Alice Goodman

May 13, 2013

New Orleans, Louisiana — While everyone agrees that pain is a priority area of research, the funding attached to it may soon shrink even further.

During the keynote lecture at the American Pain Society (APS) 32nd Annual Scientific Meeting, Story Landis, PhD, director of the National Institute for Neurological Disorders and Stroke (NINDS), reaffirmed the National Institutes of Health's (NIH's) commitment to research on the biological basis of pain and development of effective treatments, but acknowledged that the effect of the sequester will be to reduce funding for pain research over the coming year.

She explained that the NIH has designated NINDS as the lead NIH institute for pain research and has established a dedicated office to work with the Pain Care Consortium, which coordinates basic, translational, and clinical research across the NIH.

In response to her talk, American Pain Society President Roger B. Fillingim, PhD, professor of psychology at the University of Florida in Gainesville, said the level of current NIH funding is inadequate and not commensurate with the magnitude of the pain problem in the United States. He told Medscape Medical News that he is deeply concerned about the funding cuts due to the sequester.

"If Dr. Landis' figures are correct, present funding for pain research is about 1% of all NIH research funding," Dr. Fillingim stated. "Pain is the single most prevalent and expensive condition in the country, accounting for about 10% of our national healthcare expenses. Pain is the number 1 reason people seek health care. In 2012, the costs of treating pain totaled $635 billion."

Dr. Fillingim said he would like to see a "War on Pain" mounted by the government, like the War on Cancer 2 decades ago. "It would be wonderful if we could declare war on pain and develop treatments and disseminate them, leading to advances that would be similar to those achieved in treating cancer."

Exciting Time

Still, it is an exciting time in pain research, with discoveries in other fields that are applicable to pain, such as mapping the human genome and sophisticated imaging modalities, he added.

"We have made tremendous advances in understanding the neurobiology of pain. The field of pain is in a great position to take the knowledge we have and translate it to help human suffering," he added. "We will need to have adequate resources to do this."

Dr. Fillingim said that one of the challenges is getting the government and to acknowledge that pain is a major public health problem. "It's the wrong time and the wrong atmosphere to secure more funding for pain research. We can't rely on the federal government. We need to identify other sources of funding in private and foundation sectors." He emphasized that the suffering is profound for many of the100 million people in the United States with various types of pain.

In addition, the US public needs to be educated about the human and financial toll of pain, he said. A recent national opinion poll conducted by Research/America showed that only 18% of respondents perceived chronic pain as a major health problem, while nearly 50% of respondents said that addiction to painkillers was a major public health problem.

"If we had better pain management and more interdisciplinary management, I’m confident that we could reduce the misuse of opioids," Dr. Fillingim said. He noted that although the multidisciplinary approach to drug misuse and abuse has been shown repeatedly to be effective, funds have dried up for this strategy.

"Reimbursement issues sounded the death knell for multidisciplinary clinics," he said. "With healthcare reform, we hope to get back to that model."

Dr. Landis has disclosed no relevant financial relationships. Dr. Fillingim disclosed financial ties with Algynomics, Cytogel Pharma, Curatio Medical Education, and Medscape.

American Pain Society (APS) 32nd Annual Scientific Meeting. No abstract. Presented May 9, 2013.

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