Semaglutide (Ozempic, Wegovy) and alcohol dependence - what the research shows

Semaglutide is the active substance in Ozempic, a medicine for type 2 diabetes, and in Wegovy, a medicine used to treat obesity. In three small clinical trials from 2025-2026, people with a drinking problem who took semaglutide cut down their number of heavy drinking days more than people on placebo, but some other measures of drinking did not change. Neither semaglutide, nor other GLP-1 medicines (GLP-1 receptor agonists), nor tirzepatide are licensed to treat alcohol dependence, and studies have not yet established at what dose, for how long and in whom they could be used safely for this purpose. Today, dependence is treated with psychotherapy and licensed medicines, and someone who also has obesity can be treated for both diseases at the same time.

In brief

• In clinical trials involving 48, 50 and 108 people with a drinking problem, the number of heavy drinking days fell more on semaglutide than on placebo. In two of these trials, the average number of drinks per day did not change.
• In medical record studies of tens of thousands to hundreds of thousands of patients, people taking semaglutide and similar medicines had alcohol problems less often, but this does not prove that the medicine was the cause.
• No GLP-1 medicine is licensed to treat alcohol dependence. Dependence is treated with psychotherapy and licensed medicines: naltrexone, acamprosate, nalmefene or disulfiram.
• Obesity and alcohol dependence can be treated at the same time if the doctor knows how much the patient drinks and what medicines they take. For example, the obesity medicine combining naltrexone and bupropion (Mysimba) is contraindicated immediately after a dependent person has suddenly stopped drinking.

Does semaglutide reduce the urge to drink?

Semaglutide may reduce alcohol cravings, meaning a strong urge to drink, and how much someone drinks on the days they drink. The evidence, however, comes from three small, early phase II trials. In all three, the number of heavy drinking days fell more on semaglutide than on placebo.

Semaglutide acts like GLP-1, a hormone made in the body that regulates appetite and how many calories you eat, partly through receptors in the brain. Semaglutide may also affect the brain's reward system, and in clinical trials it reduced hunger and food cravings (1). In animal studies, medicines in this group reduced alcohol drinking, and people treated for diabetes or obesity reported having less desire for alcohol (2).

Participants in the three trials that compared semaglutide with placebo had a diagnosis of alcohol use disorder according to the US DSM-5 classification. This term covers drinking problems from mild to severe, so it is broader than dependence.

What did the first trial of semaglutide in people with a drinking problem show?

The first clinical trial of semaglutide in people with alcohol use disorder was carried out in the United States and published in 2025. It included 48 adults (34 of them women) whose alcohol problem was, on average, of moderate severity. The participants were not seeking treatment or trying to cut down on their drinking, and people with diabetes could not take part. For 9 weeks, half of them received a weekly injection of semaglutide at low doses (from 0.25 to 1 mg), and the other half received placebo.

After 8 weeks, participants were allowed to drink their favourite alcoholic drink in the laboratory for 2 hours, in an amount limited for safety reasons. People on semaglutide drank less than those in the placebo group and had a lower alcohol concentration in their breath (this result covers the 25 people who drank in this part of the study). In everyday life, the medicine did not change the number of days on which participants drank. On those days, however, they drank less, their number of heavy drinking days fell faster than in the placebo group, and their alcohol cravings were weaker. No serious side effects were recorded. The authors point out that the trial was small and short and the doses were low, and that larger trials are needed (2).

Does semaglutide reduce drinking in people with obesity who are being treated for alcohol problems?

In a trial published in The Lancet in 2026, semaglutide reduced the number of heavy drinking days in people with obesity more than placebo did. It was carried out at a single centre in Copenhagen, in 108 adults with obesity and moderate or severe alcohol use disorder who had sought treatment. For 26 weeks, they received either semaglutide 2.4 mg once a week or placebo, and all of them attended cognitive behavioural therapy. The researchers defined a heavy drinking day as a day on which a man drank more than 60 g of pure alcohol or a woman more than 48 g (5). Three half-litre beers of 5% strength contain roughly 60 g of alcohol in total. This threshold was used only to count the trial results and does not mean that a smaller amount of alcohol is safe.

The percentage of heavy drinking days fell by 41.1 percentage points in the semaglutide group and by 26.4 points in the placebo group. After taking into account how much participants drank before treatment, the difference between the groups was 13.7 percentage points (3, 5). People on placebo, who also attended therapy and had sought help of their own accord, had markedly fewer heavy drinking days than before treatment. Of all participants, 81% completed treatment. Stomach and bowel symptoms were more common on semaglutide, were usually mild or moderate and passed.

Does oral semaglutide also reduce drinking?

Semaglutide tablets were tested in 50 adults with moderate or severe alcohol use disorder who had sought treatment (4). For 8 weeks, they took semaglutide (first 3 mg a day, then 7 mg) or placebo. The trial did not meet its main goal, because the medicine did not reduce alcohol cravings triggered in the laboratory by alcohol-related cues. Nor did it change the average number of drinks per day. People on semaglutide did, however, have fewer heavy drinking days, drank less on the days they drank and had weaker everyday alcohol cravings.

Do other GLP-1 medicines also reduce drinking?

Exenatide, an older medicine in this group, was tested in 127 people being treated for their drinking. Over 26 weeks, it did not reduce the number of heavy drinking days more than placebo, and a reduction was seen only in an additional analysis of people with obesity (6). Dulaglutide was studied in smokers who were quitting, not in people with a drinking problem. Of the 151 participants who drank, those on dulaglutide were drinking 29% less than those on placebo after 12 weeks (7). Even less is known about tirzepatide (Mounjaro), which acts on GLP-1 and GIP receptors. A reduction in drinking was described in a study in rodents (8) and in an online survey in which people with obesity, including 50 taking tirzepatide, self-reported how much they drank (9).

What do medical record studies of people taking GLP-1 medicines show?

In medical record studies of tens of thousands to hundreds of thousands of patients, people taking semaglutide and similar medicines had alcohol problems less often. These are observations, and they do not prove that the medicine was the cause.

• In the US medical records of 83,825 people with obesity, the risk of a first diagnosis of alcohol use disorder and the risk of a relapse of this disorder within a year were 50-56% lower in those taking semaglutide than in people treated with other obesity medicines. A similar result was found in almost 600,000 people with type 2 diabetes (10).
• In Sweden, researchers analysed data from 2006-2023 on 227,866 people with alcohol use disorder. During periods when these people were taking semaglutide, their risk of being admitted to hospital because of alcohol use disorder was 36% lower than during periods without any medicines from this group. Of the whole group, 4,321 people took semaglutide (11).
• Among 524,817 US veterans with type 2 diabetes and no previous substance use disorder, those who started a GLP-1 medicine were less often diagnosed with alcohol use disorder over 3 years than those who started another diabetes medicine (an SGLT-2 inhibitor). The risk was 18% lower, which meant about 6 fewer cases for every 1,000 people (12).

Why can't medical record studies prove that a medicine reduces drinking?

In these analyses, unlike in clinical trials, nobody is randomly assigned to receive the medicine. People whose doctor prescribed semaglutide may differ from others in, for example, their health, how often they go to appointments or how ready they are to change. Medical records contain diagnoses and hospital stays, not how much people drink. The authors of these studies themselves write that clinical trials are needed (10, 11). A 2025 review showed that the two types of study give different results. In 6 observational analyses covering more than 2.7 million people, alcohol-related events were less common in those taking GLP-1 medicines. In 3 clinical trials with 430 participants, the reduction in drinking after pooling the results was too small to rule out chance (13). The review did not include trials published in 2026.

Is semaglutide approved for treating alcoholism?

No GLP-1 medicine is licensed to treat alcohol dependence. Wegovy and Saxenda (liraglutide) are licensed for weight management, Ozempic for treating type 2 diabetes, and Mounjaro (tirzepatide) for both (1, 14, 15, 16).

Studies have not yet established in whom, at what dose and for how long the medicine can be used safely to treat alcohol dependence, or how patients drink after stopping it. Semaglutide also reduces body weight: in the 2025 trial, participants taking semaglutide lost an average of 5% of their weight over 9 weeks, and the authors point out that in people with normal or low body weight, such weight loss carries additional risk (2). Then there are the side effects: nausea, vomiting and diarrhoea can lead to dehydration, and in the trials on which Wegovy's approval was based, acute pancreatitis was confirmed in 0.2% of people treated with semaglutide (1).

The situation is different for someone who has obesity, or overweight with a weight-related condition. Wegovy and Mounjaro are used in adults for weight management from a BMI of 30, or from a BMI of 27 if there is, for example, high blood pressure or prediabetes (1, 16). A doctor may decide that such a person is eligible for obesity medication, and the drinking problem is then treated separately.

What should you do if your urge to drink decreases during obesity treatment?

If your urge to drink decreases during obesity treatment, tell your doctor at your check-up, and say how much and how often you drink. This is not a reason to change the dose or stop the medicine on your own. In the 2025 trial, semaglutide reduced the amount of alcohol drunk on drinking days but not the number of those days, so a weaker urge to drink does not necessarily mean the drinking problem has gone. If you find it hard to control your drinking, even with a weaker urge to drink, you need alcohol addiction treatment, because dependence is a separate disease. We write about combining alcohol with specific obesity medicines in our article on obesity medicines and alcohol.

What treatments for alcohol dependence are available today?

Alcohol dependence is treated with psychotherapy and licensed medicines: naltrexone, acamprosate, nalmefene and disulfiram. The doctor chooses a medicine to suit the goal of treatment, the patient's medical conditions and the other medicines they take.

Naltrexone helps people stay abstinent (17), and acamprosate helps maintain abstinence in people who are also attending psychotherapy (18). Nalmefene is used to reduce the amount of alcohol drunk by people with alcohol dependence whose drinking carries a high risk but who have no physical withdrawal symptoms and do not need immediate detox. It is prescribed only together with continuous psychosocial support (19). If you drink alcohol while taking disulfiram (Anticol tablets or an implant), it causes a reaction whose course cannot be predicted and which can be dangerous. Anticol can be started after at least 24 hours without alcohol (20). We describe all these medicines on our page on pharmacotherapy for alcoholism, and working with an addiction therapist in our article on psychotherapy for alcoholism.

Someone who drinks heavily every day should not stop drinking suddenly on their own. In people who are dependent, alcohol withdrawal symptoms usually appear 6-24 hours after suddenly stopping or cutting down on drinking, ranging from shaking, nausea and anxiety to hallucinations, seizures and delirium tremens, and severe withdrawal syndrome can be life-threatening (21). This is why they should stop drinking under medical supervision, as part of alcohol detox.

How can you treat obesity and alcohol dependence at the same time?

Obesity and alcohol dependence can be treated at the same time, each according to a separate treatment plan. The doctor treating your obesity needs to know how much you drink and what medicines you have been given for dependence, and the doctor at the addiction treatment clinic needs to know what medicine you take for obesity. An obesity medicine does not replace detox or addiction treatment. Body weight also changes after you stop drinking, as we describe in our article on how much weight you can lose after you stop drinking.

At Nasz Gabinet, obesity treatment is a 6-month online programme. The doctor diagnoses the disease based on BMI and waist circumference, assesses blood test results and decides whether the patient is eligible for medication according to the criteria of the Polish Society for the Treatment of Obesity, and the patient buys the medicine at a pharmacy with an e-prescription. The programme includes video consultations with a doctor and a psychologist, as well as monthly medical check-ups based on data from the app. If a patient's drinking is hazardous, we also refer them to our addiction treatment clinic at the same time. At the assessment appointment, be open about your drinking, including weekend drinking, because it affects how the doctor will manage your obesity treatment.

Can obesity medicines be combined with medicines for alcoholism?

Not every obesity medicine can be combined with treatment for alcoholism. Mysimba, a combination of naltrexone and bupropion, is contraindicated in the period immediately after a dependent person suddenly stops drinking. Nor can it be taken by someone who takes naltrexone or bupropion for a reason other than weight loss, for example naltrexone to treat alcoholism (22). The interaction lists for Wegovy, Mounjaro and Saxenda do not include medicines used to treat alcoholism. They state in general terms that these medicines delay stomach emptying, which may affect the absorption of medicines taken by mouth (1, 14, 16). This does not mean that such a combination is safe, so the decision is made by a doctor who knows about everything the patient is taking.

Which symptoms need urgent help if you drink during obesity treatment?

If you have severe, persistent abdominal pain that may spread to the back, you need to stop using semaglutide and contact a doctor immediately, because it may be a symptom of acute pancreatitis (1). Vomiting or diarrhoea that makes you lose more fluid than you can replace also needs urgent medical advice, because it can lead to dehydration. After you stop drinking, the warning signs are severe shaking, anxiety, hallucinations, seizures or confusion. With seizures, hallucinations and confusion, medical help is needed straight away, without waiting for a scheduled appointment. This article does not replace a medical consultation.

Frequently asked questions

Does Ozempic treat alcoholism?

Ozempic is not a medicine for alcoholism but for type 2 diabetes. The semaglutide it contains reduced the number of heavy drinking days in small clinical trials, but that is not enough for it to be used to treat alcoholism.

Does Mounjaro reduce the urge to drink?

Less is known about how tirzepatide, the active substance in Mounjaro, affects drinking than about semaglutide: a reduction in drinking has been described in rodents and in a survey in which people with obesity, including 50 taking tirzepatide, self-reported how much they drank. Mounjaro is licensed to treat type 2 diabetes and for weight management, not to treat alcohol dependence.

Does the urge to drink come back after stopping semaglutide?

This is not known. In the 2026 Danish trial, people with obesity and a drinking problem took semaglutide for 26 weeks, and the results were reported only up to the end of treatment, with no follow-up after the medicine was stopped. This is why it is a good idea to plan stopping an obesity medicine with a doctor who knows about your drinking problem.

Can you ask a doctor for semaglutide to help you drink less?

Semaglutide is not licensed to treat alcohol dependence. Studies have not yet established the dose, the length of treatment or the safety of such use in people without obesity. A doctor may decide that someone with obesity is eligible for obesity medication, and the drinking problem is then treated alongside it with psychotherapy and, if needed, one of the licensed medicines.

Sources

1. Charakterystyka Produktu Leczniczego Wegovy (semaglutyd). Europejska Agencja Leków, informacja o produkcie, wersja z sierpnia 2026. ema.europa.eu
2. Hendershot CS, Bremmer MP, Paladino MB et al. Once-Weekly Semaglutide in Adults With Alcohol Use Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2025;82(4):395-405. PMID 39937469, DOI
3. Klausen MK, Justesen SK, Pedersen JN et al. Once-weekly semaglutide versus placebo in patients with alcohol use disorder and comorbid obesity: a randomised, double-blind, placebo-controlled trial. Lancet. 2026;407(10540):1687-1698. PMID 42070571, DOI
4. Schacht JP, Sakai JT, Raymond K, Shelton R. Oral Semaglutide for Alcohol Use Disorder: A Randomized Clinical Trial. Am J Psychiatry. 2026;183(9):636-645. PMID 42522065, DOI
5. Does Semaglutide Reduce Alcohol Intake in Patients With Alcohol Use Disorder and Comorbid Obesity? Trial registration NCT05895643. clinicaltrials.gov
6. Klausen MK, Jensen ME, Møller M et al. Exenatide once weekly for alcohol use disorder investigated in a randomized, placebo-controlled clinical trial. JCI Insight. 2022;7(19):e159863. PMID 36066977, DOI
7. Probst L, Monnerat S, Vogt DR et al. Effects of dulaglutide on alcohol consumption during smoking cessation. JCI Insight. 2023;8(22):e170419. PMID 37991022, DOI
8. Edvardsson CE, Adermark L, Gottlieb S et al. Tirzepatide reduces alcohol drinking and relapse-like behaviours in rodents. EBioMedicine. 2026;124:106119. PMID 41506148, DOI
9. Quddos F, Hubshman Z, Tegge A et al. Semaglutide and Tirzepatide reduce alcohol consumption in individuals with obesity. Sci Rep. 2023;13(1):20998. PMID 38017205, DOI
10. Wang W, Volkow ND, Berger NA et al. Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population. Nat Commun. 2024;15(1):4548. PMID 38806481, DOI
11. Lähteenvuo M, Tiihonen J, Solismaa A et al. Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder. JAMA Psychiatry. 2025;82(1):94-98. PMID 39535805, DOI
12. Cai M, Choi T, Xie Y, Al-Aly Z. Glucagon-like peptide-1 receptor agonists and risk of substance use disorders among US veterans with type 2 diabetes: cohort study. BMJ. 2026;392:e086886. PMID 41781010, DOI
13. Sinha B, Ghosal S. The effects of glucagon-like peptide-1 receptor agonists (GLP1-RAs) on alcohol-related outcomes: a systematic review and meta-analysis. Addict Sci Clin Pract. 2025;21(1):8. PMID 41350683, DOI
14. Charakterystyka Produktu Leczniczego Saxenda (liraglutyd). Europejska Agencja Leków. ema.europa.eu
15. Charakterystyka Produktu Leczniczego Ozempic (semaglutyd). Europejska Agencja Leków. ema.europa.eu
16. Charakterystyka Produktu Leczniczego Mounjaro (tirzepatyd). Europejska Agencja Leków. ema.europa.eu
17. Charakterystyka Produktu Leczniczego Naltex, 50 mg, tabletki powlekane. Rejestr Produktów Leczniczych. rejestrymedyczne.ezdrowie.gov.pl
18. Charakterystyka Produktu Leczniczego Campral, 333 mg, tabletki powlekane dojelitowe. Rejestr Produktów Leczniczych. rejestrymedyczne.ezdrowie.gov.pl
19. Charakterystyka Produktu Leczniczego Selincro, 18 mg, tabletki powlekane. Europejska Agencja Leków. ema.europa.eu
20. Charakterystyka Produktu Leczniczego Anticol, 500 mg, tabletki. Rejestr Produktów Leczniczych. rejestrymedyczne.ezdrowie.gov.pl
21. Mirijello A, D'Angelo C, Ferrulli A et al. Identification and management of alcohol withdrawal syndrome. Drugs. 2015;75(4):353-365. PMID 25666543, DOI
22. Charakterystyka Produktu Leczniczego Mysimba (naltrekson, bupropion). Europejska Agencja Leków. ema.europa.eu