Oral Semaglutide Cuts Heavy Drinking; VA Launches Alcoholism Trial

Oral semaglutide reduced heavy drinking days, alcohol consumption per drinking occasion, and day-to-day alcohol cravings in adults with alcohol use disorder (AUD), according to an 8-week randomized, double-blind, placebo-controlled trial published in The American Journal of Psychiatry.

Researchers at the University of Colorado Anschutz evaluated the oral formulation of semaglutide, which the authors noted may be more acceptable for people with AUD than injectable formulations previously tested for the disorder. The study enrolled 50 adults seeking treatment for moderate-to-severe AUD. Participants received oral semaglutide (3 mg/d for 4 weeks, then 7 mg/d for 4 weeks) or placebo for 8 weeks. Although semaglutide did not significantly reduce laboratory-assessed craving or drinks per day compared with placebo, it significantly reduced:

• Heavy drinking days (b=−0.580, 95% CI=−1.012, −0.148)
• Alcohol consumption per drinking occasion (b=−1.177, 95% CI=−2.307, −0.047)
• Day-to-day alcohol cravings (b=−2.195, 95% CI=−4.174, −0.216)
• Cannabis use days (b=−1.434, 95% CI=−2.568, −0.301)
• Alcohol-related problems (b=−4.618, 95% CI=−8.651, −0.585)

The treatment 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, the authors noted. Only one participant receiving semaglutide developed a rash. The researchers emphasize that larger, longer-term studies are needed to confirm the findings and determine optimal dosing and treatment strategies for AUD. With no new FDA-approved medications for AUD since 2006, identifying new therapeutic options is especially critical, the authors said. The study was funded in part by the National Institute on Alcohol Abuse and Alcoholism.

Separately, the U.S. Department of Veterans Affairs is launching a national clinical trial to test whether semaglutide can reduce alcohol consumption in veterans. The Cessation or Reduction of Alcohol Consumption in Veterans (CRAVE) trial will enroll more than 600 veterans with moderate or severe alcohol use disorder across 18 VA medical centers nationwide. Eligible participants are between 18 and 80 years old. Participants will receive weekly injections of either semaglutide or a placebo over a 24-week period, followed by a safety follow-up. Recruitment began on July 28, 2026. The federal trial record describes CRAVE as a Phase 3, randomized, double-blind study, with a maximum weekly semaglutide dose of 2.4 milligrams and a target of 438 eligible veterans randomly assigned equally between the semaglutide and placebo groups.

The trial builds on an observational study involving U.S. veterans with type 2 diabetes that found patients prescribed GLP-1 medications experienced lower rates of alcohol and substance use disorders compared with peers on alternative regimens. According to VA data, more than 400,000 veterans across the country are currently diagnosed with alcohol use disorder. A nationally representative study cited by the VA found that 40.8 percent of veterans had met the diagnostic criteria for AUD at some point in their lives, while more than 10.5 percent met the criteria for probable alcohol use disorder in the previous year. Veterans who have experienced PTSD are twice as likely to have problems with alcohol as veterans without a history of the disorder.

The VA cautioned veterans against self-medicating with GLP-1 drugs or using them as a substitute for established AUD treatments, advising patients to consult their health care providers before changing their treatment.