Helping to End Addiction Long-term® Initiative (NIH HEAL Initiative®)

Why is the NIH HEAL Initiative a priority for NIMH?

Many people with an opioid use disorder also experience a co-occurring mental disorder, and over a quarter of these are serious mental illnesses resulting in functional impairment that substantially interferes with major life activities. However, in 2020, more than half of adults with both opioid use and mental disorders had received no mental health services in the past year.

The widespread use of opioids to treat acute and chronic pain has worsened the crisis. People with a diagnosed mental disorder are more likely to be prescribed opioids and have a greater risk of opioid addiction and overdose. Thus, mental illness can make people more vulnerable to opioid use disorder and vice versa. Similarly, people with an opioid use disorder have higher rates of suicide, and the risk is greatest among those who also have a mental disorder.

NIMH prioritizes research that helps people experiencing both mental health and substance use disorders. Through the NIH HEAL Initiative, NIMH is finding ways to provide better care to people experiencing opioid use disorders and mental disorders and reduce suicide risk.

The NIH HEAL Initiative supports a range of programs to develop new or improved prevention and treatment strategies for opioid addiction and co-occurring mental disorders. The initiative also supports solutions to mitigate suicide risk and expand suicide prevention efforts for people who misuse opioids, have an opioid use disorder, or experience acute or chronic pain.

What is NIMH’s role?

NIMH leads a research program that seeks to optimize the delivery of services for people with opioid use disorders, mental disorders, and suicide risk. The program supports a range of innovative services and intervention research to develop, optimize, and test approaches to improve the delivery of care for this vulnerable population. 

• NIMH oversees research to adapt the collaborative care model  to meet the needs of people with opioid use disorder and co-occurring mental disorders. The collaborative care model is a specific, evidence-based service delivery model for treating mental and behavioral health conditions in primary care settings.
• NIMH supports a program aimed at reducing suicide deaths  by identifying people who are at risk in primary care. Known as the System of Safety (SOS) , the program seeks to standardize suicide risk identification and prevention throughout health care systems. In another project, researchers are developing a clinical decision tool that prompts primary care providers to assess patients for both opioid use disorder and suicide risk and connect them with appropriate resources.
• NIMH is helping improve how we identify and treat  mental health, substance use, and pain. Researchers are working with third-party payers to optimize a highly effective intervention known as Maintaining Independence and Sobriety through Systems Integration, Outreach, and Networking (MISSION) . By breaking the intervention into evidence-based components and testing different combinations, the goal is to identify the optimal components that are both effective and affordable.

These three projects are just a few examples of NIMH’s research program aimed at providing services to people with opioid use disorder and mental health needs. All the projects involve conducting large clinical trials and using innovative designs in real-world community settings. Program goals include:

• Developing improved screening tools to identify people with opioid use disorder and co-occurring mental disorders
• Creating efficient referral pathways to medication-based treatment for people with opioid use disorder and co-occurring mental disorders
• Assessing the cost, effectiveness, and sustainability of interventions and services, including in rural and urban areas and areas with a shortage of health care professionals
• Identifying high-value components of complex interventions   
• Building new service delivery models for people with opioid use disorder and co-occurring mental disorders
• Equipping primary care providers to identify and treat people at elevated suicide risk, with a focus on people with opioid use disorder who are at higher risk
• Developing new tools to help primary care providers identify people at risk for suicide and provide them with critical services

Together, this research program will help expand therapeutic options for treating addiction, including medication-assisted treatment for opioid use disorder and overdose reversal treatments. The research will also improve evidence-based treatments for mental disorders frequently encountered in primary care.

Contact information

For additional information on NIMH’s role in the NIH HEAL Initiative, please contact Michael Freed, Ph.D., at michael.freed@nih.gov. For general inquiries about the NIH HEAL Initiative, contact HEALquestion@od.nih.gov.

Learn more about the NIH HEAL Initiative

Additional resources

• NIH HEAL Initiative website 
• NIH HEAL Initiative Research Plan 
• NIH HEAL Initiative Open Funding Opportunities 
• HEAL Public Access and Data Sharing 
• Helping to End Addiction Over the Long-Term: The Research Plan for the NIH HEAL Initiative  
• Substance Use and Co-Occurring Mental Disorders health information page
• National Institute in Drug Abuse's Role in the NIH HEAL Initiative 
• Opioid-Related Research Supported by the National Institute of Child Health and Development 
• National Institute of Neurological Disorders and Stroke's Role in the NIH HEAL Initiative 
• National Center for Advancing Translational Sciences' Role in the NIH HEAL Initiative 
• National Center for Complementary and Integrative Health's Role in the NIH HEAL Initiative 
• NIH Pain Consortium HEAL Research Spotlight 
• A Whole Health Approach for Treating Opioid Addiction and Mental Illness 
• Taking Suicide Prevention into Primary Care Settings 
• When Addiction and Mental Illness Collide 

Science news and research highlights

• NIH Launches HEAL Initiative, Doubles Funding to Accelerate Scientific Solutions to Stem National Opioid Epidemic 
• NIH HEAL Initiative: Research Meets the Moment to Address the Opioid Public Health Crisis 
• NIMH and the NIH HEAL Initiative: Collaborating to Address the Opioid Epidemic
• NIH HEAL Initiative: Science Taking on Pain, Opioid Misuse—and Poor Sleep 
• Deep Brain Stimulation for Severe Opioid Addiction 

Last Reviewed: January 2023