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Key findings included: 14 percent lower overall risk of developing any substance use disorder 18 percent lower risk of alcohol use disorder (hazard ratio HR 0.82) 14 percent lower risk of cannabis use disorder 20 percent lower risk of cocaine use disorder 20 percent lower risk of nicotine dependence 25 percent lower risk of opioid use disorder These included: 30 percent fewer substance-related emergency department visits 25 percent fewer hospitalizations 40 percent lower overdose risk 50 percent lower risk of drug-related death Possible Mechanism: Effects on Brain Reward Pathways GLP-1 receptor agonists mimic a hormone involved in regulating insulin secretion, appetite, and gastric emptying

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doi:10.3389/frph.2021.792920 96

In clinical trials, exenatide did not significantly reduce heavy drinking days compared to placebo, but it did blunt fMRI alcohol cue reactivity in the ventral striatum and septal area, critical nodes for drug reward and addiction

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