Given their increasing prevalence it makes sense for Pennsylvania hospitals to test for fentanyl and xylazine, two of the most common additives found in heroin.

Legislation introduced recently would require just that.

Xylazine, also known as “tranq” or tranquilizer is an easily accessible veterinary tranquilizer being used as a low-cost cutting agent, and the Drug Enforcement Agency (DEA) recently reported 23% of fentanyl powder contained it in 2022. Xylazine causes depressed breathing and heart rate, unconsciousness, necrosis, and even death, and naloxone does not reverse its effects because it is not an opioid.

Fentanyl, meanwhile, is a powerful lab-made opioid that is FDA-approved to treat severe pain related to surgery or complex pain conditions. Because fentanyl is about 50 to 100 times more potent than morphine, a lethal dose of fentanyl can be very small, so using a drug like heroin, cocaine or counterfeit pills that have been contaminated with or replaced by fentanyl can greatly increase one’s risk of overdose.

Here’s the problem. Standard drug screenings do not test for fentanyl and many patients don’t know a drug contains fentanyl. A 2022 study found that, in a review of more than 315,000 emergency department overdose visits, only 5% of patients were testing for fentanyl. Of those tested, 40% came back positive for fentanyl.

It’s better for both health care providers and patients to know if they have taken something that contains either xylazine or fentanyl. Senate Bill 683, introduced by Sens. Doug Mastriano, R-Chambersburg, and Michele Brooks, R-Greenville, would require hospitals to test urine for fentanyl and xylazine when they conduct a drug screening to diagnose a patient.

“Testing for fentanyl can play a key role in saving someone’s life. It can alert a provider that a patient has fentanyl in their system, warn a patient they have ingested fentanyl, or connect people to treatment or a prescription for naloxone,” Mastriano and Brooks wrote in a legislative memo.

This bill, in our opinion, should become law quickly.

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