Laws, Regulations, and Policies

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.

• Key regulations to implement the Affordable Care Act

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).

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 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.

• About the Mental Health Parity and Addiction Equity Act

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 SUPPORT Act was reauthorized in December 2025.

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 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:

• Charitable Choice Regulations - Block Grant and Transition from Homelessness Formula Grants (CFR Title 42: Part 54)
• Charitable Choice Regulations - Discretionary Funding (CFR Title 42: Part 54a)

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:

• Regulations on Emergency Response (CFR Title 42: part 51d)

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. Additional information is available under 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:

• Certification of Opioid Treatment Programs (CFR Title 42: Part 8)

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:

• Understanding Confidentiality of Substance Use Disorder (SUD) Patient Records or “Part 2”
• FAQ: Applying the Substance Abuse Confidentiality Regulations (CFR Title 42: Part 2)

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:

• Regulations on the Protection and Advocacy Program (CFR Title 42: Part 51)

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.

• Tobacco Regulation for Substance Use Prevention, Treatment, and Recovery Services Block Grants: Final Rule - January 19, 1996 (PDF | 264 KB)

Learn more about SAMHSA’s Synar program.