GLP-1s May Treat SUD by Muffling Dopamine Reward Spikes

The rapid ascent of glucagon-like peptide-1 (GLP-1) receptor agonists like semaglutide has primarily been defined by their success in treating diabetes and obesity. However, a new frontier is emerging in addiction medicine: the use of these medications to manage substance use disorder (SUD).

While these drugs are famous for slowing gastric emptying and increasing satiety, their true potential for SUD lies in the brain’s reward center.

“They act on the brain's reward sensitivity, and because of that, they show potential across a wide range of substances. So that's one exciting aspect,” Sylvie Stacy, MD, MPH, chief medical officer at Rehab.com, told Drug Topics. “Then, the second big reason for a potential shift is that GLP-1s may fill gaps in our current treatment toolbox.”

In part 1 of our interview, Stacy introduces the novel notion that GLP-1s can make a significant impact on SUD types including alcohol use disorder, nicotine use, opioid use disorder (OUD), and more.

At this current moment, the data is most robust regarding alcohol use disorder. Clinical trials and large-scale registry studies indicate that GLP-1s can lead to medium-to-large reductions in alcohol consumption and a lower risk of hospitalization for alcohol-related issues. In tobacco cessation, the drugs offer a unique secondary benefit—the potential to eliminate the weight gain that often deters smokers from quitting.

While evidence for OUD and stimulants is still in the early or mixed stages, retrospective data already suggests a lower rate of overdoses in patients on GLP-1s. Perhaps most exciting is the potential for prevention. Recent observational studies suggest these medications may actually reduce the risk of developing various addictions in the first place, positioning GLP-1s as a revolutionary tool in public health.

Listen through for emerging insights on GLP-1s for SUD treatment and stay tuned for more from our conversation with Stacy.

READ MORE: Substance Use Disorder Resource Center

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