VA Launches Trial of Semaglutide for Alcohol Use Disorder in Veterans

The Department of Veterans Affairs on Thursday launched a nationwide clinical trial to test whether semaglutide — the drug sold as Ozempic for diabetes and Wegovy for weight management — can treat alcohol use disorder in veterans. The trial will screen more than 600 veterans at 18 VA medical centers, making it one of the largest controlled tests yet of a GLP-1 medication against a substance use disorder.

Recruitment for the study, formally named the Cessation or Reduction of Alcohol Consumption in Veterans trial, or CRAVE, began July 28, according to the department's announcement. Enrollment is open to veterans ages 18 to 80 with moderate or severe alcohol use disorder.

How the CRAVE trial is designed

Participants will be randomly assigned to receive weekly injections of either semaglutide or a placebo over 24 weeks, followed by a safety evaluation. Researchers will track changes in alcohol consumption alongside broader measures of health and quality of life to determine whether the medication offers what the VA called "a meaningful new treatment option." The nearly half-year study is expected to wrap up in the spring of 2027.

At the Minneapolis VA Health Care System, one of the 18 participating sites, the study is being led by Dr. Eric Dieperink, a psychiatrist who has spent more than two decades studying alcoholism. He described the work as foundational. "We're laying the groundwork for a potentially exciting breakthrough in treatment," Dieperink told CBS Minnesota, noting that participants will come in for eight clinical visits involving medication checks and study procedures. Veterans do not need to live near a participating site or already receive care there to enroll; the department is directing interested veterans to ClinicalTrials.gov or their local VA medical center.

The trial is explicitly not designed to replace existing care. Dieperink stressed that the goal is to learn whether semaglutide could become one more tool for veterans living with alcohol use disorder, not a substitute for therapies they already receive.

Why a weight-loss drug might curb drinking

Semaglutide belongs to a class of drugs called GLP-1 receptor agonists, developed for Type 2 diabetes and later approved for chronic weight management. Researchers at Washington University School of Medicine and elsewhere have spent years examining whether the same medications might influence the brain's reward circuitry in ways that blunt cravings for alcohol, nicotine, and opioids.

The VA cited an analysis published in March that found patients taking GLP-1 medications experienced lower rates of alcohol use disorder and other substance use disorders than similar patients on other diabetes drugs. But those findings were observational — patterns in medical records rather than randomized evidence. Department officials said larger, controlled trials are needed before semaglutide can be considered safe and effective for this use, which is precisely the gap CRAVE is built to fill.

The Food and Drug Administration has approved semaglutide for diabetes and weight management only. It has never been approved for alcohol use disorder, and the VA cautioned veterans not to self-medicate with GLP-1 drugs or swap them for evidence-based alcohol addiction treatment without consulting a health care provider.

A treatment gap affecting hundreds of thousands

The need is substantial on both sides of the veteran-civilian divide. More than 29 million people in the United States experienced alcohol use disorder in 2022, and the VA counts more than 400,000 veterans diagnosed with the condition. Yet the pharmacological toolkit has barely changed in decades: only a handful of medications are approved for alcohol use disorder, and only a small fraction of people who could benefit ever receive them.

High-risk drinking has also climbed since the start of the COVID-19 pandemic, according to a March 2024 study in the American Journal of Medicine, adding urgency to the search for new options — particularly for veterans, whose rates of co-occurring trauma complicate treatment.

Part of a broader research push at the VA

CRAVE is the second unconventional addiction trial the department has announced this year. In May, the VA launched a study of MDMA-assisted therapy for veterans with co-occurring post-traumatic stress disorder and alcohol use disorder — a notable step given the FDA's earlier rejection of MDMA as a PTSD treatment.

"This clinical trial reflects medical research that VA is uniquely situated to launch, and is aimed directly at benefitting veterans," VA Secretary Doug Collins said in the announcement. "By exploring emerging treatment options like the use of a GLP-1 for AUD, we aim to expand the tools available to help Veterans take control of their health and recovery."

Whether semaglutide earns a place in that toolkit will not be known until results arrive in 2027. In the meantime, the trial's scale — hundreds of participants across 18 sites — will produce the kind of randomized data that observational studies, however promising, cannot.