3:59 PM
Jul 12, 2018
 |  BC Innovations  |  Strategy

HEAL-ing pain at NIH

How NIH is paving new pathways for developing non-addictive pain therapies

In a move that could change how pain is studied and treated, NIH is planning a series of projects to build a platform for translational research that is more predictive and reproducible than the current paradigms. The agency hopes to find new strategies to intercept chronic pain as it develops and spur development of non-addictive therapies.

NIH’s Helping to End Addiction Long-Term (HEAL) Initiative, launched in April and described in a June Journal of the American Medical Association viewpoint, offers a path to a coordinated effort to capitalize on emerging ideas and new technologies in the field. The interdisciplinary program is part of the institute’s response to the opioid crisis and seeks solutions through preclinical, clinical and community-based research.

“The classic idea of pain dependent on a single receptor is just not true. The whole brain is involved.”

A. Vania Apkarian, Northwestern University

Increasingly, researchers are putting forward new hypotheses about the biology of pain that incorporate the whole brain, rather than specific circuits that travel through the spinal cord, and that take into account cognitive and mental state as well as physiology.

“The classic idea of pain dependent on a single receptor is just not true. The whole brain is involved,” said A. Vania Apkarian, a professor of physiology at Northwestern University’s Feinberg School of Medicine.

In addition, emerging technologies, from imaging to induced pluripotent stem (iPS) cells, are generating opportunities to upend the classical animal models of pain that have been poor predictors of clinical activity.

Rebecca Baker, special assistant to the NIH Director on Pain and Opioids, told BioCentury there’s been a long history of poor translation to the clinic that has held back progress in understanding and treating pain.

“When they went into human trials, the candidate drugs were not effective even though they were hitting the target. Meaning our models for understanding the neurobiology of pain in animals had not been helpful,” said Baker.

Baker is HEAL’s point person in the Office of the Director.

The HEAL initiative draws on funding from an FY18 $500 million Congressional appropriation for research on opioid addiction, development of opioid alternatives, pain management and addiction treatment. Of HEAL’s $266 million planned budget, over $48 million is tagged for research on enhanced pain management, covering discovery biology, preclinical screening, data and asset sharing, biomarkers and a clinical trials network (see “Table: HEAL Funding FY18”).

Table: HEAL funding FY18

The tentative FY18 budget for the National Institutes of Health (NIH) Helping to End Addiction Long-term (HEAL) Initiative comes from a $500 million Congressional appropriation for research on opioid addiction support. The planned budget earmarks over $200 million to improve treatments for opioid misuse and addiction, and around $50 million for research into pain management, with $10 million for supplemental expenses and the remainder carried into the following year. NIH’s fiscal year 2018 started on Oct. 1, 2017.

NIDA = National Institute on Drug Abuse; Source: NIH

Improve Treatments for Opioid Misuse and Addiction
Focused medication development to treat opioid use disorder (OUD) and prevent/reverse overdose$70.3
Development of novel immunotherapies for OUD$5.0
Reduction of drug craving and harm in people with...

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