The HEALing Communities Study aims to develop the best evidence for an improved response to a crisis linked to more than 115 deaths a day in the U.S. and a burden that costs the nation $78.5 billion a year, according to the National Institute on Drug Abuse (NIDA), part of NIH. The study will work within existing health care and criminal justice settings to develop models of care designed to expand access to medications and help patients stay with their treatment.
“It is a profoundly important and tragic public health crisis, and so we want to do everything we can to bring the best science to bear on this,” NIH Director Francis S. Collins told Bloomberg Law in a June 11 interview. “If we’re really going to turn this around, we need to bring all of the players together in a coordinated way.”
The study is one arm of the Helping to End Addiction Long-term (HEAL) initiative, a trans-NIH effort. Congress gave NIH an additional $500 million in March to address what Sen. Lamar Alexander (R-Tenn.), chairman of the Senate health committee, has called “our most serious public health epidemic.” Collins, along with the directors of the drug abuse and neurological institutes, provided details on how they are going to spend that money in a viewpoint published on June 12 in the Journal of the American Medical Association (JAMA). The viewpoint comes out the same week the House begins floor debate on more than 70 bills to combat the crisis.
“Scope Is Staggering”
As most individuals with an opioid use disorder started with an opioid prescription, the HEAL initiative aims to improve treatments for opioid misuse and provide better strategies for the 25 million Americans suffering from chronic pain.
“The scope of this crisis is staggering, but scientific advances offer strategies that can help the nation overcome it,” the viewpoint said. NIDA Director Nora D. Volkow and Walter J. Koroshetz, director of the National Institute of Neurological Disorders and Stroke, coauthored the article with Collins.
HEALing Communities
The HEALing Communities Study grants will work with local health systems, fire and police departments, and state and local governments to develop comprehensive strategies for opioid use disorder that cover prevention, detection, and screening; linkage to care; medicated-assisted treatments; and making sure patients with an opioid use disorder stick to treatment programs over the long term. “In our view, this is a really important research question: What could be achieved with that kind of integration?” Collins said.
HEALing Communities is still in development, but Collins said NIH hopes to release a funding announcement by the end of August, so awardees can get started “by the very first of 2019.” Multiple counties that have been affected particularly hard by the opioid epidemic can apply for three-year project grants. But Collins said he expects to be collecting data the whole time and learning and adjusting projects as new information comes in.
“This is going to be very much the kind of thing where we have heavy involvement by project management at NIH and SAMHSA,” Collins said, referring to the Health and Human Services Substance Abuse and Mental Health Services Administration, one of the leaders of the HEALing Communities study. “We’re not going to basically give away the money and say, ‘Tell us in three years what happened.’”
Other Initiatives
There are at least 15 initiatives under the plan announced on June 12, Collins said, which total about $260 million and stem from a year of brainstorming around “as many creative ideas as people could come up with.” Congress appropriated the $500 million over two years, so the agency expects to announce new projects when the next fiscal year starts Oct. 1.
Other parts of the overall HEAL initiative include research to understand how a one-time event can lead to a chronic pain disorder and how to identify and treat infants born with opioid withdrawal syndrome. The agency also is funding research on how to improve medications such as methadone, buprenorphine, and naltrexone designed to treat an opioid use disorder.
“This is the first down payment on what is going to be a major set of new initiatives,” Collins said.
Read more on the NIDA website, the NIH HEAL initiative, the Senate health committee press release, and Collins’ JAMA viewpoint.
Selected information in the "Pharmaceutical Science Update" is compiled from summaries and articles from Bloomberg BNA.