Prognosis

The Hunt fora Nonaddictive Painkiller

- Angelica Peebles

A drug that doesn't cause cravings could shake up the $22 billion opioid market

When it comes to alleviating pain, nothing beats opioids, which have been used for thousands of years to replace discomfort with euphoria. Users can easily get hooked, however, particularly with lab-made versions such as fentanyl. In the US, opioids are responsible for three-quarters of overdose deaths. Drugmakers have little to show from years of searching for alternatives that don't pose the risk of addiction, but now an experimental candidate from Vertex Pharmaceuticals Inc. offers a glimmer of hope.

The Boston drugmaker recently moved its painkiller, VX-548, into late-stage studies. The medicine blocks a sodium channel called Nav1.8, which plays an important role in telling the brain something's wrong. Sodium channels aren't anywhere near the brain, where addiction is triggered, making drugs that target them compelling potential substitutes for opioids. If Vertex can prove its drug is safe and effective, it could pave the way for a shake-up of a global opioid market estimated to be worth more than $22 billion annually. VX-548 would become a blockbuster even if it's approved only for use after surgery because the market for pain relief is so big, says Evercore ISI analyst Liisa Bayko.

"If you just take a very small slice of that, you're talking about a tremendous amount of money," she says.