October 31, 2019: Full Speed Ahead: Bringing Translational Science to the Opioid Crisis

In my July 2018 message I introduced The Helping to End Addiction Long-term℠ Initiative, or NIH HEAL Initiative℠, aimed at tackling the opioid crisis, and outlined our plans to apply NCATS’ translational science approach to the initiative. I’m excited to report that last month NIH announced $945 million in funding for projects in 41 states to develop and apply evidence-based solutions to reverse the crisis. NCATS is actively participating in several NIH HEAL Initiative projects, including the CTSA Trial Innovation Network, ASPIRE Design Challenges and Tissue Chips to Model Nociception, Addiction and Overdose.

As we celebrate this significant milestone in our fight to address this important public health issue, here’s a look back at key points in my previous message. They give some perspective on the challenge we are undertaking, the scope of the newly launched NIH HEAL Initiative and on how far we have come in a short amount of time.

  • 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 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.
  • The opioid crisis typifies the translational challenge at every step, from validation of new targets to development of innovative treatments and clinical trial endpoints 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.
  • 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 through our NCATS Chemical Genomics Center 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.

The closing thought in my earlier message still rings true today, 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