Did I miss something?
EDIT: answered in sibling post, thanks @ggm!
[1]: Non Steroidal Anti-Inflammatory Drugs
They are both Nav1.8 blockers, but in Germany you can get lots of ambroxol for cheap and OTC.
Really appreciate you mentioning it
The term 'painkiller' is reserved for strong pain relief, and wouldn't include things like ibuprofen. That made me think immediately of a non-opioid pain blocker not just a pain reliever.
Having claimed it was cultural. It have been helpful of you indicated which culture you felt this applied to.
In UK I'd say painkillers includes ibuprofen and paracetamol. I suppose with ibuprofen it's also referred to as an anti-inflammatory. Not sure how else one would refer to paracetamol other than with synonyms (analgesics) or euphemism (pain relief tablet).
I particularly disagree with the parent comment that calls this click bait. The topic's intrinsically interesting to anybody who'd be lured in by that title; it doesn't need "bait" and we all know NSAIDs exist.
The article's particularly good at citing its references inline, which I very much appreciated. Added this author to my RSS reader in fact.
In which dialect of English do you think this is true?
Maybe there's some very specific, limited medical context where this is the case but in common parlance it's not at all the case, search for "painkiller" in an online shop like Amazon and you'll find a whole lot of Paracetamol/Tylenol, and various NSAIDs (aspirin/ibuprofen) and manufacturers of those drugs actually use that specific term.
Especially when the article itself compares it to ibuprofen:
> If paracetamol and ibuprofen are inadequate for pain relief, Journavx can now be prescribed as the next alternative treatment, instead of mild- to moderate-strength opioids.
"suitable for treating post-surgery pain" isn't something to cut, just for a better title. It just makes the clickbait stench of that first line even worse.
This is a better paracetamol. Which is awesome, and something we need. This is not a world first.
This is a silly headline.
> The first non-opoid [sic] painkiller
might be:
> The first non-opioid nociceptive pain-killer
Nociceptive pain being that by actual damage to tissue, as opposed to neuropathic pain like a headache or inflammation that you might take a (non-opioid!) NSAID for.
Inflammation would be an instance of nociceptive pain, and an NSAID would alleviate it by reducing the inflammation; and most tissue damage will result in inflammation.
Neuropathic pain, on the other hand, would be due to damage of the nerves themselves, and NSAIDs are completely useless here (ask anyone with sciatica or other nerve entrapment)
Perhaps non-inflammatory (or generically) nociceptive pain killing is the point. (Which is getting a bit specific for such a broad title isn't it. Does 'painkiller' ordinarily have such a narrow meaning in your experience?)
The point isn't to accurately describe it as 'nociceptive' (which I've never heard of before either) and have that be understood, it's to qualify it such that it isn't confusing or sounding like an historical tale of how whatever the first NSAID/analgesic was came to be.
If you want to see what a "non-addictive" painkiller is like, watch Dopesick.
Huh? How can a compound contain another compound. I thought opium was the term for an extract which contained opiates (compounds) and not the other way round.
---
"Opium" is the dried latex (milky fluid) that comes from the seed capsules of the opium poppy (Papaver somniferum).
Opium contains ~12% morphine, ~2.5% codeine, and ~1.5% thebaine, all of which are analgesic alkaloids that act on the μ-opioid receptors. So opium itself is a cocktail of these, plus non-analgesics like noscapine (a cough suppressant) and papaverine (a vasodilator.)
Heroin is synthesized from morphine by acetylation.
Oxycodone is synthesized from thebaine in a more complex, multi-step process.
As for the terms "opiate" vs. "opioid", the terms are sometimes used interchangeably but "opiate" generally refers to naturally occurring chemical (morphine, codiene, thebaine, etc.) while "opioid" is a catch-all Heroin is often lumped in with the opiates since it is a simple synthesis; oxycodone could be called a "semi-synthetic" opioid, and fully synthetic opioids include fentanyl, methadone, and tramadol. Relative to morphine, codeine is about 1/10th the potency, heroin is 4x, fentanyl is 50-100x, and the veterinary analgesic carfentanil (given to elephants and rhinos) is 10,000x--yikes!
Seams strange if this one truly will not have "drug abuse" connected to it.
There are also lots of studies indicating that the speed of action of a drug is important for addiction. Which essentially boils down to the fact that the brain (beeing effected by operant conditioning) needs a drug response that is sufficiently noticeable to be connected to the action of taking the drug.
Which is why some bean counter or ideologue cutting this stuff will halt progress all over the place.
Really not sure how to feel about this part lol, I mean I get it, but at the same time this is very ugh.
If you remove the flag (pain), harm will continue.
That said, the article may not be fairly representing what happened in the first place, so...
Clicking "FDA" in the bit you quoted above takes you to a different page wherein the FDA laments the lack of data around the drug (eg, the "hypothesized mechanism"). It also suggests that the companies intend to work with the FDA more on this.
Was the vote against approval a move to "completely prevent a drug from entering the market and being used", or was it a desire to better understand it before saying "okay"?
Why do you present this as an either/or?
> Clicking "FDA" in the bit you quoted above takes you to a different page
Indeed, where I found that...
> That said, the article may not be fairly representing what happened in the first place, so...
...this is exactly what happened, i.e. I was successfully misled even before reaching your false dichotomy. Yay.
>... your false dichotomy.
I appreciate you giving me the opportunity to answer your first question before coming to the conclusion that I was using a false dichotomy.
I didn't intend to present it as an "either/or", though I can see how it can be read that way. I simply read you saying that they "completely prevent[ed]" something from coming to market when, perhaps, they're not "completely" doing anything and are open to doing it provided that they know more about it. That the "incomplete justification" you lamented may also have been how the FDA felt about the data provided to them.
It could also be for other reasons, absolutely! This is just one possibility that seems very obvious to me. There's no either/or from my end.
If I didn't already conclude that you presented a false dichotomy, why would I have inquired about why you did so? It's also not set in stone; from your reply I can just change my mind afterwards. But why do it in two rounds when I can do it in one?
I understand if I came across as hostile though, I admit it was sadly reflexive, and I apologize.
> perhaps, they're not "completely" doing anything and are open to doing it provided that they know more about it.
That's not a nuance I intended to disregard. Yes, I understand they can revisit the drug's approval later, didn't mean to suggest otherwise.
Gosh I hate natural language sometimes.
Especially when it's sometimes hard to read tone, even moreso from a stranger whose communication style we're unfamiliar with. Even harder still, comments online generally don't lend themselves well to nuance and assumptions can easily be made, such as my leaning too heavily on your use of the word "completely"! Should we hug it out?
Hope you enjoy the rest of your day. :)
The more I learn about pharmacology, the more I realize this is the norm, rather than the exception.
I worry a lot about aging, and I'm also afraid of things like tumors or cancers that I might not feel until it's too late. As an example, I can't feel cavities forming and I didn't even notice my wisdom teeth piercing through my gums when I was a teen.
The agency bears zero responsibility for the pain and suffering its caused by overcaution.
Thalidomide.
Patients (and often doctors) really don't have the skills or information to make an informed decision.
They can however have 'feelings'. This is not the same thing.
To continue my example of thalidomide, the FDA's Dr. Frances Oldham Kelsey prevented millions of American babies from being born with devastating deformities.
At the same time millions of American mothers and their GP's were clamoring for the anti-nausea drug that the British mother's were enjoying. And they too said the FDA was getting in their way.
Experts aren't "made of finer clay" : they just know a lot more than the populace about specific topics. There are other topics where I am the finer clay. See 'specialisation'.
https://www.sciencedirect.com/science/article/abs/pii/S03785...
And that's not even taking into account its cardioprotective effects.
But hey, it can be hard on the stomach in SOME people so we developed alternatives with all sorts of nasty side effects, up to and including heart attacks and strokes (rofecoxib, valdecoxib, etc.) Hell, a decade ago, the FDA issued an advisory across the board that "Non-aspirin NSAIDS increase the risk of heart attacks and strokes":
https://www.fda.gov/drugs/drug-safety-and-availability/fda-d...
Some day we will look back on the attempted replacement of aspirin with these other drugs the same way we now look back on the replacement of butter with margarine (and the replacement of saturated fats with trans fats more broadly).
technically Low‐Dose-Naltrexone (aka LDN) is not an opioid and reduces pain
(however it does it by modulating opioid receptors so okay I guess it's opioid-related)
found more background here
https://www.newyorker.com/magazine/2025/06/02/the-radical-de...
I believe it's still somewhat legal for consumption in the U.S., though other countries have been moving to ban it to varying degrees, since it can be used recreationally, though it isn't known to produce the same intensity of euphoria as opioids, and can also be addictive, though I don't believe it to produce as severe withdrawals as opioids.
All in all I think it's a sadly understudied and underutilized medicine, which is the unsurprising result of pharmaceutical companies having less incentive to study plant medicines
https://www.painnewsnetwork.org/stories/2024/12/23/more-lack...
As someone else already mentioned in this thread, in Europe there is already metamizole which is used for post-surgery pain. Anyone knows if suzetrigine is more effective than metamizole?
ggm•4h ago
It's the first non opioid painkiller applicable for situations like post operative use.
I'd have loved this after my hernia op, the last thing you need with that is opioid induced constipation.
spwa4•3h ago
Plus don't forget: even the "pain relief" provided by sticking a knife through your skin to the bone is addictive. So the side effect of addiction isn't going to go away.
bheadmaster•3h ago
> the side effect of addiction isn't going to go away
While I agree with your conclusion itself, I disagree that the premise implies the conclusion. The main difference between suzetrigine and opioids, as explained in the article:
The "pain relief" provided by sticking a knife though your skin to the bone is caused by endorphine, which functions similarly to opioids, and that's why it's addictive.Since suzetrigine doesn't affect mu receptors in the brain, this mechanism doesn't apply.
But I'm almost sure it will have some other unintended side effects. Morphine had them, heroin had them, methadon had them... And each time the inventors were sure they didn't.
skerit•2h ago
circlefavshape•2h ago
nick__m•2h ago
capitol_•2h ago
bheadmaster•2h ago
Injuries generally cause brain to release endorphins, which in turn releases dopamine, causing addiction. For example, cutting is a common type of self-mutilation depressed people do. High-intensity exercise arguably also does the same thing - as your body is "microinjured" by strain, your brain releases endorphins to help with the pain, causing effects like "the runner's high".
TeMPOraL•1h ago
And the Internet is the place where you get exposed to them at random.
CjHuber•2h ago
xeeeeeeeeeeenu•3h ago
Perhaps the first approved by FDA, I don't know. In many countries, metamizole is the first-line drug for postoperative pain.
(It should be noted that metamizole may very rarely cause agranulocytosis. It is suspected that the risk varies depending on the genetic makeup of the population, which would explain why it is banned in some countries but available OTC in others.)
arthur2e5•22m ago
Tangential: China technically banned metamizole due to the agranulocytosis scare, but somehow small clinics always have fresh stocks of this stuff. And their stocks don't look like my metamizole for horses! It's pressed out of the usual magnesium stearate instead of whatever rock-hard thing they use for animal drugs in China.
arethuza•3h ago
I had kidney stones last year, by far the most painful thing I have experienced, and got opioid based painkillers which made me constipated. To try and fix that I was eating some stoned prunes and it turns out one of them wasn't stoned and I damaged a tooth (it was weak anyway and needed replacement with an implant).
bravesoul2•2h ago
OJFord•2h ago
Findecanor•2h ago
After what felt like an eternity, I myself noticed a wetness on my shoulder onto which a broken hose adaptor had leaked. After that was replaced, there were no further issues. Thankfully, the stitches had held, and I didn't get a hernia.
Also, I did have to carry a pee-bag while the epidural was in, because the epidural made me lose control of my bladder. And the epidural itself left a scar.
dcminter•1h ago
Meanwhile my understanding of Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) was that they were exactly that by definition - Anti-Inflammatories with pain being reduced by reducing the immediate cause of it, inflammation, not by interfering with the actual mechanisms of pain.
I guess one could consider general anaesthesia (laughing gas, ether, and more modern successors) to be "painkillers" too but they're obviously not quite the same category of thing.
Anyway, I enjoyed the article - it would be interesting to hear the author give their own reasons for not accounting for NSAIDs.
billforsternz•2h ago
bgeeek•1h ago
privatelypublic•1h ago
theoreticalmal•1h ago
closewith•52m ago
Yes, but:
> Responsible for 56,000 emergency department visits and 2600 hospitalizations, acetaminophen poisoning causes 500 deaths annually in the United States. Notably, around 50% of these poisonings are unintentional, often resulting from patients misinterpreting dosing instructions or unknowingly consuming multiple acetaminophen-containing products.
Source: https://www.ncbi.nlm.nih.gov/books/NBK441917/#:~:text=Acetam...
drewg123•12m ago
Does the UK have rules that prevent mixing acetaminophen with other drugs? Its getting so its sometimes hard to find over the counter cold/flu medicines without acetaminophen
stavros•48m ago
bigfudge•11m ago
hallway_monitor•9m ago
closewith•49m ago
nick__m•2h ago
It's a NSAIDs but it's not to hard on the stomach but it's somewhat hard on the kidneys. However Ketorolac is a dangerous drug if you don't follow the posology (don't take 2 pills at the same time, the therapeutic index is that narrow) or if your a poor metaboliser, it leads to kindey failure, stomach bleeding and other life threatening side effects. I would be surprised if that new pain killer was superior to this.
I am sure it's less dangerous but more effective I really doubt it.
rob74•2h ago
wtcactus•48m ago
Well, not nothing, my stomach clearly doesn’t like it and I feel it.
Human pain and painkillers response seems extremely variable across different subjects.
4gotunameagain•1h ago
In the US it seems like they prescribe opioids like candy. I've never heard of opioids post hernia surgery in Europe.
johnisgood•48m ago
stavros•46m ago
amalcon•1h ago
PaulHoule•1h ago
https://medicalxpress.com/news/2025-06-acetaminophen-discove...
arthur2e5•19m ago
PaulHoule•14m ago
https://pubmed.ncbi.nlm.nih.gov/27217114/
https://pubmed.ncbi.nlm.nih.gov/32888031/
My primary care doc doesn't want me taking either NSAIDS or acetaminophen so when I get asked at the urgent care what I take for pain I say "Nothing".
johnisgood•45m ago
If you ask me whether I choose pain or constipation, well, I am pretty sure you know the answer.
This constipation goes away once you stop, and everything depends on the dose and the frequency and duration of taking it.