September 21, 2017 – The project, in addition to others announced this week, is intended to address the needs of current U.S. service members and veterans.
The U.S. Department of Health and Human Services, the U.S. Department of Defense (DoD), and the U.S. Department of Veterans Affairs (VA) announced this week a multi-component research project focusing on non-drug approaches for pain management addressing the needs of service members and veterans. Twelve research projects, totaling approximately $81 million over six years (pending available funds), will focus on developing, implementing, and testing cost-effective, large-scale, real-world research on nondrug approaches for pain management and related conditions in military and veteran health care delivery organizations. The National Institutes of Health (NIH) will be the lead HHS agency in this partnership.
One of these projects is led by the DCRI’s Steven George, PhD, along with co-PI Susan Nicole Hastings, MD; and Duke/DCRI faculty Chad Cook, PhD, MBA; Corey Simon, DPT, PhD; and Adam Goode, DPT, PhD. The goal of this planning and demonstration project is to improve access to recommended nondrug therapies for low-back pain in the Department of VA Health Care System and involves researchers from the DCRI, Department of Psychiatry and Behavioral Sciences, Durham VA Center for Health Services Research in Primary, and the UNC Thurston Arthritis Research Center.
“We are hoping to provide non-pharmacological, frontline options that provide optimal pain relief to veterans and prevent unnecessary surgery, injections or opioid prescriptions,” George said.
Benjamin A. Alman, MD, James Urbaniak Professor and Chair of the Department of Orthopaedic Surgery, said, “We are incredibly proud of the work Dr. George is doing for our veterans, as well as the broader implications his work could have on the way we treat patients with chronic low-back pain.”
“Finding solutions for chronic pain is of critical importance, especially for military personnel and veterans who are disproportionately affected,” said NIH Director Francis S. Collins, MD, PhD. “Bringing the science to bear through these real-world research projects will accelerate our search for pain management strategies for all Americans, especially as we work to address the nation’s opioid crisis.”
The National Center for Complementary and Integrative Health (NCCIH), part of NIH, is contributing more than half of the total funding, and it is the lead for this multi-agency initiative called the NIH-DoD-VA Pain Management Collaboratory, which is modeled on the successful NIH Health Care Systems Research Collaboratory. This initiative also addresses the need to focus on “advancing better practices for pain management,” which is outlined in HHS’ 5-point strategy to combat the opioid crisis.
Studies report nearly 45 percent of soldiers and 50 percent of veterans experience pain on a regular basis, and there is significant overlap among chronic pain, post-traumatic stress disorder (PTSD), and persistent post-concussive symptoms. Data from the National Health Interview Survey shows that American veterans experience a higher prevalence of pain and more severe pain than nonveterans. Although opioids are often prescribed to treat chronic pain, research has not shown them to be very effective, and there are many issues with long-term use. Thus, there is a need for nondrug approaches to complement current strategies for pain management and to reduce the need for, and hazards of, excessive reliance on opioids.
Seven of the 12 projects, including George’s, have been awarded by HHS/NIH. The remaining five will be announced by the DoD and VA in the coming months.