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Repurposing anti-inflammatory medications for alcohol and substance use disorders

Neuropsychopharmacology volume 49, pages 317–318 (2024)Cite this article

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Alcohol and substance use disorders (AUD, SUD) have diverse systemic and neuroinflammatory mechanisms. Existing approved pharmacotherapies for AUD/SUDs are incompletely effective with complex polysubstance use patterns complicating treatment. Some SUDs lack any approved pharmacotherapies, and where treatments exist, inaccessibility and/or high costs of medication presents additional obstacles. Recent findings support the repurposing of several promising compounds, FDA-approved for other conditions, to reduce harmful alcohol and/or drug use to help fill these gaps. Importantly, these drugs are also nearing patent expiration which will offer increased accessibility and future affordability for patients.

Decades of data show that alcohol and drug use alter cellular energy homeostasis and increase proinflammatory signaling that drives continued substance use. We highlight preclinical studies showing that anti-inflammatory compounds FDA-approved to treat other conditions effectively reduce harmful behaviors (i.e. use, craving) in animal models for AUD and SUD [1,2,3,4]. Emergent clinical findings provide further support for advancing these drugs [1, 5, 6]. We focus on apremilast, approved for psoriatic arthritis, plaque psoriasis, and oral ulcers associated with Behcet disease, and a group of drugs approved for treatment of type 2 diabetes (T2D; e.g., exenatide, semaglutide, liraglutide, metformin) and obesity (e.g., semaglutide, liraglutide). While the proximal targets of these drugs diverge, they converge on anti-inflammatory signaling.

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Acknowledgements

ARO acknowledges support and funding from the NIH/NIAAA funded Integrative Neuroscience Initiative on Alcoholism consortia (U01 AA013519) and Portland Alcohol Research Center (P60 AA010760), Department of Veteran’s Affairs (I01 BX004699), and John R. Andrews Family. SMS acknowledges support and funding from NIH (R21 DA050822).

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Authors and Affiliations

  1. Portland Alcohol Research Center, Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, 97239, USA

    Angela R. Ozburn

  2. VA Portland Health Care System, Research & Development, Portland, OR, 97239, USA

    Angela R. Ozburn

  3. Department of Pharmacology, University of Minnesota, Minneapolis, MN, 55455, USA

    Sade M. Spencer

  4. Medical Discovery Team on Addiction, University of Minnesota, Minneapolis, MN, 55455, USA

    Sade M. Spencer

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  1. Angela R. Ozburn
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  2. Sade M. Spencer
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ARO and SMS contributed equally to writing and editing this submission.

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Correspondence to Angela R. Ozburn or Sade M. Spencer.

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The authors declare no competing interests.

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Ozburn, A.R., Spencer, S.M. Repurposing anti-inflammatory medications for alcohol and substance use disorders. Neuropsychopharmacol. 49, 317–318 (2024). https://doi.org/10.1038/s41386-023-01696-z

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