Semaglutide and Liraglutide Associated with Reduction in Alcohol and Substance Use Disorder-related Hospitalizations

Preliminary research on the effectiveness of GLP-1 agonists for the treatment of substance use disorder (SUD) is raising hope for improved pharmacotherapy. This large Swedish observational cohort study evaluated whether patients with alcohol use disorder (AUD) diagnoses receiving GLP-1 agonists had a lower risk of hospitalization for AUD or SUD, compared with when they were not receiving these medications. Researchers also assessed the risk of hospitalization associated with receipt of medications approved for AUD (i.e., naltrexone, acamprosate, disulfiram).

• The cohort included 227,866 people with an AUD diagnosis, of whom 133,210 experienced AUD-related hospitalization, 138,390 experienced SUD-related hospitalization, and 6726 were prescribed GLP-1 agonists. Median GLP-1 cohort follow-up was 8.8 years.
• Periods of semaglutide and liraglutide receipt were associated with a lower risk of AUD hospitalization, compared with periods when these medications were not prescribed (adjusted hazard ratio [aHR], 0.64 and 0.72, respectively).
• Receipt of both medications was also associated with a lower risk of SUD hospitalization, compared with periods when these medications were not prescribed (aHR, 0.68 [semaglutide] and 0.78 [liraglutide]).
• Receipt of AUD medication in general was not associated with a lower risk of AUD or SUD hospitalization, although receipt of naltrexone was associated with a reduced risk of both (aHR, 0.86 for both).

Comments: This study provides additional rationale for testing GLP-1 agonists for the treatment of AUD. Bias in any comparison of GLP-1 agonists and approved AUD medications would be present if approved AUD medications were initiated at a time of worsening AUD, or if GLP medications were initiated at a time of relative AUD stability, both of which are plausible in this study. Placebo and comparative trials of GLP-1 agonists are needed.

Joseph Merrill, MD, MPH

Reference: Lähteenvuo M, Tiihonen J, Solismaa A, et al. Repurposing semaglutide and liraglutide for alcohol use disorder. JAMA Psychiatry. 2025;82(1):94–98.