Full Summary — Understanding the Neurobiological Mechanisms of Pain
Overview
July 7, 2017
As part of a government-wide effort to address the opioid crisis, NIH is initiating a public-private collaborative research initiative on (1) new and innovative medications and biologics to treat opioid addiction and for overdose prevention and reversal; (2) safe, effective, and non-addictive strategies to manage chronic pain; and (3) neurobiology of chronic pain.
To identify the scientific strategies with the greatest potential for solutions to the opioid problem, NIH brought together NIH brought together innovative experts from government, industry, and academia for a series of three cutting-edge science meetings. NIH seeks to identify and pursue promising opportunities for addressing the opioid crisis, with the aim of developing new safe and effective therapeutics for opioid addiction, overdose, and chronic pain in half the time it currently takes.
The first of these meetings was held on June 5th, entitled Medications Development for Opioid Use Disorders and Overdose Prevention and Reversal. The second meeting, entitled Development of Safe, Effective, and Non-Addictive Pain Treatments, was held on June 16th. The third meeting, held on July 7th and summarized below, focused on Understanding the Neurobiological Mechanisms of Pain.
Welcome and Opening Remarks
Dr. Francis Collins, Director of the National Institutes of Health (NIH), highlighted the urgency of the opioid crisis, and the high priority agencies throughout the federal government have placed on ending this crisis. This meeting is the final of three that were convened to identify areas for a public private partnership recently initiated by NIH to address the opioid crisis. Dr. Collins and Dr. Nora Volkow, Director, National Institute on Drug Abuse (NIDA), published a Special Report in the New England Journal of Medicine to describe the initiative which focuses on three scientific areas:
- developing better overdose reversal and prevention interventions to reduce mortality, saving lives for future treatment and recovery;
- finding new, innovative medications and technologies to treat opioid addiction; and
- finding safe, effective, nonaddictive interventions to manage chronic pain.
The previous two meetings identified the need to develop new therapeutics to treat opioid use disorder (OUD), overdose, and pain, including new formulations of existing medications, novel targets, and medical devices. Possible strategies identified to address these needs include a focus on data sharing across sectors, a targeted effort to develop biomarkers and objective measures of pain, and the strengthening of clinical trials infrastructure -- incorporating providers, real world health care settings – such as primary care and emergency departments – and patient cohorts with severe pain and unmet treatment needs for which a rare disease model can be applied.
The goal of this initiative is to develop public private partnerships to cut in half the time to develop new treatments. NIH has successfully used this model to address other scientific priority areas. For example, the Accelerating Medicine Partnership with NIH, FDA, The Foundation for NIH, and 10 pharma companies aims to develop treatments for three disease areas, with 50/50 contributions from government and industry for a total of $230 million over 5 years.
While this initiative is focused on what can be accomplished with a partnership with the pharmaceutical and biotechnology industries, NIH is also committed to research on nonpharmacological treatments for pain, and will continue to support research in this area. The goal for the day is to identify research priorities that will advance our understanding of the neurobiological mechanisms of pain in the short, medium, and long term. NIH is working to develop a strategic framework including a workplan identifying resources that can be leveraged for this effort. Engagement of leadership across sectors will be needed.