Improve Treatments for Opioid Misuse and Addiction

More than 2 million Americans have opioid use disorders (OUD). Millions more misuse opioids, taking opioid medications longer or in higher doses than prescribed. Through the HEAL (Helping to End Addiction Long-term) Initiative, NIH will support research to provide new strategies for the prevention and treatment of treat opioid misuse and addiction, that will help people with OUD achieve and maintain a meaningful and sustained recovery.

Develop New Treatments for Addiction, Overdose Prevention and Reversal

Expanded treatment options for OUD are needed to promote long-term recovery in more patients. HEAL will accelerate the development of novel medications and devices to treat all aspects of the opioid addiction cycle, including chronic use, withdrawal symptoms, craving, relapse, and overdose.

Strategy:

  • Pursue promising drug candidates for new addiction treatments through focused medication development efforts.
    • Create longer-acting formulations of existing addiction medications, such as buprenorphine and naltrexone, to promote adherence to treatment.
    • Reverse opioid overdose with stronger, longer-acting formulations of opioid antagonists, including longer-lasting naloxone formulations and new medications.
    • Develop new classes of drugs and devices to counter slowed breathing induced by opioids alone or in combination with other substances.
    • Advance new medications, immunotherapies, and devices to treat progression toward opioid addiction, withdrawal, craving, and relapse.
      • Repurpose medications already approved by the U.S. Food and Drug Administration (FDA) for other conditions, and evaluate medications approved internationally but not in the United States to prevent compulsive drug taking.
      • Build a consortium of researchers with expertise in opioid metabolism, biological transport, and mechanisms of action with vaccine development programs and resources to accelerate the development of vaccines directed at heroin and other opioids.
    • Test safety, efficacy, and underlying mechanisms of new drugs targeting the brain's reward pathway.

Enhance Treatments for Infants with Neonatal Abstinence Syndrome/Neonatal Opioid Withdrawal Syndrome

Neonatal Abstinence Syndrome (NAS)/Neonatal Opioid Withdraw syndrome (NOWs) affects up to 15 percent of infants in communities most severely affected by the opioid epidemic. To improve both short- and long-term developmental outcomes, HEAL will determine the best approaches to identify and treat newborns exposed to opioids.

Strategy:

  • Expand the Advancing Clinical Trials in Neonatal Opioid Withdrawal syndrome (ACT NOW) pilot studies to assess NOWs prevalence, variation in current approaches to clinical management, and develop common protocols for conducting large-scale studies across the country, particularly in areas hardest hit by the opioid epidemic.
    • Use results to conduct clinical trials to determine best clinical practices, including assessment of drug-free treatment approaches and currently used medications.

Optimize Effective Treatments for Opioid Addiction

Most Americans at risk for or with an OUD do not receive evidence-based prevention and treatment services. HEAL seeks to better understand how the implementation of promising and evidence-based strategies and treatments might decrease OUD, overdose events, and deaths.

Strategy:

  • Expand the National Institute on Drug Abuse’s (NIDA) Clinical Trials Network (CTN).
    • Work with academic researchers and community providers to incorporate OUD-related research questions into studies currently underway, expedite new studies of OUD treatment in general medical and other settings, and enhance clinical and research training opportunities.
  • Through the Justice Community Opioid Innovation Network (JCOIN), establish a network of research investigators to rapidly conduct studies on quality care for opioid misuse and OUD in justice populations by facilitating partnerships between local and state justice systems and community-based treatment providers.
    • Implement a national survey of addiction treatment delivery services within the justice system.
    • Conduct studies on the effectiveness and adoption of new medications, prevention and treatment interventions, and technologies in justice system settings.
  • Launch HEALing Communities, a multi-site, national research effort to develop approaches for the implementation of effective interventions for opioid misuse, OUD, and opioid overdose.
    • Test the integration of prevention, overdose treatment, and medication-assisted treatment (MAT) in an array of settings such as primary care, emergency departments, specialty care including prenatal infectious disease, behavioral health, criminal justice system, fire and police departments, and other settings in communities highly affected by the opioid crisis.
    • Measure the success of implementation strategies along sequential stages, including prevention, screening, and detection of opioid misuse and OUD, counseling and treatment services, medication initiation, and long-term retention in treatment. 

 

This page last reviewed on June 12, 2018