Full Breakdown
Federal Funding Ban Threatens Fentanyl Test Strip Program
5/4/2026, 4:36:13 AM
Federal Funding Ban on Test Strips
The Substance Abuse and Mental Health Services Administration (SAMHSA) issued a “Dear Colleague” letter stating that federal funds may not be used to purchase test strips that detect fentanyl, xylazine, or medetomidine. The guidance cites an executive order signed by President Donald Trump in July 2025, which bars SAMHSA funding for programs that “only facilitate illegal drug use.” The change reverses a July 2025 SAMHSA notice that had allowed such purchases.
Background and Policy Shift
SAMHSA began supporting harm-reduction tools, including test strips, in 2021. A 2025 agency notice listed the strips as eligible for grant support, and the 2018 SUPPORT Act—reauthorized in 2025—protected their use. Test strips are not classified as drug paraphernalia in 45 states and the District of Columbia; Nevada and California provide online directories for obtaining them. The new guidance marks a departure from the agency’s prior stance.
Key Advocates and Organizations
- Maritza Perez Medina, director of federal policy, Drug Policy Alliance.
- Shreeta Waldon, executive director, Kentucky Harm Reduction Coalition (KHRC).
- A’zhane Powell, founder and CEO, Fyrebird Recovery (South Carolina).
- Lauren Kestner, division director, Center for Prevention Services (North Carolina).
- HHS spokesperson, representing the U.S. Department of Health and Human Services.
Data and Statistics
- Test strips cost roughly $1 each.
- KHRC distributed 48,465 strips in the first quarter of fiscal 2026.
- The agency’s funding cut eliminates a $400,000 grant to KHRC and a $4,000 grant to Fyrebird Recovery.
- Overdose deaths fell from 111,000 in 2023 to about 68,000 for the 12-month period ending November 2025, according to CDC data.
Official Statements and Agency Response
A HHS spokesperson explained that the SAMHSA letter “clarifies guidance for grantees and furthers the agency’s shift away from practices that facilitate illicit drug use and are incompatible with federal law.” The agency emphasized continued support for proven interventions such as the overdose-reversing medication naloxone.
Criticism and Opposition
Advocates argue the policy undermines evidence-based harm reduction. They contend that removing test strips jeopardizes lives and reverses recent gains in overdose prevention.
On-the-Ground Impact
KHRC warns it now has only a month’s supply of strips, describing an imminent “full-blown crisis.” Fyrebird Recovery, operating on narrow margins, is seeking donations to replace the lost grant. The Center for Prevention Services expressed concern that the change may limit access to pass-through block grant funding for a range of services, from medication-assisted treatment to HIV care.
Conflicting Reports and Gaps
SAMHSA’s justification frames test strips as facilitating illegal use, while multiple organizations cite scientific studies confirming their effectiveness in preventing fatal overdoses. No quantitative impact assessment of the funding cut is provided in the sources.
Verbatim Quotes
- “People are just astonished,” — Maritza Perez Medina, Drug Policy Alliance.
- “There has been a lot of confusion about where this came from.” — Maritza Perez Medina, Drug Policy Alliance.
- “It doesn't make sense that one day something is an evidence-based protocol, and you decide, because of political climate, it is no longer evidence-based,” — Shreeta Waldon, Kentucky Harm Reduction Coalition.
- “If they follow the science and the data, we would never move in this direction.” — Shreeta Waldon, Kentucky Harm Reduction Coalition.
- “How far will it go until we're back to square one again?” — A’zhane Powell, Fyrebird Recovery.
- “Our fear is that if we are gutting all the things that work, that when people seek help, they won't find any doors open," Medina said.” — Maritza Perez Medina, Drug Policy Alliance.
What’s Next
Advocates urge states to allocate opioid-settlement funds toward harm-reduction services, though implementation varies by jurisdiction. Future SAMHSA guidance and congressional oversight may determine whether test strips regain federal eligibility.
