Oral Semaglutide Trial Suggests Fewer Heavy Drinking Days in Alcohol Use

A new clinical trial led by researchers at the University of Colorado Anschutz suggests that oral semaglutide—a medication best known for treating type 2 diabetes and for weight management—may also curb heavy drinking in adults diagnosed with Alcohol Use Disorder (AUD).

The study, published in the American Journal of Psychiatry, examined whether an oral formulation could be more acceptable than earlier injectable approaches tested in AUD populations. That matters because adherence and patient preferences often determine whether a pharmacologic strategy has any chance of scaling beyond tightly controlled settings.

Semaglutide acts through the glucagon-like peptide-1 (GLP-1) pathway, which influences appetite, reward processing, and metabolic signaling. Researchers hypothesized that these same biological effects could translate into less alcohol-seeking behavior—particularly in people who want—or feel forced—to cut back without necessarily aiming for immediate abstinence.

To test this, investigators ran an eight-week randomized, double-blind, placebo-controlled trial involving 50 adults with moderate-to-severe AUD who were actively seeking treatment. Participants were assigned to receive oral semaglutide or a placebo while researchers tracked drinking patterns, cravings, and alcohol-related consequences.

Across the trial, those taking oral semaglutide showed fewer heavy drinking days and lower alcohol consumption per drinking occasion. The intervention also corresponded with reduced day-to-day alcohol cravings, alongside fewer alcohol-related problems and an improved overall drinking risk level.

Notably, the study also reported reduced cannabis use days, hinting at broader effects on substance-related behaviors rather than a narrow, alcohol-only change. While not every laboratory-based measure shifted in controlled tests, the real-world pattern of drinking outcomes was consistent.

Importantly, the medication was generally well tolerated, with most side effects described as mild. High adherence and strong completion rates supported the feasibility of administering oral semaglutide in an AUD-like context where drop-out can otherwise obscure signal.

Experts say these results could widen the toolbox for AUD, a condition that remains difficult to treat and has seen no new FDA-approved medications in nearly two decades. Even modest reductions in heavy drinking, researchers argue, can meaningfully improve health, family stability, and safety.

The authors emphasize that larger and longer-term trials are needed to confirm the effect size, determine optimal dosing strategies, and clarify who benefits most. Funding included support from the National Institute on Alcohol Abuse and Alcoholism, and larger studies are planned.