ARTICLE SUMMARY:
Armed with a $30 million grant from BACPAC, which is part of the 2018 congressionally mandated program to end the opioid crisis, Jeff Lotz’s REACH group at UCSF is developing more accurate, nuanced diagnostic tools and classification categories of back pain. BACPAC’s goal is to bring precision medicine to this notoriously challenging and complex field.
Low back pain is common among adults and a leading cause of disability and opioid addiction. Various experts estimate that up to a third or more middle-aged adults experience lower back pain lasting more than a day, and while for many, the symptoms resolve on their own, for others, the pain lingers. Despite the prevalence, standards to diagnose and characterize the condition are lacking, often leaving primary care physicians or other non-experts with the tough task of identifying causes and optimizing treatment. Lower back pain is the second biggest indication cited for opioid use disorder, behind cancer.
As part of a congressionally funded mandate to end the opioid crisis, the National Institutes of Health in 2019 awarded nearly $1 billion to institutions throughout the US to work on its Helping to End Addiction and Lessen Substance Abuse Disorder (HEAL) initiative. One of the cornerstones of HEAL is the Back Pain (BACPAC) Consortium, which is a translational research effort to look for effective, nonaddictive and personalized therapies for chronic low back pain. BACPAC has multiple components to it, including the establishment of three mechanistic research centers (MRCs), which combine translational and clinical research in efforts to understand the relationships among biology, biomechanics, psychology, and socioeconomics, with the goals of developing innovative diagnostics and therapeutics. Other BACPAC constituents are seven university-based technology centers, and a Data Integration, Algorithm Development, and Operations Management Center (DAC) at the University of North Carolina at Chapel Hill (UNC), which coordinates all the data generated by the researchers.
The University of California, San Francisco (UCSF) MCR, under the direction of Jeffrey Lotz, PhD, has received $30 million from three of a total of 13 BACPAC five-year grants to support its work—two other MRCs are at the University of Pittsburgh and the University of Michigan.
Lotz is the David S. Bradford Endowed Chair in Orthopaedic Surgery at UCSF and vice chair of research within the department. Conor O’Neill, MD, director of the department’s nonoperative spine program is also a director of the MRC, which at UCSF is entitled REACH (The Core Center for Patient Centric Mechanistic Phenotyping in Chronic Low Back Pain). The goal of REACH is to define low back pain phenotypes and pain mechanisms to develop and validate new tools that are scalable for routine diagnosing and classification of patients.
We spoke with Lotz about BACPAC’s mission and potential achievements.
