Semaglutide misuse sparks surge in poison control center calls

The rapid expansion of semaglutide usage across the United States, following the approval of the drug for chronic weight management in 2021, has triggered a significant and sustained increase in reports to poison control centers. While medications in the glucagon-like peptide-1 receptor agonist (GLP-1RA) class were previously utilized primarily by older patients for type 2 diabetes, the demographic of users has shifted toward a younger, predominantly female population since the drug gained popularity for weight loss.

Analysis of data from the National Poison Data System indicates that before the middle of 2021, poison control centers nationwide handled between 1,000 and 1,500 GLP-1RA-related cases annually. By 2023, that figure had climbed to more than 8,000 calls. Research conducted by investigators at The University of Texas at San Antonio revealed that semaglutide specifically accounted for 64.2% of these post-approval cases. Statistical modeling identified an inflection point immediately following the regulatory approval, with semaglutide-related exposures rising by an additional 9.9% per quarter.

Most incidents reported to poison control centers stem from unintentional therapeutic errors rather than intentional misuse. Common mistakes include taking the medication daily instead of the once-weekly schedule required, or initiating treatment at a high dosage rather than following a recommended, gradual titration plan. The complexities associated with injectable delivery devices, which require users to dial and administer specific doses, have contributed to this trend. Historical data cited in the study found error rates for first-time users of similar injectable pens ranging from 17% to 57%.

The study also notes that drug shortages during this period pushed some patients toward compounded versions of these medications, which can have non-standard concentrations and create additional opportunities for dosing confusion. Despite the generally mild nature of these exposures, the rate at which patients sought care at medical facilities increased notably. Before 2021, approximately 23% of callers were either already at a medical facility or were referred to one; after the approval of weight-loss indications, that figure rose to 33.5%. Researchers emphasize that the heightened media and social media attention surrounding these drugs may have lowered the threshold for individuals to seek emergency evaluation, even when symptoms could have been managed at home.

While most outcomes were mild, the researchers documented one death involving a patient with a history of obesity who had recently undergone liposuction and had been prescribed tirzepatide, a different drug in the GLP-1 class. The patient arrived at an emergency department with severe abdominal pain and bloating, and surgery revealed extensive damage to the large intestine. The study authors stated that cause and effect cannot be established from a single case report, but they noted the timing raises clinical questions about the use of these drugs around the time of surgical procedures.

Experts suggest that better patient education at the prescribing and pharmacy levels is essential to curb these trends. Improving knowledge regarding injection device use, expected side effects, and when to contact a professional versus seeking emergency care remains a priority. For those experiencing adverse reactions or questions regarding dosage, medical experts reiterate that professional guidance is available through poison control centers or the national hotline at 800-222-1222.