In late February, Broome County Sheriff Fred Akshar sent a letter to Gov. Kathy Hochul that began with the words, “I am writing to you today from the front lines of the fight against the opioid epidemic.”

In the letter, he said that naloxone, the opioid antagonist that’s now widely available in New York, has been invaluable, but it’s not sufficient in the fight against fentanyl.

Akshar is urging the state to add a new FDA-approved “fentanyl fighter” to the arsenal of tools that New York has to fight overdoses.

“Statewide, we’re seeing significant increases (in overdoses), specifically around the issue of fentanyl being found in overdose-related deaths,” Akshar told Capital Tonight. “Back in 2015, 30% (of deaths were attributed to fentanyl). Today, we’re in the 90s. So I think the picture is very clear.”

Akshar is referring to nalmefene hydrochloride – a nasal spray for the emergency treatment of known or suspected opioid overdoses in adults and pediatric patients 12 years of age and older – which was recently approved by the FDA.

According to anecdotal evidence, Akshar thinks that Opvee, which is the common name for nalmefene hydrochloride, may work better to revive patients who have OD’d on synthetic opioids (fentanyl) than Narcan.

But registered opioid overdose programs in New York are only furnished with naloxone (Narcan) by the state Department of Health, not any other antagonists.

In response to an emailed inquiry to NYSDOH, a spokesperson sent the following statement:

“The State Department of Health whole-heartedly agrees that we must work together to develop programs, services, and strategies to treat opioid use disorder and prevent overdose deaths.

"Nalmefene, the generic for Opvee, has no known history of use in emergency department or ambulance settings in New York State and the is currently no evidence there is a need, or additional benefit, for this product.”

Former general counsel for the Biden administration’s White House of National Drug Control Policy Robert Kent, president of Kent Strategic Advisors, LLC and former general counsel for the New York State Office of Addiction Services and Supports, argues that the state of New York last issued a competitive procurement when there was only one naloxone product available, and it’s time for a new competitive procurement.

“DOH is currently approved to spend $20 million for naloxone. The taxpayers of New York should expect that their tax dollars are used to make the biggest impact towards reversing overdose and death. That is not happening right now. Overdoses have increased by 73% since 2018 and they continue to increase year after year. The state should issue a new procurement so that they can buy more product to save more lives,” Kent told Capital Tonight.