NIH Sets Research Agenda for Better Pain Treatment, Preventing Opioid Disorder

The National Institutes of Health (NIH) Tuesday outlined its research goals for improving treatment for opioid use and abuse, as well as creating better, safer therapies for chronic pain.

The head of the NIH, Francis S. Collins, MD, PhD, and 2 other NIH leaders outlined in a JAMA column how $500 million in additional funding from Congress will be spent in its Helping to End Addiction Long-term (HEAL) Initiative. The initiative, a multifaceted research program encompassing pre-clinical, clinical, drug repurposing, and community-based approaches, launched in April 2018.

At a recent summit about drug abuse, “leaders from both the public and private sectors affirmed that research is essential to the effort to end this public health crisis. It will take 'all hands on deck' to make this happen, which is why HEAL seeks to foster innovative partnerships with other government agencies, academic institutions, industry, communities, and patient advocates,” the authors wrote.

The letter pointed out that more than 25 million US adults are affected by daily pain, and more than 2 million individuals have opioid use disorder (OUD). Only a fraction of those with OUD receive medication-assisted treatment (MAT).

Ending addiction will require preventive efforts in more areas than just healthcare, the NIH said, including education, mental health, stigma, childhood trauma, and socioeconomics.

It will also involve effective management of acute and chronic pain, including supporting the discovery and development of targets for non-addictive pain management. The NIH will collect data to determine what factors lead acute pain to transition to chronic pain and how to prevent it from happening.

Other parts of the plan include:

• Developing extended-release and longer-acting OUD medications and new therapies to counteract opioid-induced respiratory depression
• Reformulating current MAT to promote improved adherence in recovery programs
• Partnering with public and private groups to test effective treatments for pain and addiction using HEAL’s clinical trial networks
• Advancing new models of care for OUD and test integrated, evidence-based interventions within healthcare and criminal justice settings through the multi-site HEALing Communities initiative

NIH said it will also expand a pilot study attempting to determine the best approach for neonatal opioid withdrawal syndrome (NOWS), also referred to as neonatal abstinence syndrome. The study is designed to assess the prevalence of NOWS, understand current approaches to managing NOWS, and develop protocols for larger-scale studies that will determine best practices for clinical care of affected infants.

Reference

Collins FS, Koroshetz WJ, Volkow ND. Helping to end addiction over the long-term: the research plan for the NIH HEAL Initiative [published online June 12, 2018]. JAMA. doi: 10.1001/jama.2018.8826.

The American Journal of Managed Care^® is issuing a call for papers for a themed issue on Substance Use Disorders, with a tentative publication date of November 2018.

Click here to view the Call for Papers for this issue.