The use of newer GLP-1 receptor agonists (semaglutide or tirzepatide) for obesity or diabetes by people with alcohol use disorder was associated with fewer alcohol-related hospitalizations, a study published online in an open access journal found BMJ Open.
The findings suggest a potential role for the drugs semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) in the treatment of alcohol use disorder.
GLP-1 receptor agonists are primarily used to treat type 2 diabetes and obesity, but reports of decreased alcohol consumption in patients taking the drugs have prompted the authors to investigate their potential impact on alcohol-related hospitalizations in adults with alcohol use disorders.
The study compared alcohol-related hospitalizations in 40,703 adults with alcohol use disorder and type 2 diabetes or obesity who started receiving a new GLP-1 receptor agonist (semaglutide or tirzepatide) or a comparator drug from January 1, 2018 to December 31, 2024. Participants were included in four trials that included clinically distinct populations: the Antidiabetic Drug (ADM) Trial, the Antiobesity Medication (AOM) Trial, the Treatment of Alcohol Use Disorder with Type 2 Diabetes (MAUD-T2D) Trial, and the Treatment of Alcohol Use Disorder with Obesity (MAUD-Obesity) Trial.
Compared with participants taking active control drugs, participants taking GLP-1 receptor agonists had a lower risk of alcohol-related hospitalization in all four trials.
Use of GLP-1 receptor agonists was associated with a 26% lower risk of alcohol-related hospitalization than other diabetes drugs during antidiabetic drug (ADM) trials and a 32% lower risk of alcohol-related hospitalization than other obesity drugs during antiobesity drug (AOM) trials.
In the MAUD trial, valid comparators were drugs to treat alcohol use disorder, such as acamprosate, disulfiram, and naltrexone. Compared with taking drugs to treat alcohol use disorder, use of GLP-1 receptor agonists by adults with type 2 diabetes was associated with a 63% lower risk of alcohol-related hospitalization during the study period, and use of GLP-1 receptor agonists among obese adults was associated with a 65% lower risk of alcohol-related hospitalization.
The authors acknowledge that their study has some limitations. Most importantly, alcohol use disorders are poorly understood, due in part to stigma, and when they are documented, they may be under-reported and unevenly documented in areas of high social deprivation. Alcohol-related outcomes may be poorly captured because they were defined using diagnostic codes and clinical tests for alcohol exposure, and treatment effects may differ in the average clinical setting because this study captures hospitalizations from treatment initiation to discontinuation in a clinical trial setting.
Finally, because newer GLP-1 receptor agonists are expensive treatments, and patients with access to these agents may differ from the comparison group, there may have been some confounding regarding socioeconomic status, underlying clinical stability or severity of alcohol use disorder, and health care engagement.
The risk of residual confounding was highest in the MAUD trial, as evidenced by the reduced risk of non-alcohol-related hospitalizations with the use of GLP-1 receptor agonists. The authors say the results of the MAUD trial should be interpreted with more caution, as treatment discontinuation rates were also high, raising the possibility of bias.
Nevertheless, the authors conclude that “initiation of new GLP-1 receptor agonists in patients with alcohol use disorder is associated with the observed reduced risk of alcohol-related hospitalization, with similar associations across populations with type 2 diabetes and obesity.”
“These findings may suggest a potential role for GLP-1 receptor agonists in alcohol use disorder.”
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Reference magazines:
Rodriguez, P.J. others. (2026). Association between GLP-1 receptor agonists and alcohol-related hospitalizations in adult alcohol use disorder patients: A multi-subject trial emulation study. BMJ open. DOI: 10.1136/bmjopen-2025-109259. https://bmjoopen.bmj.com/content/16/7/e109259
