Semaglutide, a medication approved for treating diabetes and obesity, has shown promise for also treating alcohol use disorder in several new studies. The findings suggest the drug could open up a badly needed new front in treating alcohol addiction.
New Case Series Finds Reduced Alcohol Cravings and Consumption
A case series of 17 patients published in the Journal of Clinical Psychiatry found that Semaglutide paired with counseling led to "rapid and substantial reductions in alcohol cravings and alcohol consumption" over 12-16 weeks of treatment.
All patients took Semaglutide for obesity, but also suffered from alcohol use disorder. Over the course of treatment, average number of heavy drinking days fell by 83%, from 20 per month down to 3.4 per month on average.
Dr. Lorenzo Leggio, lead author of the study at the National Institute on Alcohol Abuse and Alcoholism, said the case series warrants further research: “Larger and longer clinical trials are needed to compare semaglutide with existing medications for AUD.”
Animal Study Shows Less Alcohol Seeking Behavior
Another promising study published in Nature Communications gave alcohol to rats until they developed alcohol addiction-like symptoms. The researchers then administered Semaglutide.
They found the medication curbed cravings and alcohol-seeking behaviors compared to a control group, indicating it could work by restoring balance in brain pathways involved in compulsive drinking.
“We were quite surprised about the efficiency of semaglutide” in reducing alcohol cravings, said study co-author Olivier George of The Scripps Research Institute.
Possible Mechanisms of Action
Experts theorize several ways Semaglutide may help treat alcohol addiction:
- Increasing feelings of fullness and reducing cravings for alcohol calories
- Balancing dopamine levels and neural pathways disrupted by alcohol
- Delaying alcohol absorption into the bloodstream
"This drug has potential for treating human alcohol use disorder, based on the results from studies in mice and rats," said study co-author Rajita Sinha of Yale School of Medicine.
Calls to Investigate Real-World Impacts
In light of the new findings, some health experts are calling for real-world studies on whether Semaglutide could curb problem drinking.
“It certainly seems like time for a deeper investigation of semaglutide’s effects on problematic alcohol use in people taking it for weight management,” said Dr. Timothy Brennan, an addiction specialist at Mount Sinai Hospital.
He pointed to the case series showing people prescribed Semaglutide to manage obesity happened to see reductions in their unhealthy alcohol use.
“We need to know whether this impact on drinking is reproducible when people with alcohol problems are the primary focus,” Dr. Brennan said.
Prescription Rates Already Rising
Use of GLP-1 medications like Semaglutide is already rising swiftly, meaning more data on real-world impacts may soon emerge.
Prescriptions for GLP-1 therapies have quadrupled from 2020 to 2022 as doctors prescribed them for chronic conditions beyond diabetes including obesity. If even a fraction of these patients see drinking reductions too, it could signal a sea change.
Weight Loss Medications Show Promise for Addictions
Broader evidence is also building that medications designed for obesity and Type 2 diabetes could treat other compulsive behaviors.
Studies have shown bariatric surgery for obesity can drive remission of alcohol and opioid use disorders. And other GLP-1 agonists similar to Semaglutide reduced cocaine addiction in rats.
“The exploding prescription rates for anti-obesity meds means we’ll get more data on how they impact alcohol and other addictions,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. “This could usher in a new class of addiction therapies.”
Challenges to Using Semaglutide for Addiction
However, experts note challenges in repurposing Semaglutide as an addiction treatment.
The medication is currently only FDA approved for diabetes and obesity. And most insurance plans don’t cover it for other uses. Out-of-pocket costs for Semaglutide average $1,300 per month in the U.S.
Also, the medication requires daily or weekly self-injections, which could hamper adherence, especially among people with substance use disorders.
Still, the new findings offer hope that with more data and regulatory changes, Semaglutide could expand treatment options for the estimated 14 million Americans with alcohol use disorder.
What Happens Next
In light of accumulating evidence, the National Institute on Alcohol Abuse and Alcoholism says it plans to sponsor larger trials of Semaglutide for treating alcohol addiction.
The FDA will also likely review any new data closely to determine if regulatory changes are warranted to approve new uses. But experts say it could be 1-2 years before possible labeling changes.
In the meantime, doctors may use their discretion to prescribe Semaglutide “off-label” to patients specifically seeking help with compulsive alcohol use rather than obesity or diabetes.
But with high costs and insurance limitations, access barriers persist for now. “We hope larger trials and regulatory changes can validate using these medicines more broadly,” said Dr. Leggio. “It could give doctors an important new tool to help the many patients struggling with alcohol addiction.”
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