The Weight-Loss Drug Everyone's Talking About Might Also Be the Best Alcohol Medication Nobody's Prescribing

A new trial recruiting through UW Medicine is testing brenipatide, a dual GLP-1/GIP drug in the same family as Ozempic and Zepbound, specifically for alcohol use disorder — not weight loss, not diabetes. It’s the latest entry in a stack of research that keeps finding the same thing: people with AUD who happened to be on a GLP-1 drug for another reason cut their drinking substantially more than similar patients who weren’t, with preclinical studies pointing to the same reward-pathway circuitry in the brain that makes these drugs quiet food cravings apparently quieting alcohol cravings too.

A drug nobody built for drinking might end up treating it better than the drugs we already have — and that should embarrass us, not just excite us.

Here’s the part of this story that isn’t about the shiny new molecule: the FDA has approved three medications for alcohol use disorder for decades — naltrexone, acamprosate, and disulfiram — and a CU Anschutz analysis published this year found that almost nobody has heard of them, let alone gets prescribed them. Naltrexone blocks the opioid receptors involved in alcohol’s reward response — in plain terms, it turns down the volume on the “that felt good, do it again” signal a drink sends your brain. It’s cheap, generic, and a single daily pill. It is also, per that same review, prescribed to a small fraction of the roughly 28 million Americans with AUD who could benefit.

If a GLP-1 drug turns out to help with drinking, that’s genuinely good news — the pharmacological mechanism is plausible and worth funding all the way through Phase 3. But if you or someone you’re supporting is drinking more than you want to and waiting for a trendier drug to arrive, you don’t have to wait. Ask a primary care doctor about naltrexone this week — not a specialist, not a six-month waitlist, a regular doctor can write that prescription today. The treatment gap here isn’t a science problem. It’s a nobody-asked-for-it-by-name problem, and GLP-1 hype risks making that worse before it makes it better, by teaching another generation of patients that the only alcohol medication worth mentioning is the one that isn’t approved yet.