What are the new and emerging scientific insights and approaches that offer hope for non-addictive therapeutics and all those currently battling opioid addiction?
That was the focus of today’s packed panel moderated by James Sullivan, vice president of discovery at AbbVie. The panelists, all of whom are deeply invested in the pursuit of solutions to the opioid crisis, included:
- James Campbell, MD, President and Chief Scientific Officer at Centrexion Therapeutics Corporation
- Roger Crystal, CEO at Opiant Pharmaceuticals Inc
- Walter Koroshetz, Director, NINDS at NIH; and
- Clifford Woolf, MD,PhD, Professor of Neurology and Neurobiology at Harvard Medical School
Without question, the situation is dire. But panelists agreed that change is coming.
“We are at a tipping point,” explained Woolf. “The application of new technologies is beginning to expand our understanding of pain…and definition of pain.” For so long, pain has been narrowly defined as “mild, medium or severe,” or “on a scale of 1-10,” but as researchers now know, pain is not that simple. It is immensely complicated – and subjective – and there needs to be different ways to treat different types of pain. But we’re headed in the right direction according to Woolf: “I really think we have the chance to move away from this one-size-fits all approach that has led to the opioid crisis.”
There is a lot of promising research underway that is attacking and examining the problem from a variety of lenses, including:
- Developing better treatment for people who are already addicted, even potential vaccines. More potent drugs are hitting the streets every day, so we need equally powerful antedotes.
- Understanding the transition from acute to chronic pain. How does someone go from having a one-time surgery, after which they received an opioid prescription, to developing long-term chronic pain? This is of particular interest to the NIH, according to Koroshetz; conducted as part of the NIH’s $500M research commitment into opioid addiction support and alternative pain treatments.
- Asking: how do you advance the study of pain when you never know what another person is feeling? Panelists agreed that the answer lies in advanced technology and data. The more information that we can collect from patients – everything from change in mobility, daily activities, sleep patterns, cravings, emotions, etc. – the more accurate machine models and functional images we can create and study.
The opioid crisis was also a major focus at an FDA Town Hall with Dr. Janet Woodcock, the FDA’s Director of the Center for Drug Evaluation and Research, and Dr. Peter Marks, Director of the Center for Biologics Evaluation and Research. Dr. Woodcock noted that “the biggest problem with pain is that it’s one of the fundamental human aspects of how we’re wired and constructed. It’s an alarm mechanism – there’s no free lunch in pain treatment. Each modality that we have right now – there are some major liabilities associated with them… we need a greater menu for clinicians.”
She stressed that, while there are promising targets for acute pain that are being pursued, better treatments for the underlying causes of chronic, painful conditions such as osteoarthritis and low back pain will be key to solving the opioid crisis long term.
Woodcock also noted that the FDA will be issuing a series of new guidances for Sponsors of new pain treatments, including how to pursue a label for opioid-sparing claims.
One thing that’s for sure is no one is giving up or giving in to this crisis. The field is ripe for possibility and partnership, and solutions are at the forefront of everyone’s agenda whether it be academic, government, pharmaceutical or other healthcare companies. We’re getting closer and smarter every day.