Some people who take drugs like Ozempic have noticed a surprising but welcome side effect: They drink less.
A paper published Wednesday offers the strongest evidence yet that this is more than just anecdote, or a placebo effect: It found that semaglutide, the substance in Ozempic and the weight loss drug Wegovy, could in fact help curb alcohol cravings. It is the first randomized controlled trial on semaglutide and alcohol consumption.
The study followed 48 adults who met criteria for alcohol use disorder, a condition often characterized by difficulty controlling alcohol consumption. Half of the patients took low doses of semaglutide, and half received placebo shots. The participants spent two hours in a lab room stocked with their preferred alcoholic beverages — once before they started taking the drug, and once after. People in the study also reported how much they drank every day for nine weeks.
Those who took semaglutide still drank about as often as those who took the placebo. But by the second month of the study, people taking semaglutide were drinking nearly 30 percent less, on average, on days they consumed alcohol — compared to an average reduction of about two percent in the placebo group. People who took semaglutide were also more likely to report fewer days of heavy drinking than those on the placebo, and to say that their cravings for alcohol had diminished.
The effects on alcohol consumption were larger than the researchers anticipated, given previous data on other medications for alcohol use disorder, said Christian Hendershot, director of clinical research at the University of Southern California Institute for Addiction Science and the lead author on the study.
There has been so much research on drugs like semaglutide and alcohol, “you can’t even keep up,” said W. Kyle Simmons, a professor of pharmacology and physiology at Oklahoma State University who is currently conducting a trial on the medication’s effects on alcohol use disorder.
One such paper, published last month, examined records from over two million people with diabetes who received medical care from the U.S. Department of Veterans Affairs. The paper found that those who took a drug in the same class of medicines as Ozempic had a lower risk of developing substance use disorders, including alcohol use disorder, than people who took other diabetes drugs.
And last May, a study examining a large database of medical records found that people with both alcohol use disorder and either obesity or Type 2 diabetes who took semaglutide were less likely to relapse.
Joseph Schacht, an associate professor of psychiatry at the University of Colorado who is also conducting a study on semaglutide and alcohol cravings, said scientists have still not determined how the drug might be tamping down the desire to drink.
But a leading hypothesis is that the drug impacts reward pathways in the brain. Just as the medication can make food seem less appealing, it may also make alcohol less enticing. In addition, studies in animals have shown that drugs related to semaglutide seem to inhibit the release of dopamine associated with alcohol exposure, which in theory could reduce the motivation to drink.
“I think it’s going to turn people who struggle with their ability to control their drinking into, potentially, people who can control their drinking,” Dr. Schacht said.
Researchers have theorized that effect might extend to a range of addictive behaviors. That could explain why, among a small subset of people in the study who smoked cigarettes, those who took semaglutide saw a greater decline in the average number of cigarettes they smoked each day.
But there are a number of questions about semaglutide and alcohol left to answer — including whether the drug could be safe and effective for people who have alcohol use disorder but not obesity or diabetes.
Doctors often call medications like Ozempic “forever drugs,” because they stop working if someone stops taking them. It’s not clear yet whether someone with alcohol use disorder would need to take the medication for the rest of their lives — or what would happen to their cravings when they got off the medication.
And “no one drug works for everybody,” Dr. Simmons pointed out. Larger studies may show that some patients with alcohol use disorder respond better to the medication than others, he said.
Dr. Simmons, along with Dr. Hendershot, Dr. Schacht and other researchers, have warned in a scientific journal that there is not enough data yet to prescribe the drug for alcohol use disorder.
“I’m optimistic, don’t get me wrong,” Dr. Simmons said. “But I just don’t feel comfortable saying that patients should seek out these medications for addiction yet.”
