SAFE Glen Cove Coalition: NIH HEAL Initiative Update

The Helping to End Addiction Long-term Initiative (HEAL), or National Institutes of Health (NIH) HEAL Initiative is an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis. Almost every NIH Institute and Center is accelerating research to address this public health emergency from all angles. The initiative is funding hundreds of projects nationwide. Researchers are taking a variety of approaches to tackle the opioid epidemic through understanding, managing, and treating pain and improving treatment for opioid misuse and addiction

The COVID-19 pandemic is colliding with the public health crisis of opioid misuse, addiction, and overdose. This pandemic affects not only the initiative’s research, but also the millions of people suffering from chronic pain, those with substance use disorders, and partners in healthcare, the criminal justice system, and communities across the country. Much of current HEAL work aims to understand the effects of COVID-19 on the stakeholders and organize the path forward through engagement with HEAL networks and their deep connections in communities nationwide.

The NIH HEAL Initiative was developed to address the opioid crisis via two overarching goals – to enhance pain management, and to improve prevention and treatment strategies for opioid misuse and addiction. These goals are interdependent. The overreliance on opioids to treat pain was a primary contributor to the current opioid crisis. Yet, in HEAL’s efforts to reduce opioid misuse, they could not neglect the needs of the 25 to 30 million people suffering daily from chronic pain. We need better, non-addictive treatments for their pain conditions. Opioids can be effective, even essential medications for many patients. But the risks of opioid drugs are significant, and over time opioids often require progressively higher doses to achieve the same pain relief, increasing those risks to the patient. Not least, people in recovery, and those receiving treatment for opioid use disorder, have unique needs for options to safely and effectively treat pain without opioids. Therefore HEAL taking on this challenge through research programs that foster collaboration across the pain and addiction fields.

Pain and reward pathways associated with addiction are linked in molecular signaling pathways and common neural circuits in the brain. Opioids target these shared pathways and relieve pain but also can lead to addiction. To uncover novel treatment approaches at the molecular level, researchers are validating potential new analgesic non-opioid targets that reduce pain but, unlike opioids, don’t stimulate reward pathways, which lowers their risk for addiction. HEAL is also developing novel medications that act as analgesics and prevent opioid use disorder and overdose.

A therapeutic, non-opioid based intervention for postoperative pain is being tested for its effects on reducing both pain and opioid usage following mastectomy. One HEAL funded therapeutic to relieve pain was recently granted Fast Track designation by the Food and Drug Administration for treatment of neuropathic pain.

In the clinical research area, HEAL supports efforts to understand the interplay of treatments for pain and for opioid use disorder (OUD). One of the projects in the Pain Management Effectiveness Research Network is testing an integrated treatment for veterans with chronic pain and OUD. And a study from the Back Pain Consortium Research Program is comparing the effectiveness of treatments to relieve pain and improve function and to prevent or reduce opioid misuse.

Several studies in the translation of research to practice address the care of people with both pain and OUD. As one example, the Behavioral Research to Improve Medication-Based Treatment program focuses on pain and addiction, including combining mindfulness and Methadone treatment for opioid use and chronic pain management, psychosocial pain management to improve outcomes in the treatment of opioid use disorder, and enhancing the impact of behavioral pain management on Medication Assisted Treatment outcomes.

HEAL is working to build a future of increased trans-NIH and interdisciplinary research in the fields of pain and opioid addiction. Several cross-cutting funding opportunities seek to address pain management in the context of opioid misuse, and more are forthcoming.

For more information about the HEAL Initiative please visit heal.nih.gov.

The SAFE Glen Cove Coalition is conducting an opioid prevention awareness campaign entitled. “Keeping Glen Cove SAFE,” in order to educate and update the community regarding opioid use and its consequences. To learn. more about the SAFE Glen Cove Coalition please follow us on www.facebook.com/safeglencovecoalition or visit SAFE’s website to learn more about the Opioid Epidemic at www.safeglencove.org