A New Tool Against Opioid Addiction — If We Use It

We finally have a nonopioid alternative to treat acute pain—yet America is still defaulting to opioids. That disconnect is more than frustrating; it is dangerous.

In 2025, a long-sought milestone was reached: the U.S. Food and Drug Administration (FDA) approved a nonopioid pain medication as safe and effective. Yet the healthcare system has been slow to respond. Too many patients are still started on opioids and exposed to avoidable risk — not because safer options are unavailable, but because of insurance barriers, regulatory frictions, and a lack of awareness among both prescribers and patients. This must change. The opioid crisis, although killing fewer Americans, remains quite serious.

Annual drug overdose deaths have declined from a peak of roughly 110,000 in 2022 to about 70,000 in the most recent 12-month period, with almost 40,000 opioid-related deaths. Nonetheless, this level of drug-related fatality remains historically high — many times higher than before the introduction of OxyContin in 1996. Although opioid prescribing has declined significantly since the opioid crisis began, it remains an important and preventable pathway into opioid misuse and addiction.

According to the most recent National Survey on Drug Use and Health, approximately 7.6 million Americans misused prescription opioids in the past year (NSDUH 2025). Whether prescribed for a surgery, a dental procedure, or a sports injury, the risk of prolonged use of these medications escalates quickly. Among patients who take opioids for just five days, about one in 10 are still using them a year later; after 30 days, that figure rises to nearly one in three. Too often what begins as routine pain management becomes something far more difficult to unwind. It is far better to avoid starting patients on opioids in the first place, especially now that a safer alternative exists.

The nonopioid medication introduced by Vertex Pharmaceuticals (trade name Journavx), approved on Jan. 30, 2025, is indicated for moderate-to-severe acute pain in adults and represents the leading edge of a new class of therapies. Other companies, including Eli Lilly and Company, Pfizer, and Latigo Biotherapeutics, are advancing their own nonopioid medications. The arrival of this new class of painkillers makes clear that America’s overreliance on prescription opioids will end. The question is how quickly.

It is troubling that more prescribers and insurers have not yet embraced advances in pain treatment — but slow adoption of medical breakthroughs is not unusual. In healthcare, it can often take more than a decade for new evidence to become standard practice. That is a timeline we should not accept when it comes to prescription opioids.

There are practical barriers to address. Generic opioids are inexpensive, while newer therapies can cost more. Insurers, including Medicare, often require prior authorization or step therapy that slows adoption of new medications. These are real constraints — but they are also solvable ones. Payers should not allow relatively modest per-patient cost differences to stand in the way of safer, clinically appropriate care. Further, they should keep in mind the substantial long-term savings from avoiding the high costs of treating the health consequences of opioid addiction.

Congress can help. The bipartisan Alternatives to Prevent Addiction in the Nation (PAIN) Act — S. 475 in the Senate and H.R. 1227 in the House — would expand access to nonopioid pain treatments for Medicare beneficiaries. That matters, particularly as overdose risks among older Americans have risen sharply. Enacting this legislation would not just reduce health and safety risks to older Americans, it would also help to educate prescribers and the public about the availability — at long last — of safer approaches to managing pain.

Much of today’s anti-drug effort focuses, rightly, on the increasingly complex illicit drug supply, which now includes a potent mix of opioids, stimulants such as cocaine and methamphetamine, and sedatives such as xylazine or medetomidine. But one hard lesson we cannot ignore is that prescription opioids ignited the opioid crisis — and that continued prescribing remains an important and preventable pathway into opioid misuse and, for some patients, opioid addiction. Prescription opioid exposure is a well-established risk factor for later illicit opioid use. We should not look away from a now well-understood reality: continued opioid prescribing today can seed serious future risk.

The United States has spent decades grappling with the consequences of widespread opioid prescribing. It is time to make full use of this new class of medications and reduce opioid use — and its risks — to the absolute minimum. We now have both the opportunity and the obligation to prevent future harm at the front end. That will require changes in coverage, prescribing norms, and public awareness. The question is no longer what to do — it is when we will act to ensure that all Americans have access to safe and effective nonopioid pain medications.

Richard J. Baum is former acting director of the White House Office of National Drug Control Policy and the author of “Inside America’s Opioid Crisis: 12 Hard Lessons for Today’s Drug War.“

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