National Institutes of Health (NIH) Director Francis Collins announced in April that his agency will be partnering with drug manufacturers to address the opioid and pain crisis. The project is known as the Helping to End Addiction Long-Term (HEAL) Initiative.
The answer to that dilemma is also on the list of projects: a vaccine against opioid and pain medication addiction. In addition, the NIH is looking at "the development of the nasal form of naloxone, the most commonly used nasal spray for reversing opioid overdose, the development of buprenorphine for the treatment of opioid use disorder, and evidence for the use of nondrug and mind/body techniques such as yoga, tai chi, acupuncture, and mindfulness meditation to help patients control and manage pain."1
This "public-private partnership" will be federally funded at $1.1 billion. The NIH website further explains that "NIH is working with FDA and private sector experts to identify areas of opportunity to advance pharmacological treatments for pain and addiction." The goals are as follows:
Short Term: Enhance the range of medication options to treat opioid use disorders, prevent and reverse overdoses, and support long term recovery in patients.
- Develop new formulations and combinations of existing medications to treat opioid use disorder, and to prevent and/or reverse overdose;
- Identify potential new uses for existing or abandoned medications that were not effective for other conditions, but may be useful in treating addiction, overdose, or pain;
Longer Term: Develop new alternatives for pain relief, including safe, more effective, and non-addictive pain relievers or non-opioid analgesics.
- Facilitate sharing data to focus future resources and research and spur innovation in developing new pain medications;
- Establish new clinical trial networks with innovative study design to accelerate drug development for patients with high unmet needs for treatment;
- Develop methods to objectively measure pain in patients, and to identify biomarkers for more rapid discovery, development and approval of new medications.
The obvious irony is that the drug companies who created the opioid crisis are going to be given over a billion dollars from the NIH to develop drugs to solve this crisis or replace the opioids they are making huge profits on with other drugs that could earn them even more money.
Meanwhile, in a More Intelligent Part of the Universe...
In a recent JAMA interview, Robert Kerns, PhD, formerly the VA's first national program director for pain management, discussed the Pain Management Collaboratory he is heading up. The collaboratory is an initiative of the NIH's National Center for Complementary and Integrative Health (NCCIH), the Department of Defense and the Veterans Administration.2
Dr. Kerns explained that the "collaboratory is to study the effectiveness of a variety of nondrug approaches to pain management that have sufficient evidence to suggest their potential value in an integrated model of care." The budget for the effort includes $81 million that will hopefully fund 12 grants over six years, all of which are for trials investigating nondrug approaches to pain management.
According to an announcement made late last year, the focus is "on developing, implementing, and testing cost-effective, large-scale, real-world research on nondrug approaches for pain management and related conditions in military and veteran health care delivery organizations." Among those studies already awarded funding, Christine Goertz, DC, PhD, at Palmer College of Chiropractic, will be developing and implementing a pragmatic randomized trial looking at chiropractic care for low back pain in this setting, including maintenance care.3
The $81 million in research investigating non-pharma solutions to pain management is welcome indeed. But it is overshadowed by the $1.1 billion "public-private partnership" in a misplaced effort to solve the opioid/pain medication crises with more drugs. The NIH is essentially rewarding what many feel is criminal behavior on the part of the drug companies.
Chiropractic will undoubtedly once again emerge as a safe, effective first choice for most ailments. How much recognition these results get remains to be seen.
References
- NIH HEAL Initiative. April 4, 2018. U.S. Department of Health & Human Services, National Institutes of Health.
- Abbasi J. "Robert Kerns, PhD: Researching Nondrug Approaches to Pain Management." JAMA, published online March 28, 2018.
- "Federal Agencies Partner for Military and Veteran Pain Management Research." U.S. Department of Health & Human Services, National Institutes of Health, Sept. 20, 2017.
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