It's been more than two years since the National Institutes of Health (NIH) released its National Pain Strategy, a comprehensive population health-level strategy for pain, and a year since announcing its Federal Pain Strategy, a long-term strategic plan for pain research. The American Pain Society said today it is pleased and encouraged by significant progress that is occurring as a result toward achieving the goal of increased funding of pain research grants for both basic scientific and clinical studies.
"The stars are finally aligning as policy makers are paying serious attention to alleviating previous shortcomings in federal research grants for pain research," said Theodore Price, PhD, an American Pain Society Board member and professor, School of Behavioral and Brain Sciences, University of Texas at Dallas.
Price cited the HEAL (Helping to End Addiction Long-term) Initiative as a major example of the federal government's expanded commitment to pain research.
For the HEAL Initiative, NIH will support research on how chronic pain develops and on new treatments to alleviate chronic pain. HEAL also will develop a data sharing collaborative, new biomarkers for pain, and a clinical trials network for testing new pain therapies.
In a recent article in the Journal of the American Medical Association, NIH leaders explained components of a newly released research plan for the HEAL Initiative. With a focus on two primary areas -; improving treatments for opioid misuse and addiction and enhancing strategies for pain management -; the plan describes a multifaceted program encompassing pre-clinical, clinical, drug repurposing, and community-based approaches. Pain researchers are now eligible encourage to submit grant proposals for HEAL funding.
"HEAL is a huge step in the right direction toward rectifying long-standing inadequate levels of support for pain research. Now it's time for the research community to step up and submit cutting-edge grant proposals in priority areas identified in the HEALS Initiative," said Price.
Research priorities in the HEAL Initiative include:
- Developing extended-release and longer-acting opioid use disorder (OUD) medications and new therapies to counteract opioid-induced respiratory depression.
- Supporting discovery and development of targets for non-addictive pain management and therapies to treat those targets.
- Collecting data to determine what factors lead acute pain to transition to chronic pain and how to block that transition.
- Partnering with public and private groups to test effective treatments for pain and addiction using HEAL's clinical trial networks.
Price said he is enthused about the potential for new public-private research partnerships proposed in the HEAL Initiative and support for research to identify factors that cause acute pain to become chronic pain. He praised NIH officials for their efforts in triggering a new era in pain research.
"Requests for proposals are going out for collaborative projects and I'm confident my colleagues in the pain research community will be very productive in submitting grant requests," said Price. "Increased funding for pain research is the most important solution to solving the opioids crisis. New, non-addictive pain medications will not be developed without new discoveries achieved though pain research funding."
Prior to both the National Pain Strategy and the Federal Pain Research Strategy, in December 2014, APS published its Pain Research Agenda in The Journal of Pain. It cited five broad goals consistent with the National Pain Strategy.
- Develop novel pain treatments that enhance clinically meaningful pain relief and functional improvement with acceptable adverse effects.
- Expedite progress toward the prevention, diagnosis, and management of pain conditions.
- Optimize the use of access to currently available treatments that are known to be effective
- Understand the impact of health policies and systems on pain treatment
- Improve pain management through education research.
The APS Pain Research Agenda also identified three promising paths of therapeutic development for pain for which significant research funding is needed. They are:
- Interventions targeted at blocking pain signals at their source
- Therapeutics that disrupt or reverse molecular pain mechanisms
- Therapeutics that modulate or mimic endogenous pain control mechanisms
"New therapeutic interventions can be discovered through basic science advances that elucidate the fundamental biology of pain and its development into a chronic pain disease state," explained lead author Robert Gereau, Ph.D., professor of anesthesiology and director, Washington University Pain Center, St. Louis.