New observational research indicates that newer GLP-1 receptor agonists, semaglutide and tirzepatide, may be associated with reduced alcohol-related hospital admissions in adults with type 2 diabetes, obesity, or alcohol use disorder, though further trials are necessary to confirm these findings.
A study published in BMJ Open suggests that semaglutide and tirzepatide may be linked to fewer alcohol-related hospital admissions in adults with type 2 diabetes, obesity, or alcohol use disorder, adding to a growing but still preliminary body of evidence around the drugs’ possible effect on drinking behaviour. The analysis used electronic health record data from US health systems and compared newer GLP-1 medicines with older diabetes, obesity and alcohol use disorder treatments. Researchers said the findings were observational rather than proof of cause and effect, and stressed that randomised trials are needed before any clinical conclusions can be drawn.
The study emulated four target trials across different patient groups, including adults with type 2 diabetes, adults with obesity, and people with alcohol use disorder who also had either condition. In the diabetes cohort, those given semaglutide or tirzepatide had lower one-year risk of alcohol-related hospitalisation than people taking sulphonylureas or other diabetes drugs. In the obesity cohort, the newer GLP-1 medicines were associated with lower risk than non-GLP-1 obesity drugs, though not compared with older GLP-1 medicines.
Among patients with alcohol use disorder and type 2 diabetes, the newer drugs were linked with a markedly lower risk of alcohol-related hospitalisation than FDA-approved medicines for alcohol use disorder. A similar pattern appeared in the alcohol use disorder and obesity group. The authors also reported lower risk of non-alcohol-related hospitalisation in the two alcohol use disorder cohorts, but not in the diabetes or obesity groups, a detail they said may warrant caution in interpreting the results.
Hemalkumar B. Mehta of Johns Hopkins Bloomberg School of Public Health told Healio that the work shows an association, not a causal effect, and said the drugs are not approved for alcohol use disorder. He added that the size and consistency of the signal was surprising, but said residual confounding was still possible and that adequately powered trials with meaningful clinical outcomes are needed. Earlier research, including a Scientific Reports study of people with obesity, had already suggested semaglutide and tirzepatide might reduce alcohol consumption, while other recent summaries of the BMJ Open paper also emphasised that the observational data do not establish the medicines as treatments for alcohol use disorder.
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