WASHINGTON — The Trump administration is expanding restrictions on how federal funds can be used for harm reduction services aimed at people who use illicit drugs.
The Substance Abuse and Mental Health Services Administration (SAMHSA) recently updated its guidance, stating that Department of Health and Human Services (HHS) funding cannot be used to purchase or distribute syringes or needles used to inject illicit drugs, pipes or supplies for safer smoking kits, or fentanyl and other drug-testing strips, including those used to detect xylazine and medetomidine.
The guidance also prohibits the use of federal funds to support “overdose hotlines” that primarily provide a virtual or phone-based presence while someone is using drugs.
During a Grieving Out Loud podcast, the director of the SafeSpot Overdose Hotline at Boston Medical Center described how such services have helped save lives. The hotline connects callers with someone who stays on the line while they use drugs and can contact emergency services if needed.
Kimber King, now a peer support specialist, said she called the hotline because she feared overdosing but felt too ashamed to reach out to someone she knew. When she overdosed, emergency responders were able to reach her in time.
“I really think it was my guardian angel tapping me on the shoulder and guiding me to the hotline,” King said.
In addition to overdose hotlines, the updated policy states that HHS funding cannot be used to purchase or distribute sterile water, saline or ascorbic acid (vitamin C) used to facilitate drug use. It also bars funding for other paraphernalia not explicitly listed as allowable.
SAMHSA’s guidance outlines several services that remain eligible for federal funding, including opioid overdose reversal supplies such as naloxone and nalmefene, medication lock boxes and disposal kits, overdose prevention education, wound care supplies, and FDA-approved home testing kits for HIV and viral hepatitis.
Other supported services include sharps disposal kits, referrals for hepatitis A and B vaccinations, navigation services for HIV and hepatitis care, education on infectious disease prevention, and nicotine cessation therapies.
“To finally bring an end to this crisis and achieve the Great American Recovery, it is essential that the use of federal funding is aligned to common-sense public health strategies that focus on prevention, treatment, and long-term recovery,” SAMHSA Principal Deputy Assistant Secretary Christopher Carroll said.
