In the early 2010s, public awareness of a growing opioid crisis began building. By 2017, the U.S. Department of Health and Human Services declared a public health emergency to address the opioid epidemic, which is responsible for the deaths of more than 47,000 people a year in the U.S. While information about the opioid epidemic often focuses on those deaths and the misuse of and addition to opioids, the issue is complex and finding a solution will require a multifaceted mindset and approach.
That’s where the Comprehensive Pain and Addiction Center (CPAC) comes in. The newest center at the University of Arizona Health Sciences, the CPAC will address the opioid epidemic from all angles, including addiction, chronic pain, education, legislation, clinical trials and research.
“Everybody seems to know somebody with an addiction problem,” said College of Medicine - Tucson department head and professor of pharmacology Todd Vanderah, PhD, who spearheaded the strategic initiative to develop the CPAC at the university. “We have several core groups of faculty here who are probably some of the leading groups of faculty working on the topics of chronic pain, addiction and neonatal abstinence. The CPAC is an opportunity to pull multiple groups together as a team in moving forward.”
The center will address the opioid epidemic from several fronts, ranging from preclinical and clinical research to clinical care, education, legislation and technology development.
Approximately 100 million people in the U.S. are affected by chronic and acute pain, which negatively impacts people’s lives in significant ways and increases rates of morbidity, mortality and disability. Yet, Vanderah says, “We don’t do a great job in treating chronic pain, since physicians have been limited to the idea of simply prescribing an opiate.’”
Consequently, many scientists, Vanderah included, are researching alternatives to opioids for managing chronic pain and testing those novel molecular compounds in preclinical studies at UArizona. The CPAC offers researchers an opportunity to build on those preclinical tests through medicinal chemistry, drug formulation and pharmacokinetics, and, potentially, clinical trials of Food and Drug Administration-approved investigational new drugs.
“There’s an opportunity to have not only preclinical research, which a lot of us do, but also a component that would be clinical, so that we can actually work with the clinicians here to help people with chronic pain and addiction,” Vanderah said. “It would be like a dream to go from the chemistry of actually making new compounds, all the way through to patient trials and getting something accepted by the FDA for use worldwide.”
Vanderah envisions the center working closely with other College of Medicine – Tucson units including the Department of Anesthesiology’s Chronic Pain Management Clinic, led by associate professors Mohab Ibrahim, MD, PhD, and Amol Patwardhan, MD, PhD, as well as the UArizona Arthritis Center, headed by professor C. Kent Kwoh, MD. The CPAC will also have a special clinical focus on opioid addiction in newborns, which is a research focus of clinical associate professor Mo Bader, MD, and Lisa Grisham, neonatal nurse practitioner in the Department of Pediatrics, and clinical instructor Heather Miller, MD, in the Department of Obstetrics and Gynecology.
"I think the biggest impact the new center will have is on our community here, in the state of Arizona."Todd Vanderah, PhD
The CPAC will also foster collaborations with biomedical engineers to develop devices and technologies to help predict and prevent substance abuse, as well as help save people’s lives in overdose situations. The administration of naloxone and suboxone, used to treat opioid overdose and addiction situations, requires special training, which will also be provided through the CPAC. Several individuals from the Mel and Enid Zuckerman College of Public Health, including Ben Brady, DrPH, Alyssa Padilla, MPH, and Dan Derksen, MD, are helping with those efforts. The university has already initiated telemedicine naloxone training for continuing medical education credits and plans to expand that program through the new center.
“I think many physicians don’t know enough about opiates and addiction, but also it’s getting the information to the public and in the schools,” says Vanderah, who counts outreach and education as one of the center’s vital missions. “I think the biggest impact the new center will have is on our community here, in the state of Arizona. We can help the community with their chronic pain. We can help with understanding one’s addiction(s), and we can get education out to everybody to better understand how these things can influence the health and wellbeing of patients, their families and friends.”
The Comprehensive Pain and Addiction Center will be managed by a board made of up one representative from each of the five colleges in UArizona Health Sciences: College of Medicine – Tucson; College of Medicine – Phoenix; College of Nursing; College of Pharmacy; Mel and Enid Zuckerman College of Public Health and a community member.