A Breakthrough in Pain Management Without Opioids - Chasing Life with Dr. Sanjay Gupta - Podcast on CNN Audio

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Chasing Life

All over the world, there are people who are living extraordinary lives, full of happiness and health – and with hardly any heart disease, cancer or diabetes. Dr. Sanjay Gupta has been on a decades-long mission to understand how they do it, and how we can all learn from them. Scientists now believe we can even reverse the symptoms of Alzheimer’s dementia, and in fact grow sharper and more resilient as we age. Sanjay is a dad – of three teenage daughters, he is a doctor - who operates on the brain, and he is a reporter with more than two decades of experience - who travels the earth to uncover and bring you the secrets of the happiest and healthiest people on the planet – so that you too, can Chase Life.

Dr. Sanjay Gupta

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A Breakthrough in Pain Management Without Opioids
Chasing Life
Feb 18, 2025

Big news in pain management, the FDA has approved a new opioid-free pain medication. So how is it different from what’s already out there? Plus, if you missed your flu shot in the fall, is it still worth getting one now? Dr. Sanjay Gupta answers your questions!

Episode Transcript
Dr. Sanjay Gupta
00:00:03
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. Kyra, one of our producers, she's back with us today as well. Kyra, who's paging us first?
Kyra Dahring
00:00:23
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?
Dr. Sanjay Gupta
00:00:38
'Alright, 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 suzetrigine. It's going to be sold under the brand name Journavx. Here's how you should think about it, Stephanie, opioid pain medication, 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. Journavx, 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 is 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 back story 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 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, suzetrigine, 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 for 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 Journavx 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 dependance. 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 Journavx 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 50 milligram 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.
Dr. Sanjay Gupta
00:05:31
Now, coming up, many of you've 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.
Dr. Sanjay Gupta
00:05:44
Alright, Kyra, we got another page coming in, I hear?
Kyra Dahring
00:05:48
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 are supposed to do in the fall at the beginning of the season?
Dr. Sanjay Gupta
00:06:04
Alright, Nancy really timely question. Flu season isn't just a fall thing. That is a misconception. 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, 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 the 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 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.
Dr. Sanjay Gupta
00:08:13
'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, e-mail it to asksanjay@cnn.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.
Dr. Sanjay Gupta
00:08:35
Chasing Life is a production of CNN Audio. Our podcast is produced by Eryn Mathewson, Jennifer Lai, Grace Walker, Lori Galaretta, Jesse Remedios, Sofía Sánchez, and Kyra Dahring. Andrea Kane is our medical writer. Our senior producer is Dan Bloom, Amanda Sealey is our showrunner, Dan Dzula is our technical director, and the executive producer of CNN Audio is Steve Lickteig. With support from Jamus Andrest, Jon Dianora, Haley Thomas, Alex Manasseri, Robert Mathers, Leni Steinhardt, Nichole Pesaru and Lisa Namerow. Special thanks to Ben Tinker and Nadia Kounang of CNN Health and Katie Hinman.