Funded Projects

Social determinants of health are individual and environmental factors that affect health, the ability to function, and quality of life. This project will study the impact of the family-focused Families Actively Improving Relationships (FAIR) prevention intervention currently offered in rural Oregon counties to parents experiencing substance use and mental health challenges. Through the FAIR program, participants receive substance use treatment services; mental health treatment services; parent management training; and support to access employment, housing, education or to mitigate exposure to violence and discrimination. This research will examine how the FAIR intervention affects substance use and societal determinants of health, toward informing payors and decision makers about the cost and value of FAIR prevention services in rural communities.

The science of recovery support services for individuals choosing to take medications for opioid use disorder as part of their recovery pathway is gaining momentum and will benefit from a dedicated, sustainable cross-project research infrastructure. This project enhances research in the existing Consortium on Addiction Recovery Research Science. This effort coordinates varied research and training efforts across recovery support research projects, amplifies communication and dissemination channels for their activities, and is organizing the first national meetings on addiction recovery support services science.

Many millions of Americans experience chronic pain, including about 25 million who report pain that substantially interferes with daily activities and reduces quality of life. Many chronic pain syndromes are more prevalent in females, and the incidence of chronic pain increases dramatically during adolescence. This research will use neuroimaging and other biological, social, and psychological data from a large study of young adolescents with or without pain to identify risk and protective factors for chronic pain.

Use of both opioids and stimulants is increasing, but little is known about how polysubstance use evolves over time and how it influences overdose risk. This project will use data from two groups at high risk for overdose: i) participants in the AIDS Linked to the IntraVenous Experience (ALIVE) study who inject drugs and ii)  participants in the new Stimulant Opioid Non-Injection Cohort (SONIC) study. This research will identify drug use patterns and their association with treatment and overdose over time – toward informing overdose prevention efforts and interventions to improve the U.S. opioid crisis.

During the COVID-19 public health emergency, the Substance Use and Mental Health Services Administration relaxed regulations for take-home dosing of methadone, offering an opportunity to improve methadone treatment access and address racial and ethnic disparities. This project aims to address regulatory, legal liability, and financial concerns related to clinical practice changes in opioid treatment programs. The project will first review state administrative data and conduct qualitative interviews to inform the intervention approach. The project will then evaluate an opioid treatment program intervention involving take-home methadone and its effect on take-home dosing, retention in care, and health outcomes for Black/African American and Hispanic/Latino individuals who take methadone for opioid use disorder.

Pain in the muscles and surrounding connective tissue (myofascial pain) is a significant health concern affecting hundreds of millions of Americans. Understanding and managing myofascial pain has been limited due to a lack of tools to help clinicians diagnose and treat this disorder. While past efforts to understand myofascial pain have focused on impairments in how connective tissues connect to other tissues in the body, this project will use a new imaging technique to study myofascial tissue physical properties, including how they move in the body and their structural stiffness. This research will identify an imaging biomarker to be used in a randomized controlled clinical trial to predict patient responses to a myofascial pain treatment.

The Early Phase Pain Investigation Clinical Network (EPPIC-Net) conducts comprehensive analyses of observable traits (deep phenotyping) and aims to identify molecular and physiological signatures to help characterize specific pain conditions. To achieve these goals, researchers collect complex data using technologies such as magnetic resonance imaging of the brain, actigraphy, and electroencephalography. There is a need to train researchers to be able to extract key information from high-powered computing resources now widely available.  This research will complement the goals of EPPIC-Net by enhancing development of novel statistical methods to analyze complex data generated by EPPIC-Net pain studies.

Pain in muscles and surrounding connective tissue (myofascial pain) is a significant health concern affecting hundreds of millions of Americans. There is no objective way to identify and measure myofascial pain. This project will address this unmet challenge by developing a robust approach to identify imaging biomarker(s) that can distinguish different states of myofascial pain. The research will then examine the ability of identified biomarker(s) to predict patient responses to a myofascial pain treatment in a randomized controlled clinical trial.

An important step for identifying new, non-addictive chronic pain treatments is the search for new, non-opioid molecular targets that reflect the human condition. Recent findings show an increase in levels of two proteins (calcium channel alpha-2delta-1 subunit and thrombospondin) in sensory and spinal cord neurons after nerve injury. This increase is associated with the development of neuropathic pain. This project will determine if chronic injury to key nerve fibers involved in pain cause changes in rat behavior that indicate altered mood. These nerve fibers include the trigeminal nerve that communicates pain, touch, and temperature sensations from the face to the brain and the L5/6 spinal nerves often associated with back and leg pain. This research will also test whether small protein-like molecules (peptides) that block calcium channel alpha-2delta-1 subunit and thrombospondin also block the mood-related behaviors.

Prior research has shown that chronic pain is common among immigrants and refugees. Cultural preferences for pain management, combined with barriers to healthcare in the United States, result in a lack of effective and accessible pain treatment in these populations. Pain experiences and treatment preferences of non-English-speaking immigrant and refugee communities are poorly understood because of a lack of research conducted in non-English-speaking immigrants’ native languages. This research will develop effective, equitable, and sustainable interventions for individuals with both chronic pain and opioid use disorder: in particular, individuals within Hispanic/Latino and Bhutanese communities.

This research is using a pragmatic clinical trial to test transcutaneous electrical nerve stimulation in patients with widespread muscle pain and tenderness (fibromyalgia). The research will determine if the addition of TENS to physical therapy reduces pain, increases physical therapy adherence, and helps achieve functional goals with less medication use. This project will involve early career scientists who will gain access to pragmatic research tools as well as develop the skills needed to pursue a career in clinical pain research focused on fibromyalgia.

The Interagency Pain Research Coordinating Committee has reported that early-stage investigators are leaving the clinical pain research workforce for other fields. In addition, pain clinician researchers at the senior/mentor level are also exiting the field. This project will create a national training center for early-career clinicians and scientists interested in pursuing and sustaining independent careers in clinical pain research. Research will focus on rigorous scientific methods and procedures in pain research as well as the importance of stakeholder engagement.

Pain in the muscles and surrounding connective tissue (myofascial pain) is a significant health concern affecting hundreds of millions of Americans.  Myofascial pain is primarily diagnosed by asking people about their amount of pain as well as through a physical examination. Both approaches are imprecise ways to diagnose the specific type of pain a patient is experiencing and what is causing it. This project aims to improve myofascial pain management and treatment by developing ways to measure changes to soft tissues (e.g., muscle, connective tissues, nerves, blood vessels) in people with myofascial pain compared with soft tissues in people who are not in pain. The project will develop an imaging biomarker that can distinguish healthy and diseased soft tissues that may contribute to myofascial pain syndrome. The project will then test the ability of these biomarkers to predict patient outcomes in a randomized controlled clinical trial.