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The first non-opoid painkiller

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Re: The first non-opoid painkiller

#51

Post by pbhjpbhj »

gorjusborg wrote: post #34
Snoozus wrote: post #5

This is clickbait, there are at least two classes of non opioid painkillers in use since a long time. https://en.wikipedia.org/wiki/Analgesic

I don't feel the title is misleading, but it may be a cultural language difference. 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.

>The term 'painkiller' is reserved for strong pain relief

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).

Re: The first non-opoid painkiller

#52

Post by ck2 »

While suzetrigine is fascinating and great to see development in that field

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...

Re: The first non-opoid painkiller

#53

Post by rob74 »

ggm wrote: post #2

Colloquially acetaminophen/paracetamol and ibuprofen are "painkillers" but this is in a different class, it's amazing to have something which performs like the opioid pain relief but without at least some of the side effects. 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.

I would certainly consider ibuprofen a "painkiller", it works wonders when I get a headache. So the phrase "the first non-opioid pain reliever suitable for treating post-surgery pain" used later in the article should actually have been the title IMHO...

Re: The first non-opoid painkiller

#54

Post by OJFord »

biofox wrote: post #30
OJFord wrote: post #9

I think a better title here than: > 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. https://www.iasp-pain.org/resources/terminology/

I'm a neuroscientist by training, and that doesn't match my understanding (although the definitions might have changed). 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…

I'm happy to take that correction - I have no training in any relevant field - I was just trying to follow the description in TFA, which links indirectly to my link above in the second paragraph or so as 'nociceptive pain'; from which I inferred that's all it's talking about and existing non-opioids must therefore not target that.

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?)

Re: The first non-opoid painkiller

#55

Post by petesergeant »

gorjusborg wrote: post #34
Snoozus wrote: post #5

This is clickbait, there are at least two classes of non opioid painkillers in use since a long time. https://en.wikipedia.org/wiki/Analgesic

I don't feel the title is misleading, but it may be a cultural language difference. 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.

> The term 'painkiller' is reserved for strong pain relief,

In which dialect of English do you think this is true?

Re: The first non-opoid painkiller

#56

Post by perching_aix »

jjulius wrote: post #50
perching_aix wrote: post #44

Earlier quoted context omitted.

Sure, it just feels like an incomplete justification to completely prevent a drug from entering the market and being used. Also, that was just the hypothesized mechanism at play, it may not have been what was actually happening, which is the other "ugh" part to this. That said, the article may not be fairly representing what happened in the first place, so...

>Sure, it just feels like an incomplete justification to completely prevent a drug from entering the market and being used. 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…

> 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.

Re: The first non-opoid painkiller

#57

Post by bheadmaster »

skerit wrote: post #27
bheadmaster wrote: post #21

Earlier quoted context omitted.

> even the "pain relief" provided by sticking a knife through your skin to the bone is addictive > 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: Crucially, opioids don’t just kill pain: they also incite pleasure. When the mu opioid recep…

What is this thread? Sticking a knife through your skin to the bone kills pain and is addictive?

It's a hyperbole.

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".

Re: The first non-opoid painkiller

#58

Post by esperent »

perching_aix wrote: post #44
dakial1 wrote: post #42

Earlier quoted context omitted.

Well, pain exists for a reason for animals to pay attention to things that are harming the body. If you remove the flag (pain), harm will continue.

Sure, it just feels like an incomplete justification to completely prevent a drug from entering the market and being used. Also, that was just the hypothesized mechanism at play, it may not have been what was actually happening, which is the other "ugh" part to this. That said, the article may not be fairly representing what happened in the first place, so...

> Also, that was just the hypothesized mechanism at play, it may not have been what was actually happening

The more I learn about pharmacology, the more I realize this is the norm, rather than the exception.

Re: The first non-opoid painkiller

#59

Post by mrweasel »

dakial1 wrote: post #42
perching_aix wrote: post #38

> Another example involves nerve growth factor inhibitors like tanezumab. Although tanezumab alleviated inflammatory pain from conditions like osteoarthritis, Phase III trials revealed an unfortunate side effect: rapidly progressive osteoarthritis. Researchers hypothesized that because patients felt so much better, they overused their arthritic joints, accelerating damage. Although further trials were conducted at lo…

Well, pain exists for a reason for animals to pay attention to things that are harming the body. If you remove the flag (pain), harm will continue.

That's a very real concern. A friend of mine has a higher than normal threshold for pain and have permanent injuries as a result. Among other things has walked around on a broken foot for months and failed to register a back injury. All of this then escalated to the point where she feels the pain, but the injuries have become permanent.

Re: The first non-opoid painkiller

#60

Post by jjulius »

perching_aix wrote: post #56
jjulius wrote: post #50

Earlier quoted context omitted.

>Sure, it just feels like an incomplete justification to completely prevent a drug from entering the market and being used. 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…

> 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... ..…

>Why do you present this as an either/or?

>... 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.

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