New study: GLP-1s associated with lower overdose and alcohol intoxication
40% lower overdose and 50% less intoxication-related medical encounters in a new retrospective study
A new, large retrospective study of patient health records shows a 40% drop in opioid overdoses and a 50% drop in cases of alcohol intoxication among people who received GLP-1RAs (typically for diabetes or obesity).
These dramatic results add to the rapidly growing evidence of strong anti-addictive and substance-use reducing effects of these medications, across alcohol, nicotine, opioids, and stimulants. We have published the most comprehensive and up-to-date review of the current scientific and medical evidence on GLP-1s for addiction, which has been updated today to include this new paper.
The study shows much lower rates of these negative incidents in the first month after GLP-1 prescribing:
Yet, notwithstanding this gradual decline in those not prescribed, rates of overdose and intoxication among those prescribed were immediately low even in the first month following index encounter and remained lower throughout the study period.
The index encounter was defined as the first instance of a GIP/GLP-1 RA prescription or a randomly selected encounter for patients without such prescriptions, both occurring after a first diagnosis date of OUD or AUD.
As this is a retrospective study, there could potentially be self-selection bias in either direction— for example, you could imagine that people receiving a GLP-1 in a medical encounter may be making an effort to improve their health, and therefore could be reducing drug and alcohol use as well. Or you could also argue the inverse— that an encounter for a GLP-1 prescription could indicate that a health condition has worsened, relative to a random medical encounter that could be a positive checkup. That said, the effect sizes seen here are consistent with the randomized trials and other retrospective studies that have been recently reported.
Notably, this study includes a whole bunch of GLP-1 drugs, including much older GLP-1s that have lower anti-obesity and anti-addictive effects:
abiglutide (Eperzan, Tanzeum), dulaglutide (Trulicity), exenatide (Byetta, Bydureon), liraglutide (Victoza, Saxenda), lixisenatide (Adlyxin, Lyxumia), semaglutide (Ozempic, Rybelsus, Wegovy) and tirzepatide (Mounjaro)
It’s possible that associations that were found would be even stronger if the study had looked exclusively at semaglutide and tirzepatide, which are the current best-in-class options for weight loss. We reached out to Dr. Qeadan about this issue and he told us that a follow-up study is in progress which will be examining these newer GLP-1s specifically.