Research recommendations for the HEAL Initiative: a path forward for pain research

Chronic pain conditions affect 24% of the US population and account for the greatest cause of disability, leading to tremendous suffering and lost productivity. The enormity of the problem is magnified by the dearth of safe, effective medications. We need more research that advances our understanding of pain to aid in the development of new therapies. Existing non-drug treatments are greatly underutilized for pain management despite evidence of their effectiveness, demonstrating the need for research on how best to implement these therapies. The NIH Helping End Addiction Long-term® Initiative (the NIH HEAL Initiative®) was launched in response to the opioid overdose crisis and set out to increase research and improve treatments for addiction disorders and chronic pain conditions. The HEAL Initiative® has made tremendous strides toward these goals since its initial launch in 2018. In 2024, the NIH convened a working group of external experts to assess its progress and strategize for the next five years of HEAL funding specifically for pain research. That process culminated in the production of an accepted Report containing these ten Research Priorities and five Core Principles to guide NIH leadership in planning and funding pain research within the HEAL initiative over the next five years. Here, we present these recommendations for consideration by the wider pain research community and invite further active discussion.