Indivior PLC has discontinued marketing for Opvee, the opioid-overdose reversal product that the pharmaceutical company had claimed was more effective than naloxone. After the Food and Drug Administration approved Opvee as the first nalmefene-based antidote in 2023, it was flatly rejected by harm reductionists and then by health departments, and never got a foothold in the opioid-overdose antidote market. What it did get was attention.
Though Indivior will no longer “actively market” Opvee, it will continue to manufacture it. Licensed medical providers will be able to prescribe it, and health departments or other public interest groups will be able to order it; they’ll just have to reach out to Indivior rather than the other way around.
On September 30, the Office of New York State Attorney General Letitia James (D) announced that at the beginning of the month, Indivior agreed to a settlement requiring it to “stop making false statements” about its “unauthorized” product. Two days later, the company sent a letter to health care providers and other stakeholders informing them Opvee was no longer being promoted at all.
In the letter, which Filter has reviewed, Indivior Vice President of North America Medical Affairs Ann Wheeler wrote that the discontinuation took effect August 26.
“Indivior has not taken this action due to safety or efficacy issues related to the product,” Wheeler wrote. “Rather, the decision was based on business reasons and shifting our focus to other parts of our business.”
In recent years, the FDA has approved a handful of naloxone products as over-the-counter medications, but for years Narcan still technically required a prescription. In order to get around this—so that bystanders could legally respond to overdose without waiting for a doctor’s permission—states enacted blanket prescriptions known as “standing orders.” Like many health departments, the New York State Department of Health (NYSDOH) has a standing order authorizing non-medical distribution of naloxone, but only naloxone—not nalmefene. Opvee still requires a traditional prescription. But Indivior didn’t present it that way.
“Despite [the] clear limitation under state law, Indivior marketed and sold the drug as if it were a viable competitor to Narcan,” the OAG stated, “misleading public agencies and undermining established, evidence-based overdose prevention efforts.”
By January 2024, according to the OAG’s investigation, Indivior had pitched Opvee in at least 15 counties across New York, opening dialogues with local officials from sheriffs to commissioners to EMS chiefs.
The investigation centered on Indivior’s dealings with the Broome County Sheriff’s Office (BCSO), which in the spring of 2024 had told the company that, per NYSDOH, nalmefene-based products were not covered by the standing order. In response, Indivior suggested that BCSO “was not barred from writing its own nonpatient-specific standing order for Opvee.”
BCSO bought 300 doses, blithely violating state law in the process, and in a matter of weeks announced the launch of a “fentanyl fighter” Opvee pilot program.
Though only referenced as “business decisions” in the letter to stakeholders, Indivior is looking to offload Opvee.
Nalmefene and naloxone are both opioid antagonists, but nalmefene’s effects last up to 11 hours compared to under two hours for naloxone. Opioid antagonists work on all opioids the same way regardless of their potency, and the longer they remain in someone’s system the more likely the person is to overdose again.
“Public health officials discourage the use of Opvee,” the OAG stated. “Not only does Opvee not improve survival rates or patient outcomes, but its longer duration can also cause severe and … extended withdrawal [that] is painful for patients and puts them at risk of life-threatening conditions for longer than necessary.”
But Indivior, and the various law enforcement departments to have taken up the cause, used nalmefene’s longer half-life to frame it as new cutting-edge technology, and naloxone as weak and outdated.
For example, an Indivior-sponsored paper that purported to address the “lack of published evidence regarding [intranasal nalmefene’s] utilization, namely regarding concerns about its potential for precipitate withdrawal” described a man who was successfully revived with Opvee and—”notably”— did not experience precipitated withdrawal. Earlier in 2025 when Filter inquired about whether the man had an opioid tolerance that put him at risk for precipitated withdrawal in the first place, authors responded that to their knowledge “he had no previous issues,” which is not the framing that was used in the paper. In a separate study by researchers directly employed by Indivior, nalmefene outperformed naloxone in a lot of impressive-sounding metrics that had little to no bearing on whether someone survives an overdose.
In a fairly damning Assurance of Discontinuance issued by the OAG, effective September 29, Indivior has agreed to not describe Opvee or nalmefene—verbally or in writing—in any way “that is unfair, false, misleading, deceptive or unconscionable,” or that suggests its product “has approvals, characteristics, uses, benefits or qualities that it does not have.”
Though Indivior’s letter to stakeholders didn’t elaborate on the “business decisions,” the company is looking to offload Opvee. Its cash cow is Sublocade, the long-acting injection formulation of buprenorphine, and that’s where it intends to focus its energies going forward. On August 26, the same day it pulled Opvee’s marketing, Indivior filed a Securities and Exchange Commission report outlining a new “Action Agenda” centered on layoffs and consolidations.
“Indivior is exploring strategic alternatives for both OPVEE® and its non-US business,” the report stated. “To the extent the Company is successful in divesting and/or restructuring these assets, further one-time costs and ongoing expense savings may be realized.”
Marketing and promotion was where Opvee made an impact, much more than through use of the actual product.
Despite Opvee’s outsized presence in the media, in 2024 it brought in about $15 million—a little over 1 percent of Indivior’s net revenue. That sum came from two 100,000-unit orders from the United States Biomedical Advancement Research and Development Authority (BARDA). Since August 2024, Indivior has had a federal contract to provide BARDA with an emergency stockpile of Opvee in case of fentanyl nuclear war, or something like that.
That contract remains active, and as of August 19 the government has awarded $52.9 million. It may still award an additional $60.9 million over the next eight years. Indivior did not respond to Filter’s inquiry about the future of the BARDA contract, or whether the company is still offering to pay a portion of its opioid settlements in Opvee units.
Marketing and promotion was where Opvee made an impact, much more than through actual use of the product. Less than two years since the first law enforcement departments got access, the FDA has approved a nalmefene auto-injector from Purdue Pharma and a naloxone nasal spray containing a dose two-and-a-half times bigger than Narcan. Whether or not another company acquires it, Opvee’s legacy will be that it popularized the narrative that naloxone doesn’t cut it anymore. That it wears off too quickly, that it works too slowly, that it only works after multiple extra doses, that ultra-potent naloxone-resistant synthetic opioids are flooding the country. None of which are true.
Higher-dose naloxone products were already emerging by the time Opvee hit the market. But as the first alternative to naloxone, Opvee became a vehicle for cops to air their frustration over the fact that responding to people who use fentanyl is now such a large part of their jobs, and it validated the mythology that the only reason they haven’t yet won the drug war is because the law denies them access to the resources they need. Rather than because prohibition doesn’t work that way.
Image (cropped) via Broome County, New York
Correction, October 1: This article has been edited to identify the New York State Department of Health, which was originally misnamed as the Department of Health and Mental Hygiene.