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6.1.D. - Page 15 Officer -carry naloxone programs will not expose officers to criminal or civil liability. California Civil Code Section 1714.22 protects trained first responders from professional review, liability in a civil action, or criminal prosecution for possession or administration of an opioid antagonist. 56 However, an analysis of any possible claims that might be pursued for failure to administer naloxone is beyond the scope of this report. Opioids in San Mateo County In February 2017, San Mateo County Health System (CHS) issued the public health alert Opioid Dependency and Deaths in San Mateo County. 57 The alert reported that an estimated 7,800 County residents were dependent upon opioids, that prescription opioid use in adolescents was increasing, and that "the prevalence of synthetic fentanyl laced drugs [in the County] is likely to increase." 58 The California Department of Public Health confirmed 19 opioid overdose fatalities in the County during 2016.59 Fortunately, rates of opioid abuse, including prescription and street drugs, are currently lower in the County than in many other Bay Area communities. 60 The CHS updated its February 2017 alert in October 2017, to report that "...the County does not seem to be experiencing anywhere near the same level of morbidity and mortality that other jurisdictions in the United States are experiencing."61 San Mateo County has taken steps to address opioid abuse. The CHS is monitoring opioid prescription rates and educating prescribers about best practices. The CHS is also tracking the presence of fentanyl derivatives in the County in conjunction with law enforcement, the Coroner's Office, and other agencies. Fentanyl derivatives are becoming more prevalent in the County. The Sheriff's Forensic Laboratory, which conducts chemical testing on suspect substances seized in law enforcement operations, saw the number of fentanyl samples triple between 2016 and 2017.62 The County's close proximity to San Francisco, a major point of entry for fentanyl derivatives imported from abroad, further exposes County law enforcement and residents to fentanyl derivatives. 63 At present, the only first responders in the County authorized to carry naloxone are fire department and ambulance paramedics. While the Sheriff's Office is considering implementing a naloxone carry program for the NTF, no law enforcement agencies in the County have 56 These protections were added by California Assembly Bill No. 635, October 10, 2013. <http://www.leginfo.ca.2ov/pub/13-14/bill/asm/ab 0601-0650/ab 635 bill 20130912 enrolled.htm> 57 Scott Morrow, "Public Health Alert: Opioid Dependency and Deaths in San Mateo County" County of San Mateo Health System February 7, 2017: 1. <http://www.smchealth.or2/sites/main/files/file- attachments/opioid health alert - 020717.pdf5. 58Ibid. 59 California Department of Public Health, "San Mateo Numbers at a Glance" California Opioid Overdose Surveillance Dashboard (2018). 60 Detailed information comparing opioid abuse statistics for the County to other California counties is available at <https://pdop.shinvaDDS.io/ODdash vl>. 61 Scott Morrow, Greg Gilbert, "Open Letter to Sheriff Bolanos and Police Chiefs in San Mateo County" County of San Mateo Health System October 24, 2017. 6z Grand Jury Interviews with Sheriff's Forensic laboratory leadership. 6s Grand Jury Interviews with law enforcement leadership. 2017-2018 San Mateo County Civil Grand Jury 10