According to the Centers for Disease Control and Prevention, an estimated 81,806 people died in 2022 due to opioid addiction. Opioid medications are often prescribed to people suffering from acute pain, but overuse can lead to detrimental consequences. At the end of January, the US Food and Drug Administration (FDA) approved a new painkiller: Journavx. Unlike opioid medications that often carry the risk of addiction or overdose, Journavx is the first approved drug in a new class of pain management medicines that is likely not addictive.
Currently, most painkillers function by directly interacting with the central nervous system. Neurons in our nervous system communicate with each other through the use of chemical messengers called neurotransmitters. The neurotransmitters released by one neuron are received by the connecting neuron, and this continues at a rapid speed, allowing signals to be sent around the body. Opioid medications like morphine bind to receptors on neurons in the brain that are responsible for pain-signaling, preventing the release of pain signals from these neurons. At the same time, when opioid medications like morphine bind to opioid receptors, dopamine–a neurotransmitter connected to pleasure–is released, creating happy feelings. Because of this effect, when morphine and other opioids are used too frequently, the brain’s natural dopamine levels decrease, creating an addictive cycle where people rely on opioids to feel happy.
Journavx, on the other hand, helps patients avoid opioid addiction by blocking pain-sensing neurons from firing. Neurons fire due to a process called depolarization. Depolarization is triggered when sodium channels in a neuron open, allowing sodium ions to flow into the cell. The influx of sodium ions creates a charge imbalance, making the inside of the neuron more positively charged in comparison to the outside of the cell. As a result, action potentials are triggered, and the neuron fires, sending a signal to the connecting neuron. Journavx is a sodium channel blocker, selectively blocking the NaV1.8 sodium channel on pain-sensing neurons in the peripheral nervous system, preventing the neurons from generating an action potential and blocking the transmission of pain signals to the central nervous system. Because Journavx does not directly affect the receptors in the brain, it is very likely Journavx will have no addictive potential, opening a new world of pain relief options.
To test Journavx, Vertex (the pharmaceutical company selling Journavx) conducted two clinical trials that each had around one thousand patients who were suffering from acute pain right after surgery. Patients were assigned either a placebo pill, a combination of Tylenol and hydrocodone (an opioid), an opioid called Vicodin, or Journavx. The trials were randomized and double-blind, meaning that neither the patient nor the administrator of the drug knew which treatment group the patients were in. The trials showed that while Journavx is not as effective as Vicodin, it eased acute pain as well as the combination of Tylenol and hydrocodone. Additionally, the trials showed that Journavx does not cause the negative side effects that opioids do, such as nausea.
Even though the research shows that Journavx is an effective pain medication, there is one major drawback: Journavx currently costs 15.50 dollars per pill, while addictive alternatives cost only a few cents per pill. Considering the fact that patients need to take two pills per day, the price of Journavx makes it unattainable for many who might seriously need a non-opioid pain medication. As more non-addictive pain relievers like Journavx are further developed, they will likely become cheaper and more accessible, helping to reduce opioid addiction and overdose.
Journavx, a non-addictive, non-opioid treatment for acute pain. Vertex Pharmaceuticals
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