Announcing a major 1,200 person trial of a GLP-1 for addiction recovery and recidivism

New RCT enrolling Q1 2027 from CASPR and Allegheny County, with researchers from MIT, UCSD, Pitt, and UPMC.

I am very pleased to announce that CASPR and Allegheny County DHS will soon be launching a 1,200 person randomized controlled trial of semaglutide for individuals with AUD or OUD and high risk of incarceration, in addiction to existing care. This trial is funded with a core grant of $13.3M from Arnold Ventures and the research team includes economists and addiction specialists from MIT, UC San Diego, University of Pittsburgh, UPMC, Allegheny County, and CASPR.

Part of what makes this trial so unique and unusual (and challenging) is that we are seeking out people who are often excluded from addiction trials: people with high instability who have a strong chance of arrested or incarcerated during the trial. These are often the individuals who have suffered most acutely from addiction and many who have caused tremendous suffering to others in the course of their disease. This is also a population that is very expensive for cities and counties, driving costs for treatment, rehab, judicial costs, social service costs, disability, and unemployment.

If GLP-1s show positive health and downstream impacts as well as fiscal savings and economic benefits, then adoption by cities around the world becomes feasible. We’ve designed this trial to build comprehensive evidence that can lead to a population level impact.

This is a trial that I believe only could have been created by the unique set of organizations that have come together to make this possible. CASPR’s core thesis is that the massive harms of addiction to individuals and society cannot be solved without new generations of therapeutics. Our pilot programs have shown promise in this population. Allegheny County has both a nationally recognized integrated data system across their social service and judicial systems as well as leadership that is focused on innovation and evidence-based process improvement. Arnold Ventures brings together health and criminal justice economists who understand scale and impact and are determined to support ambitious science.

Lots more details are in our press release and lots of decisions are still being worked out by the research team. As the scientists reading this are no doubt already thinking to themselves, this will be a very challenging trial for retention and adherence. Wish us luck! Wish us smart planning!

This trial began in part because of this Substack: Alex Jutca, now the Director of the Allegheny County DHS, read my writing here two years ago and reached out. We found a shared purpose immediately and began to develop the plan. I may write more about our intersecting stories someday, but for now I’ll just say this: if you are passionate and motivated and, above all, relentless about solving a problem in our world, many things are possible.