Semaglutide cut heavy drinking days in alcohol use disorder trial, Lancet study finds

A weekly injection of semaglutide reduced heavy drinking in adults who had both alcohol use disorder and obesity, according to a randomized, double-blind, placebo-controlled trial published April 30, 2026, in The Lancet ^[1][3].

Researchers at the Mental Health Center Copenhagen assigned 108 treatment-seeking adults to semaglutide 2.4 mg or placebo for 26 weeks, with both groups also receiving cognitive behavioral therapy ^[2][3]. To take part, people had to be 18 to 70 years old, have a body mass index of 30 kg/m² or higher, report at least six heavy drinking days, and score above 15 on the Alcohol Use Disorders Identification Test ^[3].

Among those given the drug, the share of days classified as heavy drinking days dropped 41.1 percentage points (95% CI, −48.7 to −33.5). The placebo group's share fell 26.4 percentage points (95% CI, −34.1 to −18.6) ^[3]. The National Institutes of Health described the result as a 41.1% reduction on semaglutide and a 13.7% larger reduction than placebo produced ^[2].

Other measurements pointed the same way. Mean alcohol consumption fell by 1,550.2 grams per 30 days on semaglutide and 1,025.9 grams on placebo, while mean daily drinks declined by 3.5 units and 2.1 units respectively ^[3]. Body weight dropped 11.2 kg with the drug and 2.2 kg with placebo ^[3]. Blood-based markers of alcohol use backed up what participants reported about their drinking ^[2].

Eighty-eight of the 108 participants finished the full 26 weeks ^[3]. Slightly more than half were men, and the average age was 52.3 years (SD 9.8) ^[3].

Side effects were mostly digestive and more common on semaglutide: nausea, appetite loss, vomiting, abdominal pain, reflux and fatigue ^[3]. Five people withdrew because of adverse effects, and the semaglutide arm recorded one serious event, a case of abdominal pain ^[3]. The NIH said the side effects it flagged were temporary and mild ^[2].

The authors calculated a number needed to treat of 4.3, a measure of how many patients must be treated for one to benefit. For medicines already approved for alcohol use disorder, that figure is 7 or higher ^[2].

"Very few medications are currently approved for alcohol use disorder, and these are vastly underutilized. A new option that is more accessible and more effective could be a gamechanger for closing the treatment gap," said George Koob, director of NIH's National Institute on Alcohol Abuse and Alcoholism and a co-author ^[2]. Nora Volkow, director of NIH's National Institute on Drug Abuse and another co-author, said: "We're beginning to see some of that potential for GLP-1s to treat drug addiction turn into reality. Questions remain but this is nonetheless very encouraging" ^[2].

The study has limits. It ran at one center, most volunteers were White, and no one was followed after the treatment period ended, so how long any change in drinking lasts has not been reported ^[3]. An earlier trial of once-weekly semaglutide in alcohol use disorder found no effect across its whole sample; the response was concentrated in participants who had obesity ^[2][3].

Why it matters for patients

Three drugs are approved by the FDA for alcohol use disorder, and cognitive behavioral therapy is a common part of care ^[3]. Semaglutide — sold as Ozempic, Wegovy and Rybelsus — carries no approval for alcohol use disorder. The authors wrote that their results support an expanded indication, but that decision rests with regulators and has not been made ^[3].

If a doctor prescribed semaglutide for drinking, it would be off-label. Whether insurers would pay for it on those grounds, and how clinicians would choose candidates, has not been disclosed ^[2][3].

Everyone in the trial had obesity and was actively seeking treatment for alcohol use disorder, so the findings may not describe people without obesity, people not in therapy, or people drinking at other levels ^[2][3]. The drug's known digestive effects were the main reason people quit the study, and that pattern is consistent with what is already known about this class of medicines ^[2][3].

What happens next

The research team wants to test GLP-1 medicines over a longer period and in a larger group to confirm the result ^[2]. No follow-up trial, timeline, or application to regulators for an alcohol use disorder indication has been announced ^[2][3].