Prioritizing pain research in 2022
“What brings you in today?” That’s a question you’re likely to get when you visit your primary care physician. And the answer you’re most likely to give, statistically speaking, is pain. Pain in one form or another is the leading reason for seeking general medical care, accounting for about half of physical symptoms reported.
Pain is complex, with varied types affecting different body sites and different mechanisms. For older adults, multiple kinds and sites of pain are the norm, and the more pain reported, the more likely the impact on physical and cognitive function, quality of life, and social interactions. For physicians and families, knowing that an older adult is in pain may not always be straightforward, especially if that person has cognition or communication problems caused by stroke, Alzheimer’s disease or a related dementia, or another health condition. The COVID-19 public health crisis presented additional challenges, including disruptions in care for people living with pain.
Pain is also a multidimensional phenomenon that involves both a sensation and one’s psychological, social, and existential interpretations of that sensation. Understanding this whole-person perspective can inform both pharmacologic and nonpharmacologic approaches to pain care, which is important for older adults who may have multiple chronic conditions and take multiple medications. Research can help to address concerns about overprescribing while avoiding undertreatment, all while aiming to relieve suffering.
Addressing multiple public health crises
The opioid dependence and overdose epidemic continues to ravage our country and cause immense suffering for individuals, families, and communities. The NIH-wide Helping to End Addiction Long-term (HEAL) Initiative was launched in 2018 to improve prevention and treatment strategies for opioid misuse and addiction and to enhance pain management. Through HEAL, NIH has invested to date more than $1.5 billion to address the dual crises of poorly treated pain and opioid misuse. You can find active HEAL Funding Opportunity Announcements involving NIA here.
NIA has a long-standing interest in advancing research on mechanisms, measurement, and management of pain with aging. Most recently, NIA indicated its continued interest in this important field through two Notices of Special Interest. These announcements are intended to expand the scientific knowledge base of mechanisms, assessment, treatment, and outcomes of pain and pain-related conditions in aging humans and animal models:
- Notice of Special Interest: Research on Pain, Pain Management, and Opioids in Aging
- Notice of Special Interest: Availability of Administrative Supplements for Research on Pain, Pain Management, and Opioids in Aging
New opportunities for advancing pain research at NIA and beyond
There is more potential good news for pain research on the horizon. Recognizing the critical need for additional research on pain and to improve pain management, the Fiscal Year 2022 budget proposals from the President, House, and Senate each provide increased pain research funding to several NIH Institutes and Centers, including NIA. You can read more in this jointly authored message to the scientific community. If you are interested in helping to expand the science of pain, please leave a comment below and stay tuned to NIA for future updates.
There are numerous barriers to pain assessment and effective management in the ICU setting that are unique to older populations. I look forward to seeing more RFAs in this area.
We agree, and we welcome research applications to better understand these barriers and test improved approaches to helping critically ill older adults with pain.
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