Here’s what you wanted to know about new research about GLP-1 medications to reduce alcohol use.
Note: This post is for informational purposes only and is not intended to replace or substitute for any medical or other advice. Please consult your healthcare provider for guidance specific to you.
We often hear surprise when people first learn that there are medications that can help them quit or cut back on their drinking, but naltrexone was approved to treat alcohol use disorder in 1994, and acamprosate was approved in 2004. That’s decades! Now there are new medication breakthroughs being studied. Among these is emerging research about the use of GLP-1 medications—in the headlines for their use for diabetes and weight loss—to reduce alcohol cravings and change drinking behaviors.
This use of GLP-1s is new and exciting. In a recent online webinar event, Eileen Barrett, MD, MPH, Workit Health’s Senior Medical Director and VP of Quality, and Marlene Lira, MPH, Workit Health’s Senior Director of Research, discussed GLP-1 medications for alcohol use. You can watch the webinar here on YouTube.
At the end of the webinar, we opened things up for a Q & A session. Our attendees had so many fantastic questions for these experts! We wanted to take the opportunity to share Dr. Barrett and Marlene’s answers:
Questions about GLP-1 medications for alcohol use
Q: How long have GLP-1 drugs been studied?
A: The original hormone that led to the development of GLP-1 medications, exendin-4, was discovered around 1992, and studies for diabetes began thereafter, with the first GLP-1 approved by the FDA for diabetes in 2005. The neuroscientific overlaps between obesity and substance use began to surface in the early 2000s, with the first animal studies of GLP-1s for substance use disorders taking place in the 2010s. The results from the first clinical trial of exenatide (also known as Saxenda or Victoza) in humans were published in 2022. The results from the first clinical trial of semaglutide (also known as Ozempic or Wegovy) were published in 2025. Ongoing trials of GLP-1s for alcohol use disorder can be found on clinicaltrials.gov.
Q: Can you take naltrexone (Vivitrol) and a GLP-1 together?
This is a common question! Generally, it’s not believed that GLP-1s interact with (which is available as a shot called Vivitrol). However, both medications can cause nausea. So a medical provider may recommend staggering the start of these two medications to make sure someone doesn’t develop severe nausea—and also explore if medication for nausea will help, too. A medical provider will assess for the best way forward.
Q: Are there official dosing guidelines for GLP-1 medications for alcohol use?
A: Right now, there aren’t official dosing guidelines for semaglutide specifically for alcohol use. The research that’s been done so far has used the same schedule that’s recommended for weight management, but, because the trials only lasted a few weeks, the maximum dose reached was 1 mg (instead of 2mg that is sometimes used in weight loss). After a comprehensive assessment, a medical provider usually will start at a low dose and increase gradually, following the standard schedule.
Q: Are all GLP treatments shots, or is there a pill?
There is one GLP-1 medication that comes in a pill form (semaglutide—with the pill being sold under the brand name Rybelsus), and it is similarly used to reduce complications from diabetes and heart disease. It is currently being studied for alcohol use, but the results of the trial are not available yet (as of September 2025).
Q: I have friends with severe alcoholism who are also skinny. Are GLP-1s for alcohol safe for someone who isn’t obese?
A: There is variability in the BMI thresholds that have been used in studies on GLP-1s and alcohol, but the first published trial of semaglutide excluded people with a BMI less than 23. If someone has a lower BMI than that, they may want to consider naltrexone or acamprosate. Regardless of what medication someone takes, it is recommended to have a healthy diet with calories that come from protein and vegetables rather than from sugary foods.
No matter what their BMI, if someone is started on a GLP-1, they will want to try to preserve their muscle mass by doing resistance exercise (sometimes called strength-building exercise) and by focusing on having healthier foods, including adequate protein and vegetables, and trying not to have carbonated drinks like soda or seltzer.
Q: GLP-1 medications are more expensive than most people can afford. Will insurance cover this drug?
Insurance is more likely to cover GLP-1s for diagnoses such as obesity, diabetes, and cardiovascular disease—so if someone has one or more of those diagnoses, we will work with them to see if their prescription can be covered by their insurance. There are also some legitimate, reduced-cost pharmacies that mail prescriptions to someone’s home, and these bring the cash price (i.e., cost without insurance coverage) down from around $1,000 per month to $350-$500 per month.
Q: Do you all think it’s possible to cut back and use responsibly, even daily?
A: Lots of people are able to achieve their recovery goal of cutting back on alcohol to a low enough amount that it doesn’t affect their relationships or work. Although growing evidence suggests there is no ‘healthy’ level of alcohol use, any reduction of alcohol use has health benefits—even if going from a lot to some, or from some to none.
Q: My husband is on a GLP-1 for diabetes, and we’ve had issues with it being out of stock as demand has risen. For use with alcohol cravings, what would we do if it’s out of stock?
There was a recent national shortage of GLP-1s, but this is now considered resolved. If such a shortage happens again, we would ask members to speak with their providers about options such as switching pharmacies, switching medications, or even dose reductions.
Q: Will GLP-1 medications cause other health issues in the future?
A: That’s a really important question. Every medication can have possible side effects, both short- and long-term. A medical provider can help you weigh the known benefits against the possible risks. For GLP-1s, we know the common short-term side effects, prepare members for them, monitor, and manage them with strategies such as dietary adjustments, dose adjustments, and medications to help digestive symptoms. For long-term effects, we keep up with new research and share new findings that mean we should change the treatment plan. These medications have been used for over a decade in diabetes care, and so far, they have a good safety profile. However, it is possible that the case is different for individuals without diabetes. When deciding on medications, it’s important to weigh possible risks from medication use with the known risks from ongoing unhealthy alcohol use.
Q: What if I’m already on tirzepatide?
People who are already on a GLP-1 are not recommended to start another one at the same time. If they aren’t reaching their recovery goals, they can talk with a medical provider about other medications, such as naltrexone or acamprosate. They could also look into behavioral health options, such as mutual aid, peer support groups, therapeutic groups, or therapy.
Q: How long does it take to fully recover?
Given that the research on GLP-1s and alcohol use disorder is ongoing, and individuals may have different goals for their recovery (stopping all alcohol use, reducing alcohol use), there is no single, right answer about how long it takes for individuals to meet their goals. In the recent clinical trial of semaglutide for alcohol use disorder, the group taking GLP-1s saw significant reductions in alcohol use and craving after eight weeks of treatment. Once a person begins meeting their goals, we generally recommend they continue with the supports that are helping them, whether that is medication, behavioral health support, or a combination.