A UCSF Research Grant Is Addressing the Opioid Crisis by Addressing Pain Management
Dr. Sigurd H. Berven explains how an unprecedented new grant is helping to tackle the problem of low back pain and in turn, the opioid crisis.
There is no doubt the opioid crisis is one of the United States’ most urgent epidemics. According to the Centers for Disease Control and Prevention, between 1999 and 2017 almost 400,000 people died from an opioid overdose. Drug overdose is the leading cause of injury-related death in the United States.
At the root of this crisis is how people are managing often punishing pain, most significantly, low back pain. In 2016, an estimated 50 million U.S. adults suffered from chronic pain, primarily involving the lower back. Yet there are no consistently effective, durable pharmacologic interventions available to deal with this issue. Opioids remain one of the most commonly used treatments.
Now, researchers at University of California San Francisco have been given the opportunity to tackle this problem more effectively thanks to a landmark grant from the National Institutes of Health (NIH). The agency awarded 10 grants this year totaling more than $40 million to university researchers as part of the NIH Helping to End Addiction Long-term (HEAL) Initiative. Almost $30 million of it is going toward creating the Core Center for Patient-centric Mechanistic Phenotyping in Chronic Low Back Pain (REACH), made up of an interdisciplinary consortium of scientists.
We spoke to Sigurd Berven, an orthopedic surgeon chief of the Spine Service at the UCSF Department of Orthopaedic Surgery, and one of the clinical investigators on the team, about the grant.
This is the biggest grant that your department has ever received. Can you explain what makes it so extraordinary?
This is a special interdisciplinary grant. It explores both nonoperative and operative care in order to understand chronic low back pain. The priority this study was given was determined by both prevalence and impact. According to the Global Burden of Disease 2010 Study, low back pain ranked highest in terms of years lived with disability, making this the most common reason for primary care. Also, surgery for this condition is one of the most expensive. This problem has a larger impact than most common global respiratory, heart disease, osteo, or spinal disorders, even more than mental health. Eighty percent of U.S. adults will have a disability episode in their lifetime due to low back pain.
How will the grant help address the issue of opioid addiction?
Opioid addiction is what makes this grant a priority. For a large number of people, their first introduction to opioids is when being treated for musculoskeletal disorders. One out of four chronic opioid users who are taking these medicines for non-cancer reasons are sufferers of addiction. Also, opioids are often an entry point on the pathway to heroin use. Drug overdose has become the leading cause of death overall, and more of these deaths relate to prescriptions than to heroin. Is there a specific part of the population that will be most affected by this grant? Low back pain is ubiquitous. It crosses racial, social and demographic lines, so this research really could have a great impact on wider society.
How will the research for this grant be conducted?
This grant is a combined effort; it’s part of a multidisciplinary approach. We will develop models, take findings and try to figure out ways to apply these so we can develop diagnostics as well as therapeutic interventions. We are hoping to develop a more appropriate and precise approach to the broader problem of low back pain.
What do you and your colleagues hope to learn from this study?
We want to understand the biological, anatomical, pathophysiological, psychological and biosocial physiological model of this issue. If we understand this, we have an opportunity to make an impact and understand why people are using opioids. I’m optimistic about this — it’s really [addressing] an important issue and there is a great need for it.
This article originally appeared in Marin Magazine’s February 2020 issue with the headline: “Pain Point”.
Jessica is an international writer and editor who has lived and worked in London, Dubai and Cape Town. A graduate of UC Santa Cruz, Jessica is the former editor of Abu Dhabi’s airline magazine, Etihad Inflight. She also worked for six years in a creative agency in South Africa, heading up publications for wineries, jewelry companies, and even an orchestra. She then moved back to California and decided to get serious about digital, brushing up with a course at General Assembly and launching into the role of Digital Editor for both Marin Magazine and the SF Bay section of Better.net. When she’s not checking out the latest exhibit at SFMOMA or searching out the best places to eat and drink near her home in San Francisco, she volunteers at the Marin Mammal Center in Sausalito.