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NIH announces initiative to end addiction, increases research funding

April 04, 2018

Atlanta — The National Institutes of Health on April 4 announced a new program aimed at ending addiction and said it is doubling research funding in efforts to combat the opioid misuse crisis.

The Helping to End Addiction Long-term Initiative, which will be called HEAL, is "an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis," said NIH Director Francis Collins, M.D., during the 2018 National Rx Drug Abuse and Heroin Summit.

The announcement follows Congress' March passage of the 2018 spending bill that allocated $500 million to NIH for opioids research.

"Over the last year, NIH has worked with stakeholders and experts across scientific disciplines and sectors to identify areas of opportunity for research to combat the opioid crisis," said Dr. Collins in a news release. "The focus of these discussions has centered on ways to reduce the over prescription of opioids, accelerate development of effective nonopioid therapies for pain and provide more flexible options for treating opioid addiction. NIH is committed to bringing the full power of the biomedical research enterprise to bear on this crisis."

Collage of HEAL initiative goals
NIH said the HEAL program will increase research efforts preventing addiction through studies and partnerships, including:

  • Identifying opportunities to follow patients after the acute onset of musculoskeletal pain and surgery in order to identify people "more likely to transition from acute to chronic pain."
  • Looking at the genetic and social factors that put patients at risk for opioid misuse.
  • Defining and supporting best practices for pain management using nondrug and integrated therapies. This would build on research from multiple agencies that include the National Center for Complementary and Integrative Health, the U.S. Department of Veterans Affairs and Department of Defense.
  • Pursuing public-private partnerships to develop new non-addictive pain medicines.
  • Building a clinical trials network that allows "multiple new and repurposed compounds to be tested simultaneously for effectiveness."

"This nationwide crisis stemmed initially from over-prescribing of opioid medications to treat pain," said Walter J. Koroshetz, M.D., director of the National Institute of Neurological Disorders and Stroke, the lead NIH institute on pain. "The HEAL Initiative will develop the scientific evidence that informs best practices to effectively treat patients with pain while preventing addiction. A major focus will be to understand why some people go from acute to chronic pain, with the intent to prevent that transition. Importantly, the Initiative will drive the science to enable the development of powerful, nonaddictive pain treatments that would limit the need for opioid medications in the future."

The program also aims to improve treatments for opioid misuse by extending the options for medication-assisted therapy and overdose reversal treatments, evaluating treatments and long-term consequences of neonatal opioid withdrawal syndrome, and working with federal and state partners, pilot demonstration projects to test the integration of multiple addiction prevention and treatment options in health care and criminal justice settings in states with the highest rates of opioid misuse and overdose to inform evidence-based practice, NIH said. Despite multiple effective prevention and treatment approaches, the majority of the 2 million Americans with opioid use disorder do not receive appropriate or adequate treatment for their addiction.

"Science and technology have illuminated our understanding of the mechanisms underlying addiction," said Nora D. Volkow, M.D., director of the National Institute on Drug Abuse. "With these additional resources, we can develop more customized, high-quality treatments for addiction and pain, as well as harness implementation science to bring evidence-based changes to our health care system, including treatment for those in the criminal justice environment."  

On March 28 the ADA met with NIDA and the National Institute of Dental and Craniofacial Research to discuss ways the oral health community is currently addressing the current opioid crisis and opportunities to collaborate in the future.

"It's not exciting that we have to be talking about such a pervasive problem," ADA President Joseph P. Crowley told the group, "but it is exciting that as dentists we can be part of the solution."

On March 26, the Association announced a new interim policy on opioids that supports prescription limits and mandatory continuing education for dentists.

The ADA also recommends that dentists consider nonsteroidal anti-inflammatory analgesics as the first-line therapy for acute pain management and recommends dentists to be aware of each patient's substance use history and to take this into consideration when planning treatment and prescribing medication.

For more information on how the ADA is working to combat opioid abuse, visit ADA.org/opioids.