IOWA CITY — In the grip of an opioid crisis that’s killed tens of thousands and affected tens of millions, the United States has committed $945 million toward finding scientific solutions — with a chunk going toward University of Iowa research of the pain driving much of the opioid use and abuse.
“Chronic pain is an enormous and devastating problem that affects almost 50 million American adults,” UI professor of physical therapy and rehabilitation science Kathleen Sluka said.
“Reducing opioid use in patients with chronic pain requires that proven non-pharmacological treatments are applied in clinical practice.”
But, according to Sluka, the nation’s experts and practitioners need to better understand how chronic pain develops to better intervene, prevent or mitigate it without opioids.
That’s where two new UI grants come in — combining for nearly $13 million through the National Institutes of Health’s Helping to End Addiction Long-term, or HEAL, initiative.
The NIH initiative — which awarded $945 million in the 2019 budget year via grants, contracts and agreements across 41 states — aims to curb opioid abuse and overdose, facilitate long-term recovery from opioid addition, and improve chronic pain treatment and management.
UI researchers are involved in the chronic pain portion of the initiative, as Sluka said, “Iowa’s always been a strong player in the pain community — from basic science to clinical outcomes. We have a pretty big pain research group here at Iowa.”
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The first of Iowa’s two HEAL-backed grants involves 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 Program.
That program involves a consortium of sites and research institutions from Johns Hopkins to Wake Forest to Rush universities — all hoping to better understand why some people recover easily from acute pain caused by injury, while others develop chronic pain that’s hard to treat.
The consortium aims to identify biomarkers and biosignatures — which are patterns of biomarkers — capable of predicting whether a patient is either susceptible or resilient to developing chronic pain.
If researchers develop a predictive model, the hope is they can personalize acute-pain management and treatment, curtailing reliance on opioids and pushing new alternative therapies.
The first year of the grant-funded work will involve detailed planning — with data collection starting next year. The goal is to collect data from 1,800 patients over two years from a clinical center in Chicago, with UI serving as a coordinating center for that information.
“That’s a lot of data really fast,” Sluka said.
The UI team of researchers will lead the consortium in data collection, developing new protocols and coordinating logistics, while also facilitating effective communication between the conglomerate’s members.
“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 said.
The second UI grant award of almost $6.5 million over five years comes from the National Institute of Arthritis and Musculoskeletal and Skin Diseases and aims to conduct a clinical trial comparing the effectiveness of physical therapy for fibromyalgia patients with or without a transcutaneous electric nerve stimulation, or TENS, treatment.
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That research will investigate the feasibility of adding TENS to physical therapy treatment and determine whether it helped patients reduce pain and reach functional goals with less drug use.
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