PCSS-MAUD: Medications for Alcohol Use Disorder in Field Medicine Settings-Slides

Slides

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This webinar reviewed the emerging role of GLP-1 receptor agonists (GLP-1RAs), such as semaglutide and tirzepatide, as potential treatments for alcohol use disorder (AUD). It began by highlighting the large public health burden of unhealthy alcohol use and the limited reach of current FDA-approved medications for AUD. The speaker explained GLP-1 biology, including how these hormones act on appetite, satiety, reward, and stress-related brain circuits. GLP-1 receptors are found in brain regions involved in craving and reinforcement, providing a plausible mechanism for reducing substance use.<br /><br />Preclinical studies in rodents consistently showed reduced alcohol intake, reward, and relapse-related behavior after GLP-1 or GLP-1RA treatment. Human evidence is still early but growing. Observational studies and registry data suggest lower rates of alcohol-related outcomes among people taking GLP-1RAs, especially semaglutide. Early randomized trials showed mixed but encouraging results: exenatide had no overall effect on drinking but reduced alcohol cue-reactivity and may have helped obese participants; semaglutide showed stronger positive effects in later trials, including reduced heavy drinking days, alcohol craving, and lab-based alcohol self-administration. A treatment-seeking trial in individuals with obesity found semaglutide was well tolerated and produced clinically meaningful reductions in drinking.<br /><br />The talk also reviewed ongoing and planned trials across AUD and other substance use disorders, reflecting rapidly expanding interest in this area. However, important concerns remain: long-term safety, possible disordered eating, medication access, misuse or micro-dosing, counterfeit products, and drug-drug interactions due to altered pharmacokinetics. Psychiatric safety data are reassuring overall, with no clear increase in depression or suicidality, but monitoring is advised.<br /><br />The speaker concluded that GLP-1RAs are promising but not yet established AUD treatments. They may be reasonable when there is already a clinical indication, while existing evidence-based AUD treatments should remain first-line.

Keywords

GLP-1 receptor agonists

semaglutide

tirzepatide

alcohol use disorder

unhealthy alcohol use

reward circuits

alcohol craving

heavy drinking days

preclinical studies

psychiatric safety