California becomes 1st in US to include fentanyl testing in ER screenings

Hospitals across the state are preparing to add fentanyl to routine drug screenings for suspected overdose patients— with a goal of identifying the synthetic drug early for life-saving treatment. 

SB-864, titled "Tyler’s Law," says if a provider chooses to do a urine drug screen test, fentanyl will be automatically included in that test. The law would ensure the hospital provides testing access and capability.

"I basically contacted every senator in the state of California and Sen. Melendez is the one who responded and we got the law going from there," said Juli Shamash, founder of the Drug Awareness Foundation.

The bill was authored by Sen. Melissa Melendez (R-Lake Elsinore) and signed by Gov. Gavin Newsom on Aug. 22.

"It’s just a way of honoring my son and making his death not be in vain."

The law was named after Juli’s 19-year-old son who died in 2018 following a fentanyl ingestion. After Tyler’s death, Juli wanted to prevent anyone else from suffering the same heartache. 

"The night before he died he was sent to the hospital with a suspected overdose. When he got there they did a drug test and it turned out negative," said Shamash. "After he died we found out it did not cover fentanyl because it was a synthetic opioid."

Fentanyl can be found in methamphetamine, cocaine, heroin, vaping products, as well as counterfeit Xanax, hydrocodone or Oxycodone.  Some who fatally experience fentanyl may have done so without their knowledge.

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A standard urine drug screen includes a minimal of the "Federal 5" drugs being tested - namely opiates, amphetamines, THC, PCP, and cocaine. 

Since fentanyl is a synthetic opioid, it does not show up during a routine urine drug screening test.

"Only 5%  of people who overdose get tested for fentanyl. We’re very excited here in California this is the first state to have such a law," said Emergency Medicine Specialist Dr. Roneet Lev, who co-sponsored the bill.

"It doesn’t require people to be tested, but if you’re going to test, why would you not test for the number one drug people are dying from in America," said Dr. Lev.

Statistics show the opioid crisis has significantly worsened since fentanyl entered the illicit drug market.   The number of fentanyl-related deaths increased 500% statewide between 2018 and 2020, from 786 to 3,946— according to the California Health Care Foundation. 

Testing for fentanyl can play a key role in saving someone’s life. It can alert a provider that a patient has fentanyl in their system, warn a patient they have ingested fentanyl, or connect people to treatment or a prescription for naloxone – the lifesaving reversal drug.

"I feel like Tyler’s death could have been prevented." 

Juli says Tyler was a whiz at technology and was a computer genius that could program or hack anything. He was one of the first people to get into bitcoin. She imagines he would have become a video game designer or cybersecurity expert if his life wasn’t cut short. 

"It just frustrates me because myself and parents all over the country are doing everything we can to spread the word. Either the kids aren’t listening or they think they’re invincible. Something is not getting through and we just don’t know how to reach them," she said.