesity are considered, OUD patients with GIP/GLP-1 RA prescriptions still experienced 38% and 33% lower rates of opioid overdose compared to those without respectively. Similar findings were observed among AUD patients, where 50% lower rates of alcohol intoxication were experienced by patients with GIP/GLP-1 RA prescriptions. With T2DM and obesity accounted for, 49% and 42% lower rates of alcohol intoxication were seen in those with GIP/GLP-1 RA prescriptions than those without. These study results have significant implications for clinical practice regarding substance abuse treatments, encouraging the incorporation of weight loss medications. Future prospective research with better control for confounders will be helpful in studying the long-term efficacy and safety of weight loss drugs for the treatment of problematic substance abuse.
References
1. Qeadan F, et al. Addiction [Internet]. 2024 Oct 16; Available from: https://doi.org/10.1111/add.16679
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