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Can weight-loss drugs also be used to treat opioid addiction?

February 21, 2024

Early results from a new study suggest that liraglutide, a GLP-1 agonist used for weight reduction, may result in lessened cravings for opioids in people with opioid use disorder. Liraglutide mimics GLP-1 hormones but is less costly than its sister drugs, Wegovy and Ozempic.

These findings add to a growing body of research that indicates weight-loss drugs have a wide range of potential uses, including lowering blood pressure.

Patricia Grigson, MS, PhD, a behavioral neuroscientist and inaugural director of the Penn State Addiction Center for Translation, presented the findings on February 17 at the annual meeting of the American Association for the Advancement of Science in Denver, CO. The study – which was funded by the National Institute on Drug Abuse and Novo Nordisk, manufacturer of liraglutide – is the first randomized, controlled trial to test anti-obesity drugs for opioid addiction. (Bajaj, 2024)

What’s the potential patient impact?

According to the CDC, opioid addiction killed more than 80,000 people in the U.S. in 2021, the most recent year for which statistics are available. Although the FDA has approved three drugs for treating opioid addiction, the medications have a low uptake, are associated with significant relapse rates, and do not work as well in patients who have used certain drugs like fentanyl. (Bajaj, 2024)

In Grigson’s trial, the participant dropout rate was low among those participants receiving both liraglutide and buprenorphine, suggesting that the combination approach may alleviate negative side-effects and encourage individuals to stick with the treatment. Moreover, the reduction in desire for opioids was reduced by nearly 40%, the equivalent of spending two weeks in a high-quality – and likely high-cost – treatment facility, which can cost upwards of $1,000 per day. (Pinkstone, 2024)

What’s the evidence?

Pre-clinical trial data has suggested that GLP-1 medications are effective in reducing drug and alcohol intake among animals. In 2022, Grigson and her colleagues published a study in the journal Brain Research Bulletin showing that liraglutide cuts down on heroin-seeking behavior in rats. (Bajaj, 2024)

To test whether liraglutide would work in people as a treatment for opioid addition, Grigson and her team administered the drug to participants seeking treatment for opioid use disorder at Caron Treatment Center in Wernersville, PA. Most of the individuals were being treated for fentanyl addiction.

The team analyzed data from 20 people (80% White males), 10 of whom were slated to receive increasing doses over 19 days. The remaining 10 people were assigned to placebo. Participants received a notification on their phones four times a day to assess self-reported cravings in real time. (De Jésus, 2024; Pinkstone, 2024)

Over a three-week period, liraglutide appeared to reduce opioid cravings by 40%, the equivalent to 14 days of intensive treatment at a residential center. Patients who were also taking buprenorphine were more likely to report zero cravings than the placebo group. This effect became statistically significant from the tenth day of the study onward, as patients were titrated to increasingly higher doses of liraglutide. (Bajaj, 2024; Pinkstone, 2024)

There were no notable differences in side effects between patients on liraglutide and placebo, although GI distress was reported as the liraglutide dosage increased. This adverse effect was twice as common in the liraglutide group and largely responsible for the study’s high dropout rate (only nine patients completed the full trial). However, participants taking both buprenorphine and liraglutide had lower GI distress and dropout rates than participants on liraglutide alone. (Bajaj, 2024)

Because of the study’s small size, limited participant diversity, and short duration, the results should be interpreted with caution. Grigson and her team hope to study the effects of other GLP-1 drugs that might be more effective and less prone to GI side effects. They are currently planning a randomized controlled trial of 200 people on methadone or buprenorphine across three outpatient sites. (Bajaj, 2024)

Sources:

De Jésus, EG. (2024, February 17). Science News. Taking a weight-loss drug reduced a craving for opioids. https://www.sciencenews.org/article/weight-loss-drug-addiction-opioid-disorder

Bajaj, S. (2024, February 17). STAT. Opioid cravings were reduced by anti-obesity drug in small study. https://www.statnews.com/2024/02/17/opioid-cravings-glp1-weight-loss-liraglutide-penn-state/

Pinkstone, J. (2024, February 19). The Telegraph (via Yahoo News). Weight loss jabs could be cheaper and better treatment for addicts than rehab, study suggest. https://news.yahoo.com/weight-loss-jabs-could-cheaper-000100516.html