People taking semaglutide medications like Ozempic for diabetes may be at reduced risk of drug overdose, according to new research.
Prescriptions for semaglutide, which includes Ozempic and Rybelsus, were linked to lower overdose rates among patients with type 2 diabetes who were also diagnosed with opioid use disorder, according to a paper published Wednesday.
The findings add to a limited but growing body of evidence that the blockbuster medications may be more than just appetite suppressants. Recently, a small number of studies have suggested the medications can help people cut down on potentially harmful behaviors including drinking and smoking.
But the paper’s authors, including researchers at Case Western Reserve University and Nora Volkow, the director of the National Institute on Drug Abuse, cautioned that the link between GLP-1 drugs and prevention of overdose deaths is “unclear” and that more research is needed, including randomized controlled trials.
“GLP-1 medications have transformed the clinical management of type 2 diabetes and obesity by reducing associated morbidity and mortality. There is also emerging evidence of their potential in the treatment of various neurological and psychiatric disorders, including substance use disorders,” Volkow said in a statement. “The preliminary findings from this study point to the possibility that GLP-1 medications may have value in helping to prevent opioid overdoses.”
The study was based on six years of observational data from de-identified electronic health records. Eligible study subjects were restricted to patients diagnosed with type 2 diabetes and opioid use disorder, and who were prescribed semaglutide or other diabetes medications.
Overall, in a study of over 33,000, semaglutide was associated with “significantly lower” risk of opioid overdose compared to patients taking other diabetes medications, including others that also target the GLP-1 receptor.
Even if the findings are validated, however, it’s unclear what implications they hold for the drug overdose crisis and for public health more broadly.
Of the estimated 2 million Americans with opioid use disorder, it’s unclear how many also have diabetes or weight-related conditions that could prompt them to seek GLP-1s — and, given the medications’ price tag, how many could access them, even if they were interested.
Moreover, it is unclear whether people taking GLP-1s who also have opioid use disorder are those who are using the riskiest drugs. For years, the ultra-potent synthetic opioid fentanyl has accounted for the lion’s share of all U.S. overdose deaths, while deaths from prescription opioids like oxycodone and hydrocodone recently dropped below 10,000 in a recent 12-month period — a notable number that nonetheless pales in comparison to the roughly 65,000 fentanyl deaths that occurred during the same stretch.
GLP-1 drugs are also known to have significant side effects. In a small study earlier this year of people with opioid use disorder, more than 50% of patients taking liraglutide, another GLP-1, failed to complete a three-week trial due to gastrointestinal distress.
Still, medications like Wegovy and Ozempic could provide another option for patients struggling to access more traditional addiction medications like methadone or buprenorphine.
“Alternative medications to help people treat opioid use disorder and prevent overdosing are crucial,” said Rong Xu, a co-leader of the study and the professor of biomedical informatics at Case Western. “Therefore, our findings suggest that it is important to continue studying semaglutide as a possible new treatment for combating this terrible epidemic.”
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