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UI pain researchers are part of major national effort to curb opioid use

Date: Monday, October 7, 2019

UI will receive two grants through NIH HEAL Initiative

University of Iowa pain researchers are part of a major national initiative that aims to improve treatments for chronic pain, curb the rates of opioid use disorder and overdose, and achieve long-term recovery from opioid addiction.

Kathleen Sluka, PhDKathleen Sluka, PhD, UI professor of physical therapy and rehabilitation science, has received two grants totaling almost $13 million through The Helping to End Addiction Long-term Initiative, or the NIH HEAL Initiative, designed to improve prevention and treatment strategies for opioid misuse and addiction and enhance pain management. 

The University of Iowa’s two grants are among 375 grant awards totaling $945 million across 41 states made by the National Institutes of Health in fiscal year 2019 to apply scientific solutions to reverse the national opioid crisis.

“It’s clear that a multi-pronged scientific approach is needed to reduce the risks of opioids, accelerate development of effective non-opioid therapies for pain, and provide more flexible and effective options for treating addiction to opioids,” says NIH Director Francis S. Collins, MD, PhD, who launched the initiative in early 2018. “This unprecedented investment in the NIH HEAL Initiative demonstrates the commitment to reversing this devastating crisis.”

Sluka, in collaboration with Laura Frey Law, PhD, UI associate professor of physical therapy and rehabilitation science, and Christopher Coffey, PhD, UI professor of biostatistics, will use a four-year, $6.5 million award from the National Institute of Neurological Disorders and Stroke to establish a Clinical Coordinating Center for the Acute to Chronic Pain Signatures (A2CPS) Program.

Very little is known about why some people recover easily from acute pain caused by an injury, for example, while others go on to develop chronic pain that is often extremely difficult to treat. The consortium’s goals are to identify biomarkers and biosignatures—patterns of biomarkers—that can predict whether a person is susceptible or resilient to the development of chronic pain following acute pain. The hope is that being able to identify people at risk of transitioning to chronic pain could improve the management of acute pain by personalizing treatment, reducing reliance on opioids, and identifying new therapeutic targets.

“We have leveraged our wide-ranging expertise in pain science, clinical trials for pain patients, and successful coordination of large multi-site clinical trials to run the Clinical Coordinating Center for the consortium,” Sluka says. “We will lead the development of new protocols, data collection, and logistical and scientific coordination, and help facilitate effective communication between consortium members.”

The second grant awards almost $6.5 million over five years from the National Institute of Arthritis and Musculoskeletal and Skin Diseases to conduct an embedded, pragmatic clinical trial comparing the effectiveness of physical therapy with or without the addition of transcutaneous electric nerve stimulation (TENS) for patients with fibromyalgia. The trial will be done in the real-world setting of physical therapy practices and aims to show the feasibility of adding TENS to physical therapy treatment programs and to measure the effect adding TENS has on reducing patients’ pain and helping patients reach specific functional goals with less drug use.

This trial is being done in collaboration with Leslie Crofford, MD, the Wilson Family Chair of Medicine at Vanderbilt University Medical Center and the Clinical Trials Statistical and Data Management Center in the UI College of Public Health. It is an extension of the team’s recently completed clinical testing of TENS for fibromyalgia, which is a chronic pain condition involving widespread musculoskeletal pain, tenderness and stiffness associated with fatigue and sleep disturbance.

“Chronic pain is an enormous and devastating problem that affects almost 50 million American adults. Reducing opioid use in patients with chronic pain requires that proven non-pharmacological treatments are applied in clinical practice,” Sluka says. “We need to better understand how chronic pain develops so that we can intervene to prevent or mitigate it, and we need to develop effective and safe therapies to replace opioid use. With these two projects we hope to make advances in both these areas and create solutions that will help patients in real world settings.”