Every year, the Oklahoma Department of Mental Health and Substance Abuse Services distributes tens of thousands of fentanyl test strips to partner agencies and through its own mail-order harm reduction program.
But after receiving word in late April that the federal government will no longer pay for test strips, Oklahoma department officials are evaluating what's next.
Test strips are thin pieces of treated paper that can be used to quickly determine whether drugs or medicines contain deadly fentanyl or other contaminants. The federal government has championed test strips since 2021, paying to supply them to states, including Oklahoma. The Trump administration expressed support for the method as recently as July.
But last month, federal policy swiftly changed course in a letter sent to state health departments and grant recipients nationwide.
The Substance Abuse and Mental Health Services Administration announced federal funds could not be used to pay for the strips because they are "intended for use by people using drugs." It's part of a broader effort by the federal government to push back against harm reduction practices, which it says have been used to "facilitate illegal drug use."
Similar apprehension about harm reduction is being echoed at the state level. Bills to extend protections for safe injection initiatives failed at the Capitol this year, despite lawmakers' decision to carve out legal permission for registered providers to hand out clean needles to prevent the spread of Hepatitis C and HIV.
Fentanyl test strips also used to be illegal in Oklahoma, until House Bill 1987 differentiated the tests from drug paraphernalia in 2023.
The same year, the state Department of Mental Health launched its "OK I'm Ready" program, allowing Oklahomans to order naloxone and fentanyl test strips straight to their door at no cost.
In 2023, the agency fulfilled 56,635 test requests across the state.
The agency no longer lists fentanyl test strips as available for order, which it previously had available as recently as April 1. The department is re-evaluating the program in light of recent federal guidance, an agency spokesperson said.
"Naloxone also remains widely available and can reverse opioid overdoses, including those involving fentanyl," the spokesperson wrote in an email. "Fentanyl test strips are still available through community-based organizations, treatment providers and some medical supply distributors."
In a footnote, the SAMHSA letter says the change does not apply to "healthcare professionals using drug testing technologies in the regular course of discharging their professional duties, or as specifically authorized by the program statute."
That means federal funds can still be used to buy fentanyl test strips for use by behavioral health organizations that partner with the state, according to an agency spokesperson for the Department of Mental Health.
Since 2023, the department has disseminated 56,452 fentanyl test kits to partners, including crisis and addiction resource centers. Money for those fentanyl test strips, which cost about $1 each, also comes from the federal government.
The most recent wave of the opioid epidemic has been dominated by fentanyl. At its peak in Oklahoma in 2023, fentanyl was identified in toxicology reports of 54.8% of the people who died from unintentional drug overdoses. In 2024, just below half of drug overdoses in the state involved fentanyl.
This report was produced by the Oklahoma Public Media Exchange, a collaboration of public media organizations. Help support collaborative journalism by donating at the link at the top of this webpage.
