Popular diabetes and weight-loss drug associated with lower opioid overdose risk

Since being deemed a public health emergency in 2017, opioids are responsible for 72% of drug overdose deaths in the United States, according to the National Center for Drug Abuse Statistics.

New research from the Case Western Reserve University School of Medicine identifies a potential new approach to address the opioid overdose epidemic—which has devastated families and communities nationally.

The study, published in the journal JAMA Network Open, suggests semaglutide is linked to lower opioid overdoses in people with opioid-use disorder (OUD) and type 2 diabetes (T2D).

Semaglutide, a glucagon-like peptide receptor (GLP-1R) molecule that decreases hunger and helps regulate blood sugar in T2D, is also the active component in the diabetes and weight-loss drugs Wegovy and Ozempic.

The research team—led by biomedical informatics professor Rong Xu—analyzed six years of electronic records of nearly 33,000 patients with OUD who also had T2D. The researchers used a statistical approach that mimics a randomized clinical trial.

They found patients prescribed semaglutide had a significantly lower risk for opioid overdose, compared to those who had taken any of eight other anti-diabetic medications, including other types of GLP-1R-targeting medications.

About 107,500 people died from drug overdoses nationally in 2023, mostly from opioids, according to the CDC. Despite effective medications to prevent overdoses from OUD, the CDC estimates only a quarter of those with OUD receive them and about half discontinue treatment within six months.

“Not everyone receives or responds to them,” said Xu, also director of the medical school’s Center for AI in Drug Discovery. “As a result, alternative medications to help people treat opioid use disorder and prevent overdosing are crucial. Therefore, our findings suggest that it is important to continue studying semaglutide as a possible new treatment for combating this terrible epidemic.”

Nora D. Volkow, director of the National Institute for Drug Abuse, co-led the study.

Although their findings potentially support the idea that semaglutide could treat OUD and prevent overdoses, the study’s limitations restrict the researchers from making firm causal conclusions, Xu said. Semaglutide’s use will need to be further investigated through randomized clinical trials, the researchers said.