Diabetes Drugs Show Promise in Reducing Alcohol Consumption, New Trial Finds
A phase 2 clinical trial has revealed the potential of medications already approved for managing diabetes and obesity to significantly reduce alcohol consumption and cravings in individuals struggling with alcohol use disorder (AUD). The findings, published in JAMA Psychiatry, offer a novel approach to treating a condition with limited effective pharmaceutical options and a substantial public health impact.
Understanding Alcohol Use Disorder and the Urgent Need for New Treatments
AUD is characterized by a problematic pattern of alcohol use, encompassing difficulty controlling drinking, preoccupation with alcohol, and continued use despite negative consequences. According to the Mayo Clinic, it can also manifest as needing to consume more alcohol to achieve the same effect or experiencing withdrawal symptoms upon cessation. The scale of the problem is immense: an estimated 178,000 deaths annually in the U.S. and 2.6 million worldwide are attributed to alcohol consumption, contributing to major health crises like heart disease, liver disease, and cancer. Despite the prevalence – nearly 29% of U.S. adults meet the diagnostic criteria for AUD at some point in their lives – treatment rates remain low, with fewer than 10% receiving care and only 2% utilizing medication. Currently, only three drugs – disulfiram, naltrexone, and acamprosate – have FDA approval for AUD, and their use is hampered by stigma and limited awareness.
Semaglutide: A Potential Game-Changer?
The drug at the center of this promising research is semaglutide, marketed under the brand names Ozempic and Wegovy. It functions as an agonist, stimulating the GLP-1 receptor, a key regulator of blood sugar, appetite, and metabolic processes. Recent, informal reports have linked the increasing use of semaglutide – primarily prescribed for diabetes and obesity – with reduced alcohol intake and cravings among patients. Researchers, noting this trend and prior animal and laboratory studies suggesting reduced alcohol consumption with these medications, initiated a randomized clinical trial to investigate the potential further. The trial was also prompted by the growing number of individuals obtaining “off-label” prescriptions for semaglutide to address heavy drinking.
Trial Design and Participant Profile
Led by Christian S. Hendershot, Ph.D., of the Keck School of Medicine and Institute for Addiction Science at the University of Southern California, the phase 2 trial involved 48 participants recruited from the University of North Carolina, Chapel Hill. The participants, averaging around 40 years old, had met criteria for AUD within the past year and reported consuming more than seven (women) or 14 (men) drinks in a week, with at least two instances of heavy drinking. Approximately half of the participants had a BMI of 30 or higher, indicating obesity. Importantly, none of the participants were actively seeking treatment for their drinking or attempting to reduce their consumption at the study’s outset.
Participants were divided into two groups: half received weekly injections of semaglutide, starting at 0.25 mg and escalating to 0.5 mg after four weeks, then to 1 mg in the final week (the typical maximum dose for weight loss is 2.4mg/week). The other half received a placebo injection. The trial incorporated two key phases: laboratory tests assessing voluntary alcohol consumption and the ability to delay drinking, and self-reported alcohol consumption logs maintained throughout the nine-week study period. Participants who were also smokers (27% of the cohort) tracked their cigarette consumption as GLP-1 drugs are also being investigated for their potential to reduce nicotine cravings.
Encouraging Results: Reduced Drinking and Cravings
The results were encouraging. Compared to the placebo group, participants treated with semaglutide consumed significantly fewer drinks on days they drank alcohol and reported a greater reduction in heavy drinking days. They also experienced significantly lower levels of weekly alcohol craving throughout the trial. Notably, a subgroup of smokers receiving semaglutide also demonstrated a greater reduction in daily cigarette consumption compared to those receiving the placebo. Researchers observed a clear “dose-sensitivity,” with the beneficial effects of semaglutide increasing as the dosage was doubled from 0.25mg/week to 0.5mg/week.
“When participants completed both pre- and post-treatment alcohol self-administration sessions, we observed greater reductions in the medication group,” explained Dr. Hendershot. “This is a key aspect of this study because this is an objective, rather than self-report, measure of alcohol consumption.” The treatment was also found to be safe and well-tolerated.
Implications for Medication Repurposing and Future Research
The study’s findings are particularly significant given that a substantial number of individuals are already using GLP-1-based medications “off-label” to curb heavy drinking. This presents a unique opportunity for “medication repurposing,” according to the research team. The data suggest semaglutide may be most effective for individuals seeking to reduce their alcohol consumption and patterns of heavy drinking, rather than those aiming for complete abstinence.
While the current trial was small and relatively short in duration, the team emphasizes the need for larger, longer-term controlled clinical trials involving both individuals with moderate and severe AUD. Future research should also explore the efficacy of other GLP-1-based medications already approved by the FDA. These medications have already undergone rigorous safety testing, potentially accelerating their evaluation for the treatment of problematic alcohol consumption.
