Fentanyl Emergency Room Testing: Sen. Melendez Introduces Bill

RIVERSIDE COUNTY, CA — A Riverside County lawmaker's bill that proposes requiring specific urine screening to detect fentanyl in a patient's system — with the goal of identifying the synthetic drug early for lifesaving treatment — was approved Thursday in a state Senate committee, clearing its first legislative hurdle.

"Hospitals need better tools for adequate testing to properly diagnose and treat fentanyl overdoses and drug addictions," Sen. Melissa Melendez, R-Lake Elsinore, said. "Today's unanimous support of Senate Bill 864 ensures California stays ahead of the curve as we try to address the growing tsunami of new and dangerous drugs entering our communities and to ultimately save lives."

SB 864, titled "Tyler's Law," was heard by the Senate Health Committee and will now go to the Senate Appropriations Committee for additional vetting.

If passed, the law would mandate that general acute care medical facilities maintain immunoassay drug test kits that can be used to screen for signs of fentanyl poisoning, apart from urine screenings already available to test for heroin, cocaine and other drugs.

The law is named for 19-year-old Tyler Shamash, who died in 2018 following a fentanyl ingestion. The young man, who had been battling drug addiction for a protracted period, had visited a hospital the day prior to his death and was screened for opioids, but the urine analysis was not designed to detect fentanyl, which triggered a massive coronary. Shamash was later found dead in his bed.

"I am truly thankful for Sen. Melendez and the members of the committee for approving this legislation in memory of my son," Juli Shamash said. "I hope SB 864 is just the first step the Legislature takes this year to truly address this deadly epidemic of fentanyl."

One of the principal supporters of the legislation, the California Emergency Nurses Association, said that synthetic opioid deaths were the leading cause of fatalities nationwide last year for those 18 to 45 years old — surpassing COVID-19 and suicide combined in that age group.

According to the California Health Care Foundation, the number of fentanyl-related deaths increased 500 percent statewide between 2018 and 2020, from 786 to 3,946.

The California Chapter of the American College of Emergency Physicians is also backing the bill and submitted a statement noting that "including fentanyl screening as part of routine drug screening will enable providers to give more appropriate treatment and to connect the patient to appropriate substance abuse disorder resources."

Fentanyl is manufactured in foreign labs and, according to the U.S. Drug Enforcement Administration, smuggled across the U.S.-Mexico border. The substance is known to be 80-100 times more potent than morphine and is a popular additive, mixed into any number of narcotics and pharmaceuticals.

In 2021, there were 391 fentanyl poisoning deaths in Riverside County, according to sheriff's Sgt. Edward Soto.

Melendez's 28th Senate District includes the cities of Blythe, Canyon Lake, Cathedral City, Coachella, Desert Hot Springs, Indian Wells, Indio, Lake Elsinore, La Quinta, Murrieta, Temecula, Palm Desert, Palm Springs, Rancho Mirage, and Wildomar.