Feasibility of GLP-1 Receptor Agonists as an Adjuvant Treatment for Substance Use Disorder

Abstract

Substance use disorder (SUD) is a pervasive and escalating global public health issue. While current pharmacotherapies for SUD directly act on the disease state and aid in symptom management, only few treat the underlying craving in substance abuse. When coupled with low rates of seeking treatment in chronic drug users, this lack has resulted in unsuccessful efforts to mitigate SUD. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), a class of drug known for glycemic control and aiding in weight loss, have shown promise in preclinical studies to target underlying “wanting” or incentive salience in drug addiction. This review aims to examine preclinical literature and randomized controlled trials (RCTs) to determine the feasibility of GLP-1RAs in reducing craving and compulsive behavior. Findings of this review suggest that the feasibility of this class of drug is potentially contingent on dosing and duration of treatment, specificity, metabolism, and the treatment philosophies of drugs moving forward. Future directions for this topic include larger and longer clinical RCTs – which are currently in progress – evaluation of the efficacy of GLP-1RAs in different metabolic dispositions, exploration of the combination with conventional treatments as a potential adjuvant, and expanded neuroimaging to assess mechanisms.