FDA Approves Opioid Alternative for Pain Relief That Is Non-Addictive
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Pain relief without addiction has been a pharmaceutical goal long before the opioid crisis. A newly approved medicine appears to have achieved that.The U.S. Food and Drug Administration (FDA) approved Journavx to treat short-term pain. The drug, which was developed by Vertex Pharmaceuticals in Boston and tested as a pain treatment following surgeries, targets the nerves near an injury site instead of in the brain.It works in a way that is different than previous medications, says Paul Negulescu, senior vice president at Vertex.Blocking a Different Pain PathwaySuch alternatives are sorely needed. About 40 million U.S. adults are prescribed an opioid every year, with about 85,000 developing an addiction within the first year of use. Opioid prescriptions peaked in 2010 and decreased each year through 2015, according to a Centers for Disease Control and Prevention (CDC) report. However, they are still prescribed much more heavily than in 1999. And people turned to stronger, illicit drugs like fentanyl after doctors started prescribing fewer opioids. Read More: The Opioid Crisis Is Not OverTargeting Pain at its SourceThe basic science discovery that prompted Journavxs development started with a finding in 1997 that predated the opioid epidemic. Researchers discovered that a category of proteins named Nav were expressed in the peripheral nervous system, but not the brain.It seemed like that would be a good target to treat pain, says Negulescu. Work on the human genome later solidified that protein as a potential target. Since then, with the advent of gene sequencing, we discovered there is mutations in this protein that increase sensitivity to pain.Scientists eventually discovered a total of 9 nav proteins. Vertex researchers explored them all to see which would be the most effective in treating pain. If you study one Nav, you have to study them all, says Negulescu.They settled on Nav 1.8, because it appeared to be the strongest potential pain blocker. Decades of research and testing followed, to see what parts of that protein would be the most effective spot for a medicine to bind to, and thus inhibit pain sensations.Avoiding AddictionThe approach is promising, says Michael Schuh, a pharmacist and pain medicine expert at the Mayo Clinic, who was not involved in the research. The problem we have with opioids is that they attach to certain places in your brain that makes people feel good about taking them, says Schuh. Then people have a tendency to get a tolerance so they don't get that same feeling, so they have to take more and more and more of it.Journavx will be available in tablet form. It was tested for pain relief treatment for up to 14 days. The new drug will cost $15.50 per pill. Comparable opioids retail as generics for $1 a pill or less. Article SourcesOur writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:Centers for Disease Control and Prevention. Changes in Opioid Prescribing in the United States, 20062015Before joining Discover Magazine, Paul Smaglik spent over 20 years as a science journalist, specializing in U.S. life science policy and global scientific career issues. He began his career in newspapers, but switched to scientific magazines. His work has appeared in publications including Science News, Science, Nature, and Scientific American.
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