A groundbreaking study published in JAMA Psychiatry reveals that semaglutide, the active ingredient in popular GLP-1 medications like Ozempic and Wegovy, may help reduce alcohol cravings and the frequency of heavy drinking days in individuals diagnosed with alcohol use disorder (AUD). Conducted with a rigorous clinical trial, the study involved participants who significantly cut down their heavy drinking days during the last month of treatment. Notably, about 40% of the semaglutide group reported no heavy drinking days in this period. The study offers hope for approximately 400 million people worldwide living with AUD, providing a potential new treatment option that could enhance accessibility and acceptance.
Semaglutide's potential role in treating AUD is particularly significant given the low adoption rate of existing FDA-approved medications, which only about 2% of people with AUD currently use. Participants receiving semaglutide injections reported a noticeable reduction in weekly alcohol cravings, average drinks on drinking days, and heavy drinking days compared to those receiving a placebo. This finding suggests semaglutide could become an effective tool in managing AUD, offering an alternative to existing medicinal treatments.
“The reduction in alcohol craving and heavy/binge drinking days is particularly important as cravings are a significant factor for relapse. Having an alternative treatment option could increase accessibility and acceptance given the lower adoption rate of existing FDA approved AUD medications. Another promising aspect is semaglutide is already widely used in general medical settings which can potentially increase accessibility and further aim to reduce stigma often associated with AUD treatments.” – Hussain M. Abdullah, MD
Terrence Walton, MSW, executive director of NAADAC, expressed optimism about the study's implications, emphasizing that a new treatment option could enhance access and acceptance among those with AUD. He acknowledged the limitations of the study, including its small sample size and short duration, but remained hopeful for future research.
“I am always encouraged when I learn of a new tool for treating any substance use disorder, whether that is a psychosocial intervention, or a pharmaceutical,” – Terrence Walton, MSW
“Because there are several FDA-approved medications for alcohol use and opioid use disorders and none for methamphetamine, cocaine, or other stimulant use disorders, I was mildly disappointed that the focus was AUD. Nonetheless, I was intrigued to learn if a randomized, controlled, double-blind study would validate the anecdotal accounts I have heard regarding reductions in alcohol and drug cravings for people on weight loss medications,” – Terrence Walton, MSW
“I am looking forward to the next phase, which will likely include a significantly larger sample and more variation in dosage,” – Terrence Walton, MSW
Despite the promising results, experts urge caution. Fenno highlighted the necessity of high-quality studies with direct clinical utility to substantiate these findings further.
“There have been rumors that GLP1s may have an effect on alcohol consumption — we need high quality studies with direct clinical utility to know whether the rumors are true, and if so, how to use this class of medications effectively and with which patients. This study is an early step toward answering these questions. The results suggest that it is worth conducting larger and longer studies.” – Fenno
The heterogeneous nature of alcohol use disorder complicates treatment strategies. Klara Klein, MD, PhD, senior author of the study, pointed out that while semaglutide's effectiveness for AUD is encouraging, it underscores the need for FDA-approved medications for other substance use disorders.
“It is important that future studies include those with severe alcohol use disorder, including those who are treatment seeking and who may desire abstinence.” – Terrence Walton, MSW
“Alcohol use and alcohol use disorder are common and closely associated with occupational dysfunction, relationship harm, and crime, in addition to severe medical and psychiatric consequences, including early death,” – Fenno
J. Greg Hobelmann, MD, MPH, expressed excitement over the study but cautioned against relying solely on anecdotal evidence. He emphasized the importance of robust scientific research to validate initial findings.
“I am thrilled to see this study,” – J. Greg Hobelmann, MD, MPH
“There has been a lot of hype about semaglutide (and other incretin mimetics), but we ought not base treatment on intuition and anecdotal reports.” – J. Greg Hobelmann, MD, MPH
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