As part of its efforts to reverse the opioid crisis that continues to grip the nation, the National Institutes of Health (NIH) has named McLean Hospital as a recipient of a grant through the Helping to End Addiction Long-term Initiative (NIH HEAL Initiative). McLean's award is one of 375 grant awards across 41 states--totaling nearly $1 billion--made by the NIH in fiscal year 2019 to apply scientific solutions to address the crisis.
In 2016, an estimated 50 million U.S. adults suffered from chronic pain, and in 2018, an estimated 10.3 million people 12 years and older in the United States misused opioids, including heroin. The trans-NIH research effort aims to improve treatments for chronic pain, curb the rates of opioid use disorder (OUD) and overdose, and achieve long-term recovery from opioid addiction.
"It's clear that a multi-pronged scientific approach is needed to reduce the risks of opioids, accelerate development of effective non-opioid therapies for pain, and provide more flexible and effective options for treating addiction to opioids," said NIH Director Francis S. Collins, MD, PhD, who launched the initiative in early 2018. "This unprecedented investment in the NIH HEAL Initiative demonstrates the commitment to reversing this devastating crisis."
We need to ensure that people with chronic pain have effective treatment options that don't expose them to the risk of opioids. Preventing opioid misuse and addiction through enhanced pain management and improving treatments for OUD and addiction are both critical parts of our trans-NIH response to the opioid crisis."
Rebecca G. Baker, PhD, director, NIH HEAL Initiative
McLean's research, which is also part of the National Institute on Drug Abuse Clinical Trials Network, will focus on exploring ways to improve outcomes for patients who use evidence-based medications, specifically buprenorphine and naltrexone, to treat OUD.
McLean will partner with researchers from Columbia University and New York University to explore how to increase retention among patients who use these OUD treatments. According to the researchers, such retention is critical for helping more people achieve long-term recovery from OUD.
The research team will also study patients who have been successful with using these medications to treat their OUD and now want to taper off these medications. The researchers will seek to determine who can do this successfully and find optimal methods for doing it.
"We already have medications that are effective at treating OUD," said Roger D. Weiss, MD, chief of the Substance Use Disorders Division and director of the Alcohol and Drug Abuse Clinical Research Program at McLean Hospital, who is also one of three lead investigators for the study. "However, staying on them isn't always easy, and weaning off them, for those who choose to do so, can be very difficult. In general, we advise patients to stay on medications, but many people want to discontinue them despite that advice. Learning how to advise those patients is very important."
The NIH HEAL Initiative is leveraging expertise from almost every NIH institute and center to approach the crisis from all angles and disciplines, and across the full spectrum of research from basic to implementation science in the areas of:
- Translation of research to practice for the treatment of opioid use disorder
- New strategies to prevent and treat opioid use disorder
- Enhanced outcomes for infants and children exposed to opioids
- Novel medication options for opioid use disorder and overdose
- Clinical research in pain management
- Preclinical and translational research in pain management