NIH Plan for Long Term Addiction

Couple enjoying the new year

Every day in the United States, more than 130 individuals die from an opioid overdose. [1] While there are effective treatments available for opioid dependence, less than 10% of people who need treatment actually receive it. [2]

According to the Center for Disease Control, the number of people dying from opioid overdose began a steep increase around 2013 and continues to climb. [3] In addition to losing lives, the economic burden of opioid misuse, which includes the costs of healthcare, lost productivity, addiction treatment, and criminal justice are nearly $80 billion every year. [4]

The NIH HEAL Initiative

Because of these staggering realities, the National Institute of Health (NIH) launched the Helping to End Addiction Long-term (HEAL) Initiative in April of 2018. According to the NIH HEAL Initiative website, the organization is taking an “all hands on deck” approach to the opioid crisis, combining expertise from “almost every NIH Institute and Center to accelerate research and address the public health emergency from all angles.” [5]

In 2019 alone, 25 different organizations and initiatives are spending over $890 million to address various aspects of the epidemic. These initiatives include, but are not limited to:

  • Developing new treatments for opioid misuse
  • Developing new medications to prevent or reverse overdoses
  • Trials for helping newborns dependent on opioids to withdraw safely
  • Development of new ways to treat pain (other than opioids)
  • Optimizing care for treatment of patients
  • Prevention for at-risk teens
  • Alternative approaches to back pain

Research Priorities

Doctor doing Research for the NIH HEAL InitiativeResearch is the priority of the NIH HEAL Initiative. According to the HEAL website, research will focus on “urgent unmet needs across the lifespan, areas of promising scientific opportunity, and concrete strategies capable of providing rapid and durable solutions to the opioid crisis.” The goal of this research is to provide a “lasting, scientific solutions to the opioid crisis.”

The NIH HEAL Initiative has six areas of research, listed below.

Translating Research to Practice for the Treatment of Opioid Addiction

This initiative will use studies to integrate evidence-based interventions into a variety of settings. For example, the HEALing Communities Study will investigate tools to prevent and treat opioid misuse at the local level.

This study selected four sites in four states impacted by the opioid crisis. The goal is to reduce deaths by opioid overdose by 40 percent over a three year period.

New Strategies to Prevent and Treat Opioid Addiction

Supporting research to develop prevention strategies is one of the focuses of HEAL. One area of study will examine the connection between sleep problems and opioid use disorder (OUD).

Over 75 percent of people with OUD have sleep problems, and the study will examine “whether sleep deficiency contributes to the overuse of opioids and addiction, and how individuals respond to medication treatments to overcome addiction.” [5]

Enhanced Outcomes for Infants and Children Exposed to Opioids

This initiative provides funding to research the “medical and social needs of infants and children affected by opioid use disorder.” Babies exposed to opioids while in the womb are at risk of a condition called neonatal opioid withdrawal syndrome (NOWS), which causes excessive crying, irritability, and problems with sleeping, eating, and breathing.

The NIH HEAL Initiative will fund the ACT NOW Longitudinal Study to examine the best ways to treat infants with NOWS and safely withdraw them from opioids as well as better understand the long-term impact of the syndrome.

Novel Medication Options for Opioid Use Disorder and Overdose

This phase of research is designed to help develop new medications in treating all aspects of the opioid addiction cycle. Medications such as methadone, buprenorphine, naltrexone, and lofexidine are all currently approved by the FDA to treat OUD; however, the NIH believes more “flexible treatment options” are needed to achieve long-term recovery.

Clinical Research in Pain Management

Study and Research BookAbout one in every four patients prescribed opioids for chronic pain misuse them. [6] Because of this, finding new and safer ways to treat pain is a core goal of the HEAL Initiative.

Six different programs will focus their efforts on doing this. One of these, the Back Pain Consortium Research Program, will direct studies to improve ways of treating conditions such as chronic low back pain and test alternative therapies to provide relief apart from opioids.

Preclinical and Translational Research in Pain Management

Also focused on pain management, the programs under this arm of the initiative are exploring new ways to identify and treat pain without opioids. This is a challenging task, as more than 25 million Americans suffer from chronic pain and rely on opioids for relief.

According to the HEAL website, researchers plan to develop “novel pain relievers with improved specificity, fewer side effects, and low risks of misuse or dependency.” [7]

The goals of the NIH HEAL Initiative are lofty but essential. With damaged relationships, lower self-esteem, and deaths by overdose, it is critical that we find new ways to prevent and treat opioid misuse.


[1] National Institute on Drug Abuse. (2019, January 22). Opioid Overdose Crisis. Retrieved October 31, 2019, from
[2] World Health Organization. (2018, August 21). Information sheet on opioid overdose. Retrieved October 31, 2019, from
[3] National Institute on Drug Abuse. (2019, January 22). Opioid Overdose Crisis. Retrieved October 31, 2019, from
[4] Florence CS, Zhou C, Luo F, Xu L. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013. Med Care. 2016;54(10):901-906. doi:10.1097/MLR.0000000000000625.
[5] National Institutes of Health. (n.d.). Sleep Dysfunction as a Core Feature of Opioid Use Disorder and Recovery. Retrieved October 31, 2019, from
[6] National Institute on Drug Abuse. (2019, January 22). Opioid Overdose Crisis. Retrieved October 31, 2019, from
[7] Optimizing Non-Addictive Therapies to Treat Pain. (n.d.). Retrieved from

About the Author:

Travis StewartTravis Stewart, LPC has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future. Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help. This includes a special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety, and perfectionism. Specifically, he has worked with eating disorders since 2003 and has learned from many of the field’s leading experts. He has worked with hundreds of individuals facing life-threatening eating disorders in all levels of treatment. Travis’ website is

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Reviewed and Approved by Jacquelyn Ekern, MS, LPC on November 19, 2019
Published November 19, 2019, on

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