The National Institutes of Health outlined its new to combat opioid addiction and improve pain management in Tuesday.
In an editorial, NIH Director Francis Collins, MD, PhD -- along with Walter Koroshetz, MD, director of the National Institute of Neurological Disorders and Stroke, and Nora Volkow, MD, director of the National Institute on Drug Abuse -- discussed the role of the new NIH research program in the national opioid problem.
"Extraordinary focus by all segments of society is required to respond to the nation's opioid crisis," they wrote. "Now is the time to channel the efforts of the scientific community to deliver effective -- and sustainable -- solutions to this formidable public health challenge."
The NIH research plan for HEAL (Helping to End Addiction Long-term) will have a two-pronged approach: to improve opioid misuse and addiction treatment, and to prevent addiction by creating better pain management strategies. Congress added $500 million to the NIH's base appropriation to support the HEAL initiative starting in fiscal year 2018.
Only a small percentage of people who could benefit from medically assisted treatment (MAT) like methadone, buprenorphine (Suboxone), and naltrexone (Vivitrol) for addiction receive it, and about half of those relapse within 6 months, Collins and co-authors noted. HEAL will help researchers generate new addiction treatments and develop therapies to prevent and reverse overdoses and counter respiratory depression.
Moreover, HEAL will evaluate innovative ways to deliver addiction treatment in health care and criminal justice systems through a multisite HEALing Communities study. In an email to 51˶, an NIH spokesperson explained that "HEALing Communities will test the integration of MAT into an array of settings including primary care; emergency departments; specialty care settings including prenatal care, infectious disease, and behavioral health; the criminal justice system; and other community settings."
HEAL also will expand research about best practices for infants with neonatal opioid withdrawal syndrome, also known as neonatal abstinence syndrome.
To help develop new non-addictive pain treatments, HEAL will support work in novel targets for small molecules, biologics, natural products, and devices, and will fund research to validate biomarkers to evaluate whether treatments are working as intended.
Leveraging both public and private resources, HEAL also will coordinate work with government agencies, academic institutions, and industry to speed non-addictive treatments though the clinical pipeline.
"HEAL lays the foundation for an innovative therapy-development pipeline through a planned new public-private partnership," Collins and co-authors wrote. "In collaboration with biopharmaceutical groups, the Food and Drug Administration, and the Foundation for the NIH, the NIH will collect and evaluate treatment assets from academia and biopharmaceutical and device companies to coordinate and accelerate the development of effective treatments for pain and addiction." The most promising assets will be tested in HEAL's clinical trial networks, which will focus primarily on phase II trials.
In addition, HEAL will direct resources toward gaps in current plans, including prevention research, precision medicine for pain and addiction, and non-drug and integrated models of pain management.
Funding opportunities under HEAL are scheduled to be announced this summer and will be posted on the .
Disclosures
No potential conflicts of interest were reported.
Primary Source
JAMA
Collins F, et al "Helping to end addiction over the long-term: The research plan for the NIH HEAL initiative" JAMA 2018.