Can GLP-1s, Semaglutide and Liraglutide Treat Alcohol Use Disorder?
Gerti Tashko, MD
Your Comprehensive Endocrinologist | Board Certified in Lipidology, Hypertension, and Obesity
Alcohol Use Disorder (AUD) remains a major global health issue. While psychosocial treatments dominate, medications play a lesser role. Exciting new findings suggest glucagon-like peptide-1 receptor (GLP-1) agonists, primarily used for type 2 diabetes and obesity, may help. Among these, semaglutide (Ozempic or Wegovy) and liraglutide (Victoza or Saxenda) show the strongest potential for reducing alcohol-related hospitalizations. Though promising, further research is necessary to confirm these results.
GLP-1 Agonists: Unexpected Use in Treating AUD
Initially developed for diabetes and weight loss, GLP-1 agonists are now under scrutiny for their effects on alcohol consumption. Preclinical studies in animals, coupled with human case reports, indicate these medications might reduce cravings. To investigate further, Swedish researchers conducted a nationwide cohort study.
The study followed over 227,000 people diagnosed with AUD between 2006 and 2021. Researchers compared times when patients used GLP-1 agonists to periods of nonuse. Results revealed significant reductions in AUD-related hospitalizations during GLP-1 agonist use, especially for semaglutide and liraglutide. Other GLP-1 agonists, such as exenatide and dulaglutide, showed trends toward reduced hospitalizations but did not reach statistical significance.
Semaglutide and Liraglutide Lead the Way
Among the GLP-1 agonists, semaglutide delivered the most compelling results. It lowered the risk of AUD-related hospitalization by 36% and substance use disorder (SUD)-related hospitalization by 32%. Liraglutide followed closely, reducing these risks by 28% and 22%, respectively. These drugs also significantly decreased hospitalizations for physical health issues. However, their use did not noticeably impact suicide risk.
By contrast, exenatide and dulaglutide demonstrated modest trends toward reduced hospitalizations but lacked the statistical power to confirm their efficacy. These results suggest that not all GLP-1 agonists may be equally effective in addressing AUD.
Better Outcomes Than Standard AUD Medications
Standard AUD medications, like naltrexone, disulfiram, and acamprosate showed only modest effects in comparison. While these treatments remain valuable, semaglutide and liraglutide appear to offer greater protection against alcohol-related hospitalizations.
These findings highlight the potential of GLP-1 agonists to provide more effective support for individuals battling AUD.
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Why Do GLP-1 Agonists Work for AUD?
GLP-1 agonists may impact AUD by targeting the brain’s reward and craving systems, specifically dopamine pathways. By dampening the brain’s sensitivity to addictive triggers, these medications could reduce the urge to drink. This mechanism might also explain their potential to treat other addictions, broadening their appeal beyond AUD.
Limitations and What’s Next
While promising, these findings come with limitations. The study, being observational, cannot prove causation. Other factors might explain the reduced hospitalization rates seen during GLP-1 agonist use. Additionally, these results reflect Swedish healthcare data and may not apply universally.
To confirm these observations, researchers need randomized clinical trials. Such trials would clarify whether GLP-1 agonists can reliably reduce alcohol consumption and related harms. They could also explore differences between various GLP-1 agonists and identify the best treatment protocols for AUD.
A Glimpse into the Future
If clinical trials validate these findings, semaglutide and liraglutide could transform AUD treatment. They might complement existing therapies, offering new hope to individuals struggling with alcohol dependency. Exenatide and dulaglutide, while showing potential, may require further research to determine their role in AUD management.
For now, healthcare providers should interpret these findings with cautious optimism. GLP-1 agonists are not yet approved for AUD treatment, and their off-label use should remain experimental until stronger evidence supports their effectiveness.
Summary
Semaglutide and liraglutide stand out as promising candidates for reducing alcohol-related hospitalizations. Their ability to address both physical and psychological aspects of AUD offers a potential breakthrough in addiction medicine. Rigorous clinical trials are essential to confirm these results and unlock the full potential of GLP-1 agonists in treating AUD. For now, these findings provide a hopeful glimpse into a future where AUD treatments are more effective and accessible.
Corsano Health and Wellness Co-Founder|MD, MBA
3wI had a strong feeling (and hope) that GLP-1s would have this indication soon- many patients that I have treated with GLP’s mentioned a complete disinterest in alcohol, it completely diminished cravings. Admittedly none of them suffered from alcohol use disorder, but many were certainly consuming far more than they should!