You have the right not to have a hearing: an evaluation of the impact of fully advising civilly committed patients on their rights

There have long been calls for the reduction of coercion in treating civilly committed psychiatric patients. The present study assessed whether a minor procedural change intended to reduce the adversarial nature of the treatment process would have a positive impact. Results suggested that the change in procedure had a positive effect for the most direct outcome variables but results were more mixed for the indirect outcome variables. Nonetheless, overall indications were that the change of procedure affected patient outcome.     

Attributions about perpetrators and victims of interpersonal abuse: results from an analogue study

This analogue study (written vignettes and videotapes) examines the influence of victim-perpetrator relationship (spouse or acquaintance), sex of perceiver, and type of abuse (psychological vs. physical) on attributions about victims and perpetrators of domestic abuse. College student participants (73 men, 108 women) were randomly assigned to condition. As expected, type of relationship influenced observer perceptions. Specifically, participants rated the victim of marital violence as more psychologically damaged and disturbed by the abuse than the victim of acquaintance violence. Furthermore, interaction effects showed that men, more than women, rated the actions of the married perpetrator as more of a victim's rights violation than the actions of the acquaintance perpetrator. Second, type of abuse was shown to influence perceptions of the perpetrator but not the victim. Sex-of-perceiver effects were also obtained. Women held the perpetrator more responsible and assigned less blame to the victim than did men. Legal and clinical implications are then discussed.     

Sexual deviance among male college students: prior deviance as an explanation

Much research on sexual deviance on university and college campuses is limited by its narrow focus on group affiliation and leads to much speculation and conjecture. This article suggests that an alternative explanation is more suitable for explaining such an important and complex problem on college campuses. It argues that prior deviance serves as a more robust predictor variable of sexual deviance. Logistic regression analyses indicate a direct relationship between prior deviance and sexual deviance. The results lend support to the argument that group affiliation is not a suitable explanation for such a complex societal problem-sexual deviance. Limitations of the study and directions for future research on sexual deviance are discussed.     

Tramadol (Ultram) concentrations in death investigation and impaired driving cases and their significance

We reviewed a series of 66 deaths in Washington State between 1995-2000 in which tramadol (Ultram and Ultracet, Ortho-McNeil) was detected in the decedent's blood, in order to assess the role tramadol was determined to have played. Additionally, we reviewed a series of 83 impaired driving cases in which tramadol was detected in order to establish a non-lethal blood tramadol concentration reference range. In both populations, tramadol was consistently found together with other analgesic, muscle relaxant, and CNS depressant drugs. Death was rarely attributable to tramadol alone. However, tramadol may be a significant contributor to lethal intoxication when taken in excess with other drugs, via the potential interaction with serotonergic antidepressant medications, as well as the potential for increased CNS depression. Although the incidence of tramadol detection has increased consistently over the last eight years, there is no evidence of a corresponding increase in the number of cases in which death was attributed solely to tramadol. Blood drug concentrations in many deaths exceeded the therapeutic serum range of 0.28-0.61 mg/L; however, the concentrations overlapped almost completely with the range identified in living subjects arrested for impaired driving. These findings suggest caution in the interpretation of blood tramadol concentrations outside of the recognized therapeutic range. It also suggests that the drug, even when used in moderate excess, is not a principle cause of death in suicidal or accidental deaths.     

Substance use,health, and mental health: problems and service utilization among incarcerated women

This article profiles self-reported substance use, health, and mental health problems among a sample of incarcerated women in Kentucky as well as lifetime service utilization. Findings indicate that a high percentage of women reported use of alcohol, cocaine, and multiple substances during the month before incarceration. In addition, participants reported common health problems such as dental, female reproductive, physical injuries, and mental health problems including depression and anxiety. Participants reported moderate use of emergency room and mental health treatment but limited substance abuse treatment utilization. Implications for criminal justice programs and linkages with community-based aftercare services for women are recommended based on findings that health and mental health problems are associated with service utilization before incarceration.     

Ontario: pressure from stakeholders leads to improved access to selected drugs

A campaign spearheaded by the Canadian Treatment Action Council, and involving other disease groups, has convinced the Ontario government to cover the costs of vaccines for HIV-positive children and to speed up access to other subsidized drugs.     

Zaleplon and driving impairment

Zaleplon, a sedative-hypnotic, was identified in the blood of a subject arrested for impaired driving. Symptoms reported were those of central nervous system (CNS) depression. The zaleplon concentration was determined to be 0.13 microg/mL. Symptoms included slow movements and reactions, poor coordination, and lack of balance. Although no quantitative relationship between blood concentrations and degree of driving impairment is currently possible, it is reasonable to conclude that because of its specific activity as a sedative-hypnotic, blood concentrations consistent with doses exceeding therapeutic concentrations of zaleplon have the potential to cause impairment of psychomotor function, and would impair a person's level of consciousness and driving ability.