GLP-1 receptor agonists reduce alcohol and other substance use.
- Current status
- Preliminary signalEvidence strengthening · Addiction
- Why
- A small phase 2 RCT (n=48, 9 weeks, low doses) reduced laboratory alcohol self-administration, craving and drinks per drinking day, but did not change average drinks per calendar day or number of drinking days. Large observational cohorts show lower rates of opioid overdose and alcohol intoxication events; these are harm events, not measures of use. No phase 3 trial has reported; the RCT population was young and not selected for weight.
- What would change it
- A phase 3 randomized trial with abstinence or heavy-drinking-day outcomes over 6 months or more.
- Linked studies
- 3 · 3 supports
- Last updated
- Oct 19, 2026
The status is the collection's own judgment on its assessment scale, not a GRADE certainty rating and not medical advice.
01The evidence
The evidence, sorted by what it shows
Supports (3)
- Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical TrialRandomized trial · 2025 · Study tier 3 · Partial match · Benefit
Phase 2 RCT in 48 non-treatment-seeking adults with alcohol use disorder (mean age 39.9): low-dose semaglutide reduced laboratory alcohol consumption, drinks per drinking day and craving, but did not change average drinks per calendar day or number of drinking days. NIH funded.
- The association between glucose-dependent insulinotropic polypeptide and/or glucagon-like peptide-1 receptor agonist prescriptions and substance-related outcomes in patients with opioid and alcohol use disorders: A real-world data analysisRetrospective cohort · 2025 · Study tier 3 · Partial match · Benefit
EHR cohort: aIRR 0.60 for opioid overdose, 0.50 for alcohol intoxication; observational.
- Mapping the effectiveness and risks of GLP-1 receptor agonistsRetrospective cohort · 2025 · Study tier 3 · Different population · Mixed
VA atlas: reduced substance use disorders vs usual care; observational.
02History
How this assessment has changed
- Preliminary signalOct 19, 2026 · Evidence strengthening
Owner decision 2026-10-18 on IN-061 (claims audit): recommended options accepted (IN-061.29). Status unchanged; rationale corrected to match the audited links.
- Preliminary signalSep 13, 2026 · Evidence strengthening
initial curated status