Fentanyl on coroners' radar long before Nevada lawmakers took notice

Yahoo

19-02-2025

LAS VEGAS (KLAS) — The coroner's office knows what's happening in the community long before lawmakers do.
A proposal to revise Nevada laws on testing blood from people killed in crashes hammered home a couple of things during a hearing for Assembly Bill 55 (AB55) on Tuesday in Carson City.
First, the coroner's office is already performing those blood tests in 90% of the cases they see, according to Amy Davey, Director of the Nevada Office of Traffic Safety. They do it to meet accreditation standards, often a condition of federal funding.
Second, coroners see the drugs that people are using long before state lawmakers get around to making laws against them.
Fentanyl, for example.
'Of course it has to be included in our post-mortem testing or we would be missing hundreds of opioid-related deaths annually,' Washoe County Chief Medical Officer and Coroner Laura Knight explained to lawmakers.
AB55 has a couple of simple goals. It updates requirements for testing deceased victims of crashes to include drugs in addition to alcohol, and it sets out a timeline for reporting that information to the Department of Public Safety (DPS).
In data presented by DPS covering one year, alcohol testing was performed on 373 bodies. Not just drivers — passengers and pedestrians, too. In 366 of those cases, tests were also carried out for the presence of drugs.
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Bodies that aren't tested are typically cases where a long time has passed between the crash and the investigation, or in cases where the victim died in the days or weeks following the crash.
The bill hearing was an education for lawmakers on the Assembly Judiciary Committee, demonstrating that their good intentions were already being followed and offering valuable feedback on the timelines and methods provided in the bill.
Not many people stop to think about it, but testing dead bodies for the presence of alcohol and drugs is simpler than drawing blood from a driver. Knight pointed out that metabolism stops, and the liver doesn't break down alcohol after death. It's not a matter of calculating what the blood-alcohol level would have been several hours earlier. It is what it is.
The bill would require testing within eight hours, which Knight and Melanie Rouse, director of the Clark County coroner's office, said isn't realistic.
'The eight hours that is currently written into statute is often not achievable. There are many cases in which we are not even able to access the decedent within that eight-hour period either because it is a difficult extrication from the vehicle, the scene is not secured yet or has not been completely processed.'
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Knight added: 'The difference between eight, 24, 36 hours is not a big difference. The eight-hour rule is not really scientific.' DPS has offered recommendations to change AB55's requirements.
The bill presentation by DPS advised testing for 'commonly abused drugs' rather than 'prohibited drugs' that are included in Nevada statutes about driving under the influence. That concerned lawmakers who were concerned that it wouldn't be as thorough. Just the opposite.
'We watch in our community as the drug trends shift. So we know that what we have experienced in the last few years is a dramatic increase in the number of fentanyl-related cases,' Rouse said. 'Those are currently not defined in statute. Also, we have seen drug trends where we experience substances that are, again, new to the market, new to the decedents we are seeing in our case volume. So, to us, it means to really track and evaluate those drugs as the drug market changes and as those drug trends shift.'
Among the drugs currently specified in Nevada law: amphetamine, methamphetamine, cocaine, heroin, LSD, PCP and marijuana.
By using 'commonly abused drugs,' that list is quite a bit broader, including Benzodiazepines, fentanyl and other opioids such as morphine and codeine, as well as some prescription drugs.
Nevada follows national standards in post-mortem drug testing, but lawmakers also learned the state is behind others in one area.
Davey said, 'Nevada is the only state in the country that doesn't have a sort of a centralized forensic toxicological testing laboratory, and so we rely on our local partners to conduct the toxicology testing of deceased car crash victims.'
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