Legislation requiring fentanyl tests could save lives in Maryland

But everything changed when police found Josh Siems alone and unresponsive on his bathroom floor in the early morning hours of Oct. 13, 2022, Yates wrote in a Maryland Matters guest commentary. There were signs of a fentanyl overdose, and Yates and Siems’ family discovered the drug in his apartment.

He had struggled with opioid addiction for 10 years after trying OxyContin in college, according to Yates. Siems passed away on Oct. 14, his 31st birthday.

Medical reports did not show fentanyl — a powerful synthetic opioid — in Siems’ system. Hospitals generally test for five different classes of drugs, known colloquially as the “federal five,” but not always fentanyl.

A bill in the Maryland General Assembly could change that and help save lives. HB 811, sponsored by state Del. Joe Vogel, D-Montgomery, would require hospitals to conduct a test for fentanyl in patients suspected of drug overdose.

“This is critical considering the prevalence of fentanyl in our communities right now,” Vogel said during the bill’s Feb. 23 hearing in the House Health and Government Operations Committee.

Fentanyl accounts for drastically more overdose deaths than other substances in the state, according to data from the Maryland Opioid Operational Command Center.

There were 2,001 overdose deaths from fentanyl in the 12-month period ending in October 2022, more than twice as many cocaine, the substance with the second-highest overdose deaths.

Yates said hospitals serve as the first line of defense and the testing that occurs in them directly informs opioid prevention strategies.

“If we are not routinely testing for fentanyl, then we are vastly undercounting the number of fatal and nonfatal fentanyl-related overdoses that are happening in our state,” Yates said during the bill hearing.

The number of fatal overdoses from fentanyl has skyrocketed in recent years.

There were 2,348 fatal overdoses from fentanyl in 2021 compared to just 26 in 2011, according to data from the Maryland Opioid Operational Command Center, a nearly 90% increase.

“We have a public health crisis. We need to do better,” Caryl Siems, mother of Josh Siems, said during the bill hearing.

HB 811 is modeled after a California law that went into effect on Jan. 1.

Named Tyler’s Law after Tyler Shamash, a 19-year-old who died in 2018 at a sober-living facility after years of drug use, the California act is believed to be the first in the country mandating hospitals to include fentanyl when testing a patient for drugs, according to the Baltimore Banner.

Shamash spent the day before his death in an emergency room. His mother, Juli Shamash, said during the bill hearing that he claimed he wasn’t using and his toxicology report came back clear.

But his family members investigated and found he had indeed used fentanyl, Juli Shamash said. They wondered how things could be different if the hospital had run a test for it.

“This bill will save lives in situations like Tyler’s, as well as in cases where people are brought into an ER for an overdose of one substance but they unknowingly consumed fentanyl from a poisoned product,” Juli Shamash said.

The General Assembly is considering other fentanyl legislation as well.

State Sen. William Folden, R-Frederick, sponsored a bill that would double the maximum term of imprisonment for distributing fentanyl. SB 464 has its hearing Tuesday in the Senate Judicial Proceedings Committee.

Caryl Siems said that in addition to pragmatic reasons, passing HB 811 sends another message to Marylanders.

“It tells your constituents that you care about them,” she said. “It is, in fact, an act of love.”