Solving America’s Current Opioid Crisis with Pain Research: Progress through Collaboration
By Patrick Finan, PhD
Johns Hopkins School of Medicine | APS Psychosocial SIG Chair
By now, the “Opioid Crisis” has become a household name, as entire communities have been impacted by opioid addiction. Labeling a cultural phenomenon a “Crisis” in America implies that bad things already have occurred and could get worse without strong action. Now more than ever, there is a need for forward-thinking, outside-the-box approaches to effect change.
Pain researchers have rarely been in a better position to make an impact on the lives of patients. We are learning that psychological constructs like pain catastrophizing may not be limited to the bubble of pain research, but rather fit neatly into well-traveled theories of addiction, such as the negative reinforcement model. It is becoming apparent that the decades of work that form the basis of our understanding of depression or anxiety or sleep disorders in the context of chronic pain may provide clues in the search for modifiable risk factors for problematic opioid use. Recent findings also suggest that brain regions responsible for processing pain overlap with those involved in addiction. This steady drip of empirical work, abutted by our understanding of the patient experience, positions our leaders to have a critical voice in shaping pain management and protecting patients’ interests in the coming years.
So what can we do? To start, pain providers and researchers can open dialogues with our colleagues in the addiction field. There is remarkably little data on pain and addiction relative to the scope of the problem, so engaging our colleagues directly will at minimum help spawn ideas for how to efficiently develop evidence-based treatment advances that build upon our respective strengths.
Another avenue, of course, is to take advantage of the many and varied funding opportunities that are presently being offered to combat the opioid epidemic. For example, through the HEAL initiative, the NIH has already rolled out, by my count, over 40 funding opportunities, many of them with tight turnarounds requiring investigators to be prepared and ready to compete on short order (see them all here). While the NIH has made it clear that they are broadly interested in innovative nonpharmacological approaches to pain management, it is nonetheless challenging for an individual investigator to evaluate which opportunity provides the best match to a particular idea, and which institute would be most receptive. Fortunately, this year’s APS Scientific Meeting will be an excellent forum to develop, exchange, and act on our most innovative ideas. Dr. Walter Koroshetz, of the National Institute of Neurological Disorders and Stroke, will give a plenary that addresses how the HEAL initiative will promote and support pain research. And Dr. Wen Chen of the National Institute for Complementary and Integrative Health (NCCIH) will give a presentation to the Psychosocial Research SIG addressing how NCCIH plans to support psychosocial pain research to tackle the opioid crisis specifically through HEAL and other planned initiatives. At such a critical moment for our country, when clinicians and researchers are being called to offer their energy and talents to stem the tide of this pernicious biobehavioral health epidemic, I, for one, can’t wait to gather together with the best and brightest in our field and get to work.