Status Of GLP-1 drugs and their application in treating substance use disorders: A systematic review
- Design
- Systematic review · Mixed outcome
- Match to healthy normal-weight adults aged 55–75
- Population unclearUNKNOWN: systematic review of 11 studies in “diverse populations”; age, BMI and diabetes status are not reported.
- Could weight loss explain it?
- PossiblyPossibly: weight loss and HbA1c improvement were reported alongside the substance-use results, and the abstract reports no analysis separating them.
- Study tier
- Not ratedNOT_RATED: a systematic review with a study-by-study synthesis and no pooled estimate.
- Assessment
- Version 3 · Two independent AI reviews agreed · Oct 19, 2026
Study facts come from the paper. Population match, weight-loss explanation and study tier are our judgments, made against the reference group of healthy normal-weight adults aged 55–75.
This systematic review included 11 studies of GLP-1 receptor agonists and substance use disorders. Observational studies linked the drugs to lower risks of alcohol-related hospital stays, tobacco use disorder and opioid overdose, but the randomised trials in alcohol use disorder gave conflicting results, one not statistically significant. Participants also lost weight, and the authors say robust randomised trials are needed before the link can be treated as cause and effect.
01Findings
What the study reported
- Drugs
- Glp-1 receptor agonists
- Dose
- various
- Route
- various
- Comparator
- not reported in abstract
- Primary outcome
- substance use disorder outcomes (alcohol, tobacco, opioid and composite SUD)
- Effect
- Observational studies linked GLP-1RAs to lower AUD hospitalisation and incident AUD, tobacco use disorder (HR 0.68) and opioid overdose (HR 0.32-0.58); RCTs in AUD were contradictory (p = 0.37; 29% reduction, p = 0.04); no pooled estimate
- 95% confidence interval
- 95% CI 0.630.74 (tobacco use disorder, as printed)
- P value
- p = 0.37; p = 0.04 (RCTs in AUD)
- Follow-up
- Not stated
- Adverse events
- Safety profiles reported as positive, with no patterns of increasing serious adverse events
- Limitations
- Most benefit comes from observational studies rated moderate risk of bias, the RCTs disagreed, only 11 studies were included and no pooled estimate is given; the authors call for robust randomised trials.
Who was studied
- Obesity status
- not reported in abstract
- Diabetes status
- not reported in abstract
- Cvd status
- not reported in abstract
- Ckd status
- not reported in abstract
- Baseline condition
- substance use disorders (alcohol, tobacco, opioid)
- Inclusion exclusion
- 11 studies included of 1641 records identified; studies of GLP-1RAs and substance use outcomes
Study quality details
- Study design
- Systematic review
- Sample size
- not extracted
- Randomization
- n/a
- Blinding
- n/a
- Comparator
- not reported in abstract
- Follow up duration
- not stated
- Outcome type
- mixed
- Replication
- not assessed
- Consistency with other evidence
- not assessed
- Population applicability
- UNKNOWN
- Statistical precision
- one CI reported (tobacco use disorder); no pooled estimate
- Risk of bias
- not assessed
- Funding conflicts
- unclear
- Peer review status
- yes
02Funding
Funding and conflicts
- Funding
- not reported in abstract
- Industry funded
- Unclear
- Manufacturer
- not stated in source
- Sponsor role
- not reported in abstract
- Author conflicts
- Authors declare no conflict of interest.
- Independent replication
- unknown
Funding is shown on every study and never used to score it.
04Source
The source, as retrieved
Abstract
[BACKGROUND/OBJECTIVE] Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have an exciting future potential beyond metabolic disorders. This review gauges their effectiveness, safety, and clinical role in the management of substance use disorders in diverse populations. [METHODS] A PRISMA-guided systematic review searched PubMed, Scopus, WoS, CENTRAL and PsycINFO up to March 2026; 1641 records were identified, 11 included; screening, extracting and evaluating the efficacy, safety, and bias of the studies. [RESULTS] 11 studies were selected out of 1641 records. Reduced substance-related outcomes were always observed with GLP-1RAs. In alcohol use disorder (AUD), there was a decrease in the risk of hospitalization (aHR 0.640.72), and reduced incident AUD (OR 0.260.71), but randomized controlled trials (RCTs) provided contradictory outcomes (p = 0.37; 29% reduction, p = 0.04). Semaglutide reduced the risk of tobacco use disorder (HR 0.68; 95% CI 0.630.74). There was a great decrease in the risk of opioid overdose (HR 0.32-0.58). The incidence (HR 0.86), mortality (HR 0.50), and suicidal ideation were less in composite substance use disorder (SUD) outcomes (HR 0.75). Weight reduction was consistent (-2.9 kg; ≥16 kg in 37.5%), with HbA1c improvements (-0.25%). RCTs were found to be low-bias and the observational studies were moderate-bias. The safety profiles were positive, and there were no patterns of increasing serious adverse events (SAEs). [CONCLUSION] GLP-1RAs have good potential protective properties against SUD especially in observational research with good safety. However, robust randomized trials are needed to confirm causality and clinical applicability.