Acute Pain: Potential Impact of an Effective Non-Opioid Treatment to Reduce Opioid-Related Harm and Economic Burden

PainRelief.com Interview with:
Vertex Spokesperson

PainRelief.com: What is the background for this study?

Response: This study had two primary aims: (1) to provide a contemporary estimate of the societal costs of the opioid epidemic, and (2) to quantify the portion of the opioid epidemic attributable to new prescription opioids for acute pain from 2025 onwards and evaluate the potential impact of an effective non-opioid pain medication for acute pain in reducing the burden associated with the US opioid epidemic.

The United States continues to grapple with a devastating opioid epidemic. Despite growing awareness of long-term opioid risks, nearly 40 million Americans continue to receive prescription opioids for acute pain each year, and even short-term use can lead to misuse, opioid use disorder (OUD), or overdose. In 2022 alone, nearly 108,000 people died from drug overdoses — about 82,000 (~76%) involving opioids.  Overall, it is estimated that the opioid epidemic will cost ~$370B in 2025 – more than double the commonly cited 2018 estimate of $180B.

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Penn State Study Evaluates CBT vs Mindfulness for Opioid-Dependent Chronic Low Back Pain

PainRelief.com Interview with:
Aleksandra E. Zgierska, MD, PhD
Jeanne L. and Thomas L. Leaman, MD, Endowed Professor and Vice Chair for Research
Department of Family and Community Medicine
Professor, Department of Public Health Sciences
Professor, Department of Anesthesiology and Perioperative Medicine
Penn State College of Medicine, Hershey, Pennsylvania

PainRelief.com: What is the background for this study?

Response: This research began about 15 years ago, grounded in my clinical work as a family physician and addiction medicine specialist. While many patients were referred for the treatment of opioid use disorder, a growing number were adults with chronic pain treated with long-term opioids—patients who didn’t quite fit into existing systems. They weren’t appropriate for addiction treatment, yet often felt unwelcome in primary care or pain clinics. Most had tried multiple medications, procedures, and physical therapy, often with limited relief. What stood out was how few had received evidence-based psychological treatments for chronic pain, despite also struggling with mental health challenges and maladaptive coping.

I became interested in identifying safe, long-term strategies to help these patients manage pain and improve their quality of life. Medications or procedures often have limited, short-term benefits and can cause side effects. Many patients were hesitant to try physical therapy again, especially given their pain levels and fear of worsening symptoms. This led me to explore psychological approaches—particularly mindfulness, which, unlike cognitive behavioral therapy or CBT (already considered a standard but underused approach), had untapped potential for addressing pain, mental health, and overall well-being.

Our team launched a pilot study comparing mindfulness-based therapy plus usual care to usual care alone for adults with opioid-treated chronic low back pain—the most common non-cancer pain treated with opioids. The results were promising and led to a large, multisite clinical trial funded by Patient-Centered Outcomes Research Institute (PCORI). In this trial, we compared mindfulness to CBT, in partnership with expert teams across the country led by Dr. Bruce Barrett (University of Wisconsin-Madison), Dr. Robert Edwards (Brigham and Women’s Hospital), and Dr. Eric Garland (University of Utah), and coordinated by the study manager, Cindy Burzinski. We hypothesized that mindfulness would outperform CBT in improving pain, function, quality of life, and reducing opioid use.

A unique strength of our study was the meaningful involvement of stakeholders throughout the entire project. From the initial planning phase—before our proposal was even submitted to PCORI—we partnered with individuals representing the perspectives of patients, caregivers, clinicians (including physicians, mental health providers, and physical therapists), and advocacy organizations. These stakeholder advisory groups met with us regularly throughout the study to provide input on how to make the project more relevant to real-world clinical settings and more user-friendly for both patients and providers. They also played a key role in interpreting the results. Their insights enriched every phase of the project and ensured that our research stayed grounded in patient-centered priorities. We were proud to formally acknowledge our partners’ contributions in the paper; two of them, Penney Cowan and Christin Veasley, are founders of prominent patient advocacy organizations and directly co-authored the article. We believe this type of collaboration should become standard practice in clinical research. It’s a powerful way to bridge the gap between research and real-world implementation.

CMAJ Study Evaluates Risk of Health Outcomes after Opioids Prescribed in ER

PainRelief.com Interview with:

Dr. Innes

Grant Innes MD
Departments of Emergency Medicine and Community Health Sciences
University of Calgary, Calgary
Editor-in-Chief, The Canadian Journal of Emergency Medicine

PainRelief.com: What is the background for this study?

Response: Opioid prescriptions for acute pain have been identified as a possible factor in opioid epidemic mortality. The proposed causal model is that physicians provide opioid prescriptions for acute pain, which lead to prescription opioid misuse followed by illicit opioid use, subsequent overdose and death.

This paradigm has driven widespread describing initiatives, including the elimination of opioids from emergency care (“opioid free emergency departments”), but there is no research describing the link between an opioid prescription for acute pain and downstream opioid-related harm. 

Our objectives were to quantify for emergency patients filling an opioid prescription the likelihood of adverse outcomes as well as the incremental risk to opioid-treated patients vs. propensity-matched controls.

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Better Pain Relief When Music Keyed to Patient’s Individual Rhythm

PainRelief.com Interview with:
Mathieu Roy PhD
Associate Professor, Dept. of Psychology, McGill University
Canada Research Chair (tier 2) on brain imaging of pain

PainRelief.com: What is the background for this study?

Response: While it is well-established that music can reduce pain, the selection of music for pain relief has largely been based on intuition rather than scientific principles. This study aimed to investigate the role of tempo in music-induced analgesia, ie, pain reduction. Specifically, we hypothesized that a tempo matched to an individual’s spontaneous production rate (SPR)—the natural pace at which a person produces music through singing, clapping, or playing an instrument—would yield stronger pain-reducing effects.

Spontaneous production rate reflect the output of an internal neural oscillator, with frequencies that vary between individuals. Essentially, everyone has a unique internal rhythm. According to theoretical models of temporal dynamics, entrainment to music should be most effective when the external rhythm aligns with an individual’s SPR. Based on this, we predicted that music presented at a person’s SPR would optimize pain relief.

FDA Approves JOURNAVX, First New Non-Addictive Oral Medication for Moderate to Severe Pain Relief

PainRelief.com Interview with:
Ashley Mahoney
Vertex Spokesman

PainRelief.com: What is the background for this study? What are the main findings of the underlying studies?

Response: On January 30, 2025, the FDA approved JOURNAVX, a new medicine developed by Vertex Pharmaceuticals which represents the first new class of acute pain medicine in more than 20 years. In our clinical trials, which were the largest double blind, placebo-controlled trials ever conducted in acute pain, JOURNAVX was shown to be effective, safe and well-tolerated. It led to clinically meaningful reductions in pain that were rapid and sustained, acting faster than placebo with fewer side effects than an opioid comparator and in many cases even the placebo arm. Based on its MOA and clinical/pre-clinical data we’ve seen to date, we also know JOURNAVX is non-addictive. 

Given this combination of efficacy, safety and non-addictive potential, we expect JOURNAVX to become the first line prescription medicine for the treatment of moderate-to-severe acute pain. We’re excited to bring this medicine to patients and expect JOURNAVX will be on shelves in retail pharmacies within a month.

Study Demonstrates Impact of Lifestyle Habits on Low Back Pain

PainRelief.com Interview with:
Christopher Williams PhD
University Centre for Rural Health
School of Health Sciences
University of Sydney, Lismore
Research and Knowledge Translation Directorate
Mid North Coast Local Health District,
Port Macquarie, New South Wales, Australia

PainRelief.com: What is the background for this study?

Response: Other research has linked unhealthy lifestyle habits to low back pain (such as being inactive, overweight, smoking and consuming a poor diet, or too much to low back pain). However, until our study we didn’t know if changing these lifestyle habits led to improvements in a person’s back pain disability.

PainRelief.com: What are the main findings?

Response: Our clinical trial found that focusing care on lifestyle had a slightly bigger impact on back pain related disability, weight, and quality of life compared to the current recommended physiotherapy treatment for back pain (advice to stay active and exercise). The results show that helping people understand how lifestyle habits contribute to back pain and supporting them to make changes to these habits is better than the current recommended care.


PainRelief.com: What should readers take away from your report?

Response: Managing back pain is about more than the (bio)mechanics of what is going on in your spine. There are lots of things that may affect how your back feels. Lifestyle factors – activity, nutrition, weight, smoking or alcohol use, and sleep – are some of those things. Any person dealing with back pain should expect to get some help to figure out how their lifestyle habits can improve their back pain, as part of a comprehensive back pain management plan.

PainRelief.com: What recommendations do you have for future research as a result of this study?

Response: There are many ways to support lifestyle changes related to back pain. We aren’t quite sure which are the best for different people, and the best way to support people with pain make such changes. For example, while digital or virtual ways of accessing care seem promising, we aren’t sure if these are more or less effective/cost effectives as traditional ‘in-person’ models of care.

Disclosures: The study was supported by funding the National Health and Medical Research Council of Australia.

Citation: Mudd E, Davidson SRE, Kamper SJ, et al. Healthy Lifestyle Care vs Guideline-Based Care for Low Back Pain: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(1):e2453807. doi:10.1001/jamanetworkopen.2024.53807

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2828920

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Study Identifies Link Between Depression and Menstrual Pain

PainRelief.com Interview with:
Prof. John Moraros Ph.D.
Dean, Department of Biological Sciences, School of Science
Xi’an Jiaotong-Liverpool University
Suzhou, Jiangsu, China;
Institute of Population Health
University of Liverpool
Liverpool, United Kingdom

Prof. John Moraros Ph.D.
Dean, Department of Biological Sciences, School of Science
Xi’an Jiaotong-Liverpool University
Suzhou, Jiangsu, China;
Institute of Population Health
University of Liverpool
Liverpool, United Kingdom

PainRelief.com: What is the background for this study?

Response: Across the world, women are twice as likely as men to experience depression, often with more severe physical symptoms. This difference is especially noticeable during their reproductive years and affects hundreds of millions of women. While links between mental and reproductive health are known, they are not fully understood.

In our study, we wanted to figure out the relationship and directionality between depression and menstrual pain (dysmenorrhea). It is kind of like trying to solve a very complex puzzle. Instead of doing experiments directly on people, we used a clever approach called Mendelian Randomization. This method works like nature’s experiment. It uses genetic data, like tiny instructions in our DNA, to see if having certain genes linked to depression also makes people more likely to have menstrual pain. This helps us find patterns and identify cause-and-effect without the need to test it directly on people. It is like looking for clues to see how the pieces of this complex puzzle all fit together.

Review Finds Spinal Cord Stimulation Effective for Reducing Back and Leg Pain

PainRelief.com Interview with:
Prof. Dr. Frank Huygen
Erasmus Medical Center
Rotterdam, the Netherlands

PainRelief.com: What is the background for this study?

Response: Spinal cord stimulation (SCS) is a widely accepted therapy for people who have chronic pain that has been difficult to treat with conventional medical management (CMM) such as analgesics, physical therapy and cognitive behavioral therapy. Yet despite its clinical success, there is still debate about aspects of SCS therapy.

This systemic review and network meta-analysis aimed to improve upon prior evidence reviews by including more up to date randomized clinical trial data and using more advanced analytical methods. We evaluated the efficacy associated with SCS, including modern RCTs that compared novel forms of SCS compared to traditional SCS, or compared with CMM.

Cleveland Clinic Study Finds Virtual Yoga Effective Way to Manage Chronic Low Back Pain, with Added Benefit of Flexibility

PainRelief.com Interview with:
Hallie Tankha, Ph.D., Research faculty
Department of Wellness and Preventive Medicine 
Cleveland Clinic, and first author of the study

PainRelief.com: What is the background for this study?

Response: Numerous studies have highlighted the benefits of yoga for individuals with chronic low back pain, including reductions in pain intensity, improvements in daily functioning (such as walking or climbing stairs), and better sleep quality. However, these studies used in-person yoga sessions. With the onset of the COVID-19 pandemic, healthcare delivery had to adapt quickly, and yoga was no exception. As virtual healthcare options continue to expand, this led us to wonder: could virtual yoga offer the same benefits as in-person classes for chronic low back pain?

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Study Finds Back Pain May Be Eased by Reduced Sitting

PainRelief.com Interview with:
Jooa Norha, MSc (Health Sciences), PT
Doctoral researcher
Turku PET Centre
University of Turku, Finland

PainRelief.com: What is the background for this study?  What are the main findings?

Response: The previous evidence linking sedentary behavior (or sitting to simplify) and back pain is surprisingly scarce. Therefore, we wanted to investigate whether reducing sitting could help with back pain among adults who sit for major parts of the day. And indeed, we did find that reducing sitting for about 40 min/day for six months kept back pain from worsening.

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