Laws, Regulations, and Policies
Laws and regulations pertaining to substance abuse and mental health services, SAMHSA programs, and related topics.
Federal Laws Related to SAMHSA
The Patient Protection and Affordable Care Act (PDF | 2.4 MB) (Public Law 111-148) (ACA) was passed by Congress in 2010 and included several provisions aimed at helping people living with mental health conditions or substance use disorders.
The Americans with Disabilities Act of 1990 (PDF | 8 MB) (Public Law 101-336) as amended in 2008 (PDF | 142 KB) (Public Law 110-325) 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.
In 2022, SAMHSA received unprecedented supplemental funding to address the nation’s mental health and substance use crises and make our communities safer, thanks to the Bipartisan Safer Communities Act (PDF | 257 KB) (Public Law 117-159) (BSCA).
BSCA provided SAMHSA $800 million over four years, from Fiscal Years 2022 to 2025. Of the $800 million, $150 million was dedicated to the 988 Suicide & Crisis Lifeline and the remainder to SAMHSA’s Center for Mental Health Services (CMHS). See a full list of SAMHSA’s CMHS BSCA grantees (PDF | 250 KB). Watch a video of our grantees (2 minutes) talking about the impact of BSCA funding on their communities.
BSCA directed SAMHSA to provide critical additional support for its grants and programs specifically allocating funding for:
- Certified Community Behavioral Health Clinics (CCBHCs);
- Community Mental Health Services Block Grants (MHBG);
- Project Advancing Wellness and Resiliency in Education (AWARE);
- Trauma-Informed Services in Schools (TISS);
- Resiliency in Communities after Stress and Trauma (Re-CAST);
- The 988 Suicide & Crisis Lifeline;
- Mental Health Awareness Training (MHAT);
- The National Child Traumatic Stress Initiative (NCTSI).
The Consolidated Appropriations Act, 2023 (PDF | 4.1 MB) (Public Law 117–328) (CAA 23) was enacted in December of 2022. The CAA, 23 funded SAMHSA for Fiscal Year 2023 and included several provisions that reauthorized, strengthened, and expanded mental health and substance use disorder (MH/SUD) programs administered by SAMHSA. The CAA 23 contained many provisions that fall under SAMHSA’s jurisdiction including reauthorization of the State Opioid Response program and the substance use and mental health block grants.
The Comprehensive Addiction and Recovery Act of 2016 (PDF | 373 KB) (Public Law 114-198) (CARA) authorized over $181 million each year (must be appropriated each year) to respond to the opioid epidemic and was intended to greatly increase both prevention programs and the availability of treatment programs.
The Consolidated Appropriations Act, 2023 (Public Law No: 117-328) restricts the amount of direct salary to Executive Level II of the Federal Executive Pay scale. The Office of Personnel Management released new salary levels for the Executive Pay Scale and effective January 1, 2024, the salary limitation for Executive Level II is $221,900.
For awards issued prior to this change, if adequate funds are available in active awards, and if the salary cap increase is consistent with the institutional base salary, recipients may re-budget to accommodate the current Executive Level II salary level. However, no additional funds will be provided to these grant awards.
The Mental Health Parity and Addiction Equity Act of 2008 (PDF | 562 KB) (Public Law 110-343) 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.
The STOP Act of 2006 (PDF | 149 KB) (Public Law 109-422) authorized:
- A grant program to prevent and reduce alcohol use among youth ages 12-20 for current or former grantees under the Drug Free Communities Act of 1997 (PDF | 231 KB).
- SAMHSA’s “Talk. They Hear You.” prevention campaign helps parents and caregivers, educators, and community members get informed, be prepared, and take action to prevent underage drinking and other substance use.
- The federal Interagency Coordinating Committee on the Prevention of Underage Drinking provides national leadership in federal policy and programming to support state and community activities that prevent and reduce underage drinking.
The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (PDF | 749 KB) (Public Law 115-271) (SUPPORT Act) addressed the nation’s opioid overdose epidemic through provisions to strengthen the behavioral health workforce by increasing addiction medicine education; standardizing the delivery of addiction medicine; expanding access to high-quality, evidence-based care; further expanding the practice of and trauma-informed care, increasing prevention efforts and covering addiction medicine in a way that facilitates the delivery of coordinated and comprehensive treatment.
The Tribal Law and Order Act of 2010 (PDF | 233 KB) (Public Law 111-211) institutionalized reforms within the federal government to maintain a consistent focus on the issues relevant to Indian country, including alcohol and substance use prevention and treatment issues. 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 Use Prevention, Treatment, and Recovery Services Block Grant 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:
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:
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:
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.
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.
The following federal regulations specify restrictions concerning the disclosure and use of patient records pertaining to substance abuse treatment that federal programs maintain:
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 Use Prevention, Treatment, and Recovery Services Block Grant funds from states that do not comply with the Synar requirements.
Learn more about SAMHSA’s Synar program.