VA opens a 622-veteran semaglutide trial for alcohol use disorder across 18 sites

The Department of Veterans Affairs has begun recruiting veterans for a national trial testing whether semaglutide, the GLP-1 drug sold as Ozempic, Wegovy and Rybelsus, can help people cut back or stop drinking. The study aims to enroll 622 participants at 18 VA sites around the country, including Philadelphia, and randomly assigns half to receive the drug and half to receive a placebo ^[1].

Recruitment started the week of August 19, 2026, and is expected to take about two years, according to David Oslin, the psychiatrist leading the trial and chief of behavioral health at the Philadelphia VA ^[1]. Participants receive treatment for six months and will not know which group they are in, a double-blind design Oslin described as the gold standard for medical research ^[1]. He expects to publish results in about three years ^[1].

What the trial is testing

To join, a person must be a veteran receiving care through the VA, be between 18 and 80 years old, and be drinking enough to meet criteria for moderate to severe alcohol use disorder ^[1]. People taking insulin or another diabetes medication are excluded ^[1]. Oslin said the 18 sites will screen any veteran who comes forward, and those who are not eligible will be directed to other care ^[1].

The design was built around what the FDA requires before a company can add a new indication to an existing label. "Semaglutide is already FDA-approved. What you would want to be able to do is change the existing label to add the indication of alcohol use disorder," Oslin said ^[1]. Two FDA requirements shaped the study: a minimum duration of six months, which the trial meets, and a sample size large enough to test the hypothesis, which is why the target is 622 veterans ^[1].

The rationale comes from patient reports and early research. Oslin said the "driving force has been really the groundswell of anecdotal and observational data" from people taking GLP-1s for diabetes or weight loss who noticed they were drinking less ^[1]. Three small published US clinical trials followed. Oslin called them encouraging but not sufficient to establish efficacy by FDA standards, noting that one enrolled only 40 subjects ^[1]. He said the early trials suggest an effect larger than current treatments, but added that this would need to be replicated ^[1].

The proposed mechanism involves GLP-1 receptors in the brain that respond to reward. Oslin's working hypothesis is that the drugs reduce the desire to keep drinking without removing pleasure or the ability to enjoy life, much as they reduce excessive eating ^[1].

Why it matters for patients

Semaglutide is not approved for alcohol use disorder, and this trial is designed to find out whether it works and whether it is safe in this group. Those answers are not yet available.

The scale of the problem is large. Alcohol use disorder affects roughly 28 million people in the United States, and fewer than 10% of people with the condition receive any treatment in a given year, despite the existence of psychosocial treatment, peer support groups and medications ^[1]. Oslin argued that a big part of the gap is where people seek help: many do not go to specialty addiction care and instead raise the issue with a primary care doctor, who may be unfamiliar with the existing medications ^[1]. Primary care clinicians already prescribe GLP-1s routinely for diabetes and weight loss, he said, so a proven alcohol indication could make treatment easier to access ^[1].

Oslin was direct about people trying to get ahead of the evidence. "I know that you can get these compounds pretty much anywhere these days, and I would discourage people from doing that when we don't know that they're safe and efficacious," he said ^[1]. He added that the VA will try to help veterans find a path to care even if they cannot join the study ^[1].

Several details are not in the available reporting, including the specific semaglutide dose or product used, the primary outcome measure, the funding arrangement, and the names of all 18 participating sites.

What happens next

Enrollment opened the week of August 19, 2026, and is projected to run about two years, putting full enrollment around mid-2028 ^[1]. With a six-month treatment period for each participant and time for analysis, Oslin anticipates publishing results in roughly three years ^[1]. Any label change adding an alcohol use disorder indication would require FDA review after that, and no timeline for such a submission has been reported.

Veterans in the Philadelphia area interested in the study can call 215-823-5800, extension 203404 ^[1]. Veterans seeking support can reach the Veterans Crisis Line by dialing 988 and pressing 1, texting 838255, or chatting at VeteransCrisisLine.net/Chat ^[1].