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.     

A longitudinal study of ego identity development at a liberal arts college

Ego identity development in the areas of occupational choice, religion, and political ideology was studied using Marcia's categorization system. The results indicated a significant increase in the frequency of the identity achiever status for occupational choice and corresponding decreases in the frequency of the moratorium and identity diffusion statuses. A significant decrease in the frequency of foreclosures on religion was also found. In those instances where students underwent an identity crisis, the probability of resolving it successfully was very high. High scores on the Cultural Sophistication scale of the College Student Questionnaire-Part 1 were found to be associated with presence in the identity achievement status. For students not in the achiever status as freshmen, an interest in various literary and art forms was predictive of becoming an achiever while in college.Received his Ph.D. from SUNY/Buffalo. Recent research has been mainly concerned with the development of ego identity and with techniques for resolving identity crises.Received his Ph.D. from Syracuse University. Recent research has been mainly concerned with personality moderators of human judgment.     

Effect of similarity of ego identity status on interpersonal attraction

Similarity of ego identity status, assessed by Marcia's four-category classification system, was related to interpersonal attraction. Using male and female college students as subjects, this study found that (1) while all judges preferred targets who had or who are undergoing a crisis to those who have not had a crisis, (2) diffuse judges preferred targets with no commitments to those with commitments, and (3) judges with commitments preferred a foreclosure target more than judges without commitments. Differential evaluations of the targets' intelligence, knowledge of current events, adjustment, and morality were also found. Results are discussed both in terms of previous research positively relating personality similarity to attraction and Erikson's theory of the relationship between ego identity development and intimacy in interpersonal relations.     

The Effect of Jury Deliberations on Jurors' Reasoning Skills

The effect of jury deliberation on jurors' reasoning skill in a murder trial was examined. Specifically, the effect of deliberating on reasoning competence (as defined by Kuhn, Weinstock and Flaton, 1994) was explored. One hundred and four participants viewed a videotaped murder trial and either deliberated in 12-person juries or ruminated on the case individually. Among those assigned to juries, half had their reasoning skill assessed prior to deliberations, while the others were tested after deliberating. Jurors in the individual rumination condition were assessed after they had the opportunity to reflect on the case alone. As hypothesized, post-group-deliberation jurors were more likely to discount both the selected verdict and alternative theories and incorporate judgmental supporting statements than were the other mock jurors. However, the mock jurors did not differ with regard to making statements that supported alternative verdicts or including judgmental statements that discounted their chosen verdict. In terms of Kuhn's reasoning continuum from satisficing (low level) to theory–evidence coordination (high level), there is some evidence that post-group-deliberation jurors may be closer to the high end than predeliberation jurors or post-individual-rumination jurors in some aspects of the task, but not in others.     

The relationship between psychosocial maturity and assertiveness in males and females

The relationship between psychosocial maturity (psychological health) and assertiveness was investigated in a sample of United States college males and females. Results revealed a moderately high positive relationship between psychosocial maturity (PSM) and self-reported assertiveness on the Rathus and Galassi scales for both sexes. This relationship was slightly stronger (in terms of variance accounted for) for males than females, significant differences being obtained for Intimacy on the Rathus scale and PSM and Intimacy on the Galassi scale. Multiple regression analyses revealed that the personality components most consistently accounting for major portions of the variance in predicting male assertiveness scores on both the Rathus Assertiveness Schedule and the College Self-Expression Scale were Intimacy and Initiative, while in predicting female assertiveness, only Initiative was involved. The findings were related to previous research, recent work on the androgyny construct (instrumental vs. expressive behaviors), and exhortations for increased cooperation between schools of psychotherapy to establish it as a more unified discipline.Received his Ph.D. from Syracuse University in 1971. He has also been a Post-Doctoral Fellow in Clinical-Community Psychology at the University of South Carolina and a Clinical Psychologist at the Behavioral Medicine Unit of St. Joseph's Hospital- McMaster University in Hamilton, Ontario, Canada. Current research interests include personality moderators of social cognition and self-concept theory.Received his Ph.D. in Psychology from Northern Illinois University in 1972. Current research interests include personality moderators of social cognition and behavior change, and psychological assessment.