July 10, 2018: Bringing Translational Science to the Opioid Crisis

Every 13 minutes in the United States, a person dies from an opioid overdose. The number of these overdose deaths — more than 42,000 in 2016 — continues to rise dramatically, paralleling the rise in deaths from HIV/AIDS during the height of that epidemic. Opioid-induced death is a public health crisis of historic proportions, with devastating consequences for individuals, families, communities and the nation.

Opioid addiction is a complex problem that will require medical, social, legal and community solutions. But research also has an important role to play in understanding the underlying biology of addiction and pain, developing new interventions to treat them, and determining which interventions are most effective. This past April, NIH launched an innovative research agenda called the Helping to End Addiction Long-termSM Initiative, or NIH HEAL InitiativeSM,, focused on two critical areas: improving treatments for opioid misuse and addiction, and finding non-opioid approaches to pain management.

Over the past year, I have been working closely with my NIH colleagues to apply NCATS’ translational science approach to the NIH HEAL Initiative. The opioid crisis typifies the translational challenge at every step, from validation of new targets to development of innovative treatments and clinical trial end points to recruitment for clinical studies, which is particularly difficult since the population is stigmatized and may be in legal jeopardy. And even when new interventions demonstrate effectiveness in controlled clinical trials, their uptake in medical care settings is often low, limiting their dissemination to patients in need. This problem was the focus of a study published last month on medication-based treatment after opioid overdose. With support from NCATS’ Clinical and Translational Science Awards Program, investigators found that only a fraction of individuals who would likely benefit from medications to treat opioid use disorder receive them after surviving an overdose.

NCATS is bringing our unique approach to bear on these many challenges. Through the NIH HEAL Initiative, we are leading a trans-NIH effort to develop innovative, human cell-based screening platforms and novel drugs to treat opioid misuse, addiction and pain. Our efforts will tap into many of NCATS’ existing efforts, including induced pluripotent stem cells3-D Tissue Bioprinting and Tissue Chips for Drug Screening. We will use these innovative platforms to identify drugs that will undergo preclinical development via our NCATS Early Translation Branch and the Bridging Interventional Development Gaps and Therapeutics for Rare and Neglected Diseases programs. We are planning similarly ambitious and innovative efforts in the clinical development and implementation of new opioid misuse/addiction and pain interventions, and I look forward to sharing more with you in a future message.

Through the NIH HEAL Initiative, NCATS will demonstrate the breakthrough potential of translational science to address the public health challenge of our era.

Christopher P. Austin, M.D.
National Center for Advancing Translational Sciences