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Overview

The 2023 ÃÛÑ¿´«Ã½â€™s Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative®, is funded by Congress as distinct line items in the annual budgets for the  and the . Leadership at NIDA and NINDS jointly manage the HEAL Initiative, in close collaboration with partner NIH Institutes, Centers, and Offices (ICOs). NIDA leads HEAL research efforts concerning opioid use disorder and overdose while NINDS oversees HEAL research efforts to develop safe and effective therapies for acute and chronic pain to improve pain management.

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Figure 1. NIH HEAL Initiative Budget for Fiscal Years 2018 - 2025 (Dollars in Millions) for both NIDA and NINDS. *Congress approved carryover spending of the FY18 allocation into 2019. **The NIDA budget increased from $269.5 million in FY21 to $345.3 million in FY22, aligning with the broadening of HEAL scope in the congressional appropriation to expand the focus beyond solely opioids to include stimulant use, since over 40% of drug overdose deaths involve both opioids and stimulants. In FY23, both NIDA and NINDS annual budgets increased by $10 million to $355.3 million and $280.3 million, respectively. NIDA annual budget remained at $355.3 million for FY24 and FY25. NINDS annual budget was again increased to $285.3 million for FY24 and remained at that level for FY25.

HEAL Investment by Types of Research

Understanding and treating both pain and addiction are multidisciplinary endeavors that require cooperation and expertise from many different scientific areas. Accordingly, HEAL supports a variety of research approaches as exemplified by Fiscal Year 2024 (FY24) funding below (Figure 2).

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Figure 2. Chart depicting FY24 HEAL spending by research category, focusing on scientific spending and not associated administrative costs. Data based on HEAL research projects funded in FY24 as accessed in NIH RePORTER on January 17, 2025. OUD, Opioid Use Disorder; SBIR/STTR, Small Business Innovation Research/Small Business Technology Transfer.

HEAL invests in:

Novel Therapeutics for OUD and Overdose research that accelerates the development of treatments for all aspects of the opioid addiction cycle, including progression to chronic use, withdrawal symptoms, craving, relapse, and overdose - $120.7M, 21%.

Preclinical and Translational Research in Pain Management that addresses the challenges of poorly predictive animal models, changes in biopharmaceutical industry focus, and perceived regulatory and reimbursement concerns - $114.3M, 20%.

Clinical Research in Pain Management research that supports both new clinical trials and the expansion of existing programs to help establish evidence-based guidelines for treating pain with non-opioid therapies - $100.3M, 17%.

Crosscutting research that includes both OUD and pain-related research aims and data science and career development programs that represent priorities across the initiative - $60.8M, 10.5%.

Translation of Research to Practice for Treatment of Opioid Addiction research that seeks to better understand how promising, evidence-based interventions might help more people with opioid use disorder and evaluates implementation strategies for these interventions - $54.5M, 9.5%.

New Strategies to Prevent & Treat OUD research that contributes to developing new or improved prevention and treatment strategies for opioid addiction and co-occurring conditions such as mental illness and polysubstance use - $54.2M, 9%. 

Enhanced Outcomes for Infants & Children Exposed to Opioids research that advances understanding of and evidence-based strategies for neonatal and early exposure to opioids - $53.7M, 9%.

Small Business Research Programs that support eligible United States small businesses developing innovative and commercializable technologies and products to prevent, diagnose, and treat opioid use disorder and overdose, as well as to enhance pain management - $22.3M, 4%.