Exploration of Gemfibrozil as a Treatment for AUD

Inclusion Criteria: 1. males and females age 18-60 meeting DSM-V criteria for moderate or severe AUD in the past year 2. interested in cutting down or quitting drinking 3. able to provide voluntary informed consent 4. have at least 4 heavy drinking days (≥ 5 drinks per day for men, and 4 for women) in the past 30 days Exclusion Criteria: 1. severe liver disease; severe kidney disease; gallbladder disease or gallstones 2. chronic renal or hepatic failure 3. recent pancreatitis 4. insulin-dependent diabetes 5. other urgent medical problems 6. moderately elevated liver function tests (AST or ALT greater than 2 times upper limit of normal) or elevated creatine kinase (CK) 7. schizophrenia, schizoaffective disorder, Bipolar I disorder, suicidal thoughts in the last month 8. current moderate or severe other substance use disorder (SUD; except nicotine or marijuana) 9. active legal problems with the potential to result in incarceration 10. pregnancy or lactation, or child bearing age and not on birth control or not willing to use other birth control methods (e.g. condoms) 11. current daily use of anti-craving medications, mood stabilizers, benzodiazepines, or anti-psychotics 12. regularly taking a medication contraindicated for use with gemfibrozil including other fibrates, statins, repaglinide, or which are believed to interact with gemfibrozil such as dasabuvir, dabrafenib, loperamide, montelukast, paclitaxel, pioglitazone, rosiglitazone, colestipol, colchicine and warfarin41,68 13. a history of alcohol withdrawal-induced seizures or delirium tremens (hallucinations, disorientation) requiring hospital admission during the last ten years 14. a history of moderate or severe traumatic brain injury (TBI; loss of consciousness \>30 minutes69) 15. left-handedness 16. any contraindications for MRI