There’s Encouraging News for Pain Sufferers

The recent news that a final settlement would finally put Purdue Pharma, the makers of the pain medication OxyContin, out of business and settle a case that began over two decades ago comes as welcome news to many. Thousands of lawsuits have been filed against the company and its owners, the Sackler family, over the aggressive way the painkiller was marketed and the promotion of the drug as largely nonaddictive.

Under the terms of the agreement, the Sackler family, which grew very wealthy over sales of the medication, will pay as much as $7 billion over the next 15 years to settle the case. It’s believed to be the largest settlement ever with a single pharmaceutical company.

The settlement with the company is expected to result in an immediate $900 billion to cities and states, schools, and hospitals, and almost 150,000 personal injury victims, mostly from families who are raising children suffering from conditions related to opioid withdrawal.

Pain is big business in this country. It’s estimated that as many as 50 million Americans suffer from chronic pain. Many of them take Percocet and Vicodin, which, like OxyContin, are habit-forming opioids. More than two million people in this country are estimated to have an addiction to opioids and, in 2024, more than 50,000 died from overdoses.

There are also many who would like to have some relief from the pain that they suffer by not relying solely on medication. The closing author at this year’s Book Festival at the Marcus Jewish Community Center, Sanjay Gupta, has a new best seller, “It Doesn’t Have To Hurt: Your Smart Guide To A Pain Free Life.”

In his book, Gupta, a practicing neurosurgeon in Atlanta and a medical commentator for CNN, encourages pain sufferers to take charge of their pain. Since pain is largely a condition in which perception is an important component, managing our perceptions of pain may help to manage pain without drugs.

He advises patients to explore the full range of non-pharmacological alternatives to pain management. Therapies that rely on meditation, acupuncture or yoga may make a difference, particularly for those who are motivated to explore these treatments with patience and self-discipline. He advises the use of non-opioid analgesics combined with medical interventions that have been shown to be effective. For example, a technique that restores vertebrae, called kyphoplasty, has been shown to work.

Finally, he emphasizes the importance of caregivers who, when properly trained, can support those with chronic pain.

The development of new drugs that are effective against chronic pain and are not addictive has been one of the most elusive goals of medical science. It’s been 20 years since the last new drug for pain was approved. During the past several decades, there has been renewed interest in how the body perceives pain organically and how those signals are communicated to the brain. It’s this research that resulted in the latest breakthrough in pain medication.

In January of this year a new drug, suzetrigine, sold under the name Journavx, was approved. The drug, which is made by US Vertex Pharmaceuticals, blocks pain signals that travel through nerves before those signals reach the brain. It stays outside the brain and is non-addictive.

It’s expensive; the average dose of two pills per day costs $31. That’s in sharp contrast to a common prescription medication like acetaminophen (Tylenol) plus hydrocodone, which costs just a few cents per pill. But for some, the high cost may be worth paying for. In addition to being non-addictive, the drug, unlike opioids, has no side effects, such as nausea and drowsiness.

Suzetrigine works by blocking the electrical signals nerve cells send to in the brain. Those signals are sent through a pair of what are called sodium channels that are active outside the brain.

The drug took years to determine how to target the nerve channels and block them from firing. It is said to be particularly effective against those nerves that cause constant pain like when there is peripheral neuropathic pain. That can cause pain in the hands and feet or cause them to go numb. It can help those with diabetes, or the four million people with sciatica, or pinched spinal nerves.

Although the drug has had only limited success with some of these conditions, US Vertex Pharmaceuticals decided to go ahead with its marketing plans because of the encouraging research results.