Could Ozempic-like drugs curb alcohol addiction? VA launches major trial
The Department of Veterans Affairs is launching a large Phase 3 trial of semaglutide as a treatment for alcohol use disorder.
The Department of Veterans Affairs is launching a large Phase 3 trial of semaglutide as a treatment for alcohol use disorder.
The blockbuster drugs that transformed treatment for diabetes and obesity are moving into another potentially enormous field: addiction.
The Department of Veterans Affairs has launched a nationwide clinical trial to determine whether semaglutide — the active ingredient in Ozempic and Wegovy — can help people with moderate or severe alcohol use disorder cut back or stop drinking.
The study, called CRAVE, will enroll more than 600 veterans at 18 VA medical centers across the country. Participants will receive weekly injections of either semaglutide or a placebo, with researchers measuring changes in alcohol consumption as well as health and quality of life, the VA said.
The VA says more than 400,000 veterans have been diagnosed with alcohol use disorder.
“This clinical trial reflects medical research that VA is uniquely situated to launch, and is aimed directly at benefitting Veterans,” VA Secretary Doug Collins said in announcing the study.
The trial represents another striking expansion of the possible uses for GLP-1 drugs, which began as diabetes treatments and have since become widely used for obesity and cardiovascular risk reduction.
Researchers are now studying whether their effects on the brain's reward system could make the drugs useful against alcohol and other addictive substances.
James R. Hood
The evidence is becoming harder to dismiss
For several years, patients taking GLP-1 drugs have reported an unexpected side effect: alcohol sometimes becomes less appealing.
Some said they stopped wanting a nightly glass of wine. Others reported that drinking no longer produced the same sense of reward.
Those anecdotes have increasingly been backed by clinical research.
A randomized trial published this year in The Lancet studied 108 patients who had both obesity and moderate-to-severe alcohol use disorder. Everyone was offered cognitive behavioral therapy, but half also received weekly semaglutide.
Heavy-drinking days fell by 41.1 percentage points from baseline in the semaglutide group, compared with 26.4 percentage points among patients receiving placebo. The difference between the groups was statistically significant.
An earlier U.S. randomized trial involving 48 adults also found that low-dose semaglutide reduced alcohol consumed during a laboratory drinking test and reduced alcohol cravings over nine weeks, although it did not improve every measure of drinking behavior, according to a PubMed posting.
Those are still relatively small studies, which is why the VA trial matters.
A much bigger test
CRAVE is a randomized, double-blind, placebo-controlled Phase 3 study — the type of trial capable of providing substantially stronger evidence about whether a treatment actually works.
ClinicalTrials.gov lists an anticipated enrollment of 622 participants with moderate or severe alcohol use disorder. Participants can be between ages 18 and 80 and will receive semaglutide or placebo injections while researchers track drinking behavior and other outcomes.
The trial is scheduled to run for several years, with primary completion currently projected for 2028 and final study completion in 2029, according to ClinicalTrials.gov.
Unlike some earlier studies, the VA trial could also help determine whether semaglutide's apparent effect on alcohol is independent of its ability to produce weight loss.
That remains an important unanswered question.
A recently published study of more than 11,000 adults found GLP-1 users reduced their alcohol consumption by about one additional drink per week compared with people who weren't taking the drugs. But the difference was no longer statistically significant after researchers adjusted for weight loss.
In other words, scientists still don't know exactly how much of the alcohol effect comes directly from changes in the brain's reward circuitry and how much may result indirectly from losing weight or other metabolic changes.
Clues from the VA's own records
The VA already has unusually intriguing evidence because of the enormous amount of health data available through the veterans health system.
A 2026 study using VA records compared veterans with type 2 diabetes who started GLP-1 drugs with those who started another class of diabetes medications known as SGLT-2 inhibitors.
Researchers found GLP-1 users had an 18% lower relative risk of subsequently developing an alcohol use disorder. They also had lower risks of disorders involving cannabis, cocaine, nicotine and opioids.
Other observational studies have reached similar conclusions.
One recent study involving more than 40,000 adults found newer GLP-1 drugs were associated with substantially lower rates of hospitalization for alcohol-related problems among people with alcohol use disorder and either diabetes or obesity.
A Swedish study likewise found GLP-1 treatment was associated with fewer hospitalizations related to alcohol and other substance-use disorders.
Observational studies can't prove that the medication caused those improvements, however. People prescribed GLP-1 drugs may differ in many ways from people who aren't taking them.
That is precisely the question a large randomized trial such as CRAVE is designed to settle.
Why another treatment could matter
Alcohol use disorder is extremely common and surprisingly undertreated.
About 27.9 million Americans age 12 and older had alcohol use disorder in 2024, according to federal survey data. Yet only about 7.6% of people with the condition received alcohol treatment that year, the NIAAA estimated.
Only three medications are currently approved by the FDA specifically to treat alcohol use disorder: naltrexone, acamprosate and disulfiram.
Behavioral therapies can also be effective, and treatment increasingly combines medication with counseling or other support.
But researchers have been searching for additional medications because no existing treatment works for everyone.
GLP-1 drugs would represent a fundamentally different approach.
Rather than primarily blocking alcohol's effects or producing an unpleasant reaction to drinking, GLP-1 medications appear capable of changing the biological reward signals that help drive cravings.
Researchers are investigating similar effects involving nicotine, opioids and other addictive substances.
Don't try this at home
Despite the promising findings, semaglutide is not FDA-approved as a treatment for alcohol use disorder, and the VA specifically cautioned people against trying to use GLP-1 drugs as a substitute for established addiction treatment.
“VA strongly discourages self-medicating or attempting to replace other AUD treatment options with GLP-1 medications or any other unprescribed substances,” the agency said.
The drugs can also cause side effects, most commonly nausea, vomiting, diarrhea and other gastrointestinal problems. In the recent Lancet alcohol trial, adverse effects were generally mild to moderate but occurred more frequently among patients receiving semaglutide.
For now, the evidence amounts to something unusual in medicine: a phenomenon first noticed by patients and physicians in everyday use that is increasingly surviving the transition into controlled clinical trials.
If the VA study confirms those early findings, the GLP-1 revolution could turn out to be about considerably more than losing weight.
