Section

Harm Reduction

Naloxone, fentanyl test strips, xylazine, syringe services, safe supply.

69,973 Deaths. The Number That Proves Harm Reduction Works—and the Policy Quietly Undoing It.

A 13.9% drop in overdose deaths is the best news in years. Washington’s response: defund the tools that helped get us here.

CDC provisional data projects 69,973 overdose deaths for 2025—a 13.9% decline. The same spring, SAMHSA ended federal funding for fentanyl test strips. The drug supply has never been more dangerous.

Jun 1610 minRead

More in Harm Reduction

28 total in this section

02Harm ReductionJun 15

Responding to the Emerging Threat of Xylazine

On April 24, SAMHSA banned federal funding for fentanyl, xylazine, and medetomidine test strips for public distribution — precisely as the June 2026 Labcorp report shows medetomidine in 91% of Philadelphia's fentanyl supply. The policy contradiction that kills people who use drugs.

03Harm ReductionJun 13

The Drug Inside the Drug: How Medetomidine Is Breaking Every Overdose Response Playbook

Medetomidine, a veterinary sedative 200 times more potent than xylazine, has displaced xylazine in Philadelphia's fentanyl supply and is confirmed in nine states. It produces sedation that naloxone cannot reverse, withdrawal that requires ICU-level care in 91% of hospitalized patients, and clinical presentations that emergency departments are consistently misidentifying.

04Harm ReductionJun 10

The Strips That Won't Be Replaced

SAMHSA's April 24 Dear Colleague letter banned federal funding for fentanyl test strips. Columbus, Ohio is burning through its last inventory. Arizona's harm reduction programs are next — and the state's opioid settlement dollars weren't designed to fill a federal hole.

05Harm Reduction

Earlier in Harm Reduction

Every piece in this section, most recent first.

Harm Reduction

69,973 Deaths. The Number That Proves Harm Reduction Works—and the Policy Quietly Undoing It.

More in Harm Reduction

Responding to the Emerging Threat of Xylazine

The Drug Inside the Drug: How Medetomidine Is Breaking Every Overdose Response Playbook

The Strips That Won't Be Replaced

After Fentanyl: The DEA Just Scheduled Another Ketamine Analog. Here’s What’s Already Replacing It.

What Happens When You Give People With Severe AUD Their Daily Drinks

Cychlorphine Is in the Supply and Your Test Strips Won't Catch It

Earlier in Harm Reduction

Six Weeks After SAMHSA's Test Strip Ban, Here's What It Looks Like on the Ground

The April Memo That Ended the Test Strip Era

Federal Grantees Have Thirty Days

Xylazine's Treatment Gap: Why 'Tranq' Wounds and Withdrawal Still Lack a Clinical Playbook

SAMHSA Bans Federal Funding for Fentanyl Test Strips and Clean Syringes

SAMHSA Bars Fentanyl Test Strips and Syringes From Federal Block Grant Spending

The Harm Reduction Rollback: How SAMHSA's New Directives Are Cutting Off Xylazine Wound Care

When the Safety Net Is Cut: SAMHSA's Test Strip Ban and the Unraveling of America's Harm Reduction Infrastructure

SAMHSA Defunded Test Strips Three Weeks Before Arizona Posted a 17% Overdose Increase. The Timing Matters.

Galaxy Gas Litigation Is Maturing. The Inhalant Regulatory Vacuum Isn't Closing.

DEA Says the Drug Supply Has Outpaced Naloxone Again — This Time It's Cychlorphine

DEA Advisory: Fentanyl Mixtures Are Outpacing Naloxone

Galaxy Gas, Oregon HB 3447, and the slow-motion crackdown on recreational nitrous oxide

More than test strips: what SAMHSA's April 24 letter signals about the next chapter of harm reduction

Federal funding pulled from fentanyl test strips: what that means on the ground

Naloxone vending machines and $19 OTC Narcan: the new harm-reduction infrastructure

Substance Spotlight: The Drug Supply Stops Being Just Fentanyl

Xylazine: What It Is, and Why It's Changing Overdose Response

Living Through the Fentanyl Era: A Harm Reduction Primer

Xylazine: What Frontline Workers Need to Know

Living Through the Fentanyl Era