Pain affects more than 50 million Americans, with 25 million American adults reporting severe daily pain. An important pillar of NIH’s efforts to improve the treatment of pain is the Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, which seeks to find innovative scientific solutions to address the public health crises of opioid use disorder, overdose, and pain. The National Institute on Drug Abuse (NIDA) and NINDS jointly lead the HEAL Initiative, in close collaboration with other NIH Institutes, Centers, and Offices. Within HEAL, NINDS coordinates research efforts across NIH to develop safe and effective therapies for acute and chronic pain and improve pain management. You can read about our areas of progress and accomplishments across all research areas of the HEAL Initiative in the recent 2024 Annual HEAL Report.
In February, NIH held the 5th Annual NIH HEAL Initiative Scientific Meeting. More than 800 researchers, NIH leadership and staff, people with lived experience, community partners, and other collaborators from across the country participated to share exciting research advances. I am happy to highlight some of the progress presented at the meeting on HEAL-supported pain research and invite you to watch the videos of the plenary sessions available on the HEAL website.
HEAL pain research spans the discovery and validation of novel targets for treating pain conditions to preclinical development and to clinical trials and implementation research to ensure that novel treatments can be incorporated into health care practice. I’m encouraged to see HEAL researchers developing novel models and screening tools for testing new medications. For example, the Preclinical Screening Platform for Pain (PSPP) has screened 40 assets for their potential to warrant further development as new therapies. In addition, the PRECISION Human Pain Network studies human tissues and cells to identify cell types, phenotypes, and underlying human pain and to accelerate the discovery and validation of innovative therapeutic targets.
Meeting participants also described progress in HEAL-supported research on novel approaches to treat chronic pain, such as post-operative ketamine infusion to prevent persistent post-operative pain, as well as disease-modifying gene therapy and non-pharmacological therapies for chronic pain. One exciting advance is the successful use of closed loop recordings of brain activity with targeted deep brain stimulation (DBS) to alleviate chronic pain. This approach involves implanting electrodes in people with chronic pain to measure brain activity during pain, which then triggers stimulation of specific brain areas to dampen the pain-inducing signals. An individual who had experienced unrelenting, debilitating chronic pain for decades described how this tailored DBS treatment transformed his health and quality of life. After receiving the treatment in a HEAL-supported study, he has been able to resume working and playing music in a band. While his experience is a singular success, it is a powerful reminder of the importance of HEAL’s mission and the dedicated work of HEAL scientists in partnership with people who live with chronic pain.
Many presentations about clinical pain management, including efforts to enhance equity-focused pain management, emphasized the need to consider individual and contextual factors in pain research and when diagnosing patients and choosing the best course of treatment. The HEAL Health Equities program for pain will develop culturally tailored pain management strategies for a diverse range of populations across many levels of health care settings from self-management programs to emergency rooms. My colleague, Dr. Lindsey Criswell, Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, reiterated such a whole-person focus in a panel discussion with several other NIH institute directors. As Dr. Criswell pointed out, to understand and treat pain, we need not only to understand physiological drivers of pain but also the experience of the individual. Similarly, Dr. Helene Langevin, Director of the National Center for Complementary and Integrative Health, noted that we need to consider body, mind, behavior, and even social support systems when studying how pain resolves and how best to include them as part of effective treatment. The panelists emphasized that to be successful, this research requires collaboration, team science, integration of different kinds of research and data, and above all inclusion of people with lived experience at all stages of the research process.
Beyond scientific presentations, the HEAL meeting also provided an opportunity to recognize investigators who have excelled in research and community engagement. In all, 21 investigators received NIH HEAL Initiative Awards for Excellence in Research, Mentorship, Interdisciplinary Collaboration, and Community Partnership, as well as Trailblazer Awards. You can read about these exceptional 2024 awardees on the HEAL website. I applaud these individuals who, through the work they do along with their colleagues, give hope to people living with chronic pain and/or opioid use disorder.
HEAL is working on several fronts to strengthen and diversify the pain research workforce, including support of trainees and early-stage investigators to attend the annual meeting. The meeting provided a platform for these early-career investigators to network and exchange ideas with the HEAL scientific community and present their work during the scientific poster sessions. Hundreds of researchers also had the chance to connect with the PURPOSE (Positively Uniting Researchers of Pain to Opine, Synthesize, & Engage) Network, which aims to connect pain researchers across disciplines to promote collaborations on NIH-funded pain research and enhance their training experience. If you were unable to connect with the PURPOSE Network at the meeting, I encourage you to learn about it online and sign up to participate.
Although the accomplishments shared at the HEAL meeting are not sufficient to solve the pain crisis, they are proof of what we can achieve when we come together, leave our silos, collaborate across fields, and value and incorporate the input of our communities and individuals with lived experience. By convening participants with widely varying expertise and perspectives, the meeting created a dynamic venue for discovering potential synergies and sparking new connections and collaborations that will yield fruitful results in coming years.
Future directions for HEAL Initiative research were also a focus at the February meeting of the HEAL Multi-Disciplinary Working Group (MDWG). Dr. Nora Volkow, Director of NIDA, and I shared many thoughts about the evolution of the initiative and its structure and recognize the value of developing a strategic plan for HEAL’s future research directions. We aim to launch this effort soon and will provide opportunities for input on the development and content of the plan to our communities. Feedback from individuals in the trenches of research, healthcare practitioners, and affected individuals and communities is indispensable for HEAL as we work to continue impactful research advances, guided by collaborative efforts and a commitment to addressing the multifaceted challenges of pain. We look forward to hearing from you in the future.