By Walter J. Koroshetz, M.D., NINDS Director, and Nora D. Volkow, M.D., National Institute on Drug Abuse Director
September is both Pain Awareness Month and National Recovery Month, and as the world continues to face the COVID-19 pandemic, we cannot lose sight of the colliding national crises of inadequate pain management and opioid use disorder (OUD). The pandemic has exacerbated ongoing challenges for the millions of Americans who suffer with daily pain and those who are managing a substance use disorder (SUD). The complications of COVID-19, including recommendations for physical distancing, economic insecurity, and other compounding factors have in some cases increased barriers to health care, and has highlighted inequalities in access to necessary treatment for SUD. Many who experience debilitating pain or SUD also have co-morbid health conditions that may be intensified by the uncertainty around the SARS-CoV-2 virus and by the social isolation that has been necessary to control its spread.
In response to the pandemic, medical and research communities have increasingly turned to online platforms to sustain research and education, deliver care and services, and foster community. We are especially pleased to highlight the new and improved website for the Centers of Excellence in Pain Education (CoEPEs). The CoEPEs program has been supported since 2011 and was created in response to the educational and training goals outlined in the National Pain Strategy. The CoEPEs program serves as an online resource for the development, evaluation, and distribution of pain management curricula material for medical, dental, nursing, pharmacy and other schools to enhance and improve how health care professionals are taught about pain and its treatment. The educational materials include a variety of topics ranging from describing different types of pain conditions, identifying opioid misuse and dependence behaviors, outlining various treatment modalities including pharmacological and complementary health approaches, and highlighting issues related to health disparities and stigma in pain treatment. The program is managed by staff at the National Institute on Drug Abuse (NIDA) and funded as a project of the NIH Pain Consortium by NIDA, NINDS, NINR, NICHD, NCCIH, ORWH, OBSSR, and NIDCR. We hope the CoEPEs modules will be a valuable resource to assist in training future health care professionals, to more effectively assist patients in managing their pain, and improving their quality of life.
The launch of the new-and-improved CoEPEs website intersects with the larger Helping to End Addiction Long-termSM Initiative, or NIH HEAL InitiativeSM, initially announced in 2018. In past years, this blog has described the planning process, cornerstone projects of HEAL, and NINDS contributions to pain research. While the HEAL Initiative is led by NIDA and NINDS, the Initiative is strengthened by the participation of several other NIH Institutes and Centers that extend the scientific approaches used to address the ongoing opioid epidemic and identify safer, more effective treatments for pain. Through these efforts, NIH funds projects with the intertwined goals of understanding, managing, and treating pain and improving treatment for opioid misuse and addiction.
The COVID-19 pandemic has revealed health disparities that particularly affect underserved populations, including those who experience chronic pain and/or an OUD. These populations face challenges that are inadequately addressed and often poorly understood by researchers and medical professionals. The NIH Pain Consortium has created a Disparities and Diversity in Pain Care workgroup to facilitate inclusion of diverse populations in clinical research studies and promote scientific workforce diversity in pain research and increase health disparities research, with the overarching goals of reducing the burden of chronic pain in vulnerable populations and increasing generalizability of clinical outcomes for pain. Further, just last month we participated in a HEAL workshop on patient engagement in pain research to discuss the importance of including patients in clinical research at all steps of the process. This workshop highlighted the incredible possibilities for enriching our understanding of pain and improving quality of life for millions of Americans if we can bring their experience into the research process.
This September, dual awareness months reminds us that we still have a long way to go to address needs in research and care for pain and SUD, but we are heartened by new and strengthened opportunities for research, education, and engagement through HEAL, the CoEPEs program, and the NIH Pain Consortium.