Substance use disorders (SUDs) are common and burdensome for patients, families, and health systems. GLP-1 receptor agonists are used to treat type 2 diabetes and obesity. These drugs have been proposed as anti-craving agents because GLP-1 signaling interacts with stress systems and brain circuits. The study (doi:10.1136/bmj-2025-086886) tested this hypothesis using data from US veterans with type 2 diabetes from the Veterans Affairs. The authors replicated eight parallel target studies comparing initiation of a GLP-1 agonist with an SGLT2 inhibitor. Among veterans without SUDs at baseline, initiation of GLP-1 was associated with a lower risk of incidental use of alcohol (hazard ratio 0.82), cannabis (0.86), cocaine (0.80), nicotine (0.80), opioids (0.75), and other SUDs (0.87) over three years.