The Same Drug Class Reshaping Obesity Medicine Is Now in a Phase 3 Trial for Alcohol Cravings

Alcohol use disorder hasn’t had a genuinely new medication option in about twenty years — naltrexone, acamprosate, and disulfiram remain the only three FDA-approved drugs, and acamprosate, the newest of the three, was approved back in 2004. That’s the backdrop for why a Phase 3 trial now enrolling at 30 sites nationally, including UW Medicine as its only Pacific Northwest site, is drawing real attention inside addiction medicine.

A drug from the same family driving the Ozempic-era weight-loss boom is now being tested, seriously and at scale, as a treatment for alcohol cravings — not a side effect anecdote, an actual 14-month trial.

The drug is brenipatide, which works on the GLP-1 and GIP receptor pathways — in plain terms, the same brain-and-gut chemistry that GLP-1 drugs use to blunt appetite, here aimed instead at the brain’s mesolimbic pathway, the circuit that generates the pull toward reward and desire, alcohol’s included. It’s a double-blind study: participants aged 18 to 75 get either the real drug or a placebo, and researchers are watching whether cravings and drinking patterns actually shift, not just self-reported mood.

Dr. Mark Duncan, the addiction psychiatrist leading the UW site, doesn’t hedge about what’s at stake: “It is exciting to bring this study to the Seattle area, as early research suggests these medications have the potential to provide a unique and powerful new medication treatment for alcohol use disorder in the past 20 years.” That’s a strong claim from someone who treats this population for a living, and it’s worth naming the limit alongside it: this is one trial, mid-run, with results not yet public. Brenipatide is being tested concurrently across alcohol, opioid, and nicotine addiction along with bipolar disorder and cardiometabolic disease — breadth that cuts both ways, since a drug tested everywhere at once is also a drug that hasn’t proven itself anywhere yet.

Addiction psychologist Dr. Mary Hatch is co-investigating the Seattle arm. For a field that’s told patients “we have three old tools and that’s it” for two decades, a fourth mechanism worth testing at all is itself the news, whatever the trial ultimately shows. If you’re in treatment now, that’s also the honest caveat worth sitting with: a trial this early is a reason for attention, not a reason to wait on it instead of the medications that already work.