Alcohol and other substance use disorders (ASUDs) remain chronic, multifaceted, and undertreated medical conditions with profound individual and societal impacts. Despite compelling advances in neuroscience and evidence-based psychosocial treatments, pharmacotherapies for ASUDs are limited and underutilized in clinical practice. Innovative approaches that bridge metabolic science and addiction biology are critically needed in the addiction treatment landscape.
This comprehensive review explores the emerging role of glucagon-like peptide-1 receptor agonists (GLP-1RAs) — drugs currently approved for type 2 diabetes and obesity — as promising candidates for treating ASUDs. GLP-1 receptors are widely expressed in reward and stress-related neurocircuits, including the mesolimbic dopamine pathways implicated in addiction. Preclinical models demonstrate that GLP-1RAs such as exendin-4, liraglutide, and semaglutide can reduce alcohol and drug intake, attenuate reward-seeking behaviors, and modulate neurobiological drivers of addiction.
Importantly, the review frames GLP-1RAs not as standalone treatments but as integrative pharmacological tools that may enhance existing addiction care frameworks. It also identifies gaps in clinical evidence, underscoring the need for rigorous human trials and translational research to validate efficacy, optimize dosing, and assess long-term outcomes.
This synthesis spotlights an interdisciplinary frontier in addiction medicine — one that unites endocrinology, neuroscience, and clinical practice to expand therapeutic options and improve recovery-oriented outcomes for individuals with ASUDs.
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