Cessation or Reduction of Alcohol Consumption in Veterans: A Randomized, Double-Blind, Placebo-Controlled Phase 3 Trial to Evaluate the Efficacy and Safety of a GLP-1 Receptor Agonist Semaglutide in U.S. Veterans With Alcohol Use Disorder

Inclusion Criteria: * Veteran. * WHO risk drinking level of Very High or High in the 30 days prior to screening. * Current diagnosis of moderate or severe AUD (i.e., meeting at least 4 of 11 DSM-5 AUD criteria) based on semi-structured diagnostic exam. * Able and willing to provide informed consent. Exclusion Criteria: Medical and Psychiatric: * Type 1 diabetes. * Current serious psychiatric illness (i.e., schizophrenia, bipolar disorder, severe or psychotic major depression, borderline or antisocial personality disorder, eating disorder). * Current DSM-5 diagnosis of a SUD (other than moderate-to-severe alcohol, any nicotine, or mild cannabis use disorders). * At the time of randomization, moderate-to-severe alcohol withdrawal (Clinical Institute Withdrawal Assessment for Alcohol (CIWA-AR) \>8). * BMI \<21 kg/m2. * Unstable body weight defined as \>5% change in body weight (documented or self-report; intentional or not) in the 90 days prior to randomization. * History of acute or chronic pancreatitis. * History of diabetic ketoacidosis. * History of proliferative diabetic retinopathy. * History of ascites, advanced liver fibrosis, compensated cirrhosis with portal hypertension, decompensated cirrhosis, variceal bleeding, hepatic encephalopathy, spontaneous bacterial peritonitis, or hepatocellular carcinoma (HCC). * History of stage 3 fibrosis or stage 4 cirrhosis from a liver biopsy. * Presence of gastroparesis. * History of acute gallbladder disease in the prior 6 month…