A Breakthrough in Pain Management Without Opioids

Summary

Summary of "Chasing Life" Episode: A Breakthrough in Pain Management Without Opioids

Podcast Information:

• Title: Chasing Life
• Host: Dr. Sanjay Gupta, CNN
• Episode: A Breakthrough in Pain Management Without Opioids
• Release Date: February 18, 2025

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Introduction

In this episode of Chasing Life, Dr. Sanjay Gupta explores significant advancements in pain management, focusing on a newly FDA-approved painkiller that offers an alternative to traditional opioids. The discussion delves into the drug’s development, its unique mechanism of action, potential benefits, and limitations. Additionally, Dr. Gupta addresses timely health concerns related to the ongoing flu season, providing valuable insights for listeners.

Innovative Pain Management: Journavax (Suzetrogine)

The Need for New Pain Medications

Dr. Gupta begins by highlighting a critical gap in pain management: the United States had not approved a new pain medication in over 25 years until the introduction of Suzetrogine, marketed under the brand name Journavax. He states:

“In the United States, there's not been a new medication approved for pain in more than 25 years.” (01:10)

Understanding Opioids and Their Limitations

Opioids have long been the cornerstone of pain management but come with significant risks, including addiction and dependence. Dr. Gupta explains:

“Opioid pain medications... dull the pain, acting on the brain, essentially muting the sensation.” (01:30)

How Journavax Works Differently

Unlike opioids, Journavax targets pain signaling at its source before it reaches the brain. Dr. Gupta details the drug’s mechanism:

“Journavax... prevents that signaling from happening in the first place.” (02:10)

The Fascinating Backstory

The development of Journavax is rooted in a remarkable discovery involving a family in Pakistan who could endure extreme heat without experiencing pain. Dr. Gupta recounts:

“They specifically did not have pain... a certain gene... was what was actually stopping the firing of those pain signals.” (03:00)

This genetic insight led to the synthesis of Suzetrogine, aiming to replicate the pain-blocking effects observed in the family.

Mechanism of Action

Journavax operates by blocking specific sodium channels responsible for transmitting pain signals. Dr. Gupta explains:

“It targets and blocks one of those sodium channels, specifically the sodium channel responsible for carrying the pain signal.” (04:20)

Importantly, since Journavax does not act on the brain, it does not produce the euphoria associated with opioids, thereby reducing the risk of addiction.

Side Effects and Usage

While Journavax presents a promising alternative, it is not without side effects. Common issues include itching, muscle spasms, and increased proteins in the blood linked to muscle stress. Dr. Gupta notes:

“There's also the increase of certain proteins in the blood that are often associated with stressed muscles.” (05:30)

Currently, Journavax is approved for acute pain scenarios such as broken bones and post-surgery recovery. However, its efficacy in chronic pain management, specifically sciatica, has been limited:

“Patients reported about a two-point reduction in pain... no better than even just a regular placebo.” (07:00)

Cost and Accessibility

Journavax is priced at approximately $15 per 50mg pill. Dr. Gupta emphasizes the importance of insurance coverage in determining its accessibility:

“We'll see what insurance does with this.” (05:50)

Future Outlook

As Journavax enters the market, its long-term impact on pain management remains to be seen. Dr. Gupta expresses cautious optimism:

“It is a big deal in terms of the world of pain to have a new option the first time in about 25 years.” (07:15)

Addressing the Ongoing Flu Season

Transitioning from pain management, Dr. Gupta addresses concerns about the current flu season and the timing of flu shots.

Flu Season Duration and Intensity

Contrary to popular belief, flu season extends from October to May, with February typically seeing the peak. Dr. Gupta shares alarming statistics:

“So far, there have been at least 24 million flu illnesses, 310,000 hospitalizations, and around 13,000 deaths.” (08:00)

Benefits of Getting Vaccinated Now

Even if it's later in the season, receiving a flu shot can still provide protection, especially against multiple flu strains circulating concurrently. Dr. Gupta advises:

“It's not too late to get a flu shot because this is the time where flu is really peaking.” (08:20)

He also highlights the importance of vaccination for travelers, as flu activity can vary globally:

“Flu can be active all over the globe... including from April to September.” (08:40)

Conclusion on Flu Vaccination

Dr. Gupta encourages listeners to consider getting vaccinated now to protect themselves and others, underscoring the vaccine’s role in mitigating the prolonged and intense flu season.

Closing Remarks

Dr. Gupta wraps up the episode by inviting listeners to submit their health questions for future discussions. He reiterates his commitment to uncovering and sharing critical health insights to help individuals lead healthier lives.

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Notable Quotes:

• "Pain does not exist until the brain decides that it exists." – Dr. Sanjay Gupta (01:35)
• "Journavax... prevents that signaling from happening in the first place." – Dr. Sanjay Gupta (02:10)
• "It is a big deal in terms of the world of pain to have a new option the first time in about 25 years." – Dr. Sanjay Gupta (07:15)

Key Takeaways:

• Journavax represents a significant advancement in pain management by targeting pain signals before they reach the brain, offering an alternative to opioids with a lower risk of addiction.
• While promising for acute pain, Journavax has limited efficacy in chronic pain conditions like sciatica.
• The ongoing flu season remains a critical public health issue, and receiving a flu shot, even later in the season, can provide essential protection against multiple flu strains.

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Chasing Life continues to serve as a valuable resource for listeners seeking to enhance their health and well-being by staying informed about the latest medical advancements and health recommendations.

Transcript

[A]

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[B]

And now save 50% on the new sleep number limited edition smart bed, limited time, exclusively at a sleep number store near you. See storerorsleepnumber.com for details.

[C]

Welcome to Paging Dr. Gupta. This is the show where I get to hear directly from you, and I love it. You get to send me your health questions, I get to answer them. And you've been sending in a lot of questions. Kira, one of our producers, she's back with us today as well. Kira, who's paging us first.

[D]

Hey, Sanjay. So first up today, we've got a really interesting question coming from listener Stephanie, who wants to know about this new FDA approved painkiller. What's the deal and how is it different from other prescription pain meds?

[C]

All right, Stephanie, a really important question. Something that I think a lot about pain. You know, as a neurosurgeon, I in many ways am taking care of a lot of patients who have pain. And there's been a real need for new options to try and treat pain. This may shock you, but in the United States, there's not been a new medication approved for pain in more than 25 years. I think it was 1998. Celebrex was approved. Despite the fact that the FDA approves dozens of drugs every year for all kinds of different things. We haven't made any progress in pain until now. The new medication we're talking about is called Suzetrogine. It's going to be sold under the brand name Journavax. Here's how you should think about it, Stephanie. Opioid pain medications, which you're probably familiar with, the way that they work is really by dulling the pain, acting on the brain, essentially muting the sensation, if you will. Pain does not exist until the brain decides that it exists. Okay? Brain processes pain, and that's where opioids work by basically dulling that sensation. Pain signal goes to the brain, the brain processes it, and the opioids sort of interfere with that process. Journavax, this new medication we're talking about, works in a completely different way. It essentially prevents the pain signaling from firing in the first place. There's a signal that would go from the Source of pain, your foot, your hand, whatever goes to the brain, it prevents that signaling from happening in the first place. So it's very different than how opioids work. Let me tell you a quick backstory, because this story is fascinating, of how this drug came about. There was a family in Pakistan that people had noticed were able to do things like walk on very hot coals without flinching. Now, what was extraordinary about them was not just that they could walk on the hot coals, but that they could feel the coals and they could feel that they were hot, but they did not have pain. What does that mean? That means it wasn't that they were numb to the coals, or insensate, as we call it. It's rather that they specifically did not have pain. Pain signaling. So that was a really interesting thing. So they studied this family, they found that they had a certain gene in common, and that gene was what was actually stopping the firing of those pain signals. So what this medication, susetragine, really is, is the byproduct of 25 years of work trying to replicate what that gene is able to do. It is able to take away pain sensation from a period of time. This is a medication that you would take every 12 hours, for example, when you have pain. One thing I just want to explain, neurons communicate in the body basically using nerve impulses. So sending one signal to the next neuron, to the next neuron, it's kind of like Morse code. And those impulses are powered by tiny molecular batteries called sodium channels. What Journavax does, it targets and blocks one of those sodium channels, specifically the sodium channel responsible for carrying the pain signal. Now, because it's not working on the brain, you're not getting the euphoria that's associated with opioids. And that's why you don't have really the risk of addiction or dependence. There are side effects, as all medications have side effects. Itching, muscle spasms. There's also the increase of certain proteins in the blood that are often associated with stressed muscles. So that's something doctors have to keep an eye on. Some people have developed a rash, but side effects were generally pretty mild. Right now, something important to point out is Journavax is really approved for acute pain, for pain that is just in the short term. Think broken bones, post surgery, things like that. The drug was tested on chronic back pain, particularly something known as sciatica, but the results weren't great. Patients reported about a two point reduction in pain. So if you had a pain that was a 7 out of 10. It may have reduced it to a 5 out of 10. So some benefit, but really no better than even just a regular placebo. So we will see how this sort of unfolds over the next months and years. It's about 15 bucks per 50mg pill. We'll see what insurance does with this. But again, Stephanie, I'm glad you asked the question because it is a big deal in terms of the world of pain to have a new option the first time in about 25 years. Now coming up, many of you been wondering, with this year's flu season hitting hard, is it too late now to get your flu shot? We're going to tackle that right after the break.

[A]

This podcast is supported by Sleep Number. There's a reason the Sleep Number Smart Bed is the number one bed for couples. It's because you can each choose what's right for you whenever you like. Firmer or softer on either side. Sleep Number does that one side cooler and the other side warmer. Sleep Number does that too. You have to feel it to believe it. Only Sleep Number Smart Beds let you choose your ideal comfort and support your Sleep Number setting. Sleep Number Smart Beds learn how you sleep and provide personalized insights to help you sleep better. The new Sleep Number Climate Cool Smart Bed lets you adjust up to 15 degrees cooler on either side. It's perfect for couples who struggle with sleeping too hot.

[B]

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[E]

Chasing Life is supported by Neuriva Brain Health. Listening to a podcast, reading a book, or just remembering someone's name. Things that take concentration, reasoning, mental alertness, and don't forget a good memory. Neuriva understands that maintaining optimal brain health is essential to your daily life. With clinically tested ingredients like neurofactor, Neuriva Ultra can help support up to seven brain health indicators, including memory. When you need to remember, remember Neureva. Learn [e-mail] these statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

[C]

All right, Kara, we got another page coming in, I hear.

[D]

Yes, we do. And this one's coming from listener Nancy, who wants to know, since flu season is still going strong, should she be getting a flu shot right now? Or is that just something you're supposed to do in the fall at the beginning of the season?

[C]

All right, Nancy, really timely question. Flu season isn't just a fall thing. That is a misconception. It's actually flu season can be quite long, running from October to May. And I will tell you this, flu season is really the most intense. It has been in around 15 years. Let me give you some numbers. So far, there have been at least 24 million flu illnesses. So a lot of flu out there, 310,000 hospitalizations and around 13,000 deaths. Now, people often ask what is the worst month for the flu? So we looked over the last 40 years and basically October through May and charted how many cases are happening each month. And what they find is that February has typically been the month where flu has peaked. We've seen flu activity, you know, well into March and sometimes into April. But February is really where you're going to see most of flu. At least that's been the case over the last 40 years. So your question it's not too late to get a flu shot because this is the time where flu is really peaking. Do keep in mind it takes about two weeks after you've been vaccinated to to generate enough antibodies in your body to actually have protection against the flu. Now, if you've already had flu this season, this is a really important question. You may be protected, but the issue is that there's more than one strain of flu that is circulating. So let's say it was H3N2, one type of flu that got you sick. You're not really going to have any antibodies to H1N1, which is another type of flu virus that is circulating. So that is why a flu vaccine which protects against several different viruses could still be beneficial. Also, keep in mind, if you're doing any traveling, a flu vaccine could be especially important because flu can be active all over the globe as well, including from April to September, the exact opposite of the flu season here in the United States. So, Nancy, bottom line is flu season is still going strong and getting vaccinated now can still certainly help. And that's all for today's episode. I know you got a lot of questions for me, so go ahead and send them in. Record a voice memo. Email it to asksanjayn.com or give us a call. 470-396-0832. Leave a message. I love hearing from you. I love answering these questions. And I'll be back next Tuesday. Chasing Life is a production of CNN Audio. Our podcast is produced by Aaron Mathewson, Jennifer Lai, Grace Walker, Lori Gallaretta, Jesse Remedios, Sophia Sanchez and Kira Dehring. Andrea Cain is our medical writer, Our senior producer is Dan Bloom. Amanda Seely is our showrunner, Dan Dezulla is our technical director and the executive producer of CNN Audio is Steve Lichti, with support from Jamis Andrest, John Dionora, Hailey Thomas, Alex Maniseri, Robert Mathers, Lainey Steinhart, Nicole Pesaru and Lisa Namorel. Special thanks to Ben Tinker and Nadia Kanang of CNN Health and Katie Hinman.

[A]

There's a reason the Sleep Number Smart Bed is the number one best bed for couples. It's because you can each choose what's right for you whenever you like. Firmer or softer on either side. Sleep Number does that. One side cooler and the other side warmer. Sleep Number does that too. You have to feel it to believe it. Sleep better together.

[B]

And now save 50% on the new Sleep Number Limited edition Smart Bed Limited time exclusively at a Sleep Number store near you. See store or sleepnumber.com for details.

[F]

This week on the Assignment with Me, audie Cornish. With RFK Jr poised to take over the Department of Health and Human Services, this is their time.

[G]

I'm a Crunchy Mom. Of course I'm going to keep telling you that your Brit is not filtering out what they're saying.

[F]

It is a virtual army of women known as Crunchy moms. Now that crunchy moms seem to have a direct line to those in power, how will that change the access you and your family will have to vetted health information? Listen to the Assignment with Me, Audie Cornish. Streaming now on your favorite podcast app.