Blowing up drug running boats in the Caribbean is one way to fight the opioid crisis, but developing a safe and effective, non-opioid pain reliever to use in place of opioids is a better alternative. I may be comparing apples and oranges, here, but blowing up drug boats stops the sale and distribution of illegal, deadly substances, while a non-opioid alternative mostly gives physicians an alternate, non-addictive, controlled prescription drug that bites into the potential for abuse opioids convey.
In February, the FDA approved suzetrigine (Journavx by Vertex Pharmaceuticals) for the short term (1 day to 2 weeks) treatment of acute pain of moderate-to-severe degree. Since entering the market, prescriptions have steadily accelerated in number with last July and August being the bulk of RX’s. The desire to have effective, non-opioid analgesics has driven this increase.
Suzetrigine works by blocking or interrupting the pain signals before they reach the CNS, ie. the brain. It does not act within the brain so it has the advantages of no sedation, no breathing depression, and no potential for addiction. The avoidance of addictive potential is the main reason for its increasing use. As long as it relieves pain by 2-points on the 0-10 self-reporting pain scale, and lacks adverse effects, it will be an opioid alternative physicians will prescribe.
Commonly, opioids cause nausea and constipation, but not suzetrigine. It is a “really low side effect medication,” ideal for the right patient and those who have a history of opioid abuse. It can be added to opioids if necessary, but that would occur in rare instances. A better use is in conjunction with NSAID’s or Tylenol (acetaminophen) where suzetrigine will increase the pain relief effect of the initial drug eliminating the need for an opioid. It can be “first-line therapy” or “adjunctive therapy,” added to another drug. Suzetrigine has the potential to replace the need for opioids. Patients in clinical trials said it was either the “best they have ever taken” or “didn’t work.”
Use is limited to acute pain, but it can be taken for neuropathy pain if it’s used with caution. COST is the biggest hurdle with a 15-day supply costing up to $500 out-of-pocket. Prior authorization is often needed because of the drug’s newness and concern about why it’s being prescribed. Suzetrigine can reduce the effectiveness of birth control pills, a potentially serious concern.
The author of the reference calls suzetrigine “a meaningful addition to pain management.” It is approved for up to two weeks of therapy, and should be monitored closely. Many drugs at first thought to be non-addictive were found to be after a few years of use. And being alert to that outcome is advisable.
It won’t replace opioids, but it provides a safe, effective alternative in the right patient.
Reference: Salahi L. Prescriptions Rising for a New Non-opioid analgesic, but Clinicians are Still Learning Where it Fits. Medscape 2025 December 26.
