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NIH announces new initiative to fight opioid crisis

The NIH has begun a new round of public-private partnerships with scientific-based industries to fight the opioid epidemic, according to an article just published in The New England Journal of Medicine.

“The scope of the tragedy of addiction and overdose deaths plaguing our country is daunting,” Nora D. Volkow, MD director of the National Institute on Drug Abuse and Francis S. Collins, MD, PhD, NIH director, wrote. “With our partners, the NIH will take an ‘all hands on deck’ approach to developing and delivering the scientific tools that will help end this crisis and prevent it from re-emerging in the future.”

There are three prongs to the new initiative, according to the article: finding safe, effective, nonaddictive interventions to manage chronic pain; developing better overdose-reversal and prevention interventions to reduce mortality; and finding new, innovative medications and technologies to treat opioid addiction.

Volkow and Collins stated that although the NIH began talking with companies last month to kickstart this latest approach, not all aspects of the epidemic will be resolved quickly.

"Some advances may occur rapidly, such as improved formulations of existing medications, opioids with abuse-deterrent properties, longer-acting overdose reversal drugs, and repurposing of treatments for other conditions. Others may take longer, such as [mu-opioid receptor]-biased agonists, opioid vaccines and novel overdose-reversal medications,” they wrote. “For all three areas, our goal is to cut in half the time typically required to develop new safe and effective therapeutics.”

The authors pointed to earlier partnerships between federal agencies and prescription drug manufacturers that have helped stem the tide of opioid addiction, such as the creation of new formulations of existing medications to enhance compliance and reduce the likelihood of diversion, such as the creation of naloxone nasal spray and the buprenorphine implant. Volkow and Collins suggested these set the stage for history repeating itself in a beneficial way, in the battle against opioid misuse.

“As we have seen repeatedly in the history of medicine, science is one of the strongest allies in resolving public health crises. Ending the opioid epidemic will not be any different,” they wrote. “In the past few decades we have made remarkable strides in our understanding of the biologic mechanisms that underlie pain and addiction. But intensified and better-coordinated research is needed to accelerate the development of medications and the technologies to prevent and treat these disorders."

Today’s announcement is the latest by a federal entity to address the opioid crisis. In March, President Donald J. Trump signed an executive order establishing a commission to combating drug addiction and the opioid crisis, although the White House budget later slashed the budget of the Office of National Drug Control Policy by 95%. That action came just more than a year after the CDC released opioid prescription guidelines for primary care physicians, which urged such health care professionals to prescribe the lowest effective dose and closely monitor all patients receiving them. – by Janel Miller

Disclosure: Neither Volkow and Collins reported any relevant financial disclosures.