A groundbreaking international clinical trial is testing whether the blockbuster weight loss medications could also help treat alcohol addiction — and even stop the progression of alcohol-related liver disease, one of Australia’s fastest growing health crises.
The study, sponsored by pharmaceutical company Novo Nordisk, is running across Europe, the United States and seven Australian sites, involving around 240 patients worldwide.
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It’s examining combinations of three drugs: semaglutide (the main ingredient in Ozempic), cagrilintide, and a FGF21 analogue. These medications act on appetite, cravings, and liver-cell inflammation pathways.
Addiction and liver specialist Professor Paul Haber, who is leading the Australian arm of the trial, says the goal is to treat both alcohol dependence and the severe liver damage it causes.
“These are three protein drugs in various combinations that interact with the appetite, the craving for alcohol, and actually also interact with the cellular damage pathways in the liver,” he told 7NEWS in an exclusive interview.
“We believe that it has a multiple effect, both on the appetite for alcohol, the appetite for food, and the effect of those things on the inflammation within the liver.”
Although final results are not yet available, early signs look promising.
“The trial has shown that the patients lose weight and at least in some of our patients, they are showing signs of reducing their alcohol use,” he said.
The primary outcome is to see whether the drugs can improve liver inflammation and fibrosis, the precursor to cirrhosis, cancer and liver failure.
Professor Haber says the potential impact of these medications is “transformative”.
“Throughout my career we had no specific treatment for patients with both alcohol problems, overweight or liver damage … so it is a transformative time when we’re really starting to see treatments that make a material difference to people’s lives.”
He believes behavioural improvements are likely, but is “incredibly optimistic” about liver outcomes due to the drugs’ biological effects and reductions in alcohol and weight.
Haber stresses these drugs aren’t for everyone. “You wouldn’t recommend taking these medications for someone who is, you know, two kilos overweight or something,” he said.
Instead, the focus is on people at high medical risk, especially those with alcohol-related liver disease, a condition he says is rising as Australians age.
Nigel Harpley, 48, struggled for years with alcohol dependence for years, but drinking escalated in his late 30s.
“Like a couple of beers and a bottle of wine, maybe four or five times a week,” he said.
Eventually, he sought medical help and went through inpatient treatment, therapy and medication.
Asked whether he would have tried Ozempic-style treatment if it had been available earlier, Nigel was unequivocal:
“Absolutely, because I guess I did use some medications and I think if the evidence shows that this helps people, it’s something that I guess doctors or whatever would recommend, and I’d be definitely open to adding that to the tools that are available to people.”
SMART Recovery Australia CEO April Long says the need for new treatments is urgent.
“One of the biggest challenges in our country right now is alcohol dependency … it often takes people over 12 years to first seek support,” she said.
She warns that alcohol issues ripple through families: “For every individual struggling, it’s estimated that six people around them are being impacted as well.”
While supporting the trial, Long warns that drugs like Ozempic are expensive — and must not become another barrier.
“People who are financially in a hard position, it’s really important that any of these pharmaceutical options, there’s equity in how it’s distributed. That’s something we’re really committed to at Smart Recovery. Our meetings are completely free for anybody, wherever they are in Australia”
“So it’s really important that any solutions are properly funded so everybody can get the support they need.” she said.
The trial includes seven treatment groups — some receiving combinations of the three medications, others a placebo — allowing researchers to identify which approach is most effective.
Just the beginning
Full results are expected once all international data is combined but researchers say it’s just the beginning.
New trials are already being designed to investigate whether GLP-1 medications could also reduce cigarette cravings and smoking rates.
“There is a growing area of research applying these drugs … to a range of addictions,” Haber confirmed.
He predicts a wave of new GLP-1-style medications within the decade.
“I’m pretty well sure that within 10 years there’ll be a range of these new drugs available.”
With seven treatment groups — including placebo — researchers hope to identify which combination delivers the greatest improvement in alcohol use, weight, and liver inflammation.
The final results will be analysed once all global data is collected.
If successful, experts say it could redefine addiction treatment and mark a new frontier for medications originally designed for weight loss.
