With nearly 100 million people in the United States living with chronic and recurrent pain, the country is facing a societal and economic crisis.
This is further complicated by the ongoing opioid crisis, which continues to take an enormous toll on families, communities and the health care system. Patients with pain need options, and with opioid abuse at an all-time high, expediting research and development for recurrent and chronic pain treatment is crucial.
The statistics are alarming. According to the Centers for Disease Control and Prevention (CDC), on average, 115 Americans die every day from an opioid overdose. The CDC also notes deaths from prescription opioids have more than quadrupled since 1999. Families and communities have been shattered in the process.
“We’re at a critical juncture right now,” explains Rob Conley, M.D., global development leader and distinguished scholar of neuroscience at Eli Lilly and Company. “As more and more Americans are living with chronic pain, over the past decade there’s been a greatly increasing use of opioid medications, particularly to treat chronic pain, which has turned into a serious crisis.”
During the past 20 years, there’s been minimal innovation in the field of recurrent and chronic pain. Dr. Conley says it’s essential to move forward as quickly as possible the research and development of alternatives and to advance a patient-centered health care system.
A complex issue
The common denominator underlying this crisis is not addiction, misuse or prescribing practices. Rather, people living with unresolved pain depend on a health care system that offers few options for effective pain management. While physicians have used opioids to effectively treat acute pain, these treatments have not been shown to be very useful for chronic pain.
Further, diagnosing the problem can be challenging. Unlike with diabetes or high cholesterol, there’s no biomarker for pain.
“The trouble with pain is that it’s a perception,” says Conley. “Each of us doesn’t know how much pain another person is in. I think that’s one of the real difficulties.”
Understanding the challenges and unmet need of migraine
For patients dealing with migraine, for example, the pain can be excruciating.
“These are very severe attacks that include a serious headache, but it’s more than that,” Conley explains. “Nausea and sensitivity to light and sound all can come together in this debilitating disease that usually lasts hours at a time.”
For years, Lilly has been committed to developing innovative therapies for the treatment of migraine and disabling headache disorders. The currently available options provide limited efficacy and have issues with tolerability.
“I think we’re at the edge of something that has the potential to be big,” says Conley. “These drugs are not dulling your brain’s response to pain, they are really going after it at its source.”
Removing the stigma of recurrent and chronic pain
Many people living with recurrent and chronic pain are judged unfairly in the health care system and by society, which can lead to delayed diagnosis, misdiagnosis, treatment biases and decreased effectiveness of care. There’s often concern that patients are faking their pain, while others may simply grow accustomed to it.
“We want to be tough and to be there for our family and friends,” notes Conley. “You feel weak if you have pain and should be able to power through it. We are dealing with it, getting used to it.”
Developing solutions for those in need
Lilly’s goal is to make life better for people with migraine and chronic pain through ongoing research and development efforts for comprehensive solutions to address some of today’s biggest challenges in pain management.
“I feel very encouraged,” says Conley, who admits it’s been a long road. “We’ve made a huge commitment to do this work. These are things that are really happening. We’re hoping if all goes well with the medicines, we’ll have a new drug each year for the next three years.
“This is tremendously different than things were 10 or 15 years ago, when the hope was that we in medicine would create opioid-like drugs that people wouldn’t abuse. Unfortunately, we failed at that. A lot of work has gone into making sure these things are genuinely working differently than current therapies.”
Cindy Riley, [email protected]
