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The Senate Committee on Health, Education, Labor, and Pensions advanced bipartisan legislation this week that would direct the U.S. Department of Health and Human Services to develop national guidance for hospitals on incorporating fentanyl testing into routine emergency room drug screenings, a step supporters say could improve the response to the nation’s ongoing overdose crisis.
The bill, known as Tyler’s Law, is led by Sens. Alex Padilla, D-Calif., and Jim Banks, R-Ind. It aims to address gaps in hospital toxicology testing that can delay or complicate the diagnosis and treatment of fentanyl exposure in patients brought to emergency departments for suspected overdoses.
Tyler’s Law is named after Tyler Shamash, a Los Angeles teenager who died from fentanyl poisoning after he was admitted to an emergency room where fentanyl was not included in the standard toxicology screen. His death drew attention to the limitations of some hospital drug panels and helped spur legislative action in California. In 2022, California became the first state to pass a version of Tyler’s Law requiring emergency rooms to include fentanyl in certain drug screenings.
The Senate bill is a companion to legislation introduced in the House of Representatives by Reps. Ted Lieu, D-Calif., Bob Latta, R-Ohio, and Sydney Kamlager-Dove, D-Calif. House sponsors have worked alongside Shamash’s family, particularly his mother, Juli, who has advocated for expanding fentanyl testing standards nationwide.
Rather than imposing a federal testing mandate, the legislation would require HHS to study current fentanyl testing practices in hospital emergency departments across the country. The department would be directed to assess how frequently fentanyl testing is performed, evaluate existing toxicology screening protocols, and examine the potential costs and benefits associated with expanding routine fentanyl testing.
Based on those findings, HHS would be instructed to issue national guidance and best-practice recommendations to hospitals on how to incorporate fentanyl screening into emergency room drug panels. The bill also calls on the department to use that guidance to help improve the identification of fentanyl exposure and support more timely diagnosis, treatment and prevention strategies.
Padilla said the bill reflects an effort to translate California’s experience into a national framework, while Banks said the measure seeks to prevent overdose deaths by improving detection of fentanyl in hospital settings. Lawmakers in the House similarly said the proposal addresses what they view as a critical blind spot in emergency overdose care.
Public health officials have identified illicit fentanyl and related synthetic opioids as major drivers of overdose deaths nationwide. According to federal data, fentanyl and fentanyl-related substances were responsible for more than 70% of all overdose fatalities in the United States in 2023. The drug is frequently mixed into other substances, often without a user’s knowledge, increasing the risk of accidental overdose.
Supporters of Tyler’s Law argue that expanding fentanyl testing in emergency departments could help physicians more quickly determine what substances are present in a patient’s system, allowing for more targeted care. They also say improved data collection on fentanyl exposure could assist health agencies in tracking trends and refining public health responses.
The committee’s action advances the bill to the next stage of the legislative process, where it will await consideration by the full Senate. If approved by both chambers and signed into law, the measure would mark a federal effort to standardize guidance around fentanyl testing as hospitals and communities continue to confront the synthetic opioid crisis.
