Substance use disorders, including alcohol, opioid, stimulant, and cannabis use disorders, affect hundreds of millions globally and represent a major burden of psychiatric comorbidity, social harm, and premature mortality. Pharmacological treatment for alcohol and opioid use disorder is evidence-based and effective but remains dramatically underutilised. Novel targets including the GLP-1 system, neuroinflammation, and epigenetic mechanisms are generating new pharmacological development programmes.
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