Prevent Addiction through Enhanced Pain Management

More than 25 million Americans suffer from daily chronic pain. Through the NIH HEAL (Helping to End Addiction Long-term) Initiative, NIH will support research to understand how chronic pain develops, making patients susceptible to risks associated with opioid use, and will develop a data sharing collaborative, new biomarkers for pain, and a clinical trials network for testing new pain therapies. NIH will also enhance the pipeline of treatments for pain and enhance clinical practice for pain management.

Understanding the Origins of Chronic Pain

Problem: Virtually all individuals experience occasional episodes of acute pain. In some instances, acute pain gives rise to a chronic pain state, accompanied by maladaptive changes throughout the nervous system. It is not known why certain patients develop chronic pain.

Approach: Develop new tools and biomarkers to detect changes in the brain associated with the transition from acute to chronic pain to detect altered brain circuits and/or genes and develop tailored interventions to control pain and restore function:

  • Launch a longitudinal study to follow patients 1) after acute onset of musculoskeletal pain and 2) after surgery to identify biomarkers that can predict those individuals who are more likely to transition from acute to chronic pain.
  • Advance understanding of the genetic and social factors that put patients at risk for opioid misuse and addiction to inform precision prevention strategies tailored to individual risk factors.
  • Leverage innovative imaging and -omics neurotechnologies developed through the NIH BRAIN Initiative and SPARCinitiatives to identify potential new targets and approaches for treatment of chronic pain and objective biomarkers to predict which individuals will respond to a treatment.

New Treatments for Pain

Problem: Opioids do not work for many patients and carry risk of misuse and addiction. New therapies for pain are urgently needed.

Approach: Develop new, effective, and non-addictive approaches for pain management:

  • Pursue public-private partnerships to develop new non-addictive pain medicines by sharing data on past and present research projects, and matching researchers with a selection of potentially promising but abandoned pharmaceutical industry compounds to explore their effectiveness for the treatment of pain.
  • Build a clinical trials network that will allow multiple new and repurposed compounds to be tested simultaneously for effectiveness.
  • Establish a standardized platform for validating new drug targets.
  • Facilitate the development of devices to treat pain.
  • Develop new models or improve current models of integrated pain management.
  • Collect and disseminate evidence on best pain management strategies for multiple different and distinct chronic pain conditions likely to be treated with opioids, such as back pain, osteoarthritis, complex regional pain syndrome, diabetic neuropathy, pain associated with ME/CFS and sickle cell disease, vulvodynia, ocular and other craniofacial pain syndromes and others.

Enhance Clinical Practice in Pain Management

Problem: Different patients with different pain conditions need different treatment strategies. There is no current infrastructure for implementing the best pain management for patients.

Approach: Define and support best practices for pain management:

  • Build on research from the National Center for Complementary and Integrative Health, the U.S. Department of Veterans Affairs, and Department of Defense research collaborative to address the needs of service members and veterans.
  • Expand Centers of Excellence in Pain Treatment and Education.
  • Enhance medical and dental education by working with schools, board exam preparation organizations, accreditation entities, CME programs, healthcare systems, practices, hospitals, and clinics.

This page last reviewed on April 4, 2018