Making strides in Helping to End Addiction Long-term (HEAL)

September is an important month for researchers to consider ways to help people suffering from pain and addiction. Not only is it Pain Awareness Month and National Recovery Month, the President issued a proclamation observing the week of September 17-23, 2018 as Prescription Opioid and Heroin Epidemic Awareness Week to recognize the approximately 115 Americans who lose their lives every day to opioid overdoses and the courageous individuals in recovery. At NIH, we have all hands on deck to address this unprecedented national tragedy. Thus this seems like an opportune time to provide an update on the HEAL (Helping to End Addiction Long-term) Initiative, a trans-NIH effort to speed scientific solutions to stem the national opioid public health crisis.

I announced the launch of HEAL at the 2018 National Rx Drug Abuse and Heroin Summit in April, and outlined the Initiative’s research plan in a JAMA article(link is external) with Drs. Nora Volkow and Walter Koroshetz in June. Scientific solutions to the epidemic of overdose deaths will begin with an understanding of pain, to help identify precision approaches to manage pain effectively in individuals. More than 25 million Americans suffer from daily chronic pain. Recent NIH-supported research found that high-impact chronic pain is as likely to cause disability as kidney failure, emphysema or stroke. Research also shows that prescription pain killers are the cause of addiction for more than 70 percent of individuals who have an opioid use disorder (OUD). New non-addictive medications are urgently needed to treat pain and reduce the risks of opioid drugs. And for those who do become addicted, we need treatments that are effective for patients, in their communities, that address the whole person on the path to recovery. Despite several FDA-approved effective medications, the majority of patients still do not receive specialized treatment for their addiction.

Here’s what we have done for HEAL:

Announced the innovative Acute to Chronic Pain Signatures Program to understand the origins of chronic pain. Part of both the NIH Common Fund and the HEAL Initiative, this program aims to develop a set of objective biomarkers that form a “signature” that predicts which patients are likely to transition to chronic pain after an acute episode such as an accident or major surgery. This knowledge will guide pain prevention strategies and therapy development.
Awarded new research grants to study the impact of behavioral interventions for the prevention of OUD, or as a complement to Medication-Assisted Treatment (MAT) for OUD. These grants coordinate with the Substance Abuse and Mental Health Services Administration (SAMHSA) state targeted response grants, and will enhance our understanding of how behavioral interventions such as cognitive behavior therapy, yoga, and other non-pharmacological approaches can support patients’ recovery from opioid addiction.
Issued new funding opportunities calling for research to:
- Identify and validate new targets for the treatment of pain (RFA-NS-18-042), using innovative modeling and imaging technologies (RFA-NS-18-043).
- Identify biomarkers for pain that define not only how patients experience pain, but also how candidate therapies, including medications, biologics, natural products and devices, engage these molecular targets to ultimately relieve pain(RFA-NS-18-046).
- Develop a new network to evaluate medications in early-phase clinical trials, in collaboration with partners across academic, biotechnology and pharmaceutical sectors (RFA-DA-19-015). Together, this research will rapidly accelerate the approval and delivery of new treatments to patients suffering from pain (RFA-DA-19-014).
- Launch the HEALing Communities study, in collaboration with SAMHSA, to test the effect of integrating interventions that we know work for OUD, such as MAT, in an array of community-based settings, such as hospitals, emergency rooms, prison systems, in a small number of communities hardest hit by the opioid crisis (RFA-DA-19-016). This research will help define community prevention and treatment models that are most likely to reduce addiction and overdose deaths in communities nationwide (RFA-DA-19-017).

We have exciting work ahead of us. I truly believe that by tapping into the expertise of so many NIH institutes and centers, collaborating with our sibling agencies, and leveraging the resources of our academic, biotechnology and pharmaceutical partners, we are bringing the best science to the table to provide solutions to the opioid crisis. Watch for new awards and more funding opportunities in the coming months.

Francis S. Collins, M.D., Ph.D.
Director, National Institutes of Health