$4 million offered for pain solutions

New technology sought to combat opioid crisis

WASHINGTON – Every year, millions of Americans will go to their doctors complaining of pain, and their doctors will ask them to rate their degree of discomfort on a zero-to-10 scale or using a range of smiley-face symbols.

The doctor will have to take their word for it. And then, all too often, the doctor will prescribe a powerful and addictive opioid painkiller.

It’s a longstanding — if imprecise and subjective — way of measuring and treating pain. And it’s at least partly responsible for starting an opioid addiction crisis that killed 64,000 people last year.

“One of the things we heard from many physicians is that the pain-specific indicator contributed to this crisis,” said Kellyanne Conway, President Trump’s top adviser on the opioid crisis. “We don’t think health care by emoji is good idea.”

So the Trump administration, which has declared the opioid crisis a public health emergency, is backing efforts to find better ways of measuring and treating pain in the hope of developing precise treatments that would be more effective than opioids — and without the often catastrophic side effects.

Next month, the National Institutes of Health will open proposals for $4 million in small-business grants to develop a device or technology to objectively measure pain. That could take the form of a blood test, a device to measure pupil dilation or software to interpret facial expressions.

NIH Director Francis Collins calls it the “pain-o-meter.”

It’s not entirely clear what the paino-meter would look like, or exactly how it would work. It hasn’t been invented — yet. But the pain-o-meter isn’t meant to be the end game. It’s actually the first step in understanding the measurable indicators — or “biomarkers” — that can indicate pain. And that, in turn, could pinpoint causes and treatments, bringing precision medicine to pain management.

But that pain data won’t exist unless scientists find a way to effectively measure it.

“People used to think that things like pain were outside the scope of scientific inquiry. It was in your head. It was subjective,” said Dave Thomas, who manages NIH’s pain and opioid research efforts. “But pain is real, your brain changes, your body changes.”

Kellyanne Conway