Markey, Schumer, Warren, Booker, Smith Urge Behavioral Health Agency to Reverse Guidance Limiting Access to Life-Saving Tools for People with Substance Use Disorders

Letter Text (PDF)

Washington (May 8, 2026) - Senator Edward J. Markey (D-Mass.), top Democrat on the Primary Health and Retirement Security Subcommittee of the Health, Education, Labor, and Pensions (HELP) Committee today led his colleagues in writing to Christopher Carroll, Principal Deputy Assistant Secretary of the Substance Abuse and Mental Health Services Administration (SAMHSA), urging it to reverse new guidance barring grant recipients from purchasing and distributing life-saving tools, such as fentanyl test strips, for people with substance use disorders.

SAMHSA's new guidance defies evidence showing that harm reduction for substance use reduces overdose deaths and dangerous infections, threatening to reverse years of progress in combating the overdose epidemic. The new guidance also contradicts the President's National Drug Control Strategy, issued by the White House this week, which calls drug test strips "an important tool." Co-signers in the Senate include Democratic Leader Chuck Schumer (D-N.Y.), and Senators Elizabeth Warren (D-Mass.), Cory Booker (D-N.J.), and Tina Smith (D-M.N.).

In the letter, the lawmakers wrote, "SAMHSA's new guidance barring grantees from using federal funds to distribute syringes flies in the face of Congressional intent, undermining the programs designed to prevent outbreaks in the communities most vulnerable to them. It also creates a chilling effect on programs that distribute syringes, which may reject federal funding rather than risk violating increasingly restrictive guidelines. To abandon harm reduction is to do so at our own peril. At a time when this administration is raising the cost of health insurance, cutting Medicaid, and limiting funding for family planning clinics that offer testing for HIV and other infectious diseases, reducing access to clean syringes and test strips could be catastrophic. If this administration supports recovery from substance use disorder as it purports, you will support the resources that keep people alive long enough to get treatment. Every day this guidance remains in effect further risks the lives and safety of Americans."

In the House, the letter was led by Representatives Madeleine Dean (PA-04) and Brittany Pettersen (CO-07). Additional co-signers include Becca Balint (Vt.-At Large), Joyce Beatty (OH-03), Steve Cohen (TN-09), Angie Craig (MN-02), Suzan DelBene (WA-01), Dan Goldman (NY-10), Timothy Kennedy (NY-26), Greg Landsman (OH-01), Seth Moulton (MA-06), Jimmy Panetta (CA-19), Chellie Pingree (ME-01), Mark Pocan (WI-02), Jan Schakowsky (IL-09), and Paul Tonko (NY-20).

Senator Markey has been supportive of removing barriers to opioid use disorder (OUD) treatment, such as allowing people to take home doses of the medication methadone. In February 2024, SAMHSA announced a final rule to comprehensively update regulations governing Opioid Treatment Programs (OTPs), the first substantial updates to methadone access regulations in more than 20 years, which Senator Markey applauded. In March 2023, Senator Markey led a bicameral letter to SAMHSA expressing support for regulations that would expand access to OUD treatment, while highlighting barriers that continue to confront those seeking access to treatment.

In March 2023, Senators Markey and Rand Paul (R-Ky.), along with Representatives Donald Norcross (NJ-01) and Don Bacon (NE-02), introduced their bipartisan and bicameral Modernizing Opioid Treatment Access Act, which would improve patients' ability to access treatment for OUD by modernizing outdated rules, empowering board-certified physicians to prescribe methadone to patients, and allowing pharmacies to dispense methadone.

In December 2022, Senator Markey secured his bipartisan Opioid Treatment Access Act (OTAA)-legislation that reduces wait times for patients to qualify for treatment for OUD and expands access to methadone clinics-into the end-of-year omnibus spending package.

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