Might Semaglutide Lower the Risk of Opioid Overdoses?
Caution is wise when observational studies compete for our attention. But this one, from JAMA Network Open, is intriguing. In a recent analysis of 33,006 persons with both type 2 diabetes and opioid use disorder, researchers found a signal that semaglutide might lower the risk of opioid overdoses by as much as two-thirds. “It’s a big decrease,” says senior author Rong Xu.
In the same breath, she is quick to caution that these data offer no proof of a clinical effect. “We can only say semaglutide is associated with reduced risk.”
A Foundation of Experimental Data
These findings do not come in a vacuum. In a recent editorial for Addiction, Xu and Nora Volkow explained:
“Preclinical studies for the past decade have documented that various GLP-1RA drugs reduced the rewarding effects of alcohol, nicotine, cocaine and opioids and reduced cue and drug-induced relapse in rodent models of addiction.”
Volkow is director of the National Institute for Drug Abuse and a lead author of the new study. She says:
“The preliminary findings from this study point to the possibility that GLP-1 medications may have value in helping to prevent opioid overdoses.”
Much More Work Necessary
As intriguing as these observations are, much more work will be necessary before we know that semaglutide is indeed helpful for preventing opioid overdoses. The limitations of this observational research include uncontrolled or unmeasured confounding factors, systematic biases in the data, and the limitations inherent to studies of electronic health records.
So these results need validation from different data sources and in different study populations. We need research into the underlying mechanisms at work and randomized clinical trials as evidence of a true effect.
Yes, more research is needed. But if it bears fruit, semaglutide and related drugs might help with yet another wickedly difficult public health challenge.
Click here for the study in JAMA Network Open and here for the editorial in Addiction. For further reporting, click here, here, and here.
Capsule of a Common Poppy, photograph by Joaquim Alves Gaspar, licensed under CC BY-SA 3.0
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October 4, 2024
