Science delivers advances in reducing pain.
Saloni Dattani notes that “Suzetrigine (‘Journavx’) became the first non-opioid painkiller for surgical treatment in decades. In a phase 3 trial of 2,000 patients, it reduced pain as effectively as hydrocodone and paracetamol, but had fewer side effects and doesn’t appear to be addictive. Michelle Ma has written a great article about the history of pain medication leading up to it.”
The National Library of Medicine notes that “Opioids are effective for treating acute pain but have safety, tolerability, and addiction concerns while nonopioid analgesics have limited efficacy. Suzetrigine, an oral, nonopioid small molecule, selectively inhibits the voltage-gated sodium channel 1.8 (NaV1.8) and has potential to provide efficacious and safe relief for acute pain without addiction concerns….suzetrigine reduced moderate-to-severe acute pain over 48 h after abdominoplasty or bunionectomy. Pain reduction with suzetrigine was similar to that with hydrocodone bitartrate/acetaminophen.”
Michelle Ma explains:
In the nineteenth century, the invention of anesthesia was considered a gift from God. But post-operative pain relief has continued to rely on opioids, derivatives of opium, the addictive substance employed since ancient times. Although no other drug has managed to match the rapid, potent, and broadly effective relief delivered by opioids, their side effects have led to decades of addiction and overdose, leaving researchers keen to find a better solution.
This all changed in January 2025, when the FDA approved Vertex Pharmaceuticals’s Journavx (suzetrigine): the first non-opioid pain reliever suitable for treating post-surgery pain. Clinical trials found no signs of the problematic side effects associated with opioids: no drug abuse, tolerance, or withdrawal. But this was not an easy win: Vertex and other pharma companies spent decades searching for drugs like this to no avail.
Opioids are used primarily to treat nociceptive pain, pain caused by tissue damage from injury or disease. This damage activates nearby nociceptors: sensory neurons that signal physical or chemical harm. These nociceptors send signals up to the central nervous system – the brain and spinal cord – and the brain then creates a localized sensation of pain, drawing your attention to the threat.
