This Pain Awareness Month, I am reflecting on how the experience of pain reaches beyond its physical sensation. The pain circuits in our bodies are built to protect us from harm – for example, moving away from a hot flame, or building long-lasting memories/reflexive actions that prevent injurious behaviors. Simply put, pain circuits have a component that senses injury, and this is integrated in a complex way with circuits for mood, fatigue, reward and many others. How we perceive pain and pain’s effects on our lives then depends on many factors. We need a better understanding of these effects to learn how different people experience pain and how to improve a given individual’s quality of life. Listening to people affected by pain and accounting for the different experiences in our research will maximize the impact of any advances.
Racial and ethnic minority groups and socioeconomically disadvantaged populations have higher rates of chronic pain and comorbid conditions and receive poorer pain care. We must do more to address these complexities and disparities. Persons suffering with severe chronic pain frequently suffer from multiple medical conditions. The National Pain Strategy calls fora greater understanding of the impact of comorbid conditions on pain and how pain may contribute to overall health. It also addresses the need to eliminate the stigma often associated with chronic pain, and to improve access for vulnerable groups to high-quality pain care. Additionally, the Federal Pain Research Strategy is a roadmap for science to achieve the goals of the National Pain Strategy. It identified age, sex, gender, racial/ethnic, and socioeconomic differences in pain and includes several priorities acknowledging that diverse populations have unique experiences with pain and pain care.
NIH and the pain research community need to hear the lived experiences of people from diverse backgrounds who are experiencing pain to learn how their pain can be better managed. Toward this effort, the Helping to End Addiction Long-term SM Initiative, or NIH HEAL Initiative SM has established the HEAL Community Partner Committee to gain input on key issues faced by individuals who are affected by pain conditions and/or opioid use disorders to ensure the relevance and practicality of HEAL-supported research. To learn more, please read NIH HEAL Initiative Director Dr. Rebecca Baker’s latest message.
Earlier this year, the NIH Pain Consortium held a symposium called Pain and Pandemics: Challenges and Opportunities in the Current Social and Healthcare Climate. This meeting included presentations and discussions on social determinants of health as well as opportunities to reduce pain health disparities. As I wrote previously, the NIH Pain Consortium has formed a Diversity and Disparities in Pain Research Workgroup, which partnered with the NIH HEAL Initiative to facilitate a Virtual Workshop on Achieving Health Equity in the NIH HEAL Initiative and to support research supplements to Increase Participant Diversity Inclusion and Engagement in HEAL Initiative Clinical Studies.
In addition to ensuring that the diversity of the patient community is reflected among research participants, NIH is committed to growing and enhancing the diversity of the pain research workforce. A strong, diverse workforce can strengthen pain research by bringing new tools, perspectives, ideas, and expertise. The Pain Consortium supports the NIH HEAL Initiative’s funding opportunity to Promote Diversity in Health-Related Research. The Consortium hosts a monthly Grant Mechanism Webinar Series aimed at helping researchers at all stages in their career navigate the NIH grant process. Finally, a recent funding opportunity provided opportunities for HEAL researchers to devote more time to patient-oriented research and mentoring. These efforts take place alongside other NIH opportunities to raise interest in neuroscience research for individuals who are typically underrepresented in the field, including through the NIH Blueprint Initiative’s ENDURE program.
The ongoing COVID-19 pandemic has sharply increased our awareness of inequalities and inequities in health across the US. We in the NIH pain research community are striving to develop more effective treatments for chronic pain that can reduce the suffering of millions of people from all walks of life.