People with alcohol use disorder have trouble controlling their drinking. The disorder affects millions of people, but treatment options are scarce. A potential target for treating alcohol use disorder is the hormone GLP-1, the same hormone targeted by GLP-1 receptor agonists like semaglutide. That's because receptors for GLP-1 are found not only on cells in the gut, but also on cells in the reward system in the brain, the area stimulated by drinking alcohol.

Drugs like semaglutide help regulate blood sugar levels and reduce appetite by mimicking GLP-1. They also appear to reduce cravings for opioids and alcohol, including heavy drinking in adults with moderate-to-severe alcohol use disorder as well as people who are simply trying to cut back on their drinking.

“Oral semaglutide could represent a new treatment option for those with alcohol use disorder, particularly those who have not benefitted from existing medications.”

In a University of Colorado study, participants who took oral semaglutide reported fewer heavy drinking days than the control group who was given a placebo. When they did drink, they consumed less alcohol. The semaglutide group also reported fewer cravings for alcohol and less cannabis use than the control group.

Fifty men and women were enrolled in the study. The men said they had about 28 or more drinks a week in the month before they enrolled and the women said they had about 21 or more drinks a week. They also reported one heavy drinking day, when the men had five or more drinks and the women had four or more, in the week before they enrolled.

About half of the participants were randomized to the treatment group. They received three milligrams of oral semaglutide a day for four weeks followed by seven milligrams a day for four weeks. The other half, the control group, received a placebo for the eight-week study period. Oral semaglutide was well tolerated, and most of the side effects reported were mild, the researchers said.

Receptors for GLP-1 are found not only on cells in the gut, but also on cells in the reward system in the brain, the area stimulated by drinking alcohol.

“Oral semaglutide could represent a new treatment option for those with alcohol use disorder, particularly those who have not benefitted from existing medications,” Joseph Schacht, first author on the study, said in a statement.

Alcohol use disorder comes at great personal cost. It can affect many parts of people's lives, including their physical and mental health, relationships and safety. The semaglutide group had fewer problems related to their drinking, said Schacht, an associate professor of psychiatry at the University of Colorado Anschutz Medical School. Even modest reductions in heavy drinking can mean greater stability, fewer crises and an improved quality of life for people with alcohol use disorder and their families, he added.

The study is published in The American Journal of Psychiatry.