Ozempic may reduce alcohol craving and consumption, new study finds

A new clinical trial suggests that semaglutide — the active ingredient in the widely used drugs Ozempic and Wegovy — may help reduce alcohol consumption and cravings in people with alcohol use disorder. In the study, published in JAMA Psychiatry, participants who received low doses of semaglutide weekly showed reduced alcohol intake, fewer heavy drinking days, and lower craving levels compared to those who received a placebo. The results offer early evidence that semaglutide could play a role in treating alcohol use disorder and support further investigation in larger studies.

Semaglutide is a type of medication originally developed to treat type 2 diabetes. It works by mimicking a natural hormone in the body called glucagon-like peptide-1, which helps regulate blood sugar, appetite, and digestion. More recently, semaglutide has gained popularity under brand names like Ozempic and Wegovy for its strong effects on weight loss. As more people have used these drugs, some began reporting an unexpected side effect: a reduced desire to drink alcohol. This anecdotal evidence, along with earlier animal studies showing that drugs like semaglutide could reduce alcohol consumption, prompted researchers to formally test the drug’s effects in people with alcohol use disorder.

Alcohol use disorder is a serious and widespread condition that affects millions of people in the United States and around the world. It can lead to a wide range of health problems, including liver disease, heart issues, certain cancers, and early death. Despite its impact, only a small percentage of people with alcohol use disorder ever receive medical treatment. One reason is the limited number of approved medications for this condition. New options that are effective and easy to use could help close this treatment gap. Since semaglutide is already widely prescribed for other conditions, researchers wanted to explore whether it might also help people drink less — even if they weren’t actively trying to quit.

To test this idea, researchers at the University of North Carolina School of Medicine conducted a phase 2 clinical trial involving 48 adults who met diagnostic criteria for alcohol use disorder but were not currently seeking treatment. Participants were randomly assigned to receive either semaglutide or a placebo through weekly injections over a 10-week period. The study was designed to reflect real-world use, focusing on people who were still drinking regularly but not pursuing formal help. The team used a combination of laboratory and outpatient methods to measure alcohol use, craving, and other outcomes over time.

The participants completed two key lab sessions, one before and one after treatment, in which they could choose to consume alcohol in a controlled setting. They were given access to their preferred drinks and allowed to drink freely within a time limit, while researchers measured how much they consumed and tracked their breath alcohol levels. Outside of the lab, participants attended weekly clinic visits where they reported how much they drank, how often they had heavy drinking days, and how strong their alcohol cravings were. The research team also monitored weight, blood pressure, and side effects.

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The results showed that semaglutide led to noticeable changes in alcohol-related behavior. In the laboratory sessions, people who received semaglutide drank less and reached lower peak breath alcohol concentrations compared to those in the placebo group. These effects were most pronounced at the 0.5 mg weekly dose, with the drug showing a medium to large impact on how much alcohol participants consumed in that setting.

Outside of the lab, semaglutide was associated with fewer drinks per drinking day and a greater reduction in the number of heavy drinking days over time. Heavy drinking was defined as four or more drinks in a day for women, or five or more for men. Participants who received the drug were more likely to have weeks with no heavy drinking days at all, especially during the second month of the study. They also reported lower cravings for alcohol, suggesting that the drug might reduce both the desire and the tendency to drink heavily. However, semaglutide did not significantly change the number of total drinking days or the average number of drinks consumed per calendar day.

Interestingly, the researchers also found that among participants who smoked cigarettes, those in the semaglutide group reported a steeper drop in daily cigarette use compared to those on placebo. While this analysis included only a small number of people, it hints at broader effects semaglutide might have on addictive behaviors.

Importantly, the medication was well tolerated. Most side effects were mild and consistent with known effects of semaglutide, such as nausea. There were no serious adverse events or dangerous interactions with alcohol. As expected from earlier research, participants who received semaglutide also experienced modest weight loss over the course of the study.

The findings are in line with another recent study. A large population study using Swedish health records found that people with alcohol use disorder who were prescribed semaglutide had a significantly lower risk of hospitalization due to their drinking, with reductions surpassing those seen with approved alcohol use disorder medications like naltrexone.

But despite these promising findings, the new study has several limitations. It was relatively small, with only 48 participants, and lasted just 10 weeks. The researchers also used low doses of semaglutide to ensure safety, which means the full potential effects of higher doses remain unknown. In addition, participants had moderate levels of alcohol use and were not actively trying to quit, so the results might not apply to those with more severe alcohol problems or people in treatment settings.

The authors of the study say that larger and longer trials are needed to confirm the benefits and safety of semaglutide for treating alcohol use disorder. Future studies should include people with a wider range of alcohol use patterns and look at higher doses of the medication to see whether stronger effects can be achieved. It will also be important to determine whether semaglutide can support long-term changes in alcohol use and whether it can help people stay sober if they are trying to quit.

The study, “Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial,” was authored by Christian S. Hendershot, Michael P. Bremmer, Michael B. Paladino, Georgios Kostantinis, Thomas A. Gilmore, Neil R. Sullivan, Amanda C. Tow, Sarah S. Dermody, Mark A. Prince, Robyn Jordan, Sherry A. McKee, Paul J. Fletcher, Eric D. Claus, and Klara R. Klein.