Popular weight loss, diabetes drug shows promise in reducing cravings for alcohol

Unexpected benefit

By Leigh Hopper

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 research led by a USC investigator.

The findings, published in JAMA Psychiatry, showed that weekly injections of semaglutide — compared with placebo injections — reduced alcohol craving, drinking quantity and the frequency of heavy drinking days in adults with symptoms of alcohol use disorder.

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, 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 (four or more drinks for women and five or more for men).

One week prior to the first injection, researchers invited participants to drink their preferred alcoholic beverage over a two-hour period in a comfortable, lab setting, with instructions to delay drinking if they wished. Researchers documented the amount of alcohol 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. Afterward, 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 appeared greater than is often seen with existing medications to reduce alcohol cravings, even though semaglutide was only administered at the lowest clinical doses.

Medication effects also appeared stronger with increasing doses. By the second month of treatment, those in the semaglutide group had reduced the quantify of alcohol consumed on drinking days by an average of nearly 30%, compared to an average reduction of about 2% in the placebo group. Also, nearly 40% of people in the semaglutide group reported no heavy drinking days in the second 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, suggesting that semaglutide might reduce both alcohol and nicotine use.

“These data suggest the potential of semaglutide and similar drugs to fill an unmet need for the treatment of alcohol use disorder,” said senior author Klara Klein of the University of North Carolina School of Medicine. “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.”

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 and Robyn Jordan, all of University of North Carolina at Chapel Hill; Sarah S. Dermody of Toronto Metropolitan University; Mark Prince of Keck School of Medicine; Sherry A. McKee of Yale University School of Medicine; Paul J. Fletcher of University of Toronto; and Eric D. Claus of  The Pennsylvania State University.

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