Excluding the most vulnerable from equitable care: NY's ‘deal with Indivior’

During the COVID‐19 pandemic, New York state made a deal with Indivior, maker of Suboxone, to save money, at the risk of harming more people in the state living with opioid use disorder (OUD). This decision presents a major challenge for people with OUD, especially in the midst of a worsening opioid epidemic that is compounded by the COVID‐19 pandemic. Buprenorphine, a critical component of the drug Suboxone, is a life‐saving medication for people with OUD. It works by having a high affinity for the receptor that binds opiates — thereby kicking other opiates (fentanyl, heroin) off, and reducing the likelihood of overdose. Once on the receptor, the patient does not feel cravings or withdrawal. Unlike a regular opiate, buprenorphine has a ceiling effect that means it is very unlikely to cause an overdose.