Marisa Leach, Megan E. Marziali, Surita Parashar, Greg Bondy, Silvia Guillemi, Marianne Harris, Mark Hull, Sarah Stone, Katherine W. Kooij, Robert S. Hogg, Julio S.G. Montaner
Aim: Drug poisonings involving opioids and/or stimulants are a major public health concern. Pharmaceutical interventions to treat substance use disorders, particularly those involving stimulants, are limited. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), approved to manage conditions such as type 2 diabetes, have been observed to reduce substance use as a secondary effect. We examined the current literature on GLP-1RAs as a potential treatment for either stimulant or opioid use disorder. Methods: We conducted an electronic search in PubMed, PsycINFO, Scopus, and Web of Science in September 2025 and January 2026 to identify studies investigating GLP-1RA treatment for stimulant or opioid use disorder. We identified 630 unique search results. One reviewer screened the title, abstract, and the full-text of results before performing data extraction. Metrics synthesized included study design, population characteristics, dosage information, and substance use behaviours or outcomes. Results: We identified eighteen studies between animal (n = 14) or human (n = 4) participants and stimulant- (n = 6) or opioid-related (n = 12) outcomes. Research conducted in the United States represented the majority of studies (n = 13). Overall, sixteen studies found a relationship between GLP-1RA administration and reduced stimulant- or opioid-related outcomes, three observing greater reduction in groups with higher GLP-1RA dosages or more extreme substance use at baseline. One study identified the incidence rate ratio of opioid overdose as 40% lower for people with a GLP-1 RA prescription compared to those without. Conclusion: These preliminary findings support that GLP-1RAs may be a potential pharmaceutical treatment for opioid or stimulant use disorders. Further research in human populations is needed.