NIDA requests information on minimizing risks with pain meds

The National Institute on Drug Abuse has issued a notice requesting help in developing a new research strategy (NOT-DA-09-006). They are after:

Public Comment on Development of a Funding Opportunity Announcement on Translational Research on Minimizing Risks of Managing Pain with Opioids in General and Specialty Medical Settings

Post done, right? No, no, that's just the title. What they are working up to is issuing a "funding opportunity announcement". Although a Program Announcement qualifies, we are probably talking about an eventual Request For Applications. RFAs are the things we are looking for because they come with set aside money, a limited application window and an assurance that at least one or three projects will be funded. For anyone who thinks that IC research priorities are detached from real world interests or are developed a little to self-referentially (say by calling up a couple of already-funded investigators and asking them what is important to fund), well, this RFI is a cool thing. They want feedback from you.
So, why is NIDA interested in this topic?


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Well, since probably only a couple-three of my readers are fans of this unfortunate drug addict, and most of the kids these days never know about this other unfortunate drug addict, let's look at the background information.

Evidence supports the use of opioid analgesics to treat severe, acute pain and moderate to severe pain associated with cancer and other diseases. However, opioids carry a number of significant potential risks, including the possibility of misuse, abuse and addiction. Because opioids are employed to manage pain in many different medical settings, these risks confront practitioners in disciplines as diverse as primary care, critical care, oncology, geriatrics, and many other medical specialties. The complexities of managing pain in the context of abuse and addiction, coupled with growing concerns about prescription opioid abuse in the US population and recognition of the special needs of returning combatants who suffer from painful conditions, impel the research community to pursue new approaches to improving pain management while mitigating the risk for prescription drug misuse, abuse, and addiction.
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The goal of the anticipated FOA will be to advance safer, more effective approaches to prescribing opioids for treatment of acute and chronic pain, improving existing modalities to achieve optimal pain relief while minimizing the risk for misuse, abuse, and addiction, and treating abuse and addiction outcomes that may result from the use of prescription opioid analgesics.

Responses will be accepted through March 31, 2009, and can be entered at the following web site: http://www.drugabuse.gov/RFIFeedback/.

Key points of interest include:

1) Describe the needs and concerns of the medical community, including practitioners of medical specialties, regarding prescription drug abuse and addiction in the context of pain management.
2) Describe which findings from the current research can best aid in assessing opioid efficacy in pain management, especially in the context of co-occurring medical and/or psychiatric conditions.
3) Describe which findings from the current research can best aid in assessing the risks/benefits associated with using opioids in pain management in different patient populations, for example, active military and veterans.
4) Based on findings from basic and clinical neuroscience research, identify which findings, tools, and methodologies have potential for translation into new clinical practices to reduce the risk of prescription drug abuse and addiction during pain management with opioids.
5) Identify areas of human research that can lead to development of personalized or customized treatments of co-morbid pain and addiction, and/or strategies to identify and care for those patients most at risk of adverse outcomes.
6) Describe what additional considerations, stipulations, or criteria ought to be included in the anticipated FOA in order to support the objectives described in the Background section. This might include research on: addressing other health consequences/side effects of opioid use (drug overdoses, drug interactions, hyperalgesia, opioid tolerance, long-term effects of opioid use), specific development of analgesics with low/no abuse liability, new technologies (e.g. biofeedback) for analgesia, overcoming cultural barriers to service delivery, stigma, financing, implementation, and access challenges.

Additional reading: I've had a post or two related to prescription opiate risk, including a popular one on Heath Ledger's death.

3 responses so far

  • juniorprof says:

    Juniorprof would like to point out to readers that opioid-induced hyperalgesia is a very real problem and that it likely contributes to stress-induced alterations in pain. Distinguishing between opioid-induced hyperalgesia and opioid tolerance can be especially problematic and understanding this better may significantly enhance opioid-based therapies for pain control. Feel free to encourage NIH to want to learn more about such things.

  • Dr. Feelgood says:

    Hmph. How does this help the rest of us who research the really fun illegal drugs? It does not.
    Good day to you sir. I said good day!
    Doc F

  • Pinus says:

    I would say that long-term effects of opioid use could probably be something of note to many people such as you Dr. Feelgood...no?

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