A game-changing painkiller – the first in 30 years that is not based on potentially addictive opioids – has been approved by regulators in the US.

Treating pain is a huge global healthcare challenge and opioids (such as fentanyl and oxycodone) are the current standard treatment of severe pain.

However, while effective, their prolonged use can lead to a high risk of addiction, driving the current widespread misuse and overdose crisis in the US and elsewhere.

Suzetrigine, marketed as Journavx by Vertex Pharmaceuticals, is a new painkiller to treat acute pain. Unlike opioids, it targets the sodium channel gates of nerve cells, that open and close like tiny doors in response to electrical signals. When they open, sodium ions pass through, triggering a chain reaction that sends pain signals to the brain.

The targeting of this gate mechanism means that suzetrigine has minimal side effects, or risks of addiction.

Animal studies with rats and mice were the first to show that suzetrigine could block pain signalling in the gastrointestinal tract. Many other similar studies, including those using monkeys, also examined the safety and effectiveness of suzetrigine.

As Marc Rogers, a drug-discovery consultant in Cambridge, UK, told Nature: “VX-548 (suzetrigine) didn’t come out of nowhere, it’s a story of long, hard work”.