In 2018, 19-year-old Tyler Shamash was taken to an Emergency Department (ED) in California. Although EDs test for drugs in the urine of patients, fentanyl is one drug that is presently not tested. Furthermore, two of the nation's top lab facilities, Quest Diagnostics and LabCorp, do not test for fentanyl in their routine urine drug screenings (UDS) that may be required for either colleges and universities or even employment. Based on current research, it does not appear that Quest Diagnostics offers a UDS with the capability of testing for fentanyl. With LabCorp, requesting a UDS that tests for 15 or more drugs is presently how a provider, college or university, or future employer can determine if fentanyl is in an individual's system. In Tyler's case, fentanyl went undetected, and he tragically lost his life as a result of the overdose. Today, his mother, Juli, keeps Tyler's memory alive by being a strong advocate for fentanyl testing and this legislation.

S. 921, a bill brought by Republican Senator Jim Banks of Indiana in 2025, would require hospital EDs to test for fentanyl in individuals who are diagnosed with or suspected of an overdose. Administering Naloxone, also known as Narcan, is the way to determine if fentanyl was potentially used. The challenge with Naloxone is that it would show that opiates in general were used and is not able to detect what substances with specificity. While Tyler's Law has had many iterations, Banks' version has shown the most promise as it has already passed the Senate.

Relevance:

The fentanyl crisis is an epidemic of large proportion in the United States, if not in other countries in the world. Everyone may know at least one individual who has been impacted by fentanyl use. It could easily be a family member, co-worker, a well-known individual in the community, or someone hiding their own addiction; fentanyl does not discriminate in those who will encounter its grip. While this legislation will not end the crisis, it is a step in the right direction.

Impact on Patients:

If patients can be tested for fentanyl, they can receive treatment quicker. It may also allow families and friends to intervene faster with a patient using fentanyl. The challenge for family and friends is to remember that a patient can only receive help if they choose to; it cannot be forced on someone.

Impact on Nursing:

Nurses, by profession, are educators and advocates for the patients they meet, and this would allow this process to continue. Furthermore, patients will share things about themselves with their nurse they may not normally share with those close to them. The discharge process, should sobriety and/or rehabilitation be wanted, will allow this education and advocacy to continue.

Impact on Healthcare Systems:

The impact on healthcare systems is multi-faceted. For one, it would improve patient outcomes. It would also allow these hospital systems to provide data to the Healthy 2030 initiative, developed by the Office of Disease Prevention and Health Promotion, which is affiliated with the United States Department of Health and Human Services.

*** Picture taken from Senator Alex Padilla's Facebook post ***