Recruiting

Phase 2

GLP-1R AgonistGLP-1R Agonist Treatment for Opioid Use Disorder

Sponsor:

Milton S. Hershey Medical Center

Code:

NCT06548490

Conditions

Opioid Use Disorder

Opioid Abuse and Addiction

Narcotic-Related Disorders

Substance-Related Disorders

Chemically-Induced Disorders

Eligibility Criteria

Sex: All

Age: 18 - 70+

Healthy Volunteers: Not accepted

Interventions

Semaglutide Pen Injector

Placebo

Study Details

Brief summary:

The goal of this clinical trial is to learn if semaglutide can reduce illicit opioid use in adults in outpatient treatment for opioid use disorder, and who are receiving either buprenorphine or methadone maintenance treatment. The main question it aims to answer is:

• Does semaglutide increase the likelihood that participants will refrain from using illicit and nonprescribed opioids?

The investigators will compare semaglutide to a placebo (a needle prick that contains no drug) to see if semaglutide works to reduce use of illicit and nonprescribed opioids.

The participants will:

Take semaglutide or a placebo every week for 12 weeks
Visit the clinic every week for urine drug screening and pregnancy testing, vital signs, and to complete mental health and drug use questionnaires
Complete smartphone surveys sent at set times during the study

Conditions

Opioid Use Disorder

Opioid Abuse and Addiction

Narcotic-Related Disorders

Substance-Related Disorders

Chemically-Induced Disorders

Study ID

NCT06548490

Start date

Jan 27, 2025

Status verified date

Aug, 2026

Completion date

Apr 30, 2027

Anticipated

Primary completion date

Apr 30, 2027

Anticipated

Eligibility Criteria

Sex: All

Age: 18 - 70+

Healthy Volunteers: Not accepted

Inclusion Criteria:

Age 18 to 75 years.
Body mass index (BMI) > 18.
Able and willing to provide informed consent prior to any study-related activities.
Current diagnosis of Diagnostic and Statistical Manual Diploma in Social Medicine (DSM)-5 Opioid Use Disorder (OUD) as per the Mini International Neuropsychiatric Interview (MINI) or per the site clinic diagnosis. Patients are eligible if they have a MINI > 3 ("moderate" or "severe" in the "Specify If" box in the Substance Use Disorder (Non-Alcohol) module for the category of opiates).
Currently receiving outpatient treatment for OUD and at least 2 weeks on buprenorphine (BUP) or 4 weeks on methadone at the study site and/or at an associated clinic at the time of enrollment.
Have at least 1 urine test positive for opioids after 2 weeks on BUP or 4 weeks on methadone.
Have positive self-reporting of opioid use after 2 weeks on BUP or 4 weeks on methadone.
If capable of becoming pregnant and of childbearing age, is not pregnant (confirmed) or breastfeeding at the time of enrollment and agrees to use a medically accepted method of birth control or or to abstain from sexual activity that could result in pregnancy (if applicable) while in the study.
Able to read and communicate in English to the level required to accept standard care and complete all study requirements.
Able and willing to engage/adhere to the entirety of the study protocol (19 weeks).
Not currently a prisoner.

Exclusion Criteria:

Age < 18 or > 75 years.
BMI <18.
Individuals who are pregnant, planning pregnancy, breastfeeding, or unwilling to use adequate contraceptive measures.
Current use of glucagon-like peptide 1 receptor (GLP-1R) agonist.
History of angioedema, serious hypersensitivity reaction, or anaphylactic reaction to semaglutide or another GLP-1R agonist.
Personal or family history of medullary thyroid carcinoma (MTC) or patients with multiple endocrine neoplasia syndrome Type 2 (MEN 2) or thyroid nodule.
Type 1 diabetes or history of diabetic ketoacidosis.
Type 2 diabetes mellitus or current use of a dipeptidyl peptidase-4 (DPP-4) inhibitor.
Past 30-day use of Sincalide, Sulfonylureas, insulin and insulin products or other medications that may interact with semaglutide.
Hypoglycemia on intake visit (blood glucose < 60 mg/dL).
End-stage renal failure, on dialysis, or glomerular filtration rate (GFR) <30 mL/min per 1.73 square meters or previous renal transplant.
End stage liver disease or previous liver transplant.
Current or past diagnosis of pancreatitis, gastroparesis, or other severe gastrointestinal (GI) disease.
Current or past diagnosis of gallbladder disease or gallstones.
Serious cardiovascular disease within the past 6 months (e.g. uncontrolled hypertension, heart failure, significant cardiac arrhythmias, myocardial infarction, presence of angina pectoris, symptomatic coronary artery disease, deep vein thrombosis, pulmonary embolism, second- or third-degree heart block, mitral valve or aortic stenosis, hypertrophic cardiomyopathy, stroke).
Severe co-occurring psychiatric disorder (e.g., bipolar disorder, psychotic disorder, schizophrenia), and/or history or evidence of organic brain disease or dementia that would compromise safety or compliance with the study protocol in the opinion of the site principal investigator (PI) and/or physician. As there is no specific scale that determines this, this will include the Site PI/physician determining if the potential participant shows consistency in decision making and if they are alert and oriented to time, date, day and location.
Significant risk of suicide requiring a different/higher level of care, according to the clinical judgment of the study physician or site principal investigator, or history of suicide attempts within the past 1 year, unless participation is cleared by clinician assessment and/or judgment. A Columbia-Suicide Severity Rating Scale (C-SSRS) indicating a history of suicide attempts within the past year, or active suicidal ideation within the past 1 month, will qualify as significant risk of suicide.
Treatment with any investigational drug in the one month preceding the study.
Any contraindication to both methadone and BUP.
Any contraindication to a GLP-1R agonist.
Previous randomization for participation in this trial.
Any other condition at screening that precludes safe participation in the trial in the judgment of the site PI or study physician.
Plans for travel outside of the local area over the 19 weeks (1 week of baseline, 12 weeks of medication, 1 week wash-out, and follow-up after a further 28 days) that would interfere with visits during the study period or other logistic factors that would make it difficult to commit to the entire duration of study.
Currently a prisoner.

Study Design

Enrollment

200 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

experimental: Investigational group

Participants randomized to semaglutide will be started at a low dose (0.25 mg once per week) which will be gradually increased weekly until 1.0 mg is reached at Week 4 of the intervention.

placebo comparator: Control group

Participants in the control group will have placebo administered once per week.

Interventions

Semaglutide Pen Injector

Semaglutide will be provided using an injection pen

Placebo

Placebo will be a dry needle stick; no substances will be injected

Primary outcome measure

Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 2 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 3 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 4 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 5 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 6 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 7 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 8 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 9 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 10 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 11 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 12 ]
Number of participants being abstinent from illicit and nonprescribed opioids. [ Time Frame: Study week 13 ]

Central Contacts and Locations

Central contacts

Jennifer Nyland, PhD

717-531-6172 jnyland@pennstatehealth.psu.edu

Kirsten Shuler, MSc

717-531-4104 kshuler@pennstatehealth.psu.edu

Locations

Stanley Street Treatment and Resources

Recruiting

Fall River, Massachusetts, United States, 02720

Contacts

Research Hotline

508-324-3522 Research@sstar.org

Principal Investigator:

Genie Bailey

NYU Langone Health

Recruiting

New York, New York, United States, 10016

Contacts

Mat Kladney

929 573 0673 mathew.kladney@nyulangone.org

Principal Investigator:

Mathew Kladney, MD

Pennsylvania Psychiatric Institute

Recruiting

Harrisburg, Pennsylvania, United States, 17110

Contacts

Subi Upadhyay

supadhyay1@pennstatehealth.psu.edu

Angela Spangler

(717) 683-7838 aspangler@pennstatehealth.psu.edu

Principal Investigator:

Sarah Kawasaki, MD

More Information

Sponsor

Milton S. Hershey Medical Center

Last update posted

Aug 28, 2026

Last verified

Aug, 2026

Keywords

Opiate treatment
Opioid treatment
Glucagon-Like Peptide-1 Agonist
Opioid use disorder
Semaglutide

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Milton S. Hershey Medical Center on 2026-08-28.