GLP-1 Agonist Drug Class Shows Promise in Addiction Medicine
GLP-I (Glucagon-like peptide 1) agonist drugs, like Semaglutide and Liraglutide, have made waves in the medical community over the last several years as a new favorite choice for medically assisted weight loss. Originally developed for the treatment of Type II Diabetes, GLP-I agonist medications may be advantageous for patients who have fallen short with traditional medication options for weight reduction. Glucagon-like peptide 1 (GLP-1) released in the small intestine delays gastric emptying, increases satiety, and potentiates insulin secretion and reduces glucagon secretion, resulting in glucose stabilization.
GLP-I agonist drugs may also be useful in the practice of addictionology. GLP-I is also produced in the brain stem and is released as a neurotransmitter to several regions of the brain that are believed to be involved in the reward response associated with addiction. Recent studies have examined the potential therapeutic benefits of GLP-I agonists in the treatment of drug and alcohol use disorders.
Substance and alcohol use disorders are a growing concern for many families. Per a 2020 United Nations Publication, an estimated 35 million people suffer from substance abuse disorders, and a staggering 280 million from alcohol use disorder worldwide. Addiction results in significant dysregulation of the user’s neurocircuits and neurochemicals, such a dopamine, y-Aminobutyric acid (GABA), and opioid peptides. Dopamine specifically plays a prominent role in immediate reward and reinforcement of drug and alcohol use. The “Dopamine Theory” of addictionology points to this dopaminergic response, and subsequent dysregulation of the dopamine system, as a prominent contributory factor to person(s) falling into an addicted state.
While the exact mechanism(s) of GLP-I agonists on reducing addictive behaviors is not yet known, preliminary research suggest that inhibition of the dopaminergic reward response is likely. Preliminary studies on rodent and non-human primates have demonstrated encouraging results in the cessation of alcohol use, reducing the rewarding effects of alcohol consumption and attenuating recurrent binge-drinking episodes. Comparable responses were demonstrated with opioid consumption. GLP-1 agonists also demonstrated an apparent reduction of dopamine signaling in response to cocaine use, and seemed to, at least partially, mitigate the locomotor effects of both cocaine and amphetamine use.
This research, of course, is not the first to draw correlation between addiction and weight disorders. In recent years, the use of Naltrexone, traditionally used to treat opioid and alcohol use disorder, has become more prevalent in obesity medicine to assist patients with weight reduction, further demonstrating the importance of addressing the centrally active mechanisms that directly contribute to both addiction and weight related disorders. While more research still needs to be done, these preliminary findings offer promise that the GLP-1 agonist drugs may be another tool available in the future to help combat the growing epidemic of addiction.
Author: Joseph Matovich