Adam Scioli gets excited when he speaks about GLP-1 medications.
asserted
he → get → medications
Not because they’re known globally for revolutionizing weight-loss management, but because he thinks this class of drugs is the next frontier of addictions treatment.
Dr. Scioli helped to transform care at Caron Treatment Centers in the United States during his recent tenure at the elite non-profit as an addictions psychiatrist and chief medical officer.
asserted
Scioli → know → psychiatrist
Caron is believed to be the first of very few rehabilitation facilities in the world that prescribe GLP-1s off-label to treat substance-use disorders.
asserted
that → believe → disorders
Caron added GLP-1s to its arsenal of addiction medications in 2024 and has since prescribed them to more than 500 residential clients.
asserted
Caron → add → clients
Dr. Scioli said researchers warned him and his colleagues that they were “putting the cart before the horse,” but it’s a decision they stand by.
asserted
they → say → horse
“It’s no doubt groundbreaking.
asserted
It → ’ → ?
It’s no doubt transformative,” he said.
asserted
he → ’ → ?
GLP-1 medications, such as Ozempic, Wegovy and Mounjaro, are only approved by the U.S. Federal Drug Administration and Health Canada for diabetes and chronic weight management.
asserted
medications → approve → diabetes
Early research, however, has shown that this class of drugs may help dampen drug cravings, similarly to how they quiet intrusive thoughts about food.
uncertain
they → show → food
GLP-1s, developed initially for blood glucose and weight control, work by mimicking natural hormones that bind to receptors in the brain that process hunger and satiety.
asserted
that → develop → hunger
They also alter the brain’s dopamine pathway – the circuit for reward, motivation and desire – which helps to mute the mental preoccupation with eating.
asserted
which → alter → eating
The use of addictive substances triggers massive dopamine surges.
asserted
use → trigger → surges
So, a natural question has emerged: Could GLP-1s be the next big treatment for substance-use disorders?
uncertain
GLP-1s → emerge → disorders
Dr. Scioli said he has seen evidence to support this idea.
asserted
he → say → idea
“What we’ve observed is that these GLP-1 receptor agonists seem to provide a cognitive buffer,” he said.
asserted
he → observe → buffer
“They allow our patients to recognize their triggers without being compelled to act on them.”
asserted
patients → allow → them
Canadian researchers are part of a growing network of scientists who are putting such early findings to the test.
asserted
who → grow → test
Results have varied, but studies so far have shown that GLP-1s have the potential to lower the risk of developing a substance-use disorder and reduce negative outcomes and cravings associated with drug use, including for nicotine, alcohol and opioids.
asserted
GLP-1s → vary → nicotine
Experts who spoke to The Globe and Mail are optimistic about the prospects of GLP-1s, especially as opioid deaths continue to mount across the country.
asserted
deaths → speak → country
But, above all else, they are urging prudence.
asserted
they → urge → prudence
These drugs are not yet an established treatment and robust trials are still needed to confirm their safety and efficacy with greater certainty.
asserted
trials → establish → certainty
Such trials would need to look, for example, at the longer-term effects, dosing and who stands to benefit the most.
asserted
who → need → most
“There is a sense that these may be miracle drugs,” said James MacKillop, director of the Peter Boris Centre for Addictions Research at McMaster University.
uncertain
MacKillop → be → University
“But there always has to be quite a lot of caution when something doesn’t have the gold-standard evidence that we look for.
asserted
we → have → that
GLP-1s have shown tremendous success in treating weight loss and diabetes and have been praised for their potential to address a slew of other medical issues, such as heart disease and neurodegenerative disorders.
asserted
GLP-1s → show → disease
There is also an undeniable excitement about the prospect of GLP-1s being able to blunt cravings broadly.
asserted
GLP-1s → be → cravings
Researchers are even looking at their potential for behavioural addictions including sports betting, compulsive shopping and pornography.
asserted
Researchers → look → betting
To date, addiction-related research has largely focused on the relationship between GLP-1s and alcohol use disorder, but it is increasing for other substances.
asserted
it → relate → substances
Most studies have been performed on rats and mice rather than on humans.
asserted
studies → perform → humans
The gold standard, as Dr. MacKillop put it, requires randomized control trials where people are split into two groups.
asserted
people → put → groups
One cluster receives the new treatment while the other does not, removing bias and reliably proving true cause-and-effect results.
asserted
other → receive → results
But on the horizon in Canada is a randomized trial run by Eli Lilly, a leader in the GLP-1 medication market, which makes Mounjaro and Zepbound.
asserted
which → run → Mounjaro
This trial, expected to end in 2028, aims to investigate whether brenipatide, an experimental GLP-1 drug, enhances the recovery of people with opioid use disorder who are already taking a proven treatment called buprenorphine.
asserted
who → expect → treatment
Eli Lilly is looking to enroll 465 participants, ages 18 to 75, across Canada, the U.S. and Britain.
asserted
Lilly → look → Canada
The Canadian trial sites are located in Alberta, British Columbia and Ontario.
asserted
sites → locate → Alberta
Alberta-based addiction physician Monty Ghosh, Calgary’s site investigator, said this is the first study of its kind in Canada.
asserted
this → base → Canada
If brenipatide proves successful, he said it could lead to the expansion of treatment options for opioid use disorder.
uncertain
it → prove → disorder
“This is hugely exciting as we have such limited options.
asserted
we → have → options
This would provide us with a whole new class of medications to manage this severe disorder,” he said.
asserted
he → provide → disorder
The most common treatments for opioid use disorder in Canada are buprenorphine and methadone, long-acting prescribed medications used to manage drug withdrawal and cravings.
asserted
treatments → act → withdrawal
…and 52 more, not listed.
The Aporia
