The Substance Abuse and Mental Health Services Administration will no longer allow federal grants to purchase fentanyl test strips, reversing a four-year-old policy and alarming public health groups that call the cheap paper tools essential to reversing a historic decline in overdose deaths. The change, communicated in an agency letter reviewed by CBS News, cites an executive order from President Trump barring funding for programs that facilitate illegal drug use. Maritza Perez Medina of the Drug Policy Alliance said the sudden shift left advocates “astonished.”
Shreeta Waldon got the call on a Friday. Her organization, the Kentucky Harm Reduction Coalition, was losing a $400,000 federal grant. The money had paid for tens of thousands of fentanyl test strips—cheap, paper tools that let people check drugs for deadly contaminants.
Without it, Waldon said, her group has about a month’s supply left. “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,” she said. Waldon’s crisis is about to multiply across the country. The letter from SAMHSA, dated this week, states that agency funding cannot be used to purchase test strips designed to detect adulterants like fentanyl, xylazine, and medetomidine.
The strips cost about a dollar each. Users can test everything from powders to pills. The policy pivot reverses guidance from as recently as July 2025, when SAMHSA explicitly listed test strips as a fundable harm-reduction tool.
The agency’s justification rests on an executive order signed by President Trump in July 2025. That order declared SAMHSA money could not support programs that “only facilitate illegal drug use.” A Health and Human Services spokesperson told CBS News the new letter clarifies that mandate and advances a shift away from “practices that facilitate illicit drug use and are incompatible with federal laws.”
Here is what the study actually says. The evidence base for test strips is robust. They are not considered drug paraphernalia in 45 states and Washington, D.C.
States like Nevada and California maintain online directories to help people find them. The SUPPORT Act, passed by Congress in 2018 and reauthorized in 2025, protected their use. SAMHSA itself began backing harm reduction efforts, including test strips, in 2021. “It’s really a low barrier way to ensure that people know what they’re putting in their bodies,” said Medina, the Drug Policy Alliance’s federal policy director.
Knowing a substance is contaminated allows a person to make a different choice—using less, using with someone else, or not using at all. “Overdose deaths have come down from the peak that we saw during COVID, and that’s great, and that was done intentionally, because there was a lot of investment from the government to ensure that communities had what they needed.”
The numbers tell the story. US overdose deaths hit 111,000 in 2023. For the 12-month period ending in November 2025, the CDC reported that figure plummeted to roughly 68,000.
That 39% drop is one of the sharpest public health turnarounds in decades. Experts attribute it to a mix of factors: wider naloxone availability, a less potent drug supply, and harm reduction efforts that include test strips. Medina fears the funding cut will gut that progress. “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,” she said. “We’re still in the midst of the overdose crisis.
Federal funding cuts, coupled with taking away the real tools to help people... could very well lead to more drug use harms, including overdose.”
The economic toll extends beyond Kentucky. In South Carolina, A’zhane Powell runs Fyrebird Recovery on tight margins. Her organization lost a $4,000 grant.
The amount is small. The impact is not. Buying test strips in bulk now strains a budget with no slack. “How far will it go until we’re back to square one again?” Powell asked.
Fyrebird is now asking for donations. Waldon hopes states will tap opioid crisis settlement money to fill the gap. Christine Minhee operates a national database tracking those settlement funds.
She said the effort is complicated by a patchwork of state policies and a live debate over whether settlement dollars should backfill federal budget holes. Lauren Kestner, a division director at the Center for Prevention Services in North Carolina, worries the change will ripple through block grant funding—federal money that flows to states, then to local nonprofits providing everything from HIV treatment to medication for opioid use disorder. The HHS spokesperson noted that SAMHSA still prioritizes life-saving interventions, including naloxone, the overdose-reversing medication.
Powell said that assurance rings hollow after the test strip reversal. The Kentucky Harm Reduction Coalition distributed 48,465 fentanyl test strips in just the first quarter of the 2026 fiscal year. That pipeline now faces a hard stop.
The headline is dramatic. Test strips are a rare point of consensus in a polarized drug policy landscape. They do not encourage use.
They acknowledge it. A person determined to use drugs will use them. A strip offers a moment of informed decision-making.
Removing that moment, Medina argues, is “stripping people of the tools we know save lives.”
Before you panic, read the methodology. The executive order barring facilitation of illegal drug use is a broad instrument. Its application to test strips represents a specific interpretation—one that lumps a diagnostic tool in with the behavior it seeks to diagnose.
That logic unsettles even some law enforcement figures who have backed harm reduction as a pragmatic complement to interdiction. - Fentanyl test strips cost about $1 each and are legal in 45 states; SAMHSA funding for them is now barred under an executive order signed in July 2025. - The policy reversal threatens a 39% decline in US overdose deaths, which fell from 111,000 in 2023 to roughly 68,000 in late 2025. - Nonprofits from Kentucky to South Carolina are losing grants and scrambling for replacement funding, with some facing supply exhaustion within a month. - The change does not affect naloxone funding, but advocates say removing test strips undermines the full continuum of overdose prevention. Why it matters: The decision redefines the boundary between public health and drug enforcement. For years, the federal government funded tools that met people where they were—using drugs—to keep them alive long enough to seek treatment.
This reversal signals that such tools are now viewed as enabling, not saving, lives. The real-world consequence will be measured in overdoses that might have been prevented, in emergency rooms that fill up, and in the morgues of counties that had just started to see their numbers drop. What comes next is a scramble for cash.
Waldon and Powell are chasing donations and state settlement funds. The SUPPORT Act still protects test strip use on paper, but without federal dollars, the protection is symbolic. State governments face a choice: backfill the gap with their own money or let the strips run out.
Congress could clarify the law, but no such move is imminent. The overdose numbers for the next 12-month CDC report will be the first hard test of this policy’s human cost.
Key Takeaways
— - Fentanyl test strips cost about $1 each and are legal in 45 states; SAMHSA funding for them is now barred under an executive order signed in July 2025.
— - The policy reversal threatens a 39% decline in US overdose deaths, which fell from 111,000 in 2023 to roughly 68,000 in late 2025.
— - Nonprofits from Kentucky to South Carolina are losing grants and scrambling for replacement funding, with some facing supply exhaustion within a month.
— - The change does not affect naloxone funding, but advocates say removing test strips undermines the full continuum of overdose prevention.
Source: CBS News
