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By Dr. Lynn Webster

In Greek mythology, the goddess Panacea carried a potion that could heal any disease. It’s a seductive image, and it’s how GLP-1 drugs can start to feel as reports pile up about their potential in treating conditions besides diabetes and obesity.

A recent Washington Post article alludes to Panacea before describing the emerging signs that people living with pain or addiction might benefit from GLP-1s.  

The promise is real. So are the risks. If GLP-1s are going to move from metabolic medicine into the worlds of pain and substance use disorders, we should talk about them the way we would talk about any powerful new class: with evidence, not mythology.

What We Know About GLP-1s and Pain

The most solid pain evidence so far involves knee osteoarthritis — a condition where weight, inflammation, and function are tightly linked. In a 68-week placebo-controlled trial, once-weekly semaglutide (Ozempic, Wegovy) injections in people with obesity and moderate knee osteoarthritis produced significantly greater reductions in body weight — along with significant improvements in pain scores and better physical function.  

That is meaningful. But it doesn’t automatically make semaglutide a “pain drug.” Weight reduction can relieve joint pain, and metabolic improvements may dampen inflammation. Researchers are still sorting out what portion of the pain relief is caused by weight loss alone.  

Outside osteoarthritis, the evidence is thinner. Preclinical studies suggest GLP-1 receptor agonists may reduce neuropathic pain through anti-inflammatory and neuroprotective effects.  

One promising real-world signal comes from fibromyalgia. A large analysis of over 96,000 patients found GLP-1 use associated with significantly lower odds of needing an opioid prescription or of being diagnosed with chronic pain and/or fatigue.   

These observational data are hypothesis-generating, but require confirmation in future studies. More rigorous randomized trials for fibromyalgia, diabetic neuropathy, and other chronic pain syndromes are needed.

What We Know About GLP-1s and Addiction

Here the signal is surprisingly strong — but still preliminary. The evidence so far suggests that GLP-1s appear to modulate reward pathways in the brain that shape craving and compulsive drug use.

A large 2026 observational study of over 600,000 U.S. veterans with type 2 diabetes found that GLP-1s were associated with lower risk of developing substance use disorders (SUDs) involving alcohol, cannabis, cocaine, nicotine or opioids. Among those with preexisting SUDs, GLP-1s were linked to lower risks of emergency room visits, hospitalizations, mortality, overdose, and suicidal thoughts or attempts.

Observational data can’t prove causation, but the consistency across substances and outcomes provides a strong rationale for clinical trials.

We also have randomized evidence in alcohol use disorder. A small Phase 2 trial of 48 adults with alcohol use disorder found that once-weekly semaglutides reduced drinking and cravings over nine weeks compared with placebo.

More research is underway. A recent systematic review identified 33 registered trials looking at GLP-1s for SUDs, predominantly for alcohol and nicotine, but with growing interest in opioid and stimulant SUDs.  

The Risks We Can’t Minimize

The common side effects of GLP-1s — nausea, vomiting, diarrhea, constipation and appetite suppression — are often manageable, but they can be therapy-ending. That matters, because many GLP-1 benefits appear to fade when treatment stops.

In pain and addiction care, “stop-start” patterns are common when insurance coverage shifts or supply is disrupted. Those interruptions are often risky.

A 2026 Washington University School of Medicine analysis of veterans with type 2 diabetes found that even brief interruptions of GLP-1 treatment — as little as six months — were associated with higher risk of heart attack, stroke, and death compared with continuous use. The risks rise even further the longer the gap, with up to 22% higher risk of a major cardiovascular event after two years off therapy.  

More concerning are rare but serious complications. Reports of severe delayed gastric emptying (stomach paralysis) remain a clinical concern. Cohort studies have also reported an association between semaglutides and neuropathy in patients with diabetes, although causality remains debated and the absolute risks are low.  

Emerging observational data have raised questions about musculoskeletal safety, with special relevance for people already limited by pain. Some analyses link GLP-1 use to modest reductions in bone mineral density and possible increases in osteoporosis or fracture risk in older adults. Tendon injuries have also appeared in some patients with obesity.  

These findings need replication. Because GLP-1s can slow stomach emptying, clinicians must plan around procedures. The American Society of Anesthesiologists recommends individualized perioperative strategies, including temporary liquid diets for some higher-risk patients.

A Measured Path Forward

GLP-1s may end up helping people with pain and addiction — and if they do, that would be a genuine advance. But we should not rush from “promising” to “proven,” or expand GLP-1 use without a clear plan for monitoring and safety.

Panacea was a Greek myth about curing everything. The modern task — identifying who benefits, who is harmed, and how to use powerful medicines in ways that reduce suffering without creating new forms of it — is harder.

That will require larger, dedicated randomized trials in addiction, targeted studies in pain syndromes beyond knee osteoarthritis, longer-term musculoskeletal safety data, and honest communication about both the promise and the risks of GLP-1s.

Lynn R. Webster, MD, is Senior Fellow at the Center for U.S. Policy and is co-author of the forthcoming book, “Deconstructing Toxic Narratives: Data, Disparities, and a New Path Forward in the Opioid Crisis,” to be published by Springer Nature.