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Weili Lin, PhD, is the principal investigator of a research project to improve outcomes for children exposed to opioids, and Susan Gaylord, PhD, is the UNC site PI for a second project to help people with low back pain.

The National Institutes of Health announced today approximately 375 awards totaling $945 million for researchers in 41 states as part of the NIH HEAL (Helping to End Addiction Long-term) Initiative, an aggressive, trans-agency effort launched in 2018 to improve prevention and treatment strategies for opioid misuse and addiction, and to enhance pain management.

Weili Lin, PhD, Director of the Biomedical Research Imaging Center (BRIC) and the Dixie Lee Boney Soo Distinguished Professor of Neurological Medicine, Professor and Vice Chair of Basic Research in the Department of Radiology, will lead a $524,813 one-year project titled “Establishing Innovative Approaches for the HEALthy Brain and Child Development Study, which aims to enhance outcomes for infants and children exposed to opioids in several ways.UNC School of Medicine co-principal investigators are John Gilmore, MD, the Thad and Alice Eure Distinguished Professor, Vice Chair for Research & Scientific Affairs in the Department of Psychiatry, and Director of the Center for Excellence in Community Mental Health; Karen Grewen, PhD, professor of psychiatry, neurobiology and psychology; and Hendrée Jones, PhD, professor of obstetrics and gynecology and director of the UNC Horizons Program.
“Since 2000, a more than 5-fold increase in the incidence of neonatal abstinence syndrome has been reported,” said Lin, who holds joint appointments in the departments of neurology, biomedical engineering, and at the UNC Eshelman School of Pharmacy. “Preliminary studies show that prenatal opioid exposure is associated with increased risk of impaired neurodevelopment.”To address this problem, Lin and colleagues formed a consortium including Duke University, Arkansas Children’s Research Institute, Cincinnati Children’s Hospital, and the University of Illinois. This consortium will develop instruments and strategies, such recruitment/retention protocols, assessment batteries, and novel tools. They will conduct pilot studies, such as fetal and postnatal imaging, advanced imaging harmonization and quality control, assessment administration, and biosampling to evaluate their instruments. And they will analyze available data, including imaging, behavioral, cognitive, and maternal data from studies on early brain development, to guide a potential phase II study design.

For a separate study, Boston University is the lead institution for a $907,601 grant to study mindfulness techniques to alleviate low back pain. The project includes the University of Pittsburgh, the University of Massachusetts, and UNC-Chapel Hill. Susan Gaylord, PhD, associate professor of physical medicine and rehabilitation at the UNC School of Medicine, is the UNC site principal investigator. The title of the project is “Group-based mindfulness for patients with chronic low back pain in the primary care setting.”

“Our goal is to help patients in a non-invasive but effective and inexpensive way to curb chronic low back pain,” said Gaylord, who is the director of the program on integrative medicine and the director of the mindfulness-based stress and pain management program at the UNC School of Medicine. “Chronic low back pain is one of the most common conditions treated in the primary care setting, yet treatment remains unsatisfactory for many patients, and use of opioids has many unintended consequences, such as addiction, overdose, and diversion. Mindfulness has been shown to be effective for treatment of chronic low back pain, yet it remains underutilized in primary care and is not generally reimbursed by health insurance. This project will plan a pragmatic trial to better understand how a group-based mindfulness program can be effectively integrated into real-life primary-care settings, thus improving outcomes and increasing access to non-opioid treatments.”

NIH Director Francis S. Collins, MD, PhD, said, “It’s clear that a multi-pronged scientific approach is needed to reduce the risks of opioids, accelerate development of effective non-opioid therapies for pain and provide more flexible and effective options for treating addiction to opioids. This unprecedented investment in the NIH HEAL Initiative demonstrates the commitment to reversing this devastating crisis.”

The HEAL Initiative has built 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 for opioid use disorder. 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.

NIH has worked with experts from public and private organizations to identify the areas that would most benefit from focused efforts by NIH alone or in partnership with outside organizations. The NIH HEAL Initiative will continue to bolster research across NIH to improve treatments for opioid misuse and addiction and enhance pain management.

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