Opioid crisis could offer opportunity for pain management research


Charles Helmick III, MD
Charles Helmick III, MD

Former U.S. Public Health Service Capt. Charles G. Helmick III, MD, spent more than 40 years working in public health. He spent the later years at the CDC working to raise the visibility of arthritis as a public health issue. 


During the Monday session APR Distinguished Lecture: A Public Health Approach to Arthritis & Other Rheumatic Conditions: How Growing Attention to Pain Helps, Dr. Helmick first provided a look at public health — and why arthritis and other rheumatologic conditions are public health issues. He said that more than 78 million adults in the United States are projected to have arthritis by 2040. It’s the country’s leading cause of disability and cost Americans $304 billion in expenses and lost wages in 2013. 


“The saying goes ‘that which doesn’t kill you, makes you stronger.’ Unfortunately, when it comes to chronic pain, that’s not always true,” Dr. Helmick said. “Instead of making us stronger, it often leads to reduced function and reduced quality of life.”


He said one of the reasons chronic, non-life-threatening conditions such as arthritis don’t get the attention of other diseases is that mortality as an outcome is a primary driver of research, which is a problem.


Despite this, Dr. Helmick said, throughout his career at CDC there has been an evolution in the visibility of arthritis as a public health concern. It receives far more attention today than it did 40 years ago. However, more can be done, and Dr. Helmick said he believes the silver lining of the opioid epidemic may be that pain management — and conditions like arthritis that cause pain and disability — finally gets the attention it deserves as a public health concern.


“Congress appropriated almost a billion dollars to the NIH to address the opioid epidemic in 2018 and 2019,” he said. “You’d think this is all about opioids, but about half of this money is to address pain management.”


He shared highlights from the NIH’s Helping to End Addiction Long-term initiative, which supports research to enhance pain management. 


“Reducing prescribed opioids means addressing arthritis pain management,” Dr. Helmick said.