The AAMC, as a member of Friends of VA Medical Care and Health Research (FOVA), May 24 hosted a standing room-only Congressional briefing titled “Understanding Opioids and Chronic Pain: From Bench to Bedside.” Presenters included Rachel Ramoni DMD, ScD, Chief Research and Development Officer at the Department of Veterans Affairs (VA) and three researchers with dual appointments at different VA medical centers and the affiliated academic medical centers.
Dr. Ramoni opened the discussion by citing that six Veterans die each day due to opioid overdose. She emphasized the need for the VA research program to invest in projects across the research continuum, from better understanding how opioids work at a cellular level through bench research, and then at the bedside, how doctors can take a team-based, personalized medicine approach to treating Veterans’ chronic pain. Dr. Ramoni further noted that VA research projects studying opioids and other issues broadly must be well supported because the program supports research that is not duplicated in other agencies, and VA research is expected to be implemented quickly at the bedside, which is a costly transition from the lab.
The researchers then presented VA-funded projects covering the bench to bedside continuum of understanding opioids and chronic pain. Erin Krebs, MD, MPH of the Minneapolis VA and University of Minnesota presented her research on the effectiveness of opioids for chronic pain. Her work concluded that opioids should not be initiated to treat chronic back and arthritis pain in Veterans. Matt Bair, MD, MS of the Roudebush VA and University of Indiana highlighted eight ongoing VA-funded studies into chronic pain in combination with other health issues such as anxiety and depression. Many of the projects include collaborative, team-based clinical management of enrolled patients. The briefing concluded with Sulayman Dib-Hajj, PhD, of the West Haven VA and Yale University presenting on basic research into pain signaling in neurons. Dr. Dib-Hajj described the discovery of a genetic cause of severe pain disorders, and the subsequent drug target validation and clinical trial resulting in fewer, and shorter pain attack episodes in affected patients.
The briefing concluded with a variety of questions, which allowed the panel to touch on VA research more broadly. Drs. Ramoni and Dib-Hajj touched on the great expense of conducting research, with the increasing costs of biomedical inflation, and with VA’s push towards clinical trials and implementation. Drs. Krebs and Bair highlighted the advantages of conducting clinical research in the VA setting with a more streamlined system to implement their research. They touted the VA as a model for patient care that other non-VA medical centers can learn from.