Imagine you’re lying down on a hospital bed with a needle inserted in each side of your face. Every 20 seconds, you push a button to indicate how much pain you’re in. At first, you just feel a tingle, but then the pain builds. And builds. And builds.
That’s the experience of participating in a research project on pain by Alan Prossin, M.B.B.S., a psychiatrist and engineer at The University of Texas Health Science Center at Houston. Prossin works with healthy people who are scheduled to have plastic surgery and who volunteer to help him understand pain.
“They’re not so excited when they are experiencing the pain, but they’re happy to contribute to the science,” Prossin said.
Prossin’s work through the NIH Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, is part of the initiative’s research effort in discovery and validation of biomarkers for pain to create new, non-addictive treatments.
The connection between surgery and the opioid crisis
Many people first encounter opioids when the medicines are prescribed for pain after surgery. Most take opioids for only a short time, stop, and never have a problem. But for some people, those opioids lead to dependence or addiction. That’s why understanding pain and finding alternatives to opioid pain relievers are key goals of the NIH HEAL Initiative.
“One of the issues is that we don’t really have a personalized approach to dealing with pain,” said Prossin. A personalized approach to pain might include understanding how sensitive each person is to pain and whether non-opioid treatments might work better for them.
The challenge is that people vary in their sensitivity to pain. The same surgery might result in a lot of pain for one person and hardly any for another. Currently, doctors can’t know who will fall into which group. Prossin is developing new ways to predict which patients are most likely to experience pain after surgery, making it possible to tailor treatments.