California bill requiring fentanyl inclusion in routine urine drug screening advances to second chamber

Senate Bill 864, also known as Tyler’s Law, sponsored by Sen. Melissa Melendez (R–Lake Elsinore), unanimously passed its third reading on the Senate Floor on Monday.

 

Get the latest state-specific policy intelligence for the health care sector delivered to your inbox.

 

The bill requires a general acute care hospital to include testing for fentanyl in a urine drug screening if the hospital conducts a urine drug screening to assist in diagnosing the patient’s condition.  

“SB 864 is about making sure emergency room doctors can play a key role in identifying overdoses,” Melendez said.

The bill is named after Tyler Shamash, who passed away due to a fentanyl overdose after failing to be tested for synthetic opioids. Tyler’s mother, Juli Shamash, is a co-sponsor of the bill. She said 76% of drug deaths for Americans between the ages of 15 and 24 are due to fentanyl, and that most of these deaths are due to counterfeit drugs that are made from fentanyl —something users are often unaware of.

Supporters of the bill emphasize that current routine drug screens do not capture fentanyl use and that many patients are unaware that they are using fentanyl, as it has been found in methamphetamine, cocaine, and counterfeit drugs such as Xanax. 

“Tyler’s story is just one example of a doctor [who is] unaware that a separate fentanyl screening test is necessary,” Shamash said at the bill’s Senate Health Committee hearing in March. 

The bill is also sponsored by Dr. Roneet Lev, an emergency physician in San Diego. Lev says California fentanyl deaths have gone up five-fold in the last two years, and in San Diego, the medical examiner is currently dealing with an average 2.5 deaths a day from fentanyl.

“Increasingly, hospitals around California are including fentanyl as part of their standard rapid urine drug screen,” Lev said at the Senate Health Committee hearing. “This bill will push the rest of California’s hospitals to do the same.”

Testing for fentanyl in routine urine drug screening would not only inform the patient and health provider, but also friends of the patient that may be using the same drug supply, the bill’s supporters also noted.

The provisions of this bill will sunset on Jan. 1, 2028. It now waits to be heard in the Assembly.