Indivior to stop marketing Opvee, controversial overdose-reversal medication

Indivior Ceases Promotion of Controversial Opioid Reversal Drug Opvee Following Settlement

Indivior, the pharmaceutical company behind Opvee, a contentious overdose-reversal medication, has officially halted its marketing efforts after two years marked by low sales figures and significant criticism from harm reduction advocates. This decision coincides with a settlement announced by New York Attorney General Letitia James, which mandates the company to refund public funds used to purchase Opvee in New York and to facilitate the return of all unused stock.

In the weeks preceding this announcement, Indivior circulated a letter to stakeholders nationwide, indicating that it had “discontinued promotion” of Opvee due to lackluster performance in the market.

Attorney General James emphasized that the settlement and Indivior’s retreat signal a crucial victory for the harm reduction communities. Since Opvee’s approval in May 2023, advocates have consistently cautioned that Opvee is no more effective than naloxone in reversing opioid overdoses but carries a higher price tag and poses significant risks. Notably, concerns have been raised about its active ingredient, nalmefene, which may induce severe withdrawal symptoms in overdose victims, inadvertently motivating them to return to opioid use to alleviate such discomfort.

“Indivior cannot rewrite its history and exploit this drug crisis for profit,” James stated. “After playing a role in fueling the opioid epidemic, the company tried to position itself as part of the solution while misleading public officials and communities about overdose treatment effectiveness.”

Attorney General James pointed out that Indivior marketed Opvee to public bodies and law enforcement, despite the New York State Health Department not authorizing its use in non-medical settings. Additionally, she revealed settlements with specific local law enforcement agencies and a healthcare provider from prisons that purchased Opvee, both violating state regulations.

Indivior has asserted that Opvee is capable of reversing overdoses and restoring blood-oxygen levels more swiftly than naloxone. However, leading toxicology organizations have cautioned against the use of nalmefene in place of naloxone, noting that it could prove harmful without yielding better outcomes in overdose scenarios.

The settlement represents a noteworthy defeat for Indivior, which has faced multiple controversies despite being among a limited number of pharmaceutical firms tackling the drug overdose crisis. The company’s flagship product, Suboxone, is widely recognized as a standard treatment for opioid addiction, while Sublocade—its monthly buprenorphine injection—has been noted for its enhanced efficacy.

Nevertheless, Indivior’s history is marred with scandal, including settlements amounting to over $500 million after lawsuits accused it of stifling generic competition for Suboxone. In 2024, James assisted in securing an $86 million settlement involving 16 states over Indivior’s alleged failure to monitor suspicious orders, contributing to the proliferation of “pill mill” clinics.

Earlier this year, Indivior already acknowledged the challenges it faced in promoting Opvee, expressing in its 2024 annual report that it was disappointed with the slow adoption rates, emphasizing that feedback from harm reduction advocates had surpassed their expectations.

In a recent communication, the company revealed that “effective August 26, 2025, Indivior has discontinued promotion for OPVEE (nalmefene) nasal spray 2.7mg.” They reassured stakeholders that this decision was attributed to “business reasons” and not due to safety or efficacy concerns.

This retraction from Opvee adds to the ongoing discussion surrounding overdose-reversal medications in the U.S., particularly in light of the escalating opioid crisis and the increasing dominance of fentanyl in the drug supply. Many groups have reported challenges in reversing overdoses with standard naloxone, prompting pharmaceutical companies to release high-dose, complex, and significantly more expensive alternatives. However, research has not substantiated these products as more life-saving than their predecessors, which has led many public health experts to label this trend as a cash grab.

To this day, most harm reduction organizations utilize lower-dose alternatives like Narcan or generic intramuscular naloxone, primarily sourced from Pfizer.

James’ recent settlement with Indivior aligns with New York State’s broader initiatives to regulate the pharmaceutical sector regarding naloxone and nalmefene products. In early 2024, amid a proliferation of high-dose formulations, the state health department released a pioneering study demonstrating that high doses of naloxone do not correlate with increased survival rates but are associated with heightened risks of severe withdrawal symptoms.

Despite Indivior’s cessation of Opvee promotion, the medication remains available for prescription or purchase by public entities. The impact of New York’s scrutiny on Opvee’s usage in other states and its implications on an ongoing federal purchase agreement potentially worth $113.8 million remains uncertain.

Purdue Pharma, the manufacturer infamous for OxyContin, is currently producing an injectable nalmefene product named Zurnai, which received FDA approval in 2024.

“In an epidemic born of greed, there is no room for profit-driven motives that exploit people’s lives,” stated Alexis Pleus, executive director of the advocacy group Truth Pharm. “We refuse to accept medications that intentionally heighten the suffering of those battling addiction, which is precisely what Opvee does.”

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