Contributions of the Behavioral and Social Sciences in Addressing the Pain and Opioid Crises

This blog was co-authored with Dr. Wendy B. Smith, Associate Director, OBSSR

One of the central functions of the OBSSR is to facilitate and coordinate NIH's efforts on cross cutting behavioral and social science topics, such as the interrelated crises of pain and opioid addiction. In 2017, the U.S. Department of Health and Human Services declared the opioid crisis a public health emergency and developed the Five-Point Strategy to End the Opioid Crisis. As part of this effort, the OBSSR initiated activities to help coordinate and support behavioral and social science research in conjunction with The Helping to End Addiction Long-TermSM Initiative, or (NIH HEAL InitiativeSM). In this month’s blog, we highlight some of the activities that resulted in the American Journal of Public Health (AJPH) special issue on behavioral and social sciences research—“US Opioid and Pain crises: Gaps and Opportunities in Multidisciplinary Research.”

The first activity that the OBSSR undertook was to convene a diverse panel of experts with experience with these crises as part of the NIH HEAL Initiative efforts. The OBSSR—in collaboration with the National Institute on Drug Abuse, the National Institute of Neurological Disorders and Stroke, the National Center for Complementary and Integrative Health, and the National Institute on Minority Health and Health Disparities—held the 2018 NIH HEAL Initiative meeting Contributions of Social and Behavioral Research in Addressing the Opioid Crisis. The goal of the meeting was to identify key scientific information and research priorities that would inform strategies and interventions for the prevention and treatment of opioid use disorder and pain management. The diverse panelists included researchers and multiple contributors with a wide range of expertise and experiences such as researchers with expertise in pain and/or substance abuse, economics, basic science, rural communities, racial disparities, and legal and policy perspectives as well as the perspectives of people with pain and/or opioid use disorders, advocacy groups, and clinicians. This opportunity to exchange such diverse perspectives led to the panel’s final report which identifies key issues, actionable social and behavioral science priorities, and recommendations that have the potential to improve the response to the opioid crisis and alleviate the burden of pain.

In a follow-up to the March 2018 NIH HEAL Initiative meeting, an NIH-wide behavioral and social science committee was created with the participation of senior-level staff from 23 NIH Institutes and Centers. The goals of this committee included identifying needed resources, potential areas for further development, and other strategies to integrate the key recommendations from the March NIH HEAL Initiative meeting into the NIH mission to address both the opioid and pain crises. The ensuing activities included the development of funding opportunities; a workshop focused on the measurement of pain that includes behavioral, social, and biological factors; and the integration of behavioral and social factors, such as stigma, into the NIH HEAL Initiative efforts.

A major priority of this committee was to continue providing opportunities for integrating expertise and perspectives from a broad range of communities into NIH’s efforts related to the opioid and pain crises in the United States. In response to this priority, the OBSSR provided funding support for AJPH to develop a special issue. Through multiple commentaries, the special issue brings many diverse perspectives to the interpretation and understanding of the research papers included. Commentaries include those from legal professionals, government agencies, researchers, advocates, and people with lived experiences, as well as from those who describe the implications of these crises for the military and for worsening racial disparities. Research topics include prevention in both medical and work settings, policy implications from community factors and racial disparities, and challenges related to data capture that often inform the foundation for policies and next steps. This issue is designed to stimulate the focus on the biopsychological, behavioral, and social aspects of the interrelated opioid and pain crises that have continued to escalate in the United States.

We hope this blog gives you a feel for some of the types of cross-cutting activities the OBSSR facilitates and supports. We also hope you take the time to read and share the articles and commentaries in the AJPH special issue.