The Efficacy of GLP-1 Agonists in Treating Substance Use Disorder in Patients A Scoping Review

The Efficacy of GLP-1 Agonists in Treating Substance Use Disorder in Patients A Scoping Review

Published: Sept/Oct 2024
Journal Article

Overview

This one-hour, on-demand, journal article-based activity presents a scoping review on the efficacy of GLP-1 agonists in the treatment of patients with substance use disorder. While there is interest in exploring the use of GLP-1 agonists in the treatment of SUD, evidence for safety and efficacy of GLP-1 agonists in humans is limited. The results of this scoping review are mixed, and the authors call for further research to determine the efficacy of GLP-1 agonists in treating SUD.

The target audience for this intermediate continuing education activity includes: physicians, nurse practitioners, PAs, pharmacists and other clinicians, researchers, students, and policymakers.

This activity addresses the following ACGME Core Competencies: Patient Care, Medical Knowledge, Interpersonal and Communication Skills, Practice-Based Learning and Improvement, Professionalism, and Systems-Based Practice.

Article Abstract

Background
Substance use disorder (SUD) continues to be a leading cause of morbidity and mortality with limited treatments. There is interest in expanding the use of GLP-1 agonists in treating SUD. However, evidence for safety and efficacy in humans is limited. This review aims to bridge the existing knowledge gap by establishing a baseline of literature in this area to inform future trials and clinical practice. Our inclusion criteria were English peer-reviewed manuscripts reporting on use of GLP-1, GIP, and/or glucagon receptor agonists in treatment of SUDs, excluding case studies. The literature search was performed in accordance to PRISMA guidelines. Five studies were included in this review examining the use of this medication in tobacco use disorder, alcohol use disorder, and cocaine use disorder. No studies regarding substance withdrawal syndrome were identified. The included studies varied widely in terms of patient selection, dose/formulation of GLP-1 agonists, and follow-up. The results of this scoping review are mixed, with 3 studies demonstrating positive results and 2 studies finding no efficacy of this medication on SUD outcomes. It is premature to prescribe this medication off-label to patients. Further research is needed to determine the efficacy of GLP-1 agonists in treating SUD.

Methods
The search algorithm was developed with a medical librarian to search PubMed and APA PsychINFO from database inception through October 19, 2023. Search terms included the different forms of GLP-1, GIP, and glucagon receptor agonists including trade names along with SUDs by each individual substance (ie, alcohol, opioid, cocaine, stimulant, sedative, hallucinogenic, tobacco). For purposes of this review, all forms of GLP-1 agonists, including GIP/GcgR co-agonists, will be referred to as GLP-1 agonists, unless specified. Studies were identified and included, abiding by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.¹³ References were extracted and imported into Zotero, a reference manager. Duplicate articles were identified and removed. Each article was assigned a unique record number.

Results
A total of 308 studies were identified in the initial search, with 11 studies passing the title and abstract screen (Fig. 1; PRISMA). Six studies did not meet criteria. Two studies were excluded due to not being peer reviewed, 2 were excluded due to incorrect study design, and 2 were excluded for delineating a proposed protocol without results reported. Thus, in the full text review, a total of 5 studies met the criteria (Table 1). Of these 5 studies examining the effects of GLP-1 agonists in SUDs, 2 investigated tobacco use disorder, 2 studied AUD, and 1 examined cocaine use disorder. No studies regarding substance withdrawal syndrome were identified.

Discussion
This review explores the evidence base for using GLP-1 agonists, traditionally utilized in metabolic disorders, as a novel approach to treat SUDs. Given the interest in expanding the use of these medications outside of metabolic disease, it is important to understand the existing evidence to inform clinical decision-making and identify gaps in the literature in humans.

Learning Objectives

Upon completion of this activity, learners will be able to:

1. Evaluate whether the currently available evidence supports the use of GLP-1 agonists for the treatment of substance use disorder.
2. Identify avenues that future research should address to evaluate the safety and efficacy of GLP-1 agonists and their role in the treatment of substance use disorder.

Registration Rates

*Residents, Fellows-in-training, Interns, and Students must join ASAM to receive a discounted registration rate. Click here to become an ASAM member. National and Chapter membership dues apply. There is no charge for Students to become a Member, but verification of student status is required.

Membership Question?  Call ASAM at 1.301.656.3920, email us, or view the ASAM website for more information.

Refunds & Cancellations

All ASAM eLearning Center refund requests must be made in writing to education@asam.org within 90 days of purchase. Those requesting refunds for courses that are in progress will receive partial refunds or eLearning Center credit. Automatic full refunds will be made for any course with a live-course component that has been cancelled.

Open Registration: 08/01/2024 - 07/31/2027

Close Access Date: 08/31/2027

Course Instructions

1. Click on the Contents tab to begin this activity.
2. Click View Journal Article and read the journal article in its entirety. 
3. Click Complete Post Test to answer multiple choice questions. Participants will have 10 attempts to pass and must answer 2 out of 3 questions correctly.
4. Click Complete Evaluation to provide valuable activity feedback. Scroll down on all questions as there may be answer options that expand past the size of the window.
5. Click the button Claim Medical Credits in the box titled Claim Credits & Certificate. Choose the type of credit and click submit. Click the button View/Print Certificate to save or print your certificate. You can view/print your certificate at any time by visiting the ASAM eLearning Center, clicking Dashboard, and clicking Transcript/Achievements.

Need Assistance?

For assistance logging in, accessing activities, claiming credit, or for other questions or concerns, please check the FAQ page or e-mail Education@ASAM.org

ASAM is proud to offer Essential Accessibility to ensure our website is accessible and functional for all our learners while providing free assistive technology for people with the widest possible range of abilities.

Accreditation & Credits

Joint Accreditation Statement

In support of improving patient care, the American Society of Addiction Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credits Available

• Physicians: 1 Credit(s)
• Pharmacology Hour(s): 1 Hour(s)
• Certified Counselors: NBCC Contact Hours Not offered

Maintenance of Certification (MOC)/Continuing Certification Program (CCP)

This activity is designed to meet the requirements for MOC/CCP for several primary physician boards and for state licensing CME requirements. MOC Credit is only reported and designated for ABA, ABP, ABIM, and ABS. By completing the online credit application and evaluation, the learner permits ASAM to report credits to the appropriate Board. Learn more.

• ABA MOCA 2.0®*: 1 Lifelong Learning | 1 Patient Safety
• ABIM MOC Points: 1 Medical Knowledge | 1 Patient Safety
• ABP MOC: 1 Lifelong Learning & Self-Assessment
• ABS Continuing Certification: 1 Accredited CME | 1 Self-Assessment

Additionally, this activity has been designed to satisfy the requirements of the following primary physician board certification requirements. Please confirm with your individual Board.

• American Board of Addiction Medicine (ABAM)
• American Board of Preventative Medicine (ABPM)
• American Board of Psychiatry and Neurology (ABPN)
• Royal College of Physicians and Surgeons of Canada (RCPSC)

Certificates for other professions

All participants may request a certificate of participation upon completion of the activity and an online evaluation confirming their participation. Learners are strongly advised to contact their professional licensing board or professional association to confirm this certificate will be accepted as evidence supporting continuing education requirements.

California Association for Drug/Alcohol Educators (CAADE)

This educational program is approved by CAADE: #CP40 999 1225.

California Association of DUI Treatment Centers (CADTP)

This educational program is approved by CADTP: #205.

California Consortium of Addiction Programs and Professionals (CCAPP)

This educational program is approved by CCAPP: #OS-20-330-1224.

Disclosure Information

In accordance with the disclosure policies of ASAM and Joint Accreditation, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all accredited continuing education activities. These policies include identifying and mitigating all relevant financial relationships with ineligible companies for those involved in the creation and dissemination of accredited continuing education.

See the attached pdf for a list of disclosures.

  American Society of Addiction Medicine has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7062. Programs that do not qualify for NBCC credit are clearly identified. American Society of Addiction Medicine is solely responsible for all aspects of the programs.

MOCA 2.0® is a trademark of the American board of Anesthesiology®.
This activity contributes to the patient safety CME requirement for Part II: Lifelong Learning and Self-Assessment of the American board of Anesthesiology's (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, https://www.theaba.org/, for a list of all MOCA 2.0 requirements.

The complete list of disclosures and designation statements are linked below.