Suffering We Can Stop: The cruel choice between pain and addiction

The U.S. Centers for Disease Control and Prevention (CDC) recently reported an almost 27% decline in U.S. drug overdose deaths in 2024, the highest drop since 2020. Yet in the same time frame, more than 5 million people in the U.S. reported a prescription use disorder, and approximately 55,000 Americans died from opioid-involved overdoses. In studies of patients with opioid use disorder, the National Institutes of Health (NIH) has found that nearly half of people with opioid use disorder suffer from chronic pain.

Through the lens of chronic pain, the origins of opioid overuse and addiction are understandable. Pain is part of the human condition—something most of us experience every day. But when healing is delayed and the body’s pain system stays “on,” acute symptoms can devolve into chronic pain, defined as pain that persists for three months or longer. According to a CDC National Health Interview Survey, 24.3% of American adults experience chronic pain, which translates to more than 51 million people whose lives and dreams are impeded by pain that simply won’t go away.

When the prescribed fix is opioids, it comes with well-documented risks for dependency and death. Pain specialists and federal health experts warn that anyone who takes prescription opioids, including for chronic pain, can become addicted. Although pain science has advanced considerably, the marketplace remains dominated by widely promoted, first-generation opioid drugs for pain relief. So whether it stems from an injury, a post-combat condition, or another debilitating disorder, chronic pain presents the same devastating challenge for each patient: an unacceptable lack of access to non-opioid treatment options.

It’s a cruel dilemma—risk addiction or endure unrelenting pain. My biotech company was founded to develop nonaddictive treatments for chronic pain disorders such as fibromyalgia, which affects more than 10 million adults in the U.S., disproportionately women. In light of the FDA’s recent approvals for non-opioid medications for pain conditions, including one of our drugs, I’m cautiously hopeful that market conditions may finally be shifting in favor of nonaddictive pain treatments.

Yet we all know that hope is not a strategy. After 25 years of researching chronic pain disorders, I can say with confidence that we won’t disrupt the opioid status quo until leaders in pain science, government, and policy coalesce to deliver a next generation of safer painkillers. Our path to success on this front will require collaborative focus on following the science and putting patients first with a pipeline of opioid alternatives.

To the federal government’s credit, the National Institutes of Health’s HEAL (Helping to End Addiction Long-term) initiative now supports emerging treatments for pain. In addition, the NOPAIN (Non-Opioids Prevent Addiction in the Nation) Act makes non-opioid medications more accessible to Medicare patients post-surgery, and the proposed bipartisan Alternatives to PAIN (Prevent Addiction in the Nation) Act would expand non-opioid treatment options for seniors.

But even with important strides in chronic pain management and our fight against opioid addiction—including the legislative will of informed leaders in Congress and biotech’s advances in pain science—we’re still up against the power of addiction and healthcare’s dependency on opioid drugs. What we need is the kind of progress that comes from true public-private sector commitment, including broader government support for pain research, deeper biotech investment and partnership, streamlined approval processes for nonaddictive drugs, and greater patient access to safer pain relief.

Until we make that happen, more people each day will face a dark choice between pain and addiction. Millions of patients whose lives have been sidelined by chronic pain are desperate for real solutions. This means offering them proven, safe alternatives—medications that have been trialed and approved by the FDA, and made available to everyday Americans.

Let’s put an end to the unnecessary suffering caused by the dangers of overprescribed opioids. Pain science is ready with next-generation solutions, and it’s time to break the grip of our chronic pain crisis.

About the Author

Seth Lederman is co-founder, CEO and chairman of Tonix Pharmaceuticals Holding Corp., a biotech company dedicated to developing novel medicines for central nervous system disorders. The FDA recently approved Tonmya^TM (cyclobenzaprine HCl) sublingual tablets as a treatment for adults with fibromyalgia. It is the first FDA-approved therapy for fibromyalgia in over 15 years.

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