ASPR Investments Support a Broader Response to the Opioid Crisis: A Threat to National Security and Public Health
Opioids pose a serious and multifaceted threat to both national security and public health. They have been used as deadly weapons, as demonstrated in the Moscow Theater Crisis, and they remain at the center of a persistent public health emergency here at home. Every day, Americans struggle with opioid use disorder, and in 2024, opioid overdoses claimed more than 56,000 lives nationwide.
ASPR is helping address this threat on multiple fronts. We are developing new medical countermeasures and working to onshore production of existing active pharmaceutical ingredients and key starting materials needed to respond to opioid-related threats. At the same time, we are investing in a broad portfolio of medical countermeasures to ensure the nation is prepared to treat patients in the event of an attack involving opioids and to provide bystanders, first responders, and clinicians with better tools to save lives and support people affected by opioid use disorder.
In addition, ASPR supports communities across the country through the Medical Reserve Corps, helping state and local partners advance harm reduction efforts. ASPR also provides technical assistance to hospitals and healthcare coalitions as they work to respond to the opioid crisis.
The Longest-Running Public Health Emergency
On October 26, 2017, during the first Trump Administration, Acting HHS Secretary Eric Hargan formally declared the opioid crisis a public health emergency. Since then, it has become the longest-running public health emergency in U.S. history. Secretary Kennedy renewed the declaration as part of the Trump Administration’s continued commitment to addressing the opioid overdose crisis and as one of the critical steps being taken to Make America Healthy Again.
Repeated renewal of the public health emergency has allowed the federal government to sustain coordination efforts and preserve key flexibilities. These authorities enable HHS to continue responding to the opioid overdose crisis while also preparing for mass-casualty incidents involving opioids. Details on the declaration and its renewals are provided below.
Lifesaving Medical Countermeasures
The nation needs effective tools to confront the opioid threat. ASPR is investing in cutting-edge medical countermeasures and strengthening domestic production of proven products that help protect Americans from both weaponized opioids and overdose.
ASPR’s Center for Industrial Base Management and Supply Chain is supporting production of the key starting materials and active pharmaceutical ingredients used to manufacture opioid overdose reversal medications. By bringing production of these essential medicines back home, ASPR is reducing reliance on foreign sources, creating jobs in American communities, strengthening national security, reinforcing the nation’s medical supply chains, and helping address an ongoing public health crisis.
At the same time, ASPR’s Biomedical Advanced Research and Development Authority, or BARDA, continues to invest in countermeasures for CBRN threats, including treatments that reverse respiratory depression caused by opioid overdoses and other drugs commonly mixed with fentanyl. These countermeasures can be used by first responders, clinicians, and even bystanders. ASPR is also investing in other products with similar cross-cutting benefits.
| Product Name | Company Name | Type | Description |
|---|---|---|---|
| Thebaine | Antheia Inc. | Key Starting Material | Thebaine-derived medicines are critical for pain management, the treatment of alcohol use disorder, and opioid overdose reversal, yet they remain in short supply and rely on vulnerable global supply chains. ASPR invested in the expansion of domestic production of thebaine to reduce our dependence on foreign suppliers and strengthen national security.
|
| Naloxone | Apiject | Combination Product Development | Apiject will submit naloxone as the next combination product developed on the Apiject blow-fill-seal platform in a nasal spray application format for regulatory review to the FDA. Registration batches are on track to be complete in 2026. |
| Naxolone | Phlow | Active Pharmaceutical Ingredient
| Phlow’s manufacturing ecosystem can support 3 months’ worth of US demand for naloxone. |
| OPVEE (nalmefene) nasal spray | Indivior Inc. | Approved Product | OPVEE nasal spray is an emergency opioid overdose reversal treatment for known or suspected overdose induced by natural or synthetic opioids in adults and pediatric patients aged 12 years and older. |
| ENA-001 IM formulation | Enalare Therapeutics Inc. USA | Under Development | ENA-001 is a respiratory stimulant that increases ventilation and reverses respiratory depression. The MCM candidate can potentially be used as an emergency treatment against opioid- and other drug-induced respiratory depression. |
| OX390 dry-powder | Orexo US Inc. | Under Development | OX390 is a rescue nasal powder designed to treat overdoses involving drugs like xylazine and medetomidine often illicitly mixed with fentanyl. If approved, this drug could give first responders a powerful new tool to save lives in situations where current treatments fall short. |
| AI & quantum chemistry-based repurposable drug screen | Alamgir Research USA | Project Completed | This project addressed a key gap in opioid overdose treatment by focusing on respiratory stimulation targets. The screening approach identified FDA-approved drugs that may stimulate breathing and could be tested in the future for reversing drug-induced respiratory depression. |
The Medical Reserve Corps: Ensuring community needs are met before, during, and after emergencies
The Medical Reserve Corps (MRC) is a network of roughly 260,000 volunteers in more than 715 units nationwide working to improve the health and safety of your community. MRC volunteers are partnering with state and local leaders to reduce the devastating impacts of the opioid crisis and strengthen communities across the nation. The MRC has been a critical partner in combatting the opioid crisis since the initial declaration in 2017.
In 2025, MRC units in 37 states and territories responded to the opioid public health emergency by training community members to administer opioid overdose medication; connecting individuals to care; teaching harm reduction training; assembling and distributing naloxone harm reduction kits; and more.
670+
Activities
7,100
Hours
$280k
Value of Time
Learn more about the Medical Reserve Corps and find out how to join your local unit.
Technical Assistance
ASPR Technical Resources, Assistance Center, and Information Exchange (TRACIE) provides tools and technical assistance that can help healthcare facilities, health care coalitions, MRC units, and public health practitioners address the impacts of the opioid crisis in their communities. ASPR TRACIE’s Resource Library helps healthcare emergency planners address gaps in planning and response and the Information Exchange offers a peer knowledge exchange with near real-time support.
ASPR TRACIE developed two resources that can help the healthcare community address the opioid crisis: an article that highlights case studies and actions healthcare coalitions can take to address the opioid crisis, and another that features responses to FAQs for responders and other providers.
In addition, the Chemical Hazards Emergency Medical Management (CHEMM) is an online resource for emergency responders which includes resources to help responders.
Find Treatment
If you or someone you know is struggling with substance use disorder, please don’t wait. Help is available. Visit FindTreatment.gov to locate treatment options near you.
Public Health Emergency Declarations Addressing the National Opioid Crisis
March 16, 2026: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
December 15, 2025: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
September 18, 2025: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
March 18, 2025: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
December 20, 2024: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
September 19, 2024: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
March 25, 2024: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
December 21, 2023: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
September 26, 2023: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
March 31, 2023: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
December 22, 2022: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
September 29, 2022: Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis
January 3, 2022: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of the Opioid Crisis
October 6, 2021: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of the Opioid Crisis
January 7, 2021: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of the Opioid Crisis
October 7, 2020: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
July 6, 2020: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
April 2, 2020: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
January 24, 2020: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
October 16, 2019: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
July 17, 2019: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
April 19, 2019: Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
January 17, 2019: Renewal of Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
October 18, 2018: Renewal of Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
July 23, 2018: Renewal of Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
April 20, 2018: Renewal of Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
January 19, 2018: Renewal of Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis
October 26, 2017: Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis