IUPHAR Review: New strategies for medications to treat substance use disorders

• Published in: Pharmacological research 2024-02, Vol.200, p.107078-107078, Article 107078
• Main Authors: Montoya, Ivan D., Volkow, Nora D.
• Format: Article
• Language: English
• Subjects: Artificial Intelligence; Endpoints; Humans; Medications development; NIDA; Nitrosamines; Pharmaceutical Preparations; Pharmacotherapy; Research Design; Substance use disorders; Substance-Related Disorders - drug therapy
• ISSN: 1043-6618; 1096-1186
• DOI: 10.1016/j.phrs.2024.107078

Substance use disorders (SUDs) and drug overdose are a public health emergency and safe and effective treatments are urgently needed. Developing new medications to treat them is expensive, time-consuming, and the probability of a compound progressing to clinical trials and obtaining FDA-approval is low. The small number of FDA-approved medications for SUDs reflects the low interest of pharmaceutical companies to invest in this area due to market forces, characteristics of the population (e.g., stigma, and socio-economic and legal disadvantages), and the high bar regulatory agencies set for new medication approval. In consequence, most research on medications is funded by government agencies, such as the National Institute on Drug Abuse (NIDA). Multiple scientific opportunities are emerging that can accelerate the discovery and development of new medications for SUDs. These include fast and efficient tools to screen new molecules, discover new medication targets, use of big data to explore large clinical data sets and artificial intelligence (AI) applications to make predictions, and precision medicine tools to individualize and optimize treatments. This review provides a general description of these new research strategies for the development of medications to treat SUDs with emphasis on the gaps and scientific opportunities. It includes a brief overview of the rising public health toll of SUDs; the justification, challenges, and opportunities to develop new medications; and a discussion of medications and treatment endpoints that are being evaluated with support from NIDA. [Display omitted] ●Effective medications to treat substance use disorders (SUDs) is a public health priority.●Multiple scientific opportunities to accelerate the development of medications.●Clinical trial endpoints required for regulatory approval of SUD medications are challenging.●The National Institute on Drug Abuse (NIDA) leads the discovery and development of medications for SUDs.●NIDA medication pipelines available at https://nida.nih.gov/about-nida/organization/divisions/division-therapeutics-medical-consequences-dtmc