As opioid addiction continues to ravage large swaths of the country, doctors are being urged to prescribe fewer narcotic painkillers, putting pressure on drug companies to come up with new ways to treat pain patients.

Rather than treating generalized pain, some new drugs target specific types of pain. For example, some researchers looking to soothe the nerves of osteoarthritis patients aren’t taking the usual approach of affecting pain signals to the brain. Rather, they hope to cut off the signal elsewhere in the body, or to deal with the nerve endings at the source of the hurt.

One injection that’s still in clinical trials uses a synthetic version of capsaicin, the main ingredient in chili peppers, and injects it into a joint. The chemical gives the nerve endings in the joint “a hair cut,” the chief medical officer of Centrexion, the company behind the drug, explained to Bloomberg News.

Nerve-growth-factor inhibitors are another class of medicines useful for arthritis, and can be so effective that early clinical trials were stopped due to concerns that patients didn’t feel enough pain, and were using affected joints too much.

One drug that’s earlier in its development shows promise for chronic pain sufferers, and uses what scientists have learned from people with a rare disorder that keeps them from feeling pain at all. Drugs in early stages also use the same receptors that cannabis does to reduce pain, and use promising substances like toxins from snails.

Other drugmakers are taking a different tactic, developing opioids that help with pain, but that don’t have some of the side effects that make the drugs both dangerous and addictive. One medication under development reduces the euphoric effect by crossing the blood-brain barrier more slowly. Another avoids the common opioid side effect of slowed breathing.

Efforts to develop new drugs are now even more urgent after recent news about opioid medication Opana ER. The Food and Drug Administration asked manufacturer Endo Pharmaceuticals to remove the drug from the market, concluding that the drug’s potential for abuse and role in outbreaks of hepatitis and HIV outweighed its benefit to patients overall.

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