Senate Passes Bill To Standardize Fentanyl Testing in Emergency Rooms

'Tyler's Law', co-sponsored by Cantwell, would help HHS provide guidance to hospital ERs on how and when to test for fentanyl in patients that present with OD symptoms

WASHINGTON, D.C. - Today, the Senate passed Tyler's Law, a bipartisan bill that would help the U.S. Department of Health and Human Services issue guidance to hospitals on how and when to test for fentanyl in patients that present with overdose symptoms.

U.S. Senator Maria Cantwell (D-WA), ranking member of the Senate Committee on Commerce, Science, and Transportation and senior member of the Senate Finance Committee, cosponsored the legislation.

"More than 3,000 Washingtonians tragically die from drug overdoses each year. Fentanyl is driving roughly three quarters of those deaths, yet many routine drug screens still don't test for it. Tyler's Law will help hospitals get clearer guidance so clinicians can better identify fentanyl overdoses and act faster to save lives," Sen. Cantwell said.

Tyler's Law was named after Tyler Shamash, a 19-year-old who died of a fentanyl overdose in 2018 after a standard hospital emergency room drug test checked for amphetamines, heroin, and cocaine, but not fentanyl. While large-scale studies and standard practices exist for opioid testing in emergency settings, fentanyl is often not included in routine opioid test panels, creating gaps in detection. Tyler for example, was tested for opioids, but the assessment does not detect fentanyl.

This bill would direct the Department of Health and Human Services (HHS) Secretary to conduct a comprehensive federal study on how and whether hospital emergency rooms test for fentanyl when patients present with overdose symptoms. Then, based on the results of the study, the bill would require HHS to issue guidance on whether fentanyl testing should be implemented as a routine practice in emergency departments and how hospitals could implement such testing effectively at scale.

Tyler's Law was introduced by U.S. Senators Jim Banks (R-IN) and Alex Padilla (D-CA). It has 14 cosponsors, an equal number of Republicans and Democrats.

In 2023 and 2024, Sen. Cantwell traveled across the State of Washington to 10 communities -- Tacoma, Everett, Tri-Cities, Seattle, Spokane, Vancouver, Port Angeles, Walla Walla, Yakima, and Longview - hearing from people on the front lines of the fentanyl crisis, including first responders, law enforcement, health care providers, and people with firsthand experience of fentanyl addiction. She also participated in the National Tribal Opioid Summit, a gathering of approximately 900 tribal leaders, health care workers, and first responders from across the country hosted by the Tulalip Tribes following the first-ever statewide summit hosted by the Lummi Nation. Sen. Cantwell has since used what she heard in those roundtables and related events to craft and champion specific legislative solutions, including:

• The Fatal Overdose Reduction Act, which would expand a Washington state-developed, low-barrier fentanyl treatment pilot program across the United States;
• The Opioid Overdose Data Collection Enhancement Act, which would direct the U.S. Department of Justice to award grants to states, local governments, law enforcement task forces, and tribes to adopt and implement an overdose data collection program.
• The Halt All Lethal Trafficking of Fentanyl Act, signed into law by President Donald Trump, which permanently classified illicit fentanyl knockoffs as Schedule I drugs;
• The Stop Smuggling Illicit Synthetic Drugs on U.S. Transportation Networks Act, which would crack down on the trafficking of illicit synthetic drugs, like fentanyl, using the U.S. transportation network;
• The FEND Off Fentanyl Act, signed into law by President Joe Biden, which will help U.S. government agencies disrupt opioid supply chains by imposing sanctions on traffickers and fighting money laundering;
• The Fight Illicit Pill Presses Act, which would require that all pill presses be engraved with a serial number and impose penalties for the removal or alteration of the number;
• The Combating Illicit Xylazine Act, which would list xylazine as a Schedule III controlled substance while protecting the drug's legal use by veterinarians, farmers, and ranchers, enable the Drug Enforcement Administration to track xylazine's manufacturing to ensure it is not diverted to the illicit market;
• The TRANQ Research Act of 2023, signed into law by President Biden, which will spur more research into xylazine (also called "tranq") and other novel synthetic drugs by directing the National Institute of Standards and Technology to tackle these issues;
• The Parity for Tribal Law Enforcement Act, which would bolster Tribal law enforcement agencies by helping them hire and retain tribal law enforcement officers by raising their retirement, pension, death, and injury benefits to be on part with those of federal law enforcement officers; and
• The Relief of Chronic Pain Act, which will increase access to non-opioid management options for the 50 million adults living with chronic pain, almost half of whom experience high-impact chronic pain, which can be debilitating and also limits productivity and contributes to $550 billion in health care costs each year.

In addition, Sen. Cantwell voted for a series of federal funding bills allocating $1.69 billion to combat fentanyl and other illicit drugs coming into the United States, including an additional $385.2 million to increase security at U.S. ports of entry, with the goal of catching more illegal drugs like fentanyl before they make it across the border. Critical funding will go toward Non-Intrusive Inspection (NII) technology at land and sea ports of entries. NII technologies-like large-scale X-ray and Gamma ray imaging systems, as well as a variety of portable and handheld technologies-allow U.S. Customs and Border Protection to help detect and prevent contraband from being smuggled into the country without disrupting flow at the border.

A full timeline of Sen. Cantwell's actions to combat the fentanyl crisis is available HERE.