Addiction Therapeutics: Obstacles and Opportunities

Abstract

Research over the past 2 decades has led to a fundamental understanding of the neurobiological bases of addiction (1). These insights have resulted in the identification of multiple targets (2), many already proven drugable, that could potentially revolutionize the treatment of substance use disorders (SUDs). Nonetheless, the goal of developing highly effective medications to treat SUDs remains largely unmet. Thus, there are no medications approved to treat either stimulant or cannabis use disorders, and the efficacy of available therapies for other SUDs (e.g., opiates, tobacco, alcohol) is far from ideal. The dearth of innovative medications to treat SUDs has been attributed to a low level of interest by the pharmaceutical and biotechnology sectors, a problem exacerbated by the retrenchment in psychiatry research and development (3). However, both the number of potential targets (2) and the molecules that have either failed in other psychiatric indications or are now parked for strategic reasons make SUDs an attractive rescue indication. In this commentary, we will briefly summarize some of the principal obstacles to developing medications for SUDs (reviewed in [4]), as well as some recent developments, including the report by Mariani et al. (5), that offer new therapeutic opportunities.