In real-world data, GLP-1RAs differ in clinical indications, uptake over time, adherence rate, typical treatment duration, dose escalation, and patient selection, all of which can introduce residual confounding and channeling bias ( Notably, the observed reductions in the odds of substance use disorders, including a 74% decrease in the odds of AUD, a 69% reduction for OUD, a 68% reduction for NUD, and a 75% reduction for CUD, among GLP-1 RA users were consistent with emerging preclinical and clinical studies showing that GLP-1 RA modulates reward pathways in the brain to reduce SUD ( 4.1 Strengths and limitations of the study This study has several notable strengths
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