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The Study

Glucagon-like peptide-1 receptor agonists and risk of substance use disorders among US veterans with type 2 diabetes: cohort study

In simple terms

This study looked at medical records of hundreds of thousands of veterans with diabetes to see if those who started a certain diabetes drug (GLP-1 agonists) were less likely to develop drug or alcohol problems. It found a link, but because people weren’t randomly assigned to drugs, we can’t say for sure the drug caused the difference—it might be other factors.

53%

Analysis score

53/ 72

Maximum 72 for a cohort study.

Where the score came from

Reporting0
Methodology56
Publication100
Statistical54
Study type (basis of the score)
Cohort Study
Level 2b - Individual cohort study
What’s the bottom line?

This study checks if a type of diabetes medicine (GLP-1 agonists) helps prevent addiction or makes it less dangerous in veterans with diabetes.

Where does this study sit?

Reviews of RCTs (Meta-analyses)

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Cohort Studies
Level 2b
53

53 / 100

Quality score

Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.

Cannot establish causation

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Key takeaways

Summary

Based on the study abstract and findings.

  1. 1The results suggest meaningful real-world benefits, especially in high-risk groups, though the effect varies by outcome.
  2. 2For every 1000 people, 6.6 fewer got a new addiction problem.
  3. 3Among those already struggling, 8.9 fewer went to the ER, 6.2 fewer were hospitalized, and 1.5 fewer died from addiction issues over 3 years.

Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data

Publication

Journal

BMJ

Year

2026

Authors

Miao Cai, Taeyoung Choi, Yan Xie, Ziyad Al-Aly

Open Access
Analysis v5

Related Content

Claims (6)

Assertion

Starting diabetes drugs like semaglutide or liraglutide might lower the chance of developing substance use problems, and this seems to be true for people of different ages, weights, races, and types of the drug.

Correlational
Read analysis
Assertion

For US veterans with type 2 diabetes, starting a GLP-1 drug (like Ozempic) might help lower the chance of developing addiction problems—like with alcohol, drugs, or smoking—over three years compared to starting a different diabetes drug called an SGLT-2 inhibitor.

Correlational
Read analysis
Assertion

For US veterans with type 2 diabetes, taking GLP-1 drugs might help lower the chance of getting hooked on opioids over three years compared to another diabetes drug, SGLT-2 inhibitors — about 1 fewer case for every 1,000 people.

Correlational
Read analysis
Assertion

For US veterans with diabetes and substance use issues, taking GLP-1 drugs (like Ozempic) might lower their chances of ending up in the ER, being hospitalized, or dying from substance-related problems compared to those taking a different diabetes drug called SGLT-2 inhibitors.

Correlational
Read analysis
Assertion

For US veterans with type 2 diabetes and a history of substance use, starting a GLP-1 drug (like Ozempic) may lower their chances of overdosing on drugs or having suicidal thoughts compared to starting a different diabetes drug called an SGLT-2 inhibitor.

Correlational
Read analysis
Assertion

Diabetes drugs called GLP-1 agonists might help people overcome addictions by reducing how pleasurable substances like alcohol, nicotine, and opioids feel in the brain.

Mechanistic
Read analysis
Fit Body Science verdict — we translate health studies into clear verdicts backed by peer-reviewed research.

Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.