To the Editor Dr Harris and colleagues presented a timely and comprehensive Review of pharmacological treatments for opioid use disorder. The section on overdose management is detailed and well structured, placing appropriate emphasis on naloxone and summarizing the most recent evidence supporting its effectiveness. However, despite the broad scope of the Review, nalmefene was not discussed. Nalmefene is an opioid antagonist approved for alcohol use disorder and, more recently, for the reversal of opioid overdose. It first received US Food and Drug Administration (FDA) approval in 1995 as an injectable agent for overdose reversal but was withdrawn from the market approximately a decade later. A new approval was granted in 2023, when the FDA authorized an intranasal formulation for opioid overdose. Subsequently, in 2024, an autoinjector formulation (for subcutaneous or intramuscular administration) was also approved for the same indication.