The federal government has awarded 13 grants worth up to a total $21.7 million over five years to examine alternatives to drugs for treating pain.
The Veterans Affairs Department, National Institutes of Health’s National Center for Complementary and Alternative Medicine and National Institute on Drug Abuse have chosen projects focusing on a range of alternative therapies for pain, including biofeedback, light exposure, meditation and chiropractic care, according to an NIH release Thursday.
“Pain is the most common reason Americans turn to complementary and integrative health practices,” said Dr. Josephine Briggs, NCCAM director. “The need for nondrug treatment options is a significant and urgent public health imperative.”
Pain management is a significant issue for service members and veterans, more than 50,000 of whom have been injured physically in combat in the past 13 years.
A study of an Army infantry brigade in JAMA Internal Medicine in July showed that following a deployment to Afghanistan, soldiers used opiate painkillers at three times the rate of civilians and nearly half the soldiers reported chronic pain three months after deployment ended, twice the prevalence of chronic pain in the general civilian population.
The report prompted retired Lt. Gen. Eric Schoomaker, former Army surgeon general, and retired Army Lt. Col. Wayne Jonas of the Samueli Institute to pen a response in the same publication, arguing for more investment in pain research and for physicians to encourage self-management techniques like yoga, tai chi and music therapy.
“The loss of human potential is inestimable,” the pair warned. “This staggering cost will become the greatest threat to national defense as the nation is crushed under debt.”
The research efforts will take place over five years. They include studies to evaluate:
■ The effectiveness of low-dose electric current to the scalp (called transcranial direct current stimulation) when combined with cognitive behavioral therapy for pain, at the Medical University of South Carolina, Charleston.
■ The feasibility of using morning bright light to treat pain and PTSD symptoms, at Rush University Medical Center, Chicago.
■ The use of mobile devices that display real-time brain activity to support biofeedback therapy for post-traumatic stress disorder and traumatic brain injury symptoms, at the University of North Carolina Chapel Hill.
■ The effectiveness of collaboration between chiropractors and mental health specialists for pain management, at Palmer College of Chiropractic, Davenport, Iowa.
■ Self-hypnosis and mindfulness meditation for reducing pain and improving quality of life, at the University of Washington, Seattle.
■ Using data from electronic health records to assess the treatment of veterans with chronic pain, with attention paid to complementary medical treatments, at Yale University.
■ Data collection to determine the prevalence of post-deployment chronic pain in active duty and reserve Army personnel and the effectiveness of nondrug treatments for pain, at Brandeis University.
■ The effectiveness of integrated programs to decrease opioid use among combat-injured service members with multiple traumatic injuries, at the University of Texas Health Science Center, San Antonio.
■ How active-duty service members respond to and use a Web- and mobile applications-based mindfulness meditation program, at Research Triangle Institute, North Carolina.
■ The use of medical health records and survey data to develop models for understanding chronic pain outcomes, at the University of Minnesota, Minneapolis.
■ Reduction of post-operative pain and opioid use with a specialized psychotherapy called Acceptance and Commitment Therapy that focuses on awareness and acceptance of difficult emotions, at the University of Iowa, Iowa City.
■ The cost-effectiveness of alternatives for treating musculoskeletal pain in veterans, at Sepulveda Research Corp., North Hills, California.
■ The effectiveness of combining ACT and mindfulness-based relapse prevention for treating pain and managing substance abuse, at the University of New Mexico.
The hope is that the research efforts not only will teach the medical community more about pain management, but also help decrease reliance on medications that are addictive or have disabling side effects, said NIDA Director Dr. Nora Volkow.
According to NIDA, roughly 52 million people in the U.S. have used prescription drugs for nonmedical reasons at least once in their lifetimes.
“Prescription opioids are important tools for managing pain, but their greater availability and increased prescribing may contribute to their growing misuse,” Volkow said. “This body of research will add to the growing arsenal of pain management options to give relief while minimizing the potential for abuse, especially for those bravely serving our nation in the armed forces.”
