RX Summit 18: NIH unveils opioid-focused research initiative

The National Institutes of Health (NIH) this week launched a collaborative research initiative designed to help in the prevention of opioid overdose and addiction and in the improvement of opioid dependence treatment. NIH director Francis Collins, MD, PhD, unveiled details of the effort, which could involve ambitious demonstration projects in states hardest hit by the opioid epidemic, at the National Rx Drug Abuse & Heroin Summit on Wednesday.

The Helping to End Addiction Long-term (HEAL) initiative, which will be assisted by an additional $500 million in funding to NIH in the newly approved fiscal 2018 budget, is expected to feature public-private research partnerships along the lines of those that have identified treatment innovations for illnesses such as Alzheimer's disease and Parkinson's disease, Collins said. While he touted the benefits of the three approved medications available for opioid dependence, he suggested that persistently high treatment dropout and relapse rates cry out for new medication targets and delivery systems.

“We want to get to the point of precision medicine for opioid addiction,” said Collins.

The main components of HEAL will be efforts toward prevention of opioid misuse and addiction through enhanced pain management, and improved treatment for misuse and dependence. Collins said that in the prevention arena, more insight is needed on the factors that contribute to a spiraling into addiction for some pain management patients but not for others. Development of more alternatives to opioids for pain is essential as well.

Some of the priority areas in treatment will include improving therapeutic approaches, such as through discovering longer-acting agents to treat dependence, and determining best practices in treating infants affected by neonatal opioid withdrawal syndrome, Collins said.

He said that part of NIH's vision involves establishing a demonstration project, perhaps awarded competitively, that would bring all of a state's stakeholders together on initiatives toward an ambitious goal, such as reducing opioid overdose deaths by 50% in a year.

Collins' talk was followed by a presentation by National Institute on Drug Abuse (NIDA) director Nora Volkow, MD, who reinforced the message that more treatment options are needed. Volkow cited “the people we are losing because we're not delivering solutions fast enough.”

While emphasizing the life-saving importance of long-term medication treatment for opioid dependence, Volkow also discussed the potential of effective prevention. “Prevention strategies are probably one of the most remarkable things we can do to overcome the crisis,” she said.