Sweet-liking and sugar supplementation as innovative components in substance use disorder treatment: A systematic review

Objective: Substance use disorders are a major global public health concern. While a wide range of psychotherapies and pharmacotherapies are available for their treatment, efficacy is limited and many patients fail to benefit from these treatments. Like addictive substances, sugar seems to trigger the dopaminergic reward centre, and sweet-liking might be a modifier of substance use disorder treatment. Method: Systematic review to summarize the role of sugar and sugar-liking in addiction and addiction treatment. Results: Evidence from both preclinical and clinical studies suggests that a certain portion of the population has a genetic predisposition for sweet-liking, which might be related to a higher risk for substance use and dependence. Regarding nicotine dependence, glucose supplementation prior to or during smoking cessation rapidly mitigates withdrawal symptoms and increases smoking abstinence rates during nicotine replacement therapy. In alcohol dependence, sweet-liking patients encounter more challenges in achieving abstinence than sweet-disliking patients. In addition, sweet-liking patients with high cravings demonstrate higher abstinence rates than sweet-disliking patients. Finally, sweet-liking is associated with successful outcomes of naltrexone treatment in patients with an alcohol use disorder. Conclusion: These findings present promising new challenges and opportunities to fine-tune and optimize treatment protocols in addiction care.