Hendershot 2025: semaglutide (Ozempic) for alcohol use disorder

What they tested

At an academic medical center in the US, 48 adults with alcohol use disorder who weren't looking for treatment were randomly assigned to weekly semaglutide injections or a placebo for 9 weeks. The dose was 0.25 mg a week for 4 weeks, then 0.5 mg a week for 4 weeks, then 1.0 mg for 1 week.

The main outcome was a lab test of drinking: before and after treatment, participants could drink alcohol in a controlled session, and researchers measured how much they drank. Drinking in daily life and craving were assessed at outpatient visits.

What they found

In the lab session after treatment, people on semaglutide drank fewer grams of alcohol (β -0.48; 95% CI -0.85 to -0.11) and reached a lower peak breath alcohol level (β -0.46) than people on placebo. The authors described these as medium to large effects.

In daily life, semaglutide did not change average drinks per calendar day or the number of drinking days. It did reduce drinks per drinking day (β -0.41) and weekly craving (β -0.39), and it predicted greater drops in heavy drinking over time than placebo.

Among participants who smoked, semaglutide predicted bigger reductions in cigarettes per day.

Limits

• It was small, with 48 people, and treatment lasted only 9 weeks.
• Participants weren't seeking treatment, and 71% were women, so results may differ for people in treatment programs.
• The main outcome was drinking in a lab session, which may not match drinking in daily life.

What it means if you're considering naltrexone

Semaglutide is not approved for alcohol use disorder, and this is an early trial with mixed results. Naltrexone, by contrast, is approved for it and has been tested in many trials. The authors call these findings initial evidence that justifies larger trials of GLP-1 drugs for alcohol use disorder.