Gamma hydroxybutyric acid (GHB) concentrations in humans and factors affecting endogenous production

The endogenous nature of the drug of abuse gamma hydroxybutyric acid (GHB) has caused various interpretative problems for toxicologists. In order to obtain data for the presence of endogenous GHB in humans and to investigate any factors that may affect this, a volunteer study was undertaken. The GHB concentrations in 119 urine specimens from GHB-free subjects and 25 urine specimens submitted for toxicological analysis showed maximal urinary GHB concentrations of 3mg/l. Analysis of 15 plasma specimens submitted for toxicological analysis detected no measurable GHB (less than 2.5mg/l). Studies in a male and female volunteer in which different dietary food groups were ingested at weekly intervals, showed significant creatinine-independent intra-individual fluctuation with overall urine GHB concentrations between 0 and 2.55, and 0 and 2.74mg/l, respectively. Urinary concentrations did not appear to be affected by the particular dietary groups studied.The concentrations measured by gas chromatography with flame ionisation detection (GC-FID) and gas chromatography with mass spectrometry (GC-MS) lend further support to the proposed urinary and plasma interpretative cut-offs of 10 and 4mg/l, respectively, where below this it is not possible to determine whether any GHB detected is endogenous or exogenous in nature.     

South Africa: Treatment Action Campaign steps up pressure

In December 2002, in its ongoing efforts to secure access to affordable HIV/AIDS treatment for all South Africans, the grassroots organization Treatment Action Campaign (TAC) initiated two new proceedings over governmental failure to act to prevent mother-to-child transmission of HIV. In March 2003, it launched a national civil disobedience campaign to pressure government into implementing a national treatment and prevention plan, including taking measures to ensure access to affordable medicines.     

Clinical urinalysis of drugs and alcohol in instances of suspected surreptitious administration ("spiked drinks").

Many suspected victims of surreptitious drug and/or alcohol administration may present to hospitals or healthcare centres and never come to the attention of forensic or law enforcement professionals. Therefore, it is necessary to include clinical toxicological findings in order to assess the growing perception that instances have become more widespread within society. Between July 2002 and June 2004, 180 requests were received for toxicological analysis of individuals presenting to their GP or hospital following self-reported or suspected surreptitious drug administration (e.g. "spiked drink"). There was a rise of 77% in the number of requests from 2002-2003 to 2003-2004 which peaked in December of each year (most likely due to the increased socialization of people during the festive season). Between 2002 and 2004, 34% of patients were male and 66% were female with an overall average age of 25 (range 11-73). Following urinary analysis using immunoassay and gas chromatography (mass spectrometry, flame-ionisation detection and nitrogen-phosphorus detection), 59% of cases were negative for drugs and alcohol in 2002-2003 and 51% in 2003-2004. Drugs or alcohol were detected in 32% of cases in 2002-2003 and in 45% in 2003-2004. Out of the 169 cases analysed, ethanol (alcohol) was the most commonly detected compound (24% of cases), followed by amphetamines (amphetamine, MDMA, MDA, MDEA--11% of cases), cannabinoids (9% of cases), benzodiazepines (temazepam, nordiazepam, oxazepam--9% of cases), cocaine (4% of cases), opiates (dihydrocodeine, codeine--2% of cases), chlorpheniramine (0.6% of cases), ephedrine 0.6% of cases), fluoxetine (0.6% of cases), tramadol (0.6% of cases) and zopiclone (0.6% of cases). No gamma-hydroxybutyrate (GHB), gamma-butyrolactone (GBL) or flunitrazepam was detected in the cases analysed.     

Missing pieces: Notes on crime,poverty, and social policy

A long and impressive criminological tradition links crime to what social scientists call ‘persistent poverty’-and, in particular, to the corrosive effects of inadequate labor markets on a variety of social institutions. But few anticrime policies have seriously confronted those conditions, even at the height of the Great Society of the 1960s. With only scattered exceptions, those policies have sought to enhance the individual capacities of children and youth without substantially altering the surrounding economic institutions. An anticrime strategy for the next century that is both more effective and consistent with what we know about the roots of crime must involve measures that more directly address the labor market itself. Among other things, these measures include direct public job creation, systematic efforts to up grade wages, and greater support for labor organization. This essay is a revised version of a background paper presented at The Social Science Research Council Policy Conference on ‘Persistent Poverty’ in Washington D.C., November, 1993.     

Supreme Court denies leave to appeal in medical marijuana charter challenge

As previously reported in this publication, in January 2002 the Ontario Court of Appeal denied Jim Wakeford's claim that Canada's laws prohibiting marijuana possession and cultivation infringe his constitutional rights to liberty and security of the person. On 22 November 2002 the Supreme Court of Canada announced that it would not hear his appeal from that decision.     

UN Commission on Human Rights adopts resolutions on access to medication, right to health

In April 2002, the United Nations Commission on Human Rights adopted two resolutions that are important in the context of access to treatment. The Commission is the UN's leading body with respect to international human rights issues. It consists of 53 UN member states and meets annually. The Commission's resolutions can be found on the website of the Office of UN High Commissioner for Human Rights via www.unhchr.ch/ by clicking on "Documents of Charter-based bodies".     

Update to international guidelines on HIV/AIDS and human rights

On 10 September 2002, the Office of the UN High Commissioner for Human Rights (OHCHR) and the Joint UN Programme on HIV/AIDS (UNAIDS) released a revised international guideline on "Access to prevention, treatment, care and support." The update to Guideline 6 of HIV/AIDS and Human Rights: International Guidelines reflects significant therapeutic, political, and legal developments in this area since the 12 guidelines were originally published in 1998. The new Guideline 6 significantly expands the guidance given to governments on what international human rights norms require of them in relation to HIV/AIDS prevention, treatment, care and support.