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HEAL Initiative Slowed by COVID-19, but NIH Still Making Advances

April 16, 2020

While much of the research being conducted as part of the National Institutes of Health’s Helping to End Addiction Long-term (HEAL) Initiative has been put in a “hibernation state” for now thanks to COVID-19, NIH Director Francis Collins, MD, PhD, and Nora Volkow, MD, director of the National Institute on Drug Abuse took Rx Drug Abuse & Heroin Summit attendees through an overview the project’s goals and progress thus far on Thursday.

More than $900 million was distributed through HEAL to fund research on how various agencies can work together to improve prevention and treatment for opioid misuse and addiction, as well as enhance pain management. Several studies have been put on hold, Volkow said, as researchers have been diverted to other projects and/or limited in their access to the populations they had been studying in light of social distancing.

“The issue here is how can we become creative and use virtual technologies to try to advance some of the goals we aim to achieve?” Volkow said.

Collins said chronic pain was a major focus of HEAL—“We don’t want the 25 million to 30 million who deal with chronic pain every day to be neglected in the process of trying to reduce opioids”—and that researchers are exploring devices, mindfulness and other non-pharmacological interventions.

In January, more than 400 researchers whose work was being funded by HEAL gathered

“Many of them had never met each other before, but they know each other now,” Collins said. “It was remarkable to see the way in which various collaborations were being talked about. People were getting to understand something more about what’s going on in this program that they didn’t know about.

“We now have a HEAL community that is intensively invested in finding solutions for opioid use disorder and chronic pain, working together in a fashion that wasn’t the case before we did this.”

Methamphetamine use on the rise

Volkow said deaths involving methamphetamine use have increased five-fold within the past six years, and cocaine-involved deaths are also on the rise. Lessons learned from the opioid crisis—how agencies can collaborate, how healthcare systems and community treatment programs can integrate, how virtual technologies can help—have put the industry in a better position to respond to the growing concern around methamphetamine, Volkow said.

However, she added that developing medications to treat methamphetamine addiction and reverse overdoses remains a major priority.

NIH projects still moving forward

Volkow said several NIH projects are still making progress, including work around:

  • Biologics. The use of vaccines and immunotherapies are now on clinical trials for heroin and methamphetamine. For the latter in particular, if successful, it could lead to an antidote for toxicity, Volkow said.
  • Neuromodulation, which is providing alternatives to treat both addiction and pain. Pilot data in this area has been encouraging thus far, Volkow said.
  • HEALing Communities Initiative, which has brought together healthcare, justice systems and communities. Studies as part of this project are being conducted in Kentucky, Ohio, New York and Massachusetts—states that were chosen because of high overdose fatality rates.

“This is one of those areas where we wish everybody was working intensively right now, but people are having to take a slow boat for a little bit,” Collins said. “But we are going to get through this, and we are going to have a chance to get these programs started back up again.”

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