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
Here’s why the Lincoln Memorial Reflecting Pool went green so fast
Just days after the Trump administration completed millions of dollars in renovations on the Lincoln Memorial Reflecting Pool to make it American flag-blue, residents and online users noted it had turned a phosphorescent green.
Here’s why:
The calm, still waters of the Reflecting Pool make it an ideal nursery for algae growth. Algae need nitrogen and phosphorus to grow, and the Reflecting Pool is primarily fed by the Potomac River, which gets heavy doses of those nutrients from nearby urban and agricultural lands.
The Potomac also absorbed one of the largest sewage spills in U.S. history earlier this year when a pipe burst five miles upstream of Washington, although that event probably happened too long ago to contribute to the algal bloom today.
Untreated sewage is high in nitrogen and phosphorus. When nutrient levels are high, feasting algae can quickly reproduce.
The Department of the Interior said when the algae first appeared that it was “residual,” from the supply lines to the pool.
Experts also speculate that the darker blue color may be helping the Reflecting Pool absorb more heat. The higher temperatures promote algae growth by allowing their metabolisms to shift into overdrive.
Summer temperatures in D.C. aren’t helping. This week, temperatures are as high as 95 degrees in the city, prompting a heat alert.
The combination probably explains the excessive growth, turning the water surface an opaque green and preventing onlookers from seeing the new blue hue of the concrete basin.
Algae are important and beneficial organisms when the ecosystem is in balance. They’re the base of the aquatic food chain, fed on by herbivores of all shapes and sizes, including shrimp and juvenile fish, which in turn feed organisms higher up the food chain. The single-celled organisms use the power of the sun to produce energy through photosynthesis, similar to houseplants on your balcony.
In an effort combat the algae in the Reflecting Pool, employees of the National Park Service were seen pouring in gallons of hydrogen peroxide, a chemical commonly used in pool maintenance.
The Department of the Interior also is employing a “high-tech nanobubble ozone technology” to destroy the cells of the algae.
Ozone — yes, the same irritant that is in smog — is a gas composed of three oxygen molecules, and the small size of the bubbles allow the most gas transfer into the water, where it can damage algal cells, similar to how it irritates our lungs.
This only treats the symptoms, however. Generally, ozone nanobubbling is effective as a temporary solution for algae blooms. Longer-term fixes would have to address what makes the Reflecting Pool so ideal for algae, such as its depth, darker color and inflow of nitrogen and phosphorus.
In California, ozone nanobubbles also have been used in a project to improve water quality in the Tijuana River. The 120-mile river that runs near the border in northern Mexico and Southern California was the site of a pilot study in 2025. The U.S. section of the International Boundary and Water Commission reported that the nanobubbling reduced “odors and bacteria,” but the project concluded prematurely after a flood swept some of the instrumentation into the river.
Science
This plant extract can make a lethal drug cocktail. Can it also treat opioid addiction?
A plant extract that’s gaining popularity as a pain cure-all and has been associated with multiple California deaths in its concentrated, synthetic form has been approved for research as a treatment for opioid addiction by the federal government.
Kratom is derived from the leaves of Mitragyna speciosa, a tree native to Southeast Asia, and is commonly made into a powder or pill.
Researchers say people in the U.S. are using kratom to alleviate anxiety, treat chronic pain or as a remedy for the symptoms associated with quitting opioids, due to its ability to bind with opioid receptors in the body. But recently, public health officials have raised alarms about a component of the leaf called 7-hydroxymitragynine, also known as 7-OH, an alkaloid that has the potential for abuse and addiction in high doses.
Last year, the Los Angeles County Public Health Department linked the deaths of six county residents to the use of 7-OH mixed with other substances. The toxicology screens for some of the deceased revealed both kratom and 7-OH, leading to a countywide crackdown of products with either compound because they’re unregulated.
Although there is no scientific consensus on whether kratom has therapeutic value, the Food and Drug Administration has recommended that its potent 7-OH form be classified as a controlled substance. Consumers who use 7-OH as a pain reliever expecting an experience similar to consuming kratom are at risk, said Dr. Mason Turner, president-elect of the California Society of Addiction Medicine.
“I have a couple of patients that I work with who use 7-OH for chronic pain management, not realizing the potential of the medication, and then developed an opioid use disorder,” Turner said. “I think in that case it was very clear they were seeking it for the chronic pain, not to get high, not to have some kind of experience, but really to reduce their pain.”
About two decades ago, Turner said, the healthcare industry started acknowledging the limits and risks of prescribing opioids for chronic pain. Some doctors pulled back on prescriptions, recognizing the potential for abuse.
That led some patients to find alternative solutions, he said.
“Maybe they don’t get a good benefit, or maybe the benefit from some of the other treatments is not as robust as what they got from opioids,” Turner said. “So they seek out some of these illicit products … or they look for kratom or 7-OH to be able to mitigate the pain.”
Turner said he supports further research into kratom and regulation because “it could be worth exploring as a treatment for chronic pain.”
On June 1, the National Institutes of Health announced that researchers from the University of Florida would begin the first phase of clinical trials on kratom to evaluate it as a potential treatment for opioid addiction. The research would be done with the FDA’s approval, according to officials.
“This … is a major step toward expanding treatment options for the millions of Americans struggling with opioid use disorder, which has contributed to historically high overdose mortality rates,” said Dr. Nora Volkow, director of NIH’s National Institute on Drug Abuse, in a statement.
Interest in kratom surged in the last couple of years as users have reported consuming the compound in the form of a pill, powder or tea to treat various ailments. A John Hopkins survey conducted in 2020 reported that 91% of respondents used kratom to treat chronic pain, 67% to treat anxiety, 64% for depression and 41% to treat opioid dependence.
A more recent study by the University of Michigan and Texas State University found that more than 5 million people in the U.S., including more than 100,000 children ages 12 to 17, have used kratom, the compound experts say is growing in popularity with young adults.
In the study, which analyzed data from the National Survey on Drug Use and Health collected between 2021 and 2024, researchers say that despite numerous state-level bans on kratom across the nation, its use is at an all-time high and is increasing.
People between the ages of 21 and 34 said they used kratom at least once and 1% said they used it in the last year. The share of children ages 12 and older who said they had used kratom increased from 1.6% in 2021 to 1.9% in 2024.
The FDA has stated that neither kratom nor 7-OH are approved as drug products, dietary supplements or food additives, but that hasn’t stopped storefronts and companies from selling them as such.
Up until November you could find kratom and 7-OH products in smoke shops and specialty stores in California, but that has stopped.
“Until kratom and its pharmacologically active key ingredients mitragynine and 7-OH are approved for use, they will remain classified as adulterants in drugs, dietary supplements and foods,” the California Department of Public Health told The Times via email.
Kratom “Feel Free Classic” liquid products are displayed at a smoke shop in Los Angeles in 2024 before they were banned.
(Michael Blackshire / Los Angeles Times)
In May, the California Department of Public Health and Atty. Gen. Rob Bonta filed a complaint against Ashlynn Marketing Group Inc., accusing the company of repeatedly flouting the state’s regulations on kratom products.
The filing, submitted in the San Diego County Superior Court, seeks a judge’s order to condemn and destroy the embargoed kratom products, halt ongoing unlawful manufacturing and impose civil penalties.
The California Department of Public Health “is pursuing legal action because Ashlynn’s continued manufacture and sale of these products pose a clear and preventable public‑health risk and violates state and federal law,” said Dr. Erica Pan, the department’s director and state public health officer. “7-OH and kratom-derived products have been associated with addiction, serious health harms, overdose and death.”
The state is alleging its inspectors visited Ashlynn Marketing Group’s facility in Santee in May 2025 and found kratom powders, capsules, liquids and chewable tablets being manufactured and held for sale.
During the visit, inspectors issued an embargo to prohibit the sale and distribution of all kratom-related materials on-site, according to the complaint.
Public health inspectors conducted follow-up visits at the facility in October and April, “collecting evidence at both inspections that indicated embargoed kratom products had been moved, tampered with and repackaged,” according to public health officials.
“In addition, investigators observed evidence of continued manufacturing and distribution of kratom materials,” officials said. “The firm’s owner continues to manufacture kratom products and ships orders weekly.”
To date, the California Department of Public Health has seized more than $5 million worth of kratom and 7-OH products, a spokesperson for the department told The Times.
California and Los Angeles County are considering whether to tighten regulations or ban the compounds altogether.
Science
Scientists find a whale graveyard in the Indian Ocean that’s millions of years old
NEW YORK — Scientists have unearthed communities of marine life — including jellyfish, tubeworms and brittle stars — thriving on a whale graveyard that is millions of years old.
These graveyards form when whale carcasses fall to the sea floor, becoming a sustaining snack for nearby critters. This one, located up to 23,000 feet below the surface of the southeastern Indian Ocean, spans the largest area and is so far the deepest and oldest found.
A whale’s sheer size and the unique chemistry of its bones are the keys to forming these unique underwater neighborhoods, said Xikun Song, a biologist with the Chinese Academy of Sciences’ Institute of Deep-sea Science and Engineering.
“At the same time, the very nature of the deep ocean makes these sites exceptionally difficult for scientists to locate,” Song, who was involved with the latest find, wrote in an email.
Researchers explored the remains during multiple deep-sea submersible trips in 2023, collecting samples and mapping the extent of the necropolis. They found five carcass sites and fossils, including skulls belonging to beaked and baleen whales. The oldest bones date back 5.3 million years.
Feeding and living on the carcasses were myriad creatures, large and small, including sea cucumbers, squat lobsters and saltwater clams. Many of them are likely species that have never been documented, according to findings published Wednesday in the journal Nature.
“The potential number of specimens is just astounding,” said paleontologist Stephen Godfrey with the Calvert Marine Museum in Maryland, who wasn’t involved in the research.
Many factors likely conspired to preserve the bones for millions of years, according to the study authors. They’re dense enough to outlast attacks from bone-eating worms, and located deep enough in the ocean to avoid getting buried by dust and loose particles. The bones also were coated with a light layer of minerals from the surrounding seawater, which may have prevented them from degrading.
Why did so many whales die here? Maybe they were already living in the area and died of natural causes. A few could have perished from exhaustion or illness caused by deep-sea diving. The area’s shape, akin to the letter V, could also have funneled the remains to their resting spot, the authors wrote.
Such discoveries are important because they clue scientists into the vibrant communities that find a way to live even in remote, hard-to-reach environments.
Studying the whale graveyards “is important for understanding how life can adapt to such extreme conditions, not only due to the lack of light and oxygen but also to the incredibly high pressure,” said study co-author and paleontologist Giovanni Bianucci with the University of Pisa in Italy in an email.
Ramakrishnan writes for The Associated Press.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation.
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