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6.1.D. - Page 12 Fentanyl derivatives, including fentanyl, carfentanil and other analogs, can be absorbed into the body through any physical contact, including injection, oral ingestion, inhalation, transdermal transmission (through the skin), and contact with any mucus membranes .38 While, in each individual case the size of a lethal dose depends on individual tolerance and body mass, per the Drug Enforcement Administration (DEA), a lethal dose of fentanyl may be as low as 2 to 3 milligrams, the equivalent of a few grains of salt. (See Figure 3.) Figure 3. 2-3 milligrams of fentanyl. The threat of accidental exposure is present in any instance where an officer is in proximity to fentanyl derivatives. The DEA identified the following situations, among others, as presenting a heightened risk of exposure: while purchasing fentanyl during undercover operations, processing drug evidence containing fentanyl or fentanyl -related substances, and processing non -drug evidence which may be contaminated with these substances or while providing aid to overdose victims. 39 While all law enforcement officers in proximity to fentanyl derivatives are at risk of accidental exposure, the degree of risk corresponds to the individual officer's duties. Per DEA's policy guidance and Grand Jury interviews, law enforcement officers in the following units in San Mateo County are at a heightened risk of exposure to fentanyl derivatives: narcotics units, crime suppression units, Special Weapons and Tactics (SWAT) teams, K-9 units, 40 and evidence - handling units.4142 Law enforcement officers have been exposed to fentanyl derivatives when responding to opioid overdoses, serving search warrants, supporting national law enforcement actions, and during narcotics operations. Fortunately, however, no law enforcement officers in the County have, as of the date of this report, suffered overdose as the result of accidental exposure to fentanyl "U.S. Department of Justice, "A Briefing Guide for First Responder" Drug Enforcement Agency, June 6, 2017: 9. <httl)s://www.dea.izov/druginfo/Fentanyl BriefineGuideforFirstResnonders June20l7.r)df>. 39 Ibid. 41 K -9's can suffer the full effects of an opioid overdose, and due to the nature of their duties are at heightened risk of exposure. Naloxone is also an effective antidote for opioid overdose in canines. "New drug kits save police dogs from opioid overdoses" CBS News, June 1, 2017. <httl)s://www.cbsnews.com/news/new-drug-kits-save-police-dogs- from-opioid-overdoses/>. V.S. Copland, S.C. Haskins, J. Patz, "Naloxone reversal of oxymorphone effects in dogs" American Journal of Veterinary Research 50 (1989): 1854-8. <https://www.ncbi.nlm.nih.izov/pubmed/2482683>. 41 U.S. Department of Justice, "A Briefing Guide for First Responder" (2017): 13. 4' Grand Jury Interviews with law enforcement leadership. 2017-2018 San Mateo County Civil Grand Jury