Police found over 600 weapons at the house in Littleport, as well as bomb making manuals, Nazi flags and images of child abuse
A man with an obsession for weapons and a fascination with Nazi Germany has admitted to terrorism-related offences in court. Paul Page, 52, of Littleport, was discovered to have over 600 weapons, including landmines, grenades, rifles and ammunition, according to the police.
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The Eastern Region Special Operations Unit (ERSOU) stated that Page also possessed explosive substances and guides on how to create explosives and manufacture firearms. In 2023, officers from Cambridgeshire Police were investigating allegations that Page had downloaded images of child abuse.
During a search of his home, officers found Nazi flags, Second World War weapons and chemicals. The unrelated investigation into child abuse by Cambridgeshire Police revealed more than 250 illegal images on Page’s devices.
In August 2023, he was sentenced to 20 months in prison after pleading guilty to three counts of making indecent images of children. A separate investigation was then conducted by ERSOU into items retrieved from an outbuilding at Page’s property.
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Detectives from ERSOU’s Counter Terrorism Policing unit determined that Page had collected over 600 weapons and other militaria associated with Nazi activity during the war.
Police stated that whilst much of this was legal memorabilia, he was in possession of prohibited items including landmines, grenades, rifles and ammunition. A book which was seized contained instructions on how to construct a sub-machine gun, and component parts of firearms, bullet casings and shells were also recovered.
Additionally, several chemicals were found that, when combined, could serve as precursor materials for the manufacture of explosives. Page had also downloaded a prohibited document containing instructions on how to create viable explosives.
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Despite having an email address referencing numbers associated with Adolf Hitler and a tattoo linked to white supremacy, Page denied possessing an extreme right-wing mindset during police interviews, according to ERSOU. On Monday (March 2), he pleaded guilty at the Old Bailey to a series of offences, including two counts of possessing a document or record likely to be useful to a person committing or preparing an act of terrorism, ERSOU reported.
Page also admitted to two counts of possessing an explosive substance, four counts of possessing a firearm without a certificate, two counts related to the possession of a prohibited firearm, possession of prohibited ammunition and possession of ammunition without a certificate.
Hannah Wilkinson, head of ERSOU said: “Throughout our investigation, it was clear that Page had a fascination with Nazi Germany and World War Two, the clearest indication being the flags draped in his outbuilding.
“Of real concern to us was the combination of dangerous chemicals, the banned documents on how to create firearms and explosives, and Page’s clear obsession with weapons. Working closely with force colleagues in Cambridgeshire, our teams seized a significant amount of physical and digital materials which were examined by experts and identified to be a severe risk.
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“Our specialist teams are dedicated to tackling the threat of terrorism in the eastern region, and I’m thankful for all their work throughout this investigation.” Page was remanded in custody and is due to be sentenced at the Old Bailey on May 1.
Just before 11am, a car caught fire on the M60 clockwise hard shoulder near J13 (Worsley), requiring all lanes to be closed as emergency services attended.
Around the same time, an HGV lorry struck a bridge on the M61 Southbound between J2 A580 East Lancashire Road to J1 M60 J15, requiring services to attend the scene, clear up rubble, and perform emergency repairs.
A National Highways spokesperson said: “Lanes one, two, and three (of four) are closed on the M61 southbound junction one to two after a lorry struck an overbridge.
Image of the M61 showing significant traffic after a vehicle crashed into a bridge (Image: National Highways)
“Greater Manchester Police and National Highways Traffic Officers are on scene with traffic management in place while debris is cleared and the bridge is inspected.
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“We received reports of a vehicle fire just before 11am on the hard shoulder of the M60 near junction 13.
“National Highways and emergency services attended.
“The fire was put out, and the driver was taken to hospital as a precaution.”
There were no injuries reported after the M61 bridge incident.
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The driver involved in the M60 fire incident was taken to hospital as a precaution, but a Northwest Ambulance Service spokesperson has since confirmed that ‘nobody needed hospital treatment’.
Officers responded to the M61 bridge crash after receiving reports of ‘rubble, rocks, and concrete in the road’, believed to have come off the back of the HGV.
Traffic on the M61 between junctions one and two following the HGV bridge crash (Image: National highawys)
Road sweepers and maintenance teams were sent to clear debris and assess the safety of the bridge.
Delays were in place on both roads for several hours until traffic returned to normal.
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All four lanes on both the M60 and M61 were initially closed as clean-up was undertaken.
The M60 remained at a total standstill until around 12.10pm, when lanes were reopened to ease congestion.
But all four lanes were re-closed only ten minutes later as ambulances arrived at the scene.
By around 12.50pm the M61 was back to normal, with all four lanes open and drivers no longer expected to encounter repairs.
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Delays lingered slightly longer on the M60as repair work had to be carried out following the incident, meaning lane one remained closed until around 1pm.
There were still slight delays by 1.30pm, but by this point, all lanes were open.
You may qualify for PIP if you need extra help with everyday tasks due to an illness, disability or mental health condition
Levi Winchester Money Editor
03:00, 05 Mar 2026
The duration of awards for individuals making a new claim for Personal Independence Payment (PIP) will be extended from April to help reduce the backlog. PIP is the main disability benefit for people of working age in the UK.
You may qualify for PIP if you need extra help with everyday tasks due to an illness, disability or mental health condition. However, your eligibility to PIP isn’t based on your condition – it is based on how it affects your life. PIP is normally awarded for a set period of time and currently, this can be as short as nine months.
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But under changes due to come into effect from April 2026, this is to be extended to a minimum of three years for the majority of new PIP claimants aged 25 and over, rising to five years at their next review if they remain entitled.
The Department for Work and Pensions (DWP) said the measure aims to free up health professionals to carry out more face-to-face assessments and deliver more reassessments, reports the Mirror.
These operational changes are separate to the Timms Review, which will examine the role of PIP, eligibility for the daily living and mobility components and assessment process.
PIP comprises two elements – the daily living component, and the mobility component. The daily living rate is £73.90 a week if you’re awarded the standard rate, whilst the higher rate is £110.40 a week.
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The mobility component is £29.20 per week for the standard rate, and £77.05 per week for the enhanced rate. You must inform the DWP if your health or condition has changed.
If you’re terminally ill, you typically receive PIP automatically without undergoing an assessment. If you are granted PIP under the special rules for terminal illness, your award will last for three years before being reviewed.
PIP is accessible if you are aged over 16 but below state pension age. If you claim PIP and reach state pension age, your claim will usually continue.
You may be able to submit a new claim at state pension age if you were eligible for PIP in the previous 12 months.
Hartlepool Borough Council confirmed the latest roll-out, which kicks off on Tuesday, March 10, will see more homes being added.
This means about 21,000 homes, or roughly 46 per cent of all properties across the borough, will be serviced weekly.
Collections began in Hartlepool in November last year, with an initial trial in the Rossmere area. (Image: Google Maps)
Weekly collections first started in November last year, beginning with a trial in the Rossmere area.
An additional 96 streets will also now benefit from the weekly collection.
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The added streets include:
Ashburn Street,
Bedale Close,
Belgrave Court,
Bilsdale Road,
Birdforth Court,
Bolton Grove,
Bransdale Grove,
Brenda Road,
Brompton Walk,
Byland Grove,
Castleton Road,
Cath Hill Close,
Charles Street,
Chelford Close,
Church Street,
Cliffe Court,
Commondale Drive,
Cowley Close,
Crawford Street,
Crawthorne Court,
Danby Grove,
Dauntless Close,
Deacon Gardens,
East View Terrace,
Edinburgh Grove,
Egton Drive,
Elizabeth Way,
Endeavour Close,
Faceby Close,
Freemantle Grove,
Garston Grove,
Goathland Drive,
Golden Meadows,
Grace Close,
Green Terrace,
Greenhow Grove,
Groom Terrace,
Grosmont Road,
Harwich Grove,
Hatfield Close,
Headingley Court,
Hornby Close,
Ilkley Grove,
Ingleby Road,
Inglefield,
Jutland Road,
Kildale Grove,
Lawson Road,
Lealhom Road,
Lingdale Drive,
Lithgo Close,
Littlebeck Way,
Liverton Gardens,
Middleham Court,
Newholm Court,
North Road,
Ormesby Road,
Pavilion Close,
Pickering Grove,
Queen Street,
Queen Terrace,
Queensland Road,
Rectory Way,
Regency Drive,
Ripon Close,
Ross Grove,
Roxby Close,
Ruswarp Grove,
Saffron Walk,
Seaton Lane,
Selby Grove,
Skipton Court,
South End,
Staincliffe Road,
Stanmore Grove,
Station Lane,
Stockton Road,
Stokesley Road,
Swainby Road,
Tees Road,
The Ashes,
The Cliff,
The Front,
The Green,
The Links,
The Paddock (Church Street),
The Wickets,
Thirsk Grove,
Victoria Street,
Wainwright Close,
Wainwright Walk,
Warrior Drive,
West View Terrace,
Westerdale Road,
Woburn Grove,
Wyverne Court.
Councils in England must collect food waste from all homes in their area on a weekly basis from April, following changes to the law.
This is part of the Government’s plan to improve recycling rates and lower greenhouse gas emissions.
Since the introduction of the service, around 80 tonnes of food waste have been collected.
As part of the latest announcement, homes under the new roll-out will each receive two caddies before the start date – one small caddy for indoor use and a larger one for outdoor use into which the contents of the smaller caddy should be transferred.
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Deliveries for these caddies will take place this week.
Residents should present their large caddies alongside their standard refuse/recycling bins on their usual collection day.
Different vehicles are used to empty caddies and standard bins, so both should be put out by 7.30am to ensure collection.
Funding for the new caddies and specialist vehicles required for the collection of food waste has been provided by the Government so this initiative comes at no cost to Hartlepool residents.
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For extra information about food waste collections in Hartlepool, go to Hartlepool Council’s website.
What’s in store for you today? (Picture: Metro.co.uk)
Today, the Sun is in alliance with Jupiter. Emotions deepen, connections blossom and feelings you may have been avoiding will come to the surface.
Capricorn, Scorpio, and Virgo, allow yourself to be vulnerable today. Romantic and platonic connections will be fruitful, if you allow yourself to open up.
Don’ t rush things today. Within this powerful cosmic blend, you have time to slow down and turn inward; don’t waste the chance.
Ahead, you’ll find all star signs’ horoscopes for today: Thursday March 5, 2026.
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Home, family and your sense of belonging shine under today’s gentle light, offering a chance to reconnect with your roots or nourish your spirit. Original insights and intuitive nudges are flowing, so do not ignore them. Let kindness guide your actions and trust that your dreams do not need a deadline today. Sometimes the bravest move is giving yourself permission to rest deeply.
Conversations feel more heartfelt, inspiration flows freely and your intuition gets a bright green light. This is a wonderful time to share your vision, reach out to someone dear or say yes to a creative collaboration. Siblings, local people or short trips could bring unexpected joy or insight. Your steady pace now pairs beautifully with emotional intelligence.
You attract others when you mix wisdom with ambition, so trust your gut in decisions and negotiations. A creative idea could turn profitable, or a meaningful compliment may remind you of your true worth. Today is about more than money, it is about self-worth, purpose and feeling seen. The universe rewards authenticity now, especially when matched with your wit.
With the Sun aligned with Jupiter in your sign, you are glowing from the inside out. This celestial duo fills your sails with inspiration, perception and a touch of wanderlust. You are ready for growth, whether through travel, learning or expanding your emotional horizons. Your natural wisdom shines brightly, and others are drawn to your nurturing, visionary energy.
Today, you refuel your fire in sacred ways by shedding old emotional baggage and finding strength in softness. Creative breakthroughs or deeply healing moments may arise when you give yourself space to simply be. Trust your dreams, your hunches and those subtle feelings. Sometimes the biggest growth happens offstage, when your spirit is free to breathe and bloom.
Connections, whether romantic, platonic or professional, may feel more meaningful, supportive and even a little special. Someone could surprise you with kindness, or you may offer insights that deepen a bond. This is also a good time to team up around a shared dream or creative cause. Let go of the need to define everything and flow with trust.
Cosmic messages for Cosmic messages for Virgo today
Libra
September 24 to October 23
Work, wellness and routine matters feel less like chores and far more meaningful when infused with feeling and intention. A career opportunity may arrive through kindness or intuition rather than effort alone. Let emotional intelligence guide your decisions, as it is your secret superpower right now. Today’s alignment reminds you that success does not have to be stressful.
Romance, inspiration and joy bubble up in unexpected ways, through a creative spark, an alluring connection or a moment of emotional clarity. You are encouraged to play, express and dream big. Let feelings guide your actions rather than the urge to analyse or control. Good things happen when you loosen your grip. Say yes to what lights you up, it is safe to shine.
Home, healing and emotional security come into focus, inviting you to slow down and listen within. You often look to the horizon, but today’s Sun-Jupiter alignment reminds you that true expansion begins at your roots. A family moment, subtle hunch or private realisation could spark unexpected growth. Let go of the need to be everywhere at once, rest is restorative.
Your usual no-nonsense approach softens today, making room for meaningful conversations and sensitivity in communication. Whether it is a heartfelt message, a long-overdue chat or a collaborative opportunity, this gentle aspect invites warmth and emotional intelligence into your interactions. Let wisdom guide your words, there is no need to overthink something truly profound.
A key aspect brings focus to your daily rhythms, finances and wellness routines, urging you to nourish both body and bank account with kindness rather than pressure. A small shift in perspective could bring emotional and practical rewards. Let your values guide your habits, and do not underestimate the power of a well-timed break or befriending a colleague.
With the radiant Sun in your sign aligning with generous Jupiter in Cancer, you are glowing from the inside out. Creativity, love and joy flow effortlessly, as if the universe has handed you a permission slip to be fully and beautifully yourself. A romantic pull, creative breakthrough or heartfelt connection may bloom unexpectedly. Trust your instincts, they are tuned into divine timing.
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UKMTO received a report of an explosion on an anchored tanker off Kuwait on Wednesday, March 4, with oil now in the water from a cargo tank raising environmental concerns
A ‘large explosion’ has been reported on an oil tanker near Kuwait’s coast, sparking fears of a significant oil spill into the Gulf waters with potentially disatrous environmental consequences.
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The United Kingdom Maritime Trade Operations (UKMTO) confirmed receiving a report of an explosion off the coast of Kuwait on Wednesday, March 4, reports the Mirror..
According to UKMTO, the Master of an anchored tanker reported witnessing and hearing a large explosion, followed by the sight of a small craft departing the area in south-east Mubarak Al-Kabeer in Kuwait late on Wednesday, March 4, amidst the ongoing conflict in the Middle East.
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Israel and the US launched joint strikes on several key sites in Iran on Saturday, February 28. The strikes resulted in the death of Iran’s supreme leader at the time, Ayatollah Ali Khamenei, over the weekend.
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In retaliation, Iran has targeted sites across the Middle East.
“There is oil in the water coming from a cargo tank which could have some environmental impact,” warned UKMTO.
“The vessel has taken on water, there are no fires reported and the crew are safe and well.”
Authorities are currently investigating the incident.
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UKMTO advises vessels to proceed with caution and report any suspicious activity.
Mikel Arteta will know the importance of a win over Albion, particularly with Man City kicking off at home to Nottingham Forest at the same time, and has resisted making too many changes from the win over Chelsea at the weekend.
Saka, though, does start and captains the side in the absence of Odegaard and the Arsenal No7 will be wearing a different shirt against Brighton.
Why is Bukayo Saka wearing a special shirt against Brighton?
To mark his 300th first team appearance for Arsenal, Saka has that exact number engraved into the back of his matchday shirt.
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Bukayo Saka starts for Arsenal against Brighton
Arsenal FC via Getty Images
An Arsenal statement reads: “Bukayo Saka captains the team in the absence of Martin Odegaard, and makes his 300th first team appearance for us.
“He becomes the 52nd men’s player in our history to reach the milestone, across all competitions, after making his debut as a 17 year old back in November 2018.”
Saka ended his long goal drought in the Premier League by scoring after five minutes in the 2-2 draw with Wolves last month, but failed to net in back-to-back games against Tottenham and Chelsea.
If Israel and the US hoped their attack on Iran would force the country to capitulate quickly, they were wrong. Despite the death of the supreme leader, Ayatollah Ali Khamenei, and many other senior figures, Iran has managed to continue firing drones and missiles at targets across the Middle East.
This poses a challenge for the US and its allies, including Israel and the Gulf states. The challenge is that they might run out of air defences before Iran runs out of airborne projectiles.
The US and its allies use a number of weapons platforms to knock down incoming missiles and drones. The most important are Thaad interceptors, Patriot systems and SM-family naval missiles, while Israel also uses longer-range Arrow interceptors. However, the supply of these interceptors has been under severe strain in recent years.
Many have been provided to Ukraine, which faces relentless Russian aerial assault. Others have been used in the Red Sea to protect shipping against attacks by the Iran-aligned Houthis. And more still have been stationed in the Indo-Pacific to defend South Korea and Taiwan from possible North Korean and Chinese attacks.
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Despite their importance to modern warfare, US stockpiles of these munitions are dangerously low. There are simply too many competing priorities, and production has only recently been increased. The 12-day war the US and Israel fought with Iran in June 2025 is thought to have consumed around a quarter of the entire US inventory of Thaads.
When stocks of these munitions diminish during a war, choices have to be made about which targets to protect – and which not to protect. This usually means focusing on the defence of strategic military installations, allowing some civilian areas to be hit. Israel is widely believed to have made this choice during the 12-day war.
That moment may be approaching again. However, this time it is not just Israel that is at risk, but half a dozen other Middle East countries. The main problem is in the Gulf states, which are in range both of the sort of long-range missile that Iran fires at Israel and its shorter-range projectiles.
These Arab countries can also be hit more easily by Iran’s Shahed exploding drones. The drones are much easier to launch than missiles, require less risk to do so and can reach some targets in the Gulf within minutes. Iran is estimated to have 80,000 of them.
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Thick black smoke billows into the air above the Jebel Ali port in Dubai after it was struck by debris from an Iranian intercepted missile on March 1. Stringer / EPA
Ukraine has faced this type of attack mix for years and it has developed complex, multi-layered air defences to counter it. This means using expensive interceptors (each Patriot missile costs US$4 million) to take down ballistic missiles and using a combination of other things – even a machine gun will do – to take down drones.
It’s an effective system that has kept Ukraine in the fight and ensures it does not use too many interceptors. The Gulf states have not done this. Instead, they appear to be using Patriot missiles and other extremely expensive and scarce missiles to take down everything from ballistic missiles to US$20,000 (£15,000) drones.
Missile defence systems are designed to launch several interceptors at each incoming projectile, meaning their stocks can run down quickly. Probably within a few days, the Gulf states are going to have to shift their tactics.
Stocks running low
Even if the Gulf states are the most exposed, the situation is not rosy for Israel or US military forces across the region either. Some US forces are in range of Iran’s Shahed drones and short-range missiles. Others are in range of Iran’s long-range missiles.
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The exact size of missile defence stocks is classified. But a look at budgetary and procurement data suggests that US forces will become stretched within a matter of days or several weeks at the very most. At that point, the US will have to begin drawing down missile defence stocks from the rest of the world.
According to South Korean media, discussions are already underway about removing Thaads and Patriot systems from South Korea and sending them to the Middle East. Ukraine will get fewer. And US military readiness will be severely degraded around the world, inviting aggression and the possible opening of a second front.
The other side of the equation is Iran’s capabilities, which are something of an unknown. Long-range missiles are the type of munition it has the least of, and they are also the riskiest to launch. The US and its allies can be fairly confident that over time they will significantly degrade Iran’s ability to launch these missiles. Whether it will be fast enough to happen before a critical interceptor shortage is less certain.
But Iran’s short-range missiles and drones are another matter. The drones, especially, can be launched without large, visible weapons platforms, which make an easy target for US and allied air strikes. Particularly if Gulf air defences become very degraded, there are a host of highly damaging targets for them to hit – ranging from US bases to oil and gas infrastructure to shipping.
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Ultimately, the answer to how prepared the US and its allies are for a protracted conflict seems to be “not very”. Even if it runs out of long-range missiles, Iran can probably continue its drone attacks for a very long time, causing chaos throughout the region and spiking energy prices by disrupting production and shipping. Stopping them will not be easy.
A scene has been put in place to preserve any evidence and an investigation has been launched
A man left with serious injuries aftter he was attacked and robbed on a street in Cambridge. Police were called at 1.32am today (March 4) with reports of violence on Chesterton Road in Cambridge.
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Cambridgeshire Police and paramedics attended and found a man had been robbed and attacked, suffering serious injuries. The robbery is thought to have taken place between midnight and 1.32am outside Barclays Bank on Chesterton Road (Mitcham’s Corner).
A spokesperson for Cambridgeshire Police said: “A 52-year-old woman from Cambridge has been arrested on suspicion of robbery and a 22-year-old man, of no fixed address, has been arrested on suspicion of assault occasioning grievous bodily harm (GBH) and robbery. They both remain in custody at Parkside Police Station.
“A scene has been put in place to preserve any evidence and an investigation has been launched.”
Anyone with any information is urged to contact police online quoting investigation reference 35/16410/26 or call 101 if you do not have internet access.
Cancer Research UK has warned that this sign affects 65 per cent of cancer patients
Fiona Callingham Lifestyle writer
15:00, 04 Mar 2026
A “very common” symptom that “doesn’t go away” even with rest could be a warning sign of cancer. While this symptom typically affects 65 per cent of cancer patients, it could easily be overlooked or mistaken for something far less serious.
Feeling slightly tired in the morning is perfectly normal. Even after a good night’s sleep, you might still feel you need a bit more rest before starting your day.
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It’s also typical to experience some tiredness during daytime hours, especially throughout the winter months when chilly weather and reduced daylight hours can leave you feeling lethargic. However, persistent, overwhelming fatigue could indicate something much more serious.
Cancer Research UK has warned that tiredness which “doesn’t go away” despite adequate sleep or rest is a potential cancer warning sign. This type of fatigue may result from both the disease itself and its treatment, leaving patients “feeling very tired, exhausted and lacking energy”.
On its website, the charity explained: “Cancer-related fatigue can affect you physically, emotionally, and mentally. How long it lasts, how severe it is, and how often you might have it is different from person to person.”, reports the Mirror.
If you’re experiencing cancer-related fatigue, you may notice:
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Lack of energy – you might just want to stay in bed all day
The need for rest even after minimal or no activity
Feeling as though you simply can’t be bothered to do much
Sleeping issues such as insomnia or disrupted sleep
Struggling to get up in the morning
Feeling anxious, downcast or depressed
Muscle pain – you may find climbing stairs or walking short distances challenging
Feeling out of breath after completing minor tasks, like showering or making your bed
Difficulty concentrating, even on simple activities like watching TV or chatting with a friend
Struggling to think clearly or make decisions easily
Loss of interest in sex
Loss of interest in activities you usually enjoy
Negative feelings about yourself and others
This particular symptom can make everyday life incredibly difficult. Cancer Research UK said: “Fatigue can be very frustrating. You and your relatives might underestimate how much it can affect daily life.
“Everyday life can be difficult and you might not have the energy to cook, clean, bathe or go shopping. You might not even feel up to a chat. Things that you used to find easy to do can feel like hard work.”
The charity warns that this symptom could force you to stop working entirely. Cancer Research UK added: “Some people feel like fatigue is a constant reminder of their cancer and this can be hard to accept.
“You might worry that because you feel so tired all the time your cancer could be getting worse. But it is more likely to be a side effect of treatment, or due to the fact that cancer can cause fatigue.”
When should you consult a GP?
That said, exhaustion doesn’t automatically signal cancer. It might arise from other medical conditions or lifestyle factors, including inadequate sleep, poor nutrition, and insufficient exercise.
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Other health problems known for causing tiredness include:
Anaemia
Under or overactive thyroid
Diabetes
Kidney disease
Heart disease
Endometriosis
Long Covid
Mental health issues
Certain medications such as antidepressants, chemotherapy, radiation therapy, and pain relief drugs are similarly linked with fatigue. Nevertheless, if you’re experiencing persistent, unexplained tiredness that’s disrupting your daily life, you should consult your GP.
The blockbuster GLP-1 drugs that have reshaped the treatment of diabetes and obesity may help prevent multiple substance use disorders — and reduce the tragic outcomes they cause, a large new study finds.
An analysis published Wednesday in a medical journal looked at electronic health records from more than 600,000 U.S. Veterans Affairs patients with diabetes. It found that those treated with medications such as Ozempic and Mounjaro were less likely to develop addictions to alcohol, nicotine, cocaine, opioids and other substances than those treated with a different class of drugs.
In those already addicted, the GLP-1 drugs were linked to lower risks of hospitalization, overdose and death, according to the study.
The new results suggest — but don’t prove — that the weight-loss medications may be able to target the underlying source of cravings that affect the more than 48 million Americans with substance use disorders.
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“They’re actually working against the root cause of all these different addictions,” said Dr. Ziyad Al-Aly, the study’s lead author and a chief researcher at the VA St. Louis Health Care System.
Here’s what you need to know about the new research published by The BMJ:
How the study was designed
Previous studies have suggested that the drugs known as GLP-1s, or glucagon-like peptide-1 receptor agonists, could reduce addictions by targeting the brain’s reward pathways. But those studies have been small and often limited to one substance.
For this study, one of the largest to date, Al-Aly and his colleagues analyzed data from the electronic records of more than 600,000 Veterans Affairs patients with diabetes over three years. They compared people who received GLP-1 drugs with those treated with medications that lower blood sugar.
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The patients were divided into seven parallel trials that analyzed the risk of developing addictions to multiple substances including alcohol, cannabis, cocaine, nicotine and opioids. Another trial looked at the risk of specific harms among people with existing addictions when they took the different types of medication.
What the researchers found
Al-Aly and his colleagues found that people starting the GLP-1 drugs had lower risks of developing addiction to multiple substances. Compared with the other medications, people taking the GLP-1 drugs had a reduced risk for addiction: 18% for alcohol, 14% for cannabis, 20% for both cocaine and nicotine, and 25% for opioids.
In patients who already had substance use disorders, starting the GLP-1s was linked with a 31% lower risk of emergency department visits, 26% lower risk of hospitalizations, 25% lower risk of suicidal thoughts or attempts, 39% lower risk of overdose — and 50% lower risk of death.
Overall, the study found that using GLP-1 drugs likely prevented about seven cases of substance use disorder and 12 incidents involving serious harm for every 1,000 users over three years, Al-Aly said.
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The limits of the study
Among the study’s limitations: It was conducted within the VA health system, which serves a population that is mostly older, white and male, although Al-Aly said the results were consistent in more than 35,000 women. It also includes data only from people with diabetes, not the general population.
The researchers also couldn’t account for some factors, such as socioeconomic status or lifestyle choices, that could affect the results. And the analysis focuses on the effects of using GLP-1s compared with another drug, not compared with no treatment.
As an observational study, the new analysis showed that the GLP-1s are associated with reduced risk of substance use disorders and harms, not that the drugs themselves caused the reduction.
Addiction researchers see a need for new medications
The new findings are striking, said Dr. Lorenzo Leggio, a National Institute on Drug Abuse clinical director who wasn’t involved in the study.
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“Even though we don’t fully understand the mechanism, somehow the GLP-1 system is tackling addiction biology and the foundational system that underlies all these disorders,” he said.
Diabetes and weight-loss trials have shown that the GLP-1 drugs target hormones in the gut and the brain that control appetite and feelings of fullness, cutting down on what’s described as “food noise,” or intrusive thoughts of food. In the same way, this study indicates the drugs may tamp down “alcohol or drug noise,” Leggio said.
Growing evidence that GLP-1s might prevent substance use disorders is exciting, said Dr. Anna Lembke, a Stanford University addiction medicine specialist.
“We haven’t really had a new tool in our toolbox from a pharmacotherapy perspective to treat addiction in a long time,” said Lembke, noting that some addiction specialists are already prescribing GLP-1s off-label, especially when other treatments have failed.
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She cautioned that the GLP-1 drugs don’t work the same way for all users and that they have risks that must be weighed against potential benefits.
What comes next
The new findings do not, by themselves, justify prescribing GLP-1 drugs to prevent or treat substance use disorders, Al-Aly said. That evidence would need to come from randomized controlled clinical trials that directly compare the use of the drugs against a placebo, or dummy medication. Several such trials are pending, Leggio noted.
The goal is finding a new way to treat addictions, which are a leading cause of sickness and death around the world.
“The consequence in terms of chronic disease of these addictive drugs is actually gigantic in our society,” Leggio said.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
