Semaglutide Reduced Harmful Alcohol Use in Clinical Trial

A clinical trial led by researchers at CU Anschutz has found that oral semaglutide, a medication widely used for diabetes and weight loss, reduces heavy drinking in adults with Alcohol Use Disorder (AUD).

The study, published today in The American Journal of Psychiatry, evaluated the oral formulation of semaglutide, which may be more acceptable for people with AUD than the injectable formulations previously tested for AUD.

“This study suggests oral semaglutide may help reduce heavy and harmful drinking, even in people who are not trying to quit alcohol entirely,” said Joseph Schacht, PhD, associate professor at the CU Anschutz School of Medicine. “It could represent a new treatment option for AUD, particularly for those who have not benefited from existing medications, and may reduce alcohol-related health and social harms. Importantly, even reducing heavy drinking can lead to meaningful improvements for patients and families.”

AUD is a chronic medical condition in which individuals have difficulty controlling alcohol use despite harmful consequences. It affects millions of people and remains difficult to treat, with limited medication options available. No new medications have been approved for AUD in nearly two decades, underscoring the urgent need for additional treatment approaches.

KEY FINDINGS

In an eight-week randomized, double-blind, placebo-controlled trial involving 50 adults seeking treatment for moderate-to-severe AUD, participants receiving oral semaglutide showed:

• Fewer heavy drinking days
• Reduced alcohol consumption per drinking occasion
• Lower day-to-day alcohol cravings
• Fewer alcohol-related problems
• Improved overall drinking risk level
• Reduced cannabis use days

While not all measures changed in controlled laboratory settings, the overall pattern showed consistent reductions in harmful real-world drinking behavior.

WHY THIS MATTERS FOR PATIENTS AND FAMILIES

“Alcohol Use Disorder can affect nearly every part of life, including physical health, mental health, relationships and safety. Many people do not respond to current treatments, highlighting a significant unmet medical need,” Schacht said. “With no new FDA-approved medications for AUD since 2006, identifying new therapeutic options is especially critical. For families, even modest reductions in heavy drinking can mean greater stability, fewer crises and improved quality of life.”

These findings suggest oral semaglutide may:

• Help people reduce harmful drinking even without full abstinence
• Offer a new treatment option for individuals who do not respond to existing medications
• Reduce alcohol-related health, safety and social harms

SAFETY AND NEXT STEPS

Oral semaglutide was generally well tolerated, with most side effects reported as mild. Study participants demonstrated high adherence and completion rates, supporting feasibility in real-world clinical settings.

Researchers emphasize that larger and longer-term studies are needed to confirm findings and determine optimal dosing and treatment strategies for Alcohol Use Disorder.

CU Anschutz and partner institutions are planning to conduct larger trials soon.

Reference: Schacht JP, Sakai JT, Raymond K, Shelton R. Oral semaglutide for alcohol use disorder: a randomized clinical trial. Am J Psychol. 2026:appi.ajp.20260003. doi: 10.1176/appi.ajp.20260003

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