Addiction remains one of the most pervasive challenges in public health, and while traditional therapeutic methods, such as individual and group therapy, have proven effective, new research indicates that supplemental treatments may enhance recovery outcomes. Recent studies have highlighted promising developments in the field of addiction treatment, particularly the potential role of drugs typically used to manage diabetes and obesity. These drugs, namely glucagon-like peptide-1 receptor agonists (GLP-1 RAs) known popularly as Ozempic, and glucose-dependent insulinotropic polypeptides (GIPs), offer new avenues for managing substance use disorders (SUDs) such as opioid use disorder (OUD) and alcohol use disorder (AUD).
Understanding GLP-1 RAs and GIPs
GLP-1 RAs, such as liraglutide and semaglutide (Wegovy and Ozempic), are drugs commonly prescribed to individuals with type 2 diabetes and obesity. They mimic the action of the GLP-1 hormone, which helps regulate appetite and blood sugar levels. GIPs, another class of drugs used for similar purposes, work in conjunction with GLP-1 RAs to improve insulin secretion. Together, these drugs help manage hunger, leading to weight loss and better control of blood sugar levels (Qeadan et al., 2024).
Interestingly, GLP-1 RAs and GIPs have attracted attention beyond diabetes and obesity management. Their effects on the brain’s reward system—the same system that governs addictive behaviors—have led researchers to explore their potential for treating addiction. Addiction, whether to substances like opioids or alcohol, involves disruptions in the brain’s reward pathways, where substances trigger dopamine release, creating a feeling of pleasure. This pleasure-reward cycle forms the basis for addictive behaviors.
The Science Behind GLP-1 and Addiction
The brain’s reward system overlaps with areas affected by GLP-1 RAs, leading researchers to hypothesize that these drugs might influence addiction-related behaviors. GLP-1 receptors, located within the mesolimbic system—the neurological hub responsible for reward processing—modulate dopamine release. This system is crucial in both eating and substance use behaviors, which means that GLP-1 RAs could potentially decrease the craving and reward response associated with addictive substances (Qeadan et al., 2024).
Animal studies have provided compelling evidence supporting this hypothesis. For example, rodents treated with GLP-1 RA medications like liraglutide or semaglutide demonstrated reduced alcohol consumption and drug-seeking behaviors (Qeadan et al., 2024). These findings have paved the way for clinical trials exploring how GLP-1 RAs might be used to treat human patients with SUDs. Some early clinical trials have shown promising results, including a reduction in heavy drinking days among patients with alcohol use disorder (AUD) (Qeadan et al., 2024).
GLP-1 RAs and GIPs: Real-World Impact on Opioid and Alcohol Use Disorders
While early studies focused on animal models, recent research involving humans has reinforced the potential benefits of GLP-1 RAs and GIPs in addiction treatment. One such study, conducted by Qeadan et al. (2024), examined the association between these drugs and substance-related outcomes in a large population of individuals with opioid and alcohol use disorders. The study included over 500,000 individuals with opioid use disorder and more than 800,000 individuals with alcohol use disorder, spanning nearly a decade of real-world data.
The findings revealed that patients who were prescribed GLP-1 RA or GIP medications experienced significantly lower rates of opioid overdose and alcohol intoxication. Specifically, patients with opioid use disorder who received GLP-1 RA prescriptions had a 40% lower incidence of overdose compared to those who did not receive the prescription (Qeadan et al., 2024). Similarly, individuals with alcohol use disorder had a 50% lower rate of alcohol intoxication when prescribed GLP-1 RA drugs (Qeadan et al., 2024). These protective effects remained consistent across various subgroups, including those with comorbidities like diabetes and obesity.
Integrating GLP-1 RA and GIP Treatments into Addiction Therapy
Given these promising results, the question arises: How can non-prescribing therapists and patients integrate this knowledge into their practice and life? While GLP-1 RA and GIP treatments must be prescribed by a medical doctor, therapists play a critical role in coordinating comprehensive care for their clients. For instance, therapists who are informed about these emerging treatments can advocate for their clients by working closely with prescribers and medical professionals. In cases where individuals with substance use disorders also struggle with diabetes or obesity, therapists can suggest exploring GLP-1 RA medications as a supplemental treatment.
Moreover, therapists can incorporate the discussion of these treatments into group therapy sessions, helping clients understand the potential benefits and empowering them to advocate for themselves in medical consultations. Education about the physiological underpinnings of addiction and how new treatments target those mechanisms can also reduce the stigma often associated with seeking medication-assisted treatment (MAT). Understanding that these medications may reduce cravings and the risk of relapse can provide clients with additional hope and motivation during their recovery journey.
The Future of Addiction Treatment: Combining Therapeutic Approaches
As the landscape of addiction treatment evolves, therapists will continue to play an essential role in guiding clients through the myriad of available options. Traditional therapies such as cognitive-behavioral therapy (CBT) and group therapy remain foundational in treating addiction, but the addition of supplemental treatments like GLP-1 RAs and GIPs represents a significant advancement. This integrative approach can address both the psychological and physiological aspects of addiction, leading to better outcomes for clients.
In conclusion, the introduction of GLP-1 RA and GIP medications as potential treatments for addiction offers a new horizon in addiction therapy. Therapists can stay informed about these developments and work collaboratively with prescribers to ensure clients have access to the most effective and comprehensive care. As research continues to advance, it is likely that GLP-1 RAs and GIPs will become an increasingly important component of addiction treatment, supplementing the valuable work already being done in individual and group therapy settings.
References
Qeadan, F., McCunn, A., & Tingey, B. (2024). The association between glucose-dependent insulinotropic polypeptide and/or glucagon-like peptide-1 receptor agonist prescriptions and substance-related outcomes in patients with opioid and alcohol use disorders: A real-world data analysis. *Addiction*. https://doi.org/10.1111/add.16679