Chronic pain is one of the most prevalent, costly, and disabling health conditions in the United States. Estimates show that more than 11 percent of the American population suffer from chronic pain, yet the federal pain research investment has been minimal. In parallel with a gradual increased recognition of the problems of treating chronic pain, the opioid epidemic has emerged as a growing public health emergency. The intersection of these two crises lies in the fact that an unintended consequence of treating pain has been an increasing number of opioid prescriptions and diversion of drugs for illicit purposes.

In May 2017, the National Institutes of Health (NIH), and the National Institute on Drug Abuse announced a public–private partnership to develop solutions to the opioid crisis and cut in half the time it takes to develop non-addictive analgesics. To advance the planning of NIH's anticipated public–private partnerships, the National Academies' Forum on Neuroscience and Nervous Systems Disorders hosted a public workshop that brought together a diverse group of stakeholders from academia, federal agencies, advocacy organizations and companies developing therapeutics for pain and opioid use disorders. Participants discussed potential strategies to accelerate development of non-addictive pain medications and treatments for opioid use disorders. This publication summarizes the presentations and discussions from the workshop.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• PLANNING COMMITTEE ON ADVANCING THERAPEUTIC DEVELOPMENT FOR PAIN AND OPIOID USE DISORDERS THROUGH PUBLIC–PRIVATE PARTNERSHIPS
• FORUM ON NEUROSCIENCE AND NERVOUS SYSTEM DISORDERS
• Reviewers
• 1. Introduction and Background
  • WORKSHOP OBJECTIVES
  • THE PUBLIC HEALTH IMPACT OF PAIN AND OPIOID USE DISORDERS
  • SELECTED FEDERAL INITIATIVES TO ADDRESS THE CHALLENGE OF TREATING PAIN AND OPIOID USE DISORDERS AND RELATED NATIONAL ACADEMIES' REPORTS
  • ORGANIZATION OF PROCEEDINGS
• 2. Exploring Challenges to Developing Treatments for Pain and Opioid Use Disorders
  • THE COMPLEX EXPERIENCE OF PAIN
  • INSUFFICIENT RESOURCES TO TREAT PAIN
  • INSUFFICIENT UNDERSTANDING OF PAIN MECHANISMS
  • UNDERSTANDING CHALLENGES IN CONDUCTING CLINICAL TRIALS
  • THE PENDULUM SWING OF CARE: UNDERSTANDING PATIENT NEEDS
• 3. Exploring the State of the Science and Preclinical Models for Pain Therapeutic Development
  • NEURAL CIRCUITS, CELLS, AND MOLECULAR MEDIATORS OF PAIN
  • PRECLINICAL EFFORTS TO IDENTIFY PAIN TARGETS AND TREAT PAIN
• 4. Clinical Development of Non-Addictive Pain Medications
  • BIOMARKERS: A BRIDGE TO CLINICAL STUDIES
  • A TARGETED APPROACH TO THERAPY DEVELOPMENT IN THE CLINICAL SPACE
  • PREVENTING THE ACUTE-TO-CHRONIC PAIN TRANSITION
  • REGULATORY CHALLENGES RELATED TO THE APPROVAL OF PAIN MEDICATIONS
• 5. Therapeutic Development for Opioid Use Disorders and Overdose Prevention and Reversal
  • NEW TREATMENTS IN DEVELOPMENT FOR OPIOID USE DISORDERS
  • THERAPEUTIC DEVELOPMENT TO REVERSE OVERDOSE
• 6. Public–Private Partnerships to Advance Pain and Opioid Use Disorders Research and Development
  • PUBLIC–PRIVATE PARTNERSHIPS TO ACCELERATE DEVELOPMENT OF NON-ADDICTIVE PAIN MEDICATIONS
  • PARTNERSHIPS TO ADDRESS OPIOID USE DISORDERS AND REVERSE OVERDOSE
  • UNDERSTANDING THE ROLE OF PAYERS IN SUPPORTING THERAPEUTIC DEVELOPMENT FOR PAIN AND OPIOID USE DISORDERS
  • FINAL REMARKS
• APPENDIXES
  • A. References
  • B. Workshop Agenda
  • C. Registered Attendees

Rapporteurs: Clare Stroud, Sheena M. Posey Norris, and Lisa Bain.

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2018. Advancing therapeutic development for pain and opioid use disorders through public–private partnerships: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/25060.