GLP-1 agonists: a game changer in pain treatment and addiction.

Abstract

Chronic pain imposes a significant healthcare burden, with treatments often limited by side effects, opioid dependency, and preventable surgeries. Emerging evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1RAs), developed for diabetes and obesity, may offer novel analgesia and treat drug-seeking behavior. This review examines the role of GLP-1RAs in pain management, focusing on inflammation, macrophage repolarization, oxidative stress, and dopaminergic pathways in substance use disorders. We conducted a literature search in PubMed and Embase (Ovid) from January 2000 to February 2025, identifying studies on GLP-1RA and pain in headaches, osteoarthritis, diabetic neuropathy, and substance use disorders. GLP-1RAs offer a promising shift in pain management, potentially reducing opioid dependence, preventing surgical interventions, and lowering healthcare costs. While early evidence suggests analgesic and disease-modifying effects beyond weight loss, significant knowledge gaps remain. In osteoarthritis, they appear to reduce inflammation and cartilage degradation, but trials in non-obese, non-comorbid patients are needed. In diabetic neuropathy, GLP-1RAs show potential for nerve repair, but optimal dosing and long-term efficacy need clarification. Preclinical data support GLP-1RAs signaling in migraines, but human studies are lacking. Trials in alcohol addiction show promise, though evidence for other substances remains inconclusive. Larger-scale trials are needed to confirm these findings.