GLP-1 Receptor Agonists: Encouraging Signals for Treating Alcohol Use Disorder

Excessive alcohol use is a leading cause of preventable death in the USA, and the number of annual deaths from alcohol more than doubles the number from drug overdose. As newer glucagon-like peptide-1 (GLP-1) receptor agonists like semaglutide have increased in use, anecdotal reports suggest they may reduce craving for alcohol and other addictive substances. Given this increased attention, this perspective reviews findings from one trial and three recent retrospective studies assessing relationships between GLP-1 agonists and alcohol-related health outcomes. The one published GLP-1 trial for alcohol use to date resulted in null findings overall, but significant reductions in heavy drinking days and alcohol use among a subgroup of participants with obesity. The three retrospective analyses found associations between GLP-1 agonists and multiple outcomes including incident and recurrent alcohol use disorder, alcohol intoxication among individuals with alcohol use disorder, and hospitalizations related to alcohol use, substance use, and somatic health conditions. Considerations for the use of GLP-1 agonists in the context of alcohol use disorder are discussed, as well as outstanding questions and limitations with the current evidence. Additional clinical trials are needed to provide definitive answers, and to open the pathway for FDA approval and payer coverage.