These results are promising but not yet definitive. They suggest that semaglutide may help reduce alcohol cravings and the amount consumed, even without requiring complete abstinence, which may be a viable alternative for many people who have difficulty stopping drinking completely.
Alcohol consumption is one of the leading preventable causes of disease and death worldwide, accounting for an estimated 4% to 5% of the global disease burden and approximately 2.6 million deaths each year.
Alcohol is linked to more than 200 health conditions, including heart disease, cancer, and liver disease. Since 2020, the number of people with alcohol-related liver disease has increased, contributing to a 29% increase in alcohol-related deaths in the United States since 2016-2017.
Alcohol is currently estimated to cause about 178,000 deaths annually in the United States, and this number is expected to continue to rise.
In the United States, approximately 29% of adults have met the diagnostic criteria for alcohol use disorder (AUD) at some point in their lives, and 11% have had the disorder in the past year.
However, less than 10% of these people seek treatment and less than 2% receive medication to help reduce their consumption. This problem is considered one of the biggest failures in the health care system, since there are medications that could help, but they are little known, there are few options approved by the FDA (US regulatory agency) and still face barriers linked to the stigma of alcoholism.
What many do not know is that even reducing the amount of alcohol consumed, without having to stop completely, already brings health benefits.
Therefore, finding medications that help in this reduction and are widely accepted by the medical community is an urgent need. A class of medications called glucagon-like peptide 1 receptor agonists (GLP-1RAs) has shown potential to help in this process. These medications were initially developed to treat diabetes and obesity and have shown very effective results.
One of the most promising is semaglutide, which was approved in the US for diabetes in 2017 and for obesity in 2021. In recent years, some people taking semaglutide have reported a reduction in their desire and consumption of alcohol, which has caught the attention of scientists.
Animal studies have already shown that this class of drugs can reduce interest in alcohol and reduce its ability to generate pleasure in the brain, suggesting that they could be useful in the treatment of alcohol use disorder.
Although there are still no definitive clinical studies in humans, there are already reports that semaglutide has been prescribed experimentally for this purpose, reinforcing the need for more in-depth scientific tests.
To investigate this possible effect of semaglutide on alcohol consumption, researchers at the University of Southern California, USA, conducted a phase 2 clinical trial (an intermediate stage in testing new treatments).
The study was conducted in the US between September 2022 and February 2024 and involved 48 participants (14 men and 34 women), with an average age of 39 years and diagnosed with alcohol use disorder who were not seeking treatment.
The participants were randomly divided into two groups: one received progressive doses of semaglutide (starting with 0.25 mg per week and increasing to 1 mg in the last week), while the other group received a placebo (a substance with no effect).
The scientists analyzed how the participants consumed alcohol before and after treatment. The main objective was to measure the amount of alcohol consumed in a laboratory test, where the participants were allowed to drink freely. In addition, the researchers monitored changes in daily alcohol consumption and desire to drink over the nine weeks of the study.
The results showed that semaglutide significantly reduced the amount of alcohol consumed in the laboratory test. Participants who took the drug drank less and had a lower concentration of alcohol in their breath compared to those who took a placebo.
Results found in adults with alcohol use disorder who received semaglutide or placebo once a week for 8 weeks.
However, when they looked at average daily alcohol consumption over the course of the study, the researchers found no significant differences between the two groups.
Still, semaglutide helped reduce the number of drinks consumed on days when participants drank and also reduced the urge to drink. In addition, the drug appeared to have an indirect effect on reducing binge drinking over time.
Interestingly, the researchers also noted that semaglutide helped reduce the number of cigarettes smoked in a subsample of participants who were smokers.
This finding suggests that the drug may have a broader effect on the brain mechanisms involved in compulsion and craving for substances. These results are promising, but they are not yet definitive. They suggest that semaglutide may help reduce alcohol cravings and the amount consumed, even without requiring complete abstinence, which may be a viable alternative for many people who have difficulty stopping drinking completely.
However, to confirm these effects and better understand the impact of the drug in the treatment of alcohol use disorder, larger and longer studies are needed. If the results are positive, GLP-1RA drugs could become a new option in the fight against alcoholism, helping thousands of people to reduce their alcohol consumption and improve their health.
READ MORE:
Once-Weekly Semaglutide in Adults With Alcohol Use Disorder
A Randomized Clinical Trial
Christian S. Hendershot, Michael P. Bremmer, Michael B. Paladino, Georgios Kostantinis, Thomas A. Gilmore, Neil R. Sullivan, Amanda C. Tow, Sarah S. Dermody, CPsych5; Mark A. Prince, Robyn Jordan, Sherry A. McKee, Paul J. Fletcher, Eric D. Claus, and Klara R. Klein
JAMA Psychiatry. Published online February 12, 2025.
doi:10.1001/jamapsychiatry.2024.4789
Abstract:
Preclinical, observational, and pharmacoepidemiology evidence indicates that glucagon-like peptide 1 receptor agonists (GLP-1RAs) may reduce alcohol intake. Randomized trials are needed to determine the clinical significance of these findings. To evaluate the effects of once-weekly subcutaneous semaglutide on alcohol consumption and craving in adults with alcohol use disorder (AUD). This was a phase 2, double-blind, randomized, parallel-arm trial involving 9 weeks of outpatient treatment. Enrollment occurred at an academic medical center in the US from September 2022 to February 2024. Of 504 potential participants assessed, 48 non–treatment-seeking participants with AUD were randomized. Participants received semaglutide (0.25 mg/week for 4 weeks, 0.5 mg/week for 4 weeks, and 1.0 mg for 1 week) or placebo at weekly clinic visits. The primary outcome was laboratory alcohol self-administration, measured at pretreatment and posttreatment (0.5 mg/week). Secondary and exploratory outcomes, including prospective changes in alcohol consumption and craving, were assessed at outpatient visits. Forty-eight participants (34 [71%] female; mean [SD] age, 39.9 [10.6] years) were randomized. Low-dose semaglutide reduced the amount of alcohol consumed during a posttreatment laboratory self-administration task, with evidence of medium to large effect sizes for grams of alcohol consumed (β, −0.48; 95% CI, −0.85 to −0.11; P = .01) and peak breath alcohol concentration (β, −0.46; 95% CI, −0.87 to −0.06; P = .03). Semaglutide treatment did not affect average drinks per calendar day or number of drinking days, but significantly reduced drinks per drinking day (β, −0.41; 95% CI, −0.73 to −0.09; P = .04) and weekly alcohol craving (β, −0.39; 95% CI, −0.73 to −0.06; P = .01), also predicting greater reductions in heavy drinking over time relative to placebo (β, 0.84; 95% CI, 0.71 to 0.99; P = .04). A significant treatment-by-time interaction indicated that semaglutide treatment predicted greater relative reductions in cigarettes per day in a subsample of individuals with current cigarette use (β, −0.10; 95% CI, −0.16 to −0.03; P = .005). These findings provide initial prospective evidence that low-dose semaglutide can reduce craving and some drinking outcomes, justifying larger clinical trials to evaluate GLP-1RAs for alcohol use disorder.
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