Md. man’s fatal overdose is prompting legislation to require fentanyl testing in hospitals

Josh Siems died from an overdose on his 31st birthday in October, after years of battling an opioid addiction. Although his family said he exhibited all of the signs of a fentanyl overdose and even had the deadly drug on him, Siems, who grew up in Baltimore, wasn’t tested for it.

“When we got the test back and it only came back for cocaine, we were confused,” said Melanie Yates, Josh’s partner. “His parents and I spent at least an hour, maybe two hours, going around in circles trying to figure it out.

“We had found fentanyl in his apartment. We had seen what he was doing. He also would tell you that he knew he was using fentanyl. And we couldn’t quite understand why … that’s when we found out that they hadn’t run a fentanyl test.”

Josh Siems and his girlfriend Melanie Yates. (Courtesy Joe Vogel)

During standard toxicology screenings, many Maryland hospitals run what is called the “Federal 5,” which screens for drugs, such as cocaine and cannabis. Fentanyl is not always included in that test unless requested.

Yates, along with Siems’ parents, is now urging lawmakers to require that when a hospital orders a toxicology screening for a patient with a known or suspected overdose, it must include fentanyl. The only exception would be if the hospital doesn’t have the ability to do rapid urine drug testing.

State Del. Joe Vogel, of Montgomery County, is the lead sponsor of House Bill 811. He said this gap in fentanyl testing needs to be filled in order to empower patients and accurately gather data about how prevalent the crisis is. He said he is worried that without the legislation, the state will continue underestimating the fentanyl epidemic.

“Gov. (Wes) Moore is supportive of this bill because his approach, and we agree with his approach, is that we need data-driven solutions to this fentanyl overdose epidemic,” Vogel said. “And this is one step forward at helping us get toward those data-driven solutions.”

A recent study by the University of Maryland showed that only 5% of suspected drug overdose patients are tested for fentanyl; of those 40%, more than 40% come back positive. According to the Maryland Hospital Association, a majority of hospitals in the state already require fentanyl to be included in all toxicology screening or are moving in that direction.

“This is not an effort to legislate clinical care,” Vogel said. “We’re not telling doctors when or how to conduct toxicology screenings, how to medically respond to these overdoses.

“What we’re saying is that considering the prevalence of fentanyl in our communities right now, if you are testing for the standard Federal 5 drugs that are tested for in toxicology screenings, that are tested for because historically those have been the main drivers of overdoses, considering the prevalence of fentanyl in our community, you should also be testing for fentanyl.”

Siems’ family was motivated to get involved, after learning about a similar bill that recently passed in California, in memory of a young man who went to the hospital with symptoms of an overdose, was not tested for fentanyl, went home and died the next day. Though as of now, the bill is not named after Siems, his family considers it a part of his legacy.

“I always knew that he was meant for bigger things,” Yates said. “I was hoping we could do that together with him alive. I think this would really honor his memory, and to help educate and save other people’s lives in Maryland, and then across the United States as well.”

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