Emerging medications and pharmacological treatment approaches for substance use disorders.
Joel S Raymond, Alexander G Athanasopoulos, Connie J Badolato, Tylah J Doolan, Rhianne L Scicluna, Nicholas A Everett, Michael T Bowen, Morgan H James
Pharmacology, biochemistry, and behavior March 1, 2025 DOI: 10.1016/j.pbb.2024.173952 via PubMed
Summary
AI-generated from the abstractMedications for substance use disorders are limited, especially for stimulants and cannabis, due to addiction's biological complexity, regulatory hurdles, and pharmaceutical industry disinterest. The opioid crisis has spurred urgent efforts to find new treatments. Several neurobiological systems newly implicated in drug reward offer novel medication targets. This review covers ongoing clinical trials and authors' research on psychedelics targeting serotonin 2A receptors, glucagon-like peptide 1 receptor agonists, cannabidiol, dynorphin/kappa opioid receptor, orexin/hypocretin, and oxytocin receptor systems, plus agonist therapies for stimulant use disorders. These innovations suggest an improved therapeutic landscape is near.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Citations | 7 |
| Key finding | New classes of medications targeting serotonin 2A receptor, glucagon-like peptide 1 receptor, cannabidiol, dynorphin/kappa opioid receptor, orexin/hypocretin, and oxytocin receptor systems, along with agonist therapies for stimulant use disorders, are being explored in ongoing clinical trials and offer hope for improved treatment of substance use disorders. |
Abstract
Medications to treat substance use disorders (SUDs) remain suboptimal or, in the case of stimulants and cannabis, non-existent. Many factors have contributed to this paucity, including the biological complexity of addiction, regulatory challenges, and a historical lack of enthusiasm among pharmaceutical companies to commit resources to this disease space. Despite these headwinds, the recent opioid crisis has highlighted the devastating consequences of SUDs for both individuals and society, stimulating urgent efforts to identify novel treatment approaches. In addition, several neurobiological systems have been recently implicated in unique aspects of drug reward, opening the door to candidate medications with novel mechanisms of action. Here, we provide an overview of efforts to target several of these new systems, with a focus on those that are the subject of ongoing clinical trials as well as being areas of interest among the authors' research groups (MHJ, MTB, NAE). Specifically, we discuss new classes of medications targeting the serotonin 2A receptor (i.e., psychedelics), glucagon-like peptide 1 receptor, cannabidiol, dynorphin/kappa opioid receptor, orexin/hypocretin, and oxytocin receptor systems, as well as emergent approaches for modulating the more canonical dopaminergic system via agonist therapies for stimulant use disorders. Collectively, innovations in this space give reason for optimism for an improved therapeutic landscape for substance use disorders in the near future.