In April 2018, NIH launched the HEAL (Helping to End Addiction Long-term) Initiative, an aggressive, trans-agency effort to speed scientific solutions to stem the national opioid public health crisis. This Initiative will build on extensive, well-established NIH research, including basic science of the complex neurological pathways involved in pain and addiction, implementation science to develop and test treatment models, and research to integrate behavioral interventions with Medication-Assisted Treatment (MAT) for opioid use disorder (OUD). Successes from this research include the development of the nasal form of naloxone, the most commonly used nasal spray for reversing opioid overdose, the development of buprenorphine for the treatment of opioid use disorder, and evidence for the use of nondrug and mind/body techniques such as yoga, tai chi, acupuncture, and mindfulness meditation to help patients control and manage pain. Over the past year, NIH has worked with experts from public and private organizations to identify the...

The incresing rate of deaths due to opioids, alcohol and suicides are part of a public health crisis described as “deaths of despair” in a new report published recently. Life expectancy in the United States has decreased for the second year in a row because of these factors, researchers wrote in BMJ. The drop was particularly steep among middle-age white Americans and people living in rural areas, USA Today reports. “Why white Americans are dying at higher rates from drugs, alcohol, and suicides is unclear, complex, and not explained by opioids alone,” the researchers wrote. They note that possibilities include the collapse of industries and the local economies they supported, the erosion of social cohesion and greater social isolation, economic hardship, and distress among white workers over losing the security their parents once enjoyed.

It is well known that deaths associated with the abuse of substances structurally related to fentanyl in the United States are on the rise and have already reached alarming levels. While a number of factors appear to be contributing to this public health crisis, chief among the causes is the sharp increase in recent years in the availability of illicitly produced, potent substances structurally related to fentanyl. Fentanyl is approximately 100 times more potent than morphine, and the substances structurally related to fentanyl that DEA is temporarily controlling also tend to be potent substances. Typically, these substances are manufactured outside the United States by clandestine manufacturers and then smuggled into the United States. As a result, the Administrator of the Drug Enforcement Administration has issued a temporary scheduling order to schedule fentanyl-related substances that are not currently listed in any schedule of the Controlled Substances Act (CSA) and their isomers, esters, ethers,...

Opioid misuse and addiction is an urgent and rapidly evolving public health crisis. An estimated 2 million Americans are addicted to opioids, and approximately 25 million suffer daily from chronic pain. The urgency and scale of this crisis calls for innovative scientific solutions, from prevention to intervention and treatment. Today, the President declared America's opioid crisis a public health emergency. The National Institutes of Health is committed to bringing the full power of the biomedical research enterprise to bear on this crisis. That effort ranges from basic science of the complex neurological pathways involved in pain and addiction, to services and implementation science to develop and test treatment models, to integrating behavioral interventions with medication-assisted therapy, to forging strategic partnerships to advance safer, non-addictive treatments for pain. In 2016, NIH spent $483 million on pain research ranging from cell and molecular mechanisms of acute and chronic pain, to safe, effective therapy...