GLP-1 Receptor Agonists Explained: Their Potential Role in Addiction Treatment

In this episode of ASAM Practice Pearls, Dr. Stephen Taylor hosts Dr. Stephanie Weiss from the National Institute on Drug Abuse (NIDA) to explore the potential of GLP-1 receptor agonists (GLP-1RA), particularly semaglutide, in treating alcohol use disorder. They discuss the underlying science, current research, and the challenges and implications of integrating these innovative treatments into addiction care.

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Host

Stephen M. Taylor, MD, MPH, DFAPA, DFASAM

Dr. Stephen M. Taylor is ASAM’s President-Elect and is board-certified in general psychiatry, child and adolescent psychiatry, addiction psychiatry, and addiction medicine. With over 30 years of practice experience, Dr. Taylor is dedicated to helping adolescents and adults overcome addiction and co-occurring psychiatric disorders. He has served as the Medical Director of the NBA and NBPA Player Assistance and Anti-Drug Program for 16 years and is the Chief Medical Officer of Pathway Healthcare, which operates multiple outpatient addiction and mental health treatment offices across six states.

Expert

Stephanie Weiss, MD, PhD

Dr. Stephanie T. Weiss is a Research Physician with the Translational Addiction Medicine Branch (TAMB) of the NIDA Intramural Research Program. She holds a PhD in pharmaceutical chemistry and a medical degree from the Cleveland Clinic Lerner College of Medicine. Board-certified in emergency medicine, addiction medicine, and medical toxicology, Dr. Weiss focuses on caring for patients with poisonings, overdoses, and medication misuse. Her research interests include novel psychoactive substances, medication misuse, and improving urine drug testing interpretation.

📖 Show Segments

• 00:03 - Introduction
• 01:19 - Exploring GLP-1RA in the News
• 02:49 - Scientific Background of GLP-1 RA
• 05:38 - Current Research on Semaglutide
• 07:13 - Study Design and Methodology
• 10:38 - Potential Applications of GLP-1RA Beyond Alcohol Use Disorder
• 12:15 - Challenges in Integrating GLP-1RA into Addiction Care
• 15:16 - Practical Steps for Addiction Care Providers
• 18:19 – Looking to the Future
• 19:27 – Conclusion and Additional Learning Opportunities

📋 Key Takeaways

• Semaglutide, a GLP-1RA, is currently being studied as a potential adjunctive therapy for alcohol use disorder.
• It shows promise for treating various substance use disorders and is generating significant excitement in the addiction medicine field.
• Challenges to utilizing GLP-1RA for addiction care include high costs, limited access, and stigma associated with addiction treatment.
• For patients with co-occurring conditions such as type 2 diabetes or obesity and alcohol use disorder, semaglutide may offer dual therapeutic benefits.
• Future research will shed light on the efficacy and safety of GLP-1RA, but questions remain about long-term effects.
• Despite FDA-approved treatments, alcohol use disorder remains severely undertreated. Providers should prioritize these medications while awaiting more data on semaglutide.
• It is important to exercise caution when integrating new treatments such as GLP-1RA into practice.

🔗 Resources

• ASAM’s 56th Annual Conference: Register here.
• JAMA Psychiatry article: Repurposing Semaglutide and Liraglutide.
• NPR article: Ozempic shows promise for alcohol and drug addiction.
• NIDA/NIAAA-funded STAR trial: ClinicalTrials.gov.
• Early studies examining GLP-1RAs in rodent models of alcohol consumption:   
  • Egecioglu et al., Psychoneuroendocrinology (2013) 38: 1259  
  • Shirazi et al., PLOS ONE (2013) 8: e61965  
• Vervet monkey study on liraglutide: Thomsen et al., Psychopharmacology (2019) 236: 603  
• Exenatide randomized clinical trial in Denmark: Klausen et al., JCI Insight (2022) 7: e159863  

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