Liraglutide, a GLP-1 medication, has shown promise in reducing opioid cravings, according to the first randomized controlled trial conducted on anti-obesity drugs for opioid addiction. The study, presented at the American Association for the Advancement of Science conference, revealed that patients on liraglutide experienced a 30% reduction in opioid cravings over the three-week study period. This effect was observed even at the lowest dose of liraglutide.
The trial involved 20 patients with opioid use disorder, some of whom were already on buprenorphine, an FDA-approved medication for treating opioid addiction. The results showed that patients who received both liraglutide and buprenorphine were more likely to report zero cravings compared to the placebo group. This suggests that there may be an additive effect when these two medications are used together, possibly because they target different mechanisms.
One notable finding from the study was that there were no significant differences in side effects between patients on liraglutide and those on placebo, indicating that the GLP-1 drug is safe for patients with opioid use disorder. However, gastrointestinal distress was twice as common in the liraglutide group, leading to a high drop-out rate in the study. Interestingly, patients who received both liraglutide and buprenorphine had lower gastrointestinal distress and drop-out rates than those on liraglutide alone, suggesting that combining the two medications could alleviate some of these issues.
The study was conducted at The Caron Treatment Center in Wernersville, Pennsylvania, and was funded by the National Institute of Drug Abuse, a donor family, and Novo Nordisk, the pharmaceutical company that sells liraglutide as Victoza for diabetes and Saxenda for obesity. The participants were all residential and had recently undergone medication-assisted withdrawal.
While this trial shows promising results, it is important to note its limitations. The small sample size, limited participant diversity, and relatively short duration of the study mean that the results should be interpreted with caution. Additionally, studying patients in a residential treatment facility may not accurately reflect real-world conditions where patients are exposed to relapse-promoting cues. The high drop-out rate also raises concerns about using GLP-1s to treat drug addiction, as patients may interpret nausea as a sign of withdrawal and seek to avoid it.
Despite these limitations, experts in the field recognize the significance of these findings as a proof-of-concept and a stepping stone towards larger trials. The reduction in cravings observed in this study is crucial since cravings often predict relapses. The next step is to determine whether drugs like liraglutide can suppress craving and relapse in real-world environments.
The researchers, Patricia Grigson and Scott Bunce, acknowledge the preliminary nature of their findings and emphasize the need for follow-up studies. They are planning a randomized controlled trial involving 200 people on methadone or buprenorphine, with half receiving semaglutide (a similar GLP-1 medication) and half receiving a placebo. This larger trial will take place across three outpatient sites in Pennsylvania, New York, and Maryland.
Considering the devastating impact of opioid addiction, with approximately 80,000 deaths in the U.S. each year, there is a sense of urgency to find new treatments. The potential of liraglutide and other GLP-1 medications to address opioid use disorder offers hope for those struggling with addiction. However, further research is needed to fully understand the effectiveness and safety of these drugs in treating opioid cravings and preventing relapse.
This article was supported by a grant from Bloomberg Philanthropies, and the financial supporters have no involvement in editorial decisions. The researchers and experts involved in the study express optimism about the possibility of a new treatment for opioid use disorder, but they also emphasize the importance of conducting rigorous studies to validate these initial findings.
