Semaglutide May Reduce Opioid Overdose Risk in T2DM, Opioid Use Disorder

For individuals coping with both type 2 diabetes (T2D) and opioid use disorder (OUD), semaglutide—a medication typically used to manage diabetes—has been linked to a notably lower risk of opioid overdose when compared to other antidiabetic drugs. This finding emerges from a study led by William Wang at the Case Western Reserve University School of Medicine in Cleveland. The research, published online on September 25, 2024, in JAMA Network Open, represents a significant step in understanding how diabetes medications can impact the risk of opioid overdose in patients with dual diagnoses.

The research team performed an emulation target trial to examine the relationship between semaglutide use and the risk of opioid overdose, in contrast to other diabetes medications. The study cohort consisted of 33,006 patients, with 3,034 patients being treated with semaglutide and 29,972 patients receiving other antidiabetic treatments. The patients were monitored over a follow-up period of one year to assess the incidence of opioid overdoses.

Results indicated that patients on semaglutide experienced a considerably lower risk of opioid overdose compared to those on other diabetes medications. The hazard ratios for overdose among semaglutide users ranged from 0.32 to 0.58, highlighting a significant protective effect. Importantly, this reduction was consistent even when compared to other medications within the same class, such as other glucagon-like peptide 1 (GLP-1) receptor agonists.

In addition to the primary findings, the researchers looked at a negative control outcome—medical encounters for congenital malformations, deformations, and chromosomal abnormalities—and found no differences between the two groups. This suggests that the observed protective effect is specific to opioid overdose risk rather than a general reduction in healthcare encounters for unrelated conditions.

The authors of the study concluded that semaglutide's association with a reduced risk of opioid overdose in patients with comorbid T2D and OUD points to its potential therapeutic value in preventing overdoses. This finding is particularly significant given the current opioid crisis and the ongoing efforts to identify effective interventions that can mitigate overdose risks in vulnerable populations.

This research underscores the importance of considering the broader impacts of diabetes medications beyond their primary purpose of controlling blood sugar levels. The potential of semaglutide to offer additional benefits, such as reducing the risk of opioid overdose, could inform clinical decisions and guidelines for treating patients with both T2D and OUD. Further studies are warranted to explore the mechanisms behind this association and to confirm these findings in diverse patient populations.