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

In April 2026, federal guidance changed: fentanyl test strips are no longer on the list of expenditures supported by federal harm-reduction grants, reversing prior guidance that had explicitly permitted them. The Drug Policy Alliance is tracking the change along with broader cuts and reorganizations affecting overdose-prevention infrastructure.

Test strips are a low-cost, evidence-supported tool. They don’t tell a person whether to use; they tell a person what’s in front of them. In a supply where medetomidine is increasingly mixed with fentanyl — and where the clinical picture for a polydrug overdose is messier than for fentanyl alone — knowing what’s in the supply matters more, not less, than it did three years ago.

What’s actually happening

The federal funding change does not ban test strips. It removes federal grant support for them, which means harm-reduction programs operating on a SAMHSA grant or its state pass-through now have to source another funding stream — opioid settlement dollars, philanthropic, or state appropriation — to keep distributing strips. Some states and counties are absorbing the cost. Some are not.

In Travis County, Texas, Central Health is expanding its naloxone distribution network to 45 self-serve, anonymous, 24/7 vending units between April and September 2026 — paid through county and settlement funds rather than federal harm-reduction grants. That’s the model many programs are moving toward. It works only if the local funding exists.

In Arizona, the supply chain for both naloxone (via the Hikma settlement shipment scheduled for late 2026) and harm-reduction infrastructure broadly is still federally and settlement-funded in different proportions. The April federal change shifts more weight onto the settlement and state side.

Why this matters for people in recovery

For people who use drugs: test strips are still available, still legal in most jurisdictions, and still effective. Local harm-reduction programs may now be more reliant on donations or settlement funds — but the strips themselves are not going away.

For people in recovery and their loved ones: this is a moment to know where naloxone is in your home, in your car, and in your community, and to know which local organization keeps the supply you would actually use. Federal funding volatility is now a feature of the system. The people closest to the work are absorbing it; the rest of us can support that work with attention and dollars.

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If you or someone near you is overdosing, call 911. Most states have Good Samaritan laws that protect callers and victims.