Science
FDA Approves Journavx Drug to Treat Pain Without Addiction Risk
The Food and Drug Administration approved a new medication Thursday to treat pain from an injury or surgery. It is expensive, with a list price of $15.50 per pill. But unlike opioid pain medicines, it cannot become addictive.
That is because the drug, suzetrigine, made by Vertex Pharmaceuticals and to be sold as Journavx, works only on nerves outside the brain, blocking pain signals. It cannot get into the brain.
Researchers say they expect it to be the first of a new generation of more powerful nonaddictive drugs to relieve pain.
To test the drug, Vertex, which is based in Boston, conducted two large clinical trials, each with approximately 1,000 patients who had pain from surgery. They were randomly assigned to get a placebo; to get the opioid sold as Vicodin, a widely used combination pain medicine of acetaminophen (Tylenol) and hydrocodone; or to get suzetrigine.
In one trial, patients had an abdominoplasty, or tummy tuck. In the other, they had a bunionectomy. Side effects of suzetrigine reported by patients were similar to the ones reported by those taking the placebo.
The company also submitted data from a 250-person study that assessed the drug’s safety and tolerability in patients with pain from surgery, trauma or accidents.
Suzetrigine eased pain as much as the combination opioid. Both were better than the placebo at relieving pain.
Suzetrigine’s price, though, is much higher than that of acetaminophen plus hydrocodone. Patients are expected to take two pills a day, for a total cost of $31 a day. The older drug, said Dr. John D. Loeser, an emeritus pain expert at the University of Washington, is “dirt cheap” at pennies per pill.
But suzetrigine does not have opioids’ unpleasant side effects like nausea and drowsiness, and it is nonaddictive.
“There are a number of people who, once they have an opioid, want an opioid constantly,” Dr. Loeser said.
About 85,000 people a year become addicted after taking a prescription opioid, said Dr. David Altshuler, chief scientific officer at Vertex. It’s a small proportion of the 40 million prescribed opioids each year for acute pain — from surgery, accidents or trauma — but is nonetheless a large number, he said.
The story of suzetrigine began in the late 1990s with basic research by Dr. Stephen Waxman of Yale. He wondered how nerve cells signal pain to the brain.
Nerve cells have nine sodium channels — tiny molecular batteries — that generate electrical signals.
But, he discovered, two of those channels are only active outside the brain. One, called Nav1.7, is like the fuse for a firecracker, Dr. Waxman said. A nerve cell activates Nav1.7. That signal, in turn, activates a second channel, Nav1.8, which, he said, sends electrical signals of pain to the brain.
It seemed that a drug that could block Nav1.7 or Nav1.8 could be a potent pain medication that would have no effects on the brain, and therefore would not be addictive. (Dr. Waxman is not paid by Vertex, but does consult for other companies working on similar drugs.)
But there was another piece of the puzzle: Were these lab results applicable to humans?
If the lab work was predictive, people with mutations that made Nav1.7 or Nav1.8 fire constantly would be in constant pain. And people with the opposite mutation — one that blocked the channels — should feel no pain.
Both sorts of mutations would be extremely rare, if they existed.
Dr. Waxman contacted pain physicians across the entire Northern Hemisphere, asking if they had patients who had constant, intractable pain that could be caused by mutations that made Nav1.7 or Nav1.8 overactive. He came up empty-handed.
Then, in 2004, the Erythromelalgia Association told him about a family in Alabama whose members were wracked with pain. Most had ended up addicted to opioids and were unable to go to school or to work. Their condition was called “Man on Fire syndrome.”
Dr. Waxman and his colleagues found that the members of this family had a mutation in the Nav1.7 channel that made their pain nerves fire constantly.
Another group of researchers reported that a family in Pakistan whose members felt no pain had a mutation that blocked the same channel from firing. People called them firewalkers because they could walk on hot coals and feel nothing, which they did for money.
Vertex’s new drug, which blocks the Nav1.8 channel, is highly specific — the other sodium channels are left alone by the drug. Suzetrigine’s effects disappear when people stop taking the pills.
But although people with acute pain might need such a drug, there is also another group that needs pain relief but has few good options — those who have damaged nerves that cause constant pain, called peripheral neuropathic pain. That group includes people with diabetes, which can make the hands or feet hurt or go numb, among other symptoms. And it includes people with lumbosacral radiculopathy, or pinched nerves in the spine. Sciatica is one form of this condition.
In small studies, Vertex found that suzetrigine helped those with diabetic neuropathy, but was no better than placebo in those with pinched spinal nerves.
But, Dr. Altshuler said, the company is going ahead with larger studies in both groups of patients. While analysts and researchers deemed the results disappointing in patients with pinched nerves in their spines, the company decided to proceed because there are no approved drugs for the painful condition, and because the drug is safe and “the mechanism of action is so clearly validated.”
“No one has ever helped these four million people,” he said.
Science
What to plant (and what to remove) in California’s new ‘Zone Zero’ fire-safety proposal
After years of heated debates among fire officials, scientists and local advocates, California’s Board of Forestry and Fire Protection released new proposed landscaping rules for fire-prone areas Friday that outline what residents can and can’t do within the first 5 feet of their homes.
Many of these proposed rules — designed to reduce the risk of a home burning down amid a wildfire — have wide support (or at least acceptance); however, the most contentious by far has been whether the state would allow healthy plants in the zone.
Many fire officials and safety advocates have essentially argued anything that can burn, will burn and have supported removing virtually anything capable of combustion from this zone within 5 feet of houses, dubbed “Zone Zero.” They point to the string of devastating urban wildfires in recent years as reason to move quickly.
Yet, researchers who study the array of benefits shade and extra foliage can bring to neighborhoods — and local advocates who are worried about the money and labor needed to comply with the regulations — have argued that this approach goes beyond what current science shows is effective. They have, instead, generally been in favor of allowing green, healthy plants within the zone.
The new draft regulations attempt to bridge the gap. They outline more stringent requirements to remove all plants in a new “Safety Zone” within a foot of the house and within a bigger buffer around potential vulnerabilities in a home’s wildfire armor, including windows that can shatter in extreme heat and wooden decks that can easily burst into flames. Everywhere else, the rules would allow residents to maintain some plants, although still with significant restrictions.
The rules generally do not require the removal of healthy trees — instead, they require giving these trees routine haircuts.
Once the state adopts a final version of the rules, homeowners would have three years to get their landscaping in order and up to five years for the bigger asks, including removing all vegetation from the Safety Zone and updating combustible fencing and sheds within 5 feet of the home. New constructions would have to comply immediately.
The rules only apply to areas with notable fire hazard, including urban areas that Cal Fire has determined have “very high” fire hazard and rural wildlands.
Officials with the Board will meet in Calabasas on Thursday from 1 p.m. to 7 p.m. to discuss the new proposal and hear from residents.
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Some L.A. residents are championing a proposed fire-safety rule, referred to as “Zone Zero,” requiring the clearance of flammable material within the first five feet of homes. Others are skeptical of its value.
Where is the Safety Zone?
The proposed Safety Zone with stricter requirements to remove all vegetation would extend 1 foot from the exterior walls of a house.
In a few areas with heightened vulnerabilities to wildfires, it extends further.
The Safety Zone covers any land under the overhang of roofs. If the overhang extends 3 feet, so does the Safety Zone in that area. It also extends 2 feet out from any windows, doors and vents, as well as 5 feet out from attached decks.
What plants would be allowed in the Safety Zone?
Generally, nothing that can burn can sit in the Safety Zone. This includes mulch, green grass, bushes and flowers.
What plants would be allowed in the rest of Zone Zero?
Homeowners can keep grasses (and other ground-covers, like moss) in this area, as long as it’s trimmed down to no taller than 3 inches.
The rules also allow small plants — from begonias to succulents — up to 18 inches tall as long as they are spaced out in groups. Residents can also keep spaced-out potted plants under this height, as long as they’re easily movable.
What about fences, trees and gates?
Any sheds or other outbuildings would need noncombustible exterior walls and roofs in Zone Zero — Safety Zone or not.
Residents would have to replace the first five feet of any combustible fencing or gates attached to their house with something made out of a noncombustible material, such as metal.
Trees generally would be allowed in Zone Zero. Homeowners would need to keep any branches one foot away from the walls, five feet above the roof and 10 feet from chimneys.
Residents would also have to remove any branches from the lower third of the tree (or up to 6 feet, whichever is shorter) to prevent fires on the ground from climbing into the canopy.
Some trees with trunks directly up against a house in this 1-foot buffer or under the roof’s overhang might need to go — since keeping branches away from the home could prove difficult (or impossible).
However, the board stressed it wants to avoid the removal of trees whenever feasible and encouraged homeowners to work with their local fire department’s inspectors to find case-by-case solutions.
What’s new and what’s not
Some of the rules discussed in Zone Zero are not new — they’ve been on the books for years, classified as requirements for Zone One, extending 30 feet from the home with generally less strict rules, and Zone Two, extending 100 feet from the house with the least strict rules.
For example, homeowners are already required to remove any dead or dying grasses, plants and trees. They also have to remove leaves, twigs and needles from gutters, and they already cannot keep exposed firewood in piles next to their house.
Residents are also already required to keep grasses shorter than 4 inches; Zone Zero lowers this by an inch.
Science
Video: Rescuers Mount a Likely Final Push to Save a Stranded Whale
new video loaded: Rescuers Mount a Likely Final Push to Save a Stranded Whale
By Jorge Mitssunaga
April 17, 2026
Science
1,200% jump in kratom-related calls to poison control centers in last decade, analysis shows
Over the last decade, poison control centers around the country have received tens of thousands of calls from consumers of kratom products reporting adverse and life-threatening health effects, with researchers saying reports in 2025 reached a new level. California’s poison center is reporting similar findings.
Last month, researchers analyzed information from the National Poison Data System and found that between 2015 and 2025, poison control centers across the nation received 14,449 calls related to kratom. More than 23% of those calls, or 3,434, were made last year, according to a published report in the Centers for Disease Control and Prevention. That represents a more than 1,200% increase from 2015, when only 258 calls were reported.
Officers gather illegally grown kratom plants in 2019 in Phang Nha province, Thailand. The country decriminalized the possession and sale of kratom in 2021.
(Associated Press)
Kratom is derived from the leaves of Mitragyna speciosa, a tree native to Southeast Asia. It has a long history of being used for chronic pain or to boost energy and in the U.S., research points to Americans also using it to alleviate anxiety. In low doses, kratom appears to act as a stimulant but in high doses, it can have effects more like opioids.
But in the last few years, a synthetic form of kratom refined for its psychoactive compound, 7-hydroxymitragynine or 7-OH, has entered the market that is highly concentrated and not clearly labeled, leading to confusion and problems for consumers. The synthetic form gaining momentum in the market is sparking concern among public health officials because of its ability to bind to opioid receptors in the body, causing it to have a higher potential for abuse.
Los Angeles County leaders, meanwhile, have grappled with differentiating the two and regulating the products that come in the form of powder, capsules and drinks and have been linked to six county deaths. Sales of kratom and 7-OH products were banned in the county in November.
In reviewing the data, which did not differentiate whether callers had consumed natural or synthetic kratom, researchers set out to understand the effect of what they believe is a “rapidly evolving kratom market,” and highlight the role poison centers can play as an early warning surveillance system to detect new trends.
National Poison Data System findings
The data showed that over the last 10 years, 62% of the kratom-related calls to poison control centers were from people who said they consumed the drug by itself, and the other 38% were from people who combined it with another substance or substances.
Those who consumed kratom with another substance combined it most frequently with one or a combination of the following: alcohol, opioids, benzodiazepines (like Xanax or Valium), cannabis and cannabinoids, stimulants and antidepressants.
The data also broke down hospitalizations related to kratom — adults who took it alone or in combination and experienced “adverse” health effects; and adults who took it alone or in combination and experienced more serious “moderate” or “major” health effects, including death.
Kratom powder products are displayed in a smoke shop in Los Angeles in 2024.
(Michael Blackshire/Los Angeles Times)
Hospitalizations for adults who had consumed kratom alone and experienced adverse effects increased from 43 in 2015 to 538 in 2025. For those who took it in combination and were hospitalized with an adverse health effect, the total jumped from 40 in 2015 to 549 last year.
The numbers were even higher for hospitalizations where the health effects were more serious or fatal.
In 2015, there were 76 reports of people being hospitalized after taking kratom alone and experiencing a serious health effect or dying. By last year, that number had climbed to 919. The reports of serious health effects, including death, for those who took kratom in combination with another substance grew from 51 in 2015 to 725 last year.
The research does not break down kratom-related deaths by year but states that there were 233 deaths over the 10-year study period, or just over 3% of all 7,287 serious medical outcomes. Of the total number of kratom-related deaths, 184 cases involved the consumption of multiple substances.
What California’s poison control system found in its state data
The California Poison Control System is currently reviewing its data concerning kratom-related calls but an initial analysis shows parallels to the national report, said Rais Vohra, medical director of the state poison control system.
“We have about 10% of the national population and about 10% of the national call volume with poison control,” Vohra said. “And so, not surprisingly, we were able to identify over 900 cases of calls related to kratom in that same period.”
Local researchers are still deciphering the state data but they too have found that kratom-related calls are climbing.
“It’s accelerating, which I think is one of the main points of the [published] report,” Vohra said.
A majority of calls received by poison control come from healthcare facilities where “presumably someone has a problem … severe enough to warrant calling 911 or going to the emergency room, and that’s when our agency gets involved,” Vohra said.
Kait Brown, clinical managing director for America’s Poison Control Centers, said the fact that kratom and 7-OH are federally unregulated products sold online, in gas stations and smoke shops gives people across the country easy access.
And while kratom enthusiasts maintain that it has been used in its natural form for hundreds of years, “there are new formulations that are a little bit different than how people have used it, at least historically,” said William Eggleston, a pharmacist and the assistant clinical director of the Upstate New York Poison Center in Syracuse.
People are no longer consuming kratom only as a powder or capsule but also in the form of an energy shot or extract; it’s similar for synthetic, more concentrated 7-OH products.
When regional poison centers compare their findings and experiences with the analysis of calls in the National Poison Data System, Eggleston said, “undeniably there is an increase in calls related to kratom.”
“But when you put it in the bigger perspective of all the calls … this is still a very small percentage of what we’re dealing with on a day to day basis,” he said.
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