Substance use disorder affects more than 40 million Americans. Treatment has historically relied on counseling and a small set of medications for opioid, alcohol, and nicotine dependence. Recent research is expanding medication options, testing new delivery methods, and studying how brain circuits change with addiction and recovery.
What's actually going on in research
Trials are testing long-acting injectable medications that reduce relapse, vaccines that block drug effects, drugs that reduce cravings for stimulants like cocaine and methamphetamine, and digital therapeutics that extend treatment access. Researchers are also studying medications that treat both addiction and co-occurring mental health conditions, which affect most people seeking addiction treatment.
Stimulant use treatments
No FDA-approved medications exist for cocaine or methamphetamine use disorder. Trials are testing drugs that reduce cravings and withdrawal, including medications already approved for other conditions.
Long-acting formulations
Monthly and longer-acting versions of buprenorphine and naltrexone aim to remove daily dosing barriers. Extended-release implants and injections are being tested to improve treatment retention.
Dual-diagnosis treatments
Many people with substance use disorder also have depression, anxiety, or PTSD. Trials are testing whether treating both conditions simultaneously with single medications improves outcomes.
What to know before you search
Eligibility typically depends on which substance, how long and how heavily used, whether currently using or in early recovery, and presence of other medical or mental health conditions.
What types of trials are currently open
- Medication trials — Testing new drugs or new formulations of existing medications to reduce cravings, prevent relapse, or ease withdrawal symptoms.
- Behavioral intervention trials — Testing counseling approaches, contingency management programs, and digital apps that support recovery alongside or instead of medication.
- Combination treatment trials — Testing medication plus counseling or multiple medications together to see if combined approaches work better than single treatments.
- Prevention trials — Testing interventions in people at high risk, such as those prescribed opioids after surgery or individuals with family history of addiction.
- Long-term follow-up studies — Following people in recovery to understand what factors predict lasting sobriety and what triggers relapse.
Recently added Substance Use Disorder trials
Exercise Training Decreases Alcohol Consumption and Tissue Injury by an FGF21-dependent Mechanism
This randomized study will examine whether a 12-week supervised home-based endurance exercise program can reduce alcohol use and alcohol craving in adults with alcohol use disorder (AUD) and alcohol-related liver disease (ALD). Thirty participants will be assigned in a 1:1 ratio to endurance exercise plus standard of care or standard of care alone. Participants in the exercise group will cycle at home three days per week for approximately 60 minutes per session with remote supervision. The study will also evaluate effects of exercise on FGF21, liver injury markers, exercise capacity, physical function, body composition, fatigue, skeletal muscle and mitochondrial function, and exploratory molecular and microbiome measures. The investigators hypothesize that endurance exercise will reduce alcohol use and craving while improving liver and skeletal muscle outcomes, potentially through an FGF21-related mechanism.
Imaging Mitochondrial Complex-I in Alcohol Use Disorder
Studies proposed in this application will image mitochondrial Complex-I (MCI-I) and cerebral glucose metabolism (CGM) in alcohol use disorder (AUD) and matched healthy controls
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