This story appears in the September–October 2026 issue of Dispense Times.
An opportunity for independent pharmacists to sell better pain treatments and lead America out of the opioid crisis.
You’ve watched this happen a hundred times.
A customer stands in front of your analgesic set. She picks up a box, turns it over, and struggles to read the ingredient list on the back. She sets it down and picks up another one, doing the same thing. Then she either walks out empty-handed or carries up the same product she’s already tried, the one that only kind of worked. She isn’t confused about the price. She’s confused about which product will actually take the pain away — and unlike the clerk at a chain drugstore three miles away, you’re one of the few people in her day who could actually tell her.
The Everyday Customer
She’s 58, with bilateral knee osteoarthritis. She isn’t ready for a replacement, and her surgeon isn’t pushing one yet. She has a GI history, so oral NSAIDs are off the table.
She’s tried the cooling gel, which works for about twenty minutes. She’s tried the diclofenac gel, and while it helps the swelling, it does nothing for the nerve pain running down the inside of her leg. There’s a lidocaine patch in a drawer at home that wouldn’t stay on.
She, or someone like her, is in your store every day. Depending on your traffic, you might see ten, twenty, even fifty pain-suffering customers in a single shift — and every one of them is a chance to be the reason they come back instead of driving to the nearest big-box counter.
Nearly one-in-four U.S. adults reported experiencing chronic pain in 2023, and 8.5 percent had high-impact chronic pain severe enough to limit work, school or daily life. Incredibly, more than one in two American adults reports a chronic musculoskeletal condition, which means half the people walking through your door are dealing with something that hurts.
How the Analgesic Shelf Got This Weak, and Why That’s Your Opening
The category didn’t end up here by accident. It ended up here structurally. OTC topical analgesics were built to do one thing at a time: menthol cools, diclofenac reduces inflammation, lidocaine blocks nerve signals. Each is a real mechanism with real clinical evidence behind it, used safely by millions of people every year — but stocked side by side as single-mechanism products, they leave a gap that no chain planogram is built to solve.
The trouble is that your customer doesn’t usually have one kind of pain. She has inflammation, plus nerve involvement, plus the surface ache sitting on top of both. She wants a home-run product, but the OTC dugout is all singles hitters.
She might buy two or three different products, using them in sequence to get partial relief. Or she decides that nothing over the counter really works and calls her prescriber for something stronger — something that far too often in America becomes dangerous, even deadly. That’s the moment an independent pharmacist, with the time and trust a chain counter doesn’t offer, can change the outcome with a single recommendation.
What Pain Is Costing All of Us
The economic cost of chronic pain in the United States reached $722.8 billion in 2021, including $530.6 billion in medical care and nearly $200 billion in lost productivity. Musculoskeletal conditions alone account for roughly 364 million lost work days a year — about 10 days per worker — more than any other health condition.
Then there’s the bill we ran up trying to treat it instead. CDC analysts put the cost of fatal overdose and opioid use disorder at $1.02 trillion in 2017, more than twice what Americans spend on all retail prescription drugs in a year. An estimated 69,973 Americans died from overdose in 2025, and 7.6 million Americans misused prescription opioids, with nearly 5 million meeting the criteria for opioid use disorder.
Where did those pills come from? About 42.5 percent came from a friend or relative, and 40.5 percent came through a prescription written by a single doctor. Only 1.3 percent were stolen from a pharmacy or a clinic.
“The supply chain for opioid misuse isn’t the black market. It’s the neighborhood medicine cabinet, filled one legitimate prescription at a time.”
Washington is taking action. The Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act was passed by Congress and signed into law at the end of 2022. Effective January 1, 2025, it now requires CMS to pay hospitals and surgery centers separately for qualifying non-opioid pain treatments through 2027. As CMS pays providers to move away from opioid-based treatment, more of those patients are going home and searching for the strongest, safest option they can find at retail — often at the independent pharmacy that took the time to explain it to them.
What Belongs on Your Shelf, and Nowhere Else
As the list of products applying for NOPAIN reimbursement grows every month, independent pharmacies have a rare chance to carry something the chains down the street don’t: a genuinely differentiated pain-relief option, backed by a story your staff can actually tell.
Ortho Freeze was formulated by Mark Malone, PT, after 31 years in clinical practice, because he couldn’t find a single product that sufficiently treated the complex pain his patients were actually living with. Mark has treated thousands of patients with both acute and chronic pain, and Ortho Freeze is helping his patients find greater, longer-lasting relief through a formula potent enough to work, yet still OTC-safe.
Ortho Freeze is applied topically to the skin over and around the area of pain, and the cream-based formula absorbs well with little effort. Best of all, it delivers four active ingredients in a single application — which means one recommendation instead of three separate ones:
- 4% Lidocaine USP to block the nerve signal
- 1% Diclofenac Sodium to reduce inflammation
- 1% Menthol for immediate cooling relief and to carry the co-actives deeper into the tissue
- 0.3% Methyl Salicylate for additional counterirritant analgesia
No prescription is needed to purchase Ortho Freeze, because every ingredient meets regulatory standards for OTC sale. It’s non-narcotic, non-addictive, and safe for a wide range of ages and health conditions. It’s available in three sizes to fit different customer needs and budgets, and can be re-applied as needed, usually every four to six hours — giving your team an easy, repeatable recommendation and a reason for that customer to keep coming back to you instead of ordering it, or something like it, online.
What an Hour Is Worth
Think back to the customer from the beginning. What would several hours of real pain relief actually do for her?
Maybe she sleeps through the night for the first time in months, or can play with her grandchild at the park. She might walk the dog around the neighborhood and still feel well enough to cook a healthy dinner. Perhaps she doesn’t miss those two weeks of work and takes a vacation instead of lying on the couch. A life with less pain is something a lot of your customers have quietly stopped expecting — and independent pharmacists are uniquely positioned to hand it back to them, one conversation at a time.
“That’s what your recommendation and your analgesic aisle are really selling. Not a bottle of cream, but daily hours of somebody’s life handed back to them.”
That kind of relief changes what a person believes is still possible for them, and you can bet they’ll tell their friends and neighbors where they found it — the same word-of-mouth trust that built your business in the first place.
Perhaps most importantly, safe, effective pain relief recommended at the independent retail pharmacy counter can meaningfully reduce America’s reliance on opioids, one customer at a time.
Pain in America, by the Numbers
- 24.3% of U.S. adults reported chronic pain in 2023
- 8.5% had high-impact chronic pain that limits daily life
- 1 in 2 adults reports a chronic musculoskeletal condition
- 78M U.S. adults projected to have arthritis by 2040
- $722.8B annual economic cost of chronic pain (2021)
- 364M work days lost each year to musculoskeletal conditions
- 4.8M Americans meeting criteria for opioid use disorder
- $1.02T cost of opioid overdose and opioid use disorder (2017)
To learn about wholesale pricing, samples and patient-facing materials for Ortho Freeze, visit orthofreeze.com.
Sources: CDC/NCHS Data Brief No. 518, “Chronic Pain and High-Impact Chronic Pain in U.S. Adults, 2023” · The Burden of Musculoskeletal Diseases in the United States, 4th ed. · “Economic Costs of Chronic Pain—United States, 2021,” Medical Care 63(9), 2025 · Luo et al., “The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017,” CDC · CMS National Health Expenditure Data, retail prescription drug spending, 2024 · CDC/NCHS provisional overdose death counts, 2025 · SAMHSA, 2024 National Survey on Drug Use and Health · CDC arthritis surveillance, 2024 · Consolidated Appropriations Act, 2023, Div. FF (NOPAIN Act); 42 U.S.C. § 1395l(t)(16)(G); CMS CY 2025 and CY 2026 OPPS/ASC final rules.
