NRHA statement on recent SAMSHA grant funding cuts.

On January 13, 2026, the Substance Abuse and Mental Health Services Administration (SAMHSA) sent letters of termination for thousands of federal grants for behavioral health and substance use disorder programs administered by agency. Over 2,000 grants approaching a total of $2 billion were reported to have been terminated. These grants supported programs for pregnant and postpartum women, youth overdose education and prevention, medication assisted treatment, recovery, drug courts, among other initiatives. These programs provide an important avenue to treat and prevent substance use, including opioid use disorders (OUD). In rural areas, about 7.2 million adults misused prescription opioids at least once in the previous year, with approximately 1.2 million of those adults residing in a nonmetropolitan area.

On January 15, 2026, SAMHSA reinstated grants following pushback from stakeholders and advocates. This 24-hour reversal demonstrates the importance of health care funding across America. NRHA applauds the immediate action to reverse the termination of these federal grants as these programs are essential to rural health care. Between 2020 to 2024, overdose rates for men and women in rural counties slowly improved but still lagged behind improvement in urban areas. Behavioral health resources are needed in rural areas to continue to reduce overdose rates and close the gap between rural and urban outcomes. About 62% of counties in the US with the highest rates of OUDs are in rural areas.

NRHA emphasizes the importance of continued funding of vital behavioral health programs and avoidance of any future cuts towards these programs. Cutting these funds strains an already struggling rural behavioral health workforce, puts rural Americans at a higher risk of poor behavioral health outcomes, and limits support systems that provide treatment for substance use disorders in rural areas.