Top 10 Addiction Research Articles of 2024

In 2024, researchers made considerable progress in understanding and treating addictions. This is important, because substance use disorders (SUDs) remain a global challenge, profoundly affecting individuals, families, and communities.

Each year, researchers publish thousands of peer-reviewed papers, and I selected 10 articles to discuss based on the novelty of the findings, their unique utility, and their focus on critical gaps in addiction understanding and care. Staying informed can be life-saving, empowering, and transformative. My intention is not to present an ordered ranking but to share insights into research most likely to resonate with and benefit individuals navigating the complexities of addiction and recovery.

1. Tan B, et al. Drugs of abuse hijack a mesolimbic pathway that processes homeostatic need. Science.

In this paper, we understand for the first time how food-water-sex and other natural reward systems are corrupted by drugs of abuse. Eric Nestler’s group found that drugs of abuse promote addiction partly by hijacking brain reward systems, reversing normal reinforcements so that health, family, friends, and basic drives are deprioritized and, instead, drug-seeking/using becomes key. For example, with cocaine use disorder, the usual motivators of food, water, sex, friends, and work are replaced by cocaine.

The researchers found the protein RHEB (Ras homolog enriched in the brain) is a crucial molecular substrate enabling drugs to hijack dopamine neurons that process natural rewards in the brain’s nucleus accumbens. (See my post on this research.)

2. Saloni Mehta, et al. Alterations in Volume and Intrinsic Resting-State Functional Connectivity Detected at Brain MRI in Individuals with Opioid Use Disorder. Radiology

Scientists at the Yale School of Medicine identified structural/functional brain changes in individuals with opioid use disorder (OUD). Using MRI and fMRI data, they observed alterations in key brain regions, including differences in connectivity and volume. The brain's thalamus and right medial temporal lobe were smaller in volume, while the cerebellum and brainstem were larger than controls.

These data may be an important first step in understanding how opioids, considered dangerous, brain-altering, and addicting, can also be life-saving medications for patients with OUDs. (See my post on this research.)

3. Miech RA, et al. Missing rebound: Youth drug use defies expectations, continues historic decline. University of Michigan News Service

After declining significantly during the COVID-19 pandemic, substance use among adolescents has continued declining, based on results from the annual Monitoring the Future Survey. Teenagers in the US roughly doubled their use of nicotine pouches in 2024 despite turning away from alcohol and other drugs. The survey found adolescents reporting much less use of alcohol, nicotine vaping, and cannabis. This trend is unprecedented. (See my post on this research.)

4. Marc Duque, et al. Ketamine induces plasticity in a norepinephrine-astroglial circuit to promote behavioral perseverance. Neuron

Ketamine is a game-changer in treating severe depression, but there are many questions about how the drug works. Researchers have found that ketamine’s antidepressant effects target astroglia, a type of brain support cell. The finding challenges conventional views about how ketamine works, especially in quickly reversing depression, even treatment-resistant depression.

Using zebrafish, scientists observed ketamine-suppressed “giving up” behavior caused by futility signals, analogous to learned helplessness. Brief ketamine exposure causes long-term suppression of futility-induced passivity, reversing the “giving-up” response. Maybe this effect explains the black market for ketamine in self-treating depression, anxiety, OCD, and burnout. The authors also tested other fast-acting antidepressants like psychedelic compounds, finding ketamine-like effects.

5. Koob GF. Alcohol Use Disorder Treatment: Problems and Solutions. Annual Review of Pharmacology and Toxicology

Alcohol use disorder (AUD) imposes a significant burden on society. In the United States, most afflicted individuals do not receive treatment, and closing this treatment gap is an ongoing challenge. Estimates suggest less than 8% of adults needing treatment receive any treatment (behavioral or medical) within one year.

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Though rarely prescribed or taken, three medications have been approved by the FDA as safe and effective for AUD. Antabuse (disulfiram) was approved in 1951, the first drug approved to treat alcoholism. In 1994, naltrexone was FDA-approved as an oral medication and in 2006 as an extended-release injectable. In 2004, the FDA approved acamprosate. It is thought to ease negative effects related to quitting drinking by dampening glutamate activity and reducing brain hyperexcitability associated with alcohol withdrawal. (See my post on this research.)

6. Nosyk B, et al. Buprenorphine/Naloxone vs Methadone for the Treatment of Opioid Use Disorder. JAMA

Previous studies on the comparative effectiveness of buprenorphine and methadone, used in medication-assisted treatment programs (MAT), provided limited evidence. Methadone was superior based on retention or longer duration of treatment, fewer treatment dropouts, or discontinuation against medical advice.

In this study, risks of death if actively receiving MAT were similar for buprenorphine/naloxone and methadone, but methadone was superior as it is taken for more extended time periods.

Experts have been concerned that methadone access for OUD remains limited to methadone programs while buprenorphine/naloxone can be prescribed by telephone by most physicians. (See my post on this research.)

7. Jones CM, et al. Estimated Number of Children Who Lost a Parent to Drug Overdose in the US From 2011 to 2021. JAMA Psychiatry

Researchers reported that 649,599 adults aged 18 to 64 years died from drug overdoses from 2011-2021, leaving 321,566 children behind, with significant disparities across racial and ethnic groups. More children lost fathers than mothers. Responses to the overdose crisis should consider the entire burden of drug overdose on the economic, social, educational, and health needs of children who lost parents to overdose.

8. Lähteenvuo M, et al Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder. JAMA Psychiatry

Wang W, et al. Associations of semaglutide with incidence and recurrence of alcohol use disorder in real-world population. Nature Communications

The hypothesis that highly reinforcing foods act in the brain like drugs of abuse has stimulated research to see whether treatments for SUDs might also treat overeating and vice versa

Ghrelin and glucagon-like peptide-1 (GLP-1) are substances that work in gut-brain neuroendocrine systems implicated in alcohol-seeking and dependence. Recent mouse and rat experiments have shown robust preventive effects of semaglutide on alcohol. Preliminary studies suggest GLP-1 receptor agonists, used to treat type-2 diabetes and obesity, may decrease alcohol consumption. Among patients with AUD and comorbid obesity/type-2 diabetes, semaglutide and liraglutide were associated with a substantially reduced risk of hospitalization from AUD. Well-designed randomized controlled trials are needed.

Some researchers have studied the association of GLP-1s like semaglutide with a reduced incidence and relapse of cannabis use disorder in real-world populations.

9. Kosten TR. Vaccines as Immunotherapies for Substance Use Disorders. American Journal of Psychiatry

Substance use disorders present a worldwide challenge, with few effective therapies. The proliferation of illicit fentanyl use initiated a dramatic epidemic of lethal overdose. The rise in overdoses regenerated interest in vaccine immunotherapy. New anti-fentanyl vaccines show remarkable promise for ending the epidemic of fentanyl deaths. It was not an overnight success; 36 years of work went into this anti-fentanyl vaccine. Kosten summarizes lessons learned from previous vaccine clinical trials. (See my post on this research.)

10. Fitzgerald ND, Cottler LB, Palamar JJ. Public health surveillance of new psychoactive substances: recent developments. Current Opinion in Psychiatry

New psychoactive substances (NPS) and substance use problems continue emerging globally, presenting threats to public health. Linda Cottler and fellow researchers at the University of Florida and NYU alerted us to xylazine, a new drug adulterant added to fentanyl and drug supplies and causing “zombie-like” behavior. This group also helped us identify ketamine use disorders.

This article summarizes the most recent approaches for monitoring NPS use and adverse events related to use, released weekly as NDEWS by the University of Florida, New York University, and Florida Atlantic University analyzing early warnings, wastewater poison control, Florida Drug-Related Outcomes Surveillance and Tracking System, the Palamar Lab at NYU, which monitors the nightclub scene, and the Machine Perception and Cognitive Robotics Lab at FAU. (See my post on this research.)