At the same time, 2 million Americans today are addicted to opioids. In April 2017, Thomas E. Price, MD, Secretary of the DHHS, announced a five-pronged national strategy to combat the opioid crisis, including:
- Improving access to treatment and recovery services;
- Promoting the use of overdose-reducing drugs (such as naloxone);
- Strengthening our understanding of the epidemic through better public health surveillance;
- Supporting cutting-edge research on pain and addiction; and
- Advancing better practices for pain management.
The Pain Management Best Practices Inter-Agency Task Force is pulling together federal and nonfederal partners from a broad range of interests, including providers, pain advocacy groups, veterans’ services organizations, the Department of Defense and the Office of National Drug Control Policy. Its charge: Identify gaps in pain management best practices, recommend how to address them and disseminate information about those best practices. Nominations for the Inter-Agency Task Force were accepted through Sept. 27, and the DHHS is currently reviewing applications for the Task Force.
‘We have an opioid problem, & we have a pain problem, & we believe there’s a need to develop new pain therapies.’ —Dr. Porter
Research Priorities
Research into better, safer pain management and the fundamental understanding of pain remains an essential part of the pain puzzle. The 2017 Federal Pain Research Strategy was developed by the NIH Office of Pain Policy, with oversight by the Interagency Pain Research Coordinating Committee, a federal advisory committee created by the DHHS to enhance pain research efforts and promote collaboration across government agencies. This plan fulfills mandates in the Affordable Care Act while aiming to avoid duplication of federal pain research efforts. It has identified five research priority areas, as well as opportunities to apply Common Fund Support (a source of federal dollars in the Office of the Director at NIH) for transformative projects too big for one institute, Dr. Porter said.
The government’s research strategy also includes publications, public–private partnerships and research to address the opioid use disorder crisis. Delivery targets include enhancing the evidence base for pain care and integrating it into clinical practice. The Agency for Healthcare Research and Quality is driving a systematic review of evidence-based nonpharmacological pain treatments, from acupuncture to exercise, Dr. Singh noted. The government is also developing an online pain education portal and trying to standardize comprehensive pain assessments and outcome measures.
Charles (Chad) G. Helmick, MD, medical epidemiologist in the Arthritis Program at the Centers for Disease Control and Prevention, said a lot is going on in the pain arena at the federal level. It’s not just the opioid crisis, with increasing fatalities affecting all demographic groups, he said, but also recognition that the current pain management system is dysfunctional. Much of the pain experienced by Americans is musculoskeletal, either due to arthritis or low back pain.
