Blockbuster drug for diabetes and obesity could also help reduce alcohol intake

The blockbuster drug semaglutide, better known as Ozempic for diabetes and Wegovy for obesity, could also help people cut down on their alcohol intake, according to new USC research.

The findings, published in JAMA Psychiatry, showed that the weekly medication, compared with a placebo, reduced alcohol craving, drinking quantity and the frequency of heavy drinking days.

The discovery could help address an important treatment gap: An estimated 178,000 U.S. deaths per year can be attributed to alcohol, which is linked to liver disease, cardiovascular disease and is a known cause of cancer, as noted recently by the U.S. Surgeon General. Nearly a third of American adults have met criteria for problem drinking at some point in their lives - yet very few seek or receive treatment.

The study affirms a common observation by many patients and doctors since Ozempic and drugs like it exploded in popularity: people begin weekly injections of semaglutide for obesity or diabetes - and suddenly lose their desire for alcohol.

This is the first randomized, placebo-controlled clinical trial of semaglutide designed to study the phenomenon, said Christian Hendershot, first author of the study and director of clinical research at USC's Institute for Addiction Science.

The drugs currently approved to treat alcohol use disorder aren't widely used. The popularity of semaglutide and other GLP-1 receptor agonists increases the chances of broad adoption of these treatments for alcohol use disorder, if approved for this indication, said Hendershot, who is a professor of population and public health sciences at the Keck School of Medicine of USC.

These results justify larger studies of GLP-1 receptor agonists for alcohol use disorder, Hendershot added.

The experiment

For the trial, researchers recruited 48 adults with alcohol use disorder who weren't actively seeking treatment. Alcohol use disorder is defined by a range of possible symptoms, including the inability to stop or control one's drinking despite negative consequences.

Participants had a past-month drinking history of more than seven (for women) or more than 14 (for men) standard drinks in a week as well as two or more heavy drinking episodes (4 or more drinks for women and 5 or more for men).

One week prior to the first injection, researchers invited participants to drink their preferred alcoholic beverages over a two-hour period in a comfortable, lab setting, with instructions to delay drinking if they wished. Researchers documented delays and drinks consumed.

Participants were then randomly assigned to receive weekly, low-dose injections of Ozempic or a placebo for nine weeks, during which time their weekly drinking patterns were also measured. Afterwards, participants and researchers returned to the drinking lab to repeat the process and see what changed.

What changed?

Results, measured by grams of alcohol consumed and breath alcohol concentration, indicated that semaglutide injections reduced weekly alcohol craving, reduced average drinks on drinking days, and led to greater reductions in heavy drinking days, relative to the placebo. A key finding was that the magnitude of semaglutide's effects on several drinking outcomes was relatively greater than is often seen with existing medications to reduce alcohol cravings, even though semaglutide was only administered at the lowest clinical doses.

In the last month of treatment, those in the semaglutide group significantly reduced their number of heavy drinking days. Also, nearly 40% of people in the semaglutide group reported no heavy drinking days in the last month of treatment, compared to 20% in the placebo group.

Among a small subgroup of participants who smoked cigarettes at baseline, those treated with semaglutide had significantly greater reductions in average cigarettes per day compared to those in the placebo group.

These data suggest the potential of semaglutide and similar drugs to fill an unmet need for the treatment of alcohol use disorder. Larger and longer studies in broader populations are needed to fully understand the safety and efficacy in people with alcohol use disorder, but these initial findings are promising."

Klara Klein, senior author, University of North Carolina School of Medicine

About this study

In addition to Hendershot and Klein, other authors of the study are Michael Bremmer, Michael Paladino, Georgios Kostantinis, Thomas Gilmore, Neil Sullivan, Amanda Tow, Robyn Jordan, all of University of North Carolina at Chapel Hill; Sarah S. Dermody Toronto Metropolitan University; Mark Prince of Keck School of Medicine of USC; Sherry A. McKee of Yale School of Medicine; Paul J. Fletcher of University of Toronto; and Eric D. Claus of Pennsylvania State University.

This research was supported by National Institute on Alcohol Abuse and Alcoholism grant R21AA026931.