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On August 26, pharmaceutical manufacturer Indivior announced that it had begun supplying the Biomedical Advanced Research and Development Authority (BARDA) with Opvee, its opioid overdose antidote that hit the market in 2023. Opvee is a nasal spray device like Narcan, but instead of naloxone it contains nalmefene, an unnecessarily longer-acting alternative.
“Through BARDA’s contract with Indivior, communities will be better equipped to respond to mass poisoning emergencies and address biosecurity threats involving synthetic opioids … if medical countermeasure shortages occurred during an emergency response,” the company stated its press release. “OPVEE would be used in the prehospital setting (first responder/EMS) in accidental or intentional mass casualty situations. The need for this product is pressing given the increase in fentanyl overdoses in the US.”
Whenever a fentanyl-related announcement starts using language normally reserved for nuclear war, there’s a good chance you’ll come away not entirely sure whether it was talking about the opioid-involved overdose crisis, or a crisis that is hypothetical. Maybe the “mass casualty situation” is the one we already have going on; maybe Opvee is being stockpiled for something a bit more post-apocalyptic. BARDA is actually talking about both.
“Opioids are lethal chemicals that pose both a public health and chemical mass casualty threat,” BARDA wrote in a July 2023 notice as it closed in on its Indivior contract. “[S]ynthetic opioids, including fentanyl, pose a threat to national security if purposely released as a chemical weapon. Procurement of opioid reversal medical countermeasures is urgently needed to enable the [federal government’s] preparedness and response to the current public health emergency and to mitigate the threat of chemical attacks.”
Slide from August 2023 BARDA meeting on first-responder engagement
The office’s investment in Opvee comes from Project BioShield, a multi-billion dollar fund to develop medical countermeasures against weapons of mass destruction.
BARDA’s responsibility is to make sure the nation is prepared for potential medical disasters, like pandemics, and mainly focuses on what are known as CBRN threats—chemical, biological, radiological, nuclear. It is not overly known for concerning itself with the opioid-involved overdose crisis, but began shopping around for a new overdose antidote after the crisis was declared a public health emergency in 2017. Opvee exists because of BARDA.
In 2018, BARDA began sinking millions into getting a nalmefene nasal spray product approved by the Food and Drug Administration. There was no public demand whatsoever, but the office took the stance that we needed such a product as a defense against potential “weaponization” of fentanyl in “a large-scale terrorist attack.”
BARDA did not respond to Filter’s short-notice inquiry as to what kind of terrorist attack it was picturing—whether fentanyl would be deployed into the air, or via some other form of passive exposure that’s been debunked as an overdose risk—or how its supply of Opvee would be deployed “within minutes” of such an event.
Talking about fentanyl like this is a good way to scare people. And to tap into hundreds of millions of dollars in federal anti-terrorism reserves.
It’s not the first public-private partnership to shove a needlessly powerful overdose antidote into existence for similar reasons. The Department of Defense partnered with Kaleo, Inc. to get a 10 mg naloxone autoinjector approved for military use in 2022, as a precaution in case of some future scenario where “high-potency opioids such as fentanyl analogues as a chemical weapon is suspected.”
In the decade since the FDA approved Narcan, we’ve manufactured a need for high-dose naloxone; longer-acting alternatives to naloxone; higher-dose naloxone; longer-acting alternatives in an autoinjector.
Meanwhile, it’s getting harder to separate fearmongering from carelessness from actual preoccupation with fentanyl-based terrorist attacks. Cops are hitting people with five back-to-back Narcans and then dosing themselves prophylactically “just to be safe.” Members of Congress are criminalizing exposure and trying to classify fentanyl as a weapon of mass destruction. Reporters are describing fentanyl analogs as deadly new “strains,” like the whole thing’s an airborne virus.
Talking about fentanyl like this is a good way to scare people; voters, for instance. It’s also a good way to tap into more material things than public sentiment, such as hundreds of millions of dollars in federal anti-terrorism reserves.
Top image (cropped) via United States Department of Justice/YouTube. Inset graphic via Office of Emergency Medical Services.