Adults with moderate-to-severe alcohol use disorder who took a daily semaglutide pill for eight weeks had fewer heavy drinking days than those who took a placebo, according to a randomized, double-blind trial led by researchers at the University of Colorado Anschutz and published July 29 in the American Journal of Psychiatry. The trial enrolled 50 adults who were seeking treatment for their drinking, and it tested the oral tablet form of semaglutide rather than the injectable version used in earlier alcohol trials.
Key takeaways
- In 50 adults over eight weeks, oral semaglutide reduced heavy drinking days, drinks per drinking occasion, day-to-day cravings, and alcohol-related problems compared with placebo.
- Participants also had fewer cannabis use days, and the drug was generally well tolerated with mostly mild side effects.
- Fifty people over eight weeks is an early signal, not a reason to change practice. Larger and longer trials are already being planned.
What the study found
The trial was randomized, double-blind, and placebo-controlled, according to the announcement from CU Anschutz. Per the trial registration, participants took semaglutide 3 mg each morning for four weeks, then 7 mg each morning for four more weeks, or a matching placebo capsule on the same schedule. The study was funded in part by the National Institute on Alcohol Abuse and Alcoholism.
Compared with placebo, people on oral semaglutide had fewer heavy drinking days, drank less on the occasions when they did drink, reported lower day-to-day cravings, reported fewer alcohol-related problems, and improved on an overall drinking risk rating. They also had fewer days of cannabis use.
The picture was not uniform. The researchers noted that not all measures changed in the controlled laboratory setting, even though the real-world drinking measures moved consistently in the same direction. The registered primary endpoint was a craving score measured in the lab after participants were shown alcohol cues.
Side effects were mostly mild, and adherence and completion rates were high, which the team described as supporting feasibility in ordinary clinical settings. Researchers said larger and longer studies are needed to confirm the findings and work out the right dose and treatment approach.
“This study suggests oral semaglutide may help reduce heavy and harmful drinking, even in people who are not trying to quit alcohol entirely,” said Joseph Schacht, PhD, associate professor at the CU Anschutz School of Medicine, in the announcement.
Dr. Kumar’s take
The word doing the most work in this headline is “oral.” Earlier alcohol signals for semaglutide came from the weekly injection, and asking someone in the middle of an addiction to inject themselves every week is a real barrier. A tablet you swallow with your morning coffee is the form people will actually accept and stay on, so the high adherence and completion rates here matter to me as much as the drinking numbers do. I covered the earlier injectable data in can semaglutide help people drink less alcohol.
The size is the limit. Fifty people over eight weeks is a phase-2-sized signal. It is the kind of result that justifies a large trial, not the kind that changes what I prescribe on Monday. Small psychiatric trials look impressive and then shrink when they are repeated at scale, which is what I flagged when writing about the first double-blind psilocybin depression trial. The lab result also needs stating plainly: the cue-craving measure in the laboratory did not move the way the real-world drinking measures did, and that gap deserves an explanation rather than a shrug.
The most interesting finding is the one buried in the announcement. Drinking fell in people who were not trying to quit at all, and cannabis use days fell too. That is not an alcohol-specific effect. That looks like a drug turning down a general reward and craving circuit, the same circuit that governs food, alcohol, nicotine, and probably several other things people compulsively pursue. If so, the real question is not whether semaglutide treats alcohol use disorder. It is whether GLP-1 drugs treat wanting.
What it means for you
Nothing here justifies asking your doctor for semaglutide to control your drinking. It is not approved for alcohol use disorder, this trial was small, and eight weeks tells us nothing about whether the effect lasts or what happens when you stop.
If you already take semaglutide for diabetes or weight and you have noticed you want alcohol less, that is a real and increasingly documented effect. Mention it to your doctor rather than treating it as a private curiosity.
If you are drinking at a level that worries you, the useful step today is the boring one. Three medications for alcohol use disorder are already FDA approved, naltrexone, acamprosate, and disulfiram, and most people who could benefit from them have never been offered one. Ask about those now, and watch semaglutide for the larger trials.