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6.1.D. - Page 13 derivatives. 13 As fentanyl derivatives continue to become more common in the County, the risk of exposure will continue to increase. The DEA recommends that, where an individual may have been exposed to fentanyl derivatives, immediate medical attention be sought.44 Law enforcement agencies across the U.S. have successfully implemented officer -carry naloxone programs. As of December 2016, over 1,200 law enforcement agencies in 39 states have equipped their officers with intranasal naloxone. 45 As of the date of this report, 40 agencies in 24 California counties have implemented programs for their officers to carry naloxone. Another six agencies have approved an officer -carry naloxone program but have not yet implemented it. For a complete list of agencies that equip officers with Narcan in California, see Appendix 1. Only eight California agencies have, as of the date of this report, published information regarding officer -administered naloxone "rescues" of overdose victims. 46 Those eight have reported a total of 103 rescues. As a majority of these agencies have not reported on their rescues, the actual number may well be higher than 103. Officer -carry naloxone programs can be implemented with as little as one hour of training and can be added into existing annual first aid certification programs. 41 Such programs are readily available through a variety of sources .48 Additionally, using "train -the -trainer" methods, agencies can quickly and efficiently train their entire force with minimal impact.49 The Commission on Peace Officer Standards and Training (POST) sets minimum selection and training standards for California law enforcement.50 While the POST has yet to establish training protocols for the administration of naloxone, in October 2014 POST and California Emergency Medical Standards Authority began the process of developing course content and competencies for naloxone administration as an "optional skill. ,51 4s Grand Jury Interviews with law enforcement leadership. 44 U.S. Department of Justice, "A Briefing Guide for First Responder" (2017): 16. 45"US Law Enforcement Who Carry Naloxone" North Carolina Harm Reduction Coalition Last modified February 12, 2018 <httn://www.nchrc.or2/law-enforcement/us-law-enforcement-who-carrv-naloxone>. 46 The Grand Jury counts a "rescues," as an intervention in which a trained officer administered nasal naloxone, the naloxone reversed the effects of an opioid overdose, the patient survived the incident, and the law enforcement agency publicized the results. 47 Rian Fisher, Daniel O'Donnell, Bradley Ray, and Daniel Rusyniak "Police Officers Can Safely and Effectively Administer Intranasal Naloxone" Journal of Prehospital Emergency Care (Vol. 20:6, 2016): 675-680. DOI: 10.1080/ 10903127.2016.1182605 48 "Law Enforcement Training Safety Videos and Resources" North Carolina Harm Reduction Coalition. Accessed on April 5, 2018 <httD://www.nchrc.or2/law-enforcement/law-enforcement-safety-videos-and-resources> 49 Grand Jury Interviews with law enforcement leadership. 50 "About POST" The Commission on Peace Officer Standards and Training. Accessed on: May 10th, 2018 https://Dost.ca.gov/About-Us 51 POST Monthly Reports, "Monthly Report: October 2014" The Commission on Peace Officer Standards and Training Accessed on May 10th, 2018. < https://Dost.ca.2ov/October-2014-Report> 2017-2018 San Mateo County Civil Grand Jury