SAMHSA Prohibits Use Of Grant Funding For Fentanyl Test Strips & Overdose Hotlines In Updated Guidance

May 5, 2026

The Substance Abuse and Mental Health Services Administration (SAMHSA) added two more substance use harm reduction practices that cannot be supported by grant funding, according to guidance issued on April 24, 2026, that updates guidance issued on July 29, 2025. Both guidance documents emphasize a federal shift away from certain harm reduction practices. The April guidance explicitly prohibits the use of grant funding to supply fentanyl test strips or fund overdose hotlines that provide only a virtual or telephonic companion to people using drugs. Neither had been mentioned in the July guidance.

The July guidance outlined the administration’s shift away from harm reduction services such as syringe exchanges or safe injection sites, which the administration states facilitate illicit drug use. The new guidance, issued as a Dear Colleague letter on April 24, 2026, states that test strips and overdose hotlines are incompatible with the administration’s priorities.

Like the July 2025 guidance, the new guidance states that SAMHSA funding can be used for the purchase and distribution of opioid overdose reversal medications (naloxone and nalmefene). It can also be used to purchase medication lock boxes, medication disposal kits, and training on how to use overdose reversal medications.

Grant funding can also be used to purchase supplies to prevent infectious diseases such as viral hepatitis (types A, B, or C), human immunodeficiency virus (HIV), and sexually transmitted diseases (STDs). Funding can also be used for nicotine cessation therapies. Eligible supplies include wound care supplies, home testing kits for viral hepatitis and HIV, and sharps disposal kits. It also includes navigation services to ensure linkage to HIV and viral hepatitis prevention, testing, treatment, and care services, as well as education on preventing hepatitis, HIV, and other STDs.

Grantees cannot use federal funding directly or through subsequent reimbursement to purchase and distribute supplies and services that SAMHSA considers to facilitate the use of illicit drugs.

A link to the full text of Updated Funding Guidance For Grantees On Supplies & Services is in the OPEN MINDS Circle Library.

For more information, contact: Christopher Carroll, MSc, Principal Deputy Assistant Secretary, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, Maryland 20857; Fax: 240-276-2135; Email: media@samhsa.hhs.gov; Website: https://www.samhsa.gov/