Laws and regulations pertaining to substance abuse and mental health services, SAMHSA programs, and related topics
Federal Laws Related to SAMHSA
Affordable Care Act
The Affordable Care Act of 2010 is one aspect of a broader movement toward reforming the health care system. The Affordable Care Act makes health insurance more affordable for individuals, families, and small business owners. People living with mental health challenges or substance use disorders often have problems getting private health insurance. Now there are special insurance protections to help.
Americans with Disabilities Act
The Americans with Disabilities Act (ADA) establishes requirements for equal opportunities in employment, state and local government services, public accommodations, commercial facilities, transportation, and telecommunications for citizens with disabilities—including people with mental illnesses and addictions.
Children’s Health Act
The Children’s Health Act of 2000 (PDF | 531 KB) reauthorizes SAMHSA programs that work to improve mental health and substance abuse services for children and adolescents. It also provides SAMHSA the authority to implement proposals that give U.S. states more flexibility in how they use block grant funds, with accountability based on performance. The Act also allows SAMHSA to consolidate discretionary grant authorities, which provides the Secretary of HHS with more flexibility to respond to individuals and communities in need of mental health and substance abuse services. It also provides a waiver from the requirements of the Narcotic Addict Treatment Act, allowing qualified physicians to dispense (and prescribe) Schedule III, IV, or V narcotic drugs, or combinations of such drugs, approved by the Food and Drug Administration (FDA) to treat heroin addiction. Additionally, the Act provides a comprehensive strategy to combat methamphetamine use.
Garrett Lee Smith Memorial Act
The Garrett Lee Smith Memorial Act, signed into law in October 2004, was the first legislation to provide funding specifically for youth suicide prevention programs. Under this legislation, funding was set aside for campuses, states, tribes, and U.S. territories to develop, evaluate, and improve early intervention and suicide prevention programs. This funding appropriation authorizes the GLS Suicide Prevention Program, which is administered by the SAMHSA Center for Mental Health Services (CMHS).
Mental Health Parity and Addiction Equity Act
The Mental Health Parity and Addiction Equity Act of 2008 requires insurance groups offering coverage for mental health or substance use disorders to make these benefits comparable to general medical coverage. Deductibles, copays, out-of-pocket maximums, treatment limitations, etc., for mental health or substance use disorders must be no more restrictive than the same requirements or benefits offered for other medical care.
- About the Mental Health Parity and Addiction Equity Act
- Interim Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; Final Rule (45 CFR Part 146) (PDF | 361 KB)
Sober Truth on Preventing (STOP) Underage Drinking Act
The STOP Act of 2006 authorized:
- A grant program providing additional funds to current or former grantees under the Drug Free Communities Act of 1997 to prevent and reduce alcohol use among youth ages 12-20
- A national, adult-oriented public service media campaign
- The federal Interagency Coordinating Committee on the Prevention of Underage Drinking, which provides high-level leadership from SAMHSA and other federal agencies to coordinate federal efforts to prevent and reduce underage drinking. The coordinating committee is also responsible for providing an annual report to Congress.
Tribal Law and Order Act (TLOA)
The purpose of the TLOA is to institutionalize reforms within the federal government so that justice, safety, education, youth, and alcohol and substance abuse prevention and treatment issues relevant to Indian country remain the subject of consistent focus, not only in the current administration, but also in future administrations. The law requires a significant amount of interagency coordination and collaboration between the Department of Justice (DOJ), the Department of the Interior (DOI), and the Department of Health and Human Services (HHS).
Federal Regulations Related to SAMHSA
Federal regulations apply to states, local governments, and religious organizations that receive Substance Abuse Prevention and Treatment Block Grants or Projects for the Assistance in the Transition from Homelessness Formula Grants, or both. The following federal regulations apply to states, local governments, and religious organizations that receive discretionary funding to pay for substance use prevention and treatment services:
The following federal regulations detail grant application procedures for states and Indian tribes to support local community emergency response related to substance use and mental illness:
Protection and Advocacy for Individuals with Mental Illness Program
The following federal regulations detail the requirements of protection and advocacy services receiving federal assistance under the Protection and Advocacy for Mental III Individuals Act of 1986:
The Synar Amendment to the Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act of 1992 requires states to enact and enforce laws prohibiting the sale or distribution of tobacco products to anyone under the age of 18.
The SAMHSA Center for Substance Abuse Prevention oversees implementation of the Synar Amendment and can withhold Substance Abuse Prevention and Treatment Block Grant funds from states that do not comply with the Synar requirements.
- Tobacco Regulation for Substance Abuse Prevention and Treatment Block Grants: Final Rule - January 19, 1996 (PDF | 259)
Learn more about SAMHSA’s Synar program.
Mandated by Executive Order 12564 and Public Law 100-71, the Federal Drug-Free Workplace Program is a comprehensive program that:
- Addresses illegal drug use by federal employees
- Certifies executive agency drug-free workplace plans
- Identifies safety-sensitive positions subject to random drug testing
The SAMHSA Center for Substance Abuse Prevention is responsible for oversight of HHS-certified laboratories operating under the mandatory guidelines for federal workplace drug testing programs.
The following Federal Register notice announces proposed revisions to the mandatory guidelines for the federal workplace drug testing programs. The guidelines establish the scientific and technical procedures for federal workplace drug testing programs and establish standards for the certification of laboratories engaged in drug testing for federal agencies:
- Notice of Proposed Changes to the Mandatory Guidelines for the Federal Workplace Drug Testing Programs - April 13, 2004 (PDF | 409 KB)
The following Federal Register notice details the final notice of revisions to the mandatory guidelines for the federal workplace drug testing programs:
The following Federal Register notice highlights a correction to the effective date of the revisions to the mandatory guidelines for the federal workplace drug testing programs published in the Federal Register on November 25, 2008:
- Mandatory Guidelines for Federal Workplace Drug Testing Programs - December 10, 2008 - Corrections to the Effective Date (PDF | 138 KB)
Learn more about SAMHSA’s drug-free workplace programs.
In the United States, treatment of opioid dependence with opioid medications is governed by Federal Regulation 42 CFR Part 8, which provides for an accreditation and certification-based system for opioid treatment programs. The regulation acknowledges that addiction is a medical disorder that may require differing treatment protocols for different patients.
The Division of Pharmacologic Therapies, part of the SAMHSA Center for Substance Abuse Treatment, is responsible for overseeing accreditation standards and certification processes.
The following federal regulations specify the procedures for the certification of opioid treatment programs to dispense opioid drugs in the treatment of opioid addiction:
Learn more about medication-assisted treatment.
Patient Record Confidentiality
The following federal regulations specify restrictions concerning the disclosure and use of patient records pertaining to substance abuse treatment that federal programs maintain:
- Confidentiality of Alcohol and Drug Abuse Patient Records (CFR Title 42: Part 2)
- FAQ: Applying the Substance Abuse Confidentiality Regulations (CFR Title 42: Part 2)
Other Federal Regulations Related to SAMHSA
Many federal regulations related to SAMHSA are listed under Title 42: Public Health of the Code of Federal Regulations (CFR). The regulations are accessible online in the e-CFR, an up-to-date electronic posting of the CFR: