Combating Pain and Preventing Addiction

September is Pain Awareness Month. In recognition of this, NINDS Director Walter Koroshetz and National Institute on Drug Addiction (NIDA) Director Nora Volkow have written a blog post highlighting NIH’s efforts to foster research, education, and patient care.

Pain is a symptom, a condition, not a disease.  But do not let this fool you.  Pain is among the most common and most disabling conditions known.  It can be acute (sudden in onset and relatively short-lived) or chronic (long-lasting).  Acute pain, most often with a known cause, sometimes becomes chronic pain.  Often, it is not known why the transition occurs or why the pain persists.

It is estimated that between 20 and 30% of people have been affected by pain that lasted at least 24 hours in the past 6 months.  Pain can afflict anyone at any age.  While scientists have learned a great deal about pain and have developed medications, devices, and techniques that counteract some of the steps in the pathway that leads to initiation, production, and perception of pain, many medications that are effective against pain are addicting and those that are not are ineffective against the most severe and most chronic painful conditions.

NINDS has developed a free phone app for pediatric migraines called Migraine Trainer to help teens manage their migraines with behavioral techniques. Users can also log their headaches and share this information with their doctor in order to develop a personalized treatment plan. The app is available in the Apple and Android stores.

One exception to this is migraine.  Migraine is a headache syndrome often associated with nausea, aversion to sound and light, transient and evolving changes in vision, and, sometimes, transient motor or sensory abnormalities.  It usually starts in childhood and almost always runs in families.  Migraine is responsible for an enormous number of days lost from school, work, family events and visits, and recreational activities.  In recent years, scientists have used what is known about the unique steps that initiate, propagate, and sustain migraine and result in its symptoms, including pain, to develop non-addicting medications aimed at each step in this process.  There are medications that help prevent, treat acute, or treat chronic migraine.

Largely under the auspices of the NIH’s Helping to End Addiction Long-term℠ (HEAL) Initiative, NINDS is funding and working with scientists around the US to delineate and understand the steps responsible for other painful conditions and pain syndromes and to leverage this information to develop non-addicting medications, devices, and techniques with which to treat pain.  In addition, scientists funded by NINDS are trying to determine what circumstances and steps are responsible for the conversion of acute pain into chronic pain and to develop strategies that prevent this conversion.