Morphine Concentrations in Stomach Contents of Intravenous Opioid Overdose Deaths

Abstract:  Death caused by heroin overdose is almost always the result of intravenous injection of the drug in Australia. We briefly describe a case where a heroin overdose was initially thought to be the result of oral ingestion of the drug, primarily as a result of higher concentrations of morphine in stomach contents than in blood. During the subsequent criminal trial and investigation, however, the issue of the entero-hepatic circulation of morphine was raised as a possible reason for the presence of morphine in the stomach contents. In this study, we report on the distribution of opioids in blood, stomach contents, urine, liver, and bile in 29 deaths caused by intravenous heroin overdose. The mean total and free blood morphine concentrations were 0.60 and 0.32 mg/L , respectively, and the mean stomach contents total morphine concentration was 1.16 mg/kg. All cases had detectable morphine in the stomach contents, and 24 of 29 cases (83%) had higher concentrations of total morphine in stomach contents than in blood. The mean total morphine concentration in bile was c. 100 times that in blood, and the liver total morphine concentration averaged twice that of blood levels. We conclude that the entero-hepatic circulation of morphine and subsequent reflux of duodenal contents back into the stomach can result in the deposition of morphine in gastric contents. Consequently, the relative levels of opioids in blood and stomach contents cannot be used to determine the site of administration of the drug.     

Threat-Inducing Violent Events Exacerbate Social Desirability Bias in Survey Responses

A key challenge in survey research is social desirability bias: respondents feel pressured to report acceptable attitudes and behaviors. Building on established findings, we argue that threat-inducing violent events are a heretofore unaccounted for driver of social desirability bias. We probe this argument by investigating whether fatal terror attacks lead respondents to overreport past electoral participation, a well-known and measurable result of social desirability bias. Using a cross-national analysis and natural and survey experiments, we show that fatal terror attacks generate turnout overreporting. This highlights that threat-inducing violent events induce social desirability, that researchers need to account for the timing of survey fieldwork vis-à-vis such events, and that some of the previously reported post-violent conflict increases in political participation may be more apparent than real.     

Data hubris? Humanitarian information systems and the mirage of technology

This article looks at the promise of technology to revolutionise humanitarian action, especially in terms of the gathering and use of data. With many heralding a ‘data revolution’, the opportunities and enthusiasm for using social media and SMS data in crisis response are on the rise. The article constructs an analytical framework in order to scrutinise the three main claims made on behalf of technologically advanced humanitarian information systems: that they can access data more accurately, more quickly, and alter power relations in emancipatory ways. It does so in relation to two aspects of digital humanitarianism: visual technology and crisis mapping, and big data. The article is partly informed by a historical perspective, but also by interview and other material that suggests some of the claims made on behalf of technology are exaggerated. In particular, we argue that the enthusiasm for the data is vastly outstripped by the capacity to meaningfully analyse it. We conclude by scoping the implications of the future technological evolution of humanitarianism, in particular by examining how technology contributes to what Duffield terms ‘post-modern humanitarianism’.     

Successful and Unsuccessful Pirate Attacks Worldwide: A Situational Analysis

Using concepts drawn from situational crime prevention theory, this study compares successful and unsuccessful pirate attacks (n = 4,638) against ships worldwide and the situational factors that help prevent such attacks. The results show that when a ship’s crew takes proactive self-protective measures that increase the perceived effort (increasing speed, employing evasive maneuvers) and increase the perceived risk (embarking private security, having watchman present, raising alarm, increasing lighting, anti-piracy) of perpetrating an attack, unsuccessful attacks are significantly more likely after controlling for environmental influences. Despite a few common data limitations, the study contributes to the crime prevention literature by analyzing piracy from a micro level instead of a macro level. Future research should examine how the piracy “ecosystem” contributes to the problem and the costs and benefits counter-piracy activities.     

Democratic theory with critical intent: reply to Newey

My critical assessment of competing views on the marching controversy at Drumcree is found wanting by Glen Newey for at least three reasons. The Habermasian approach I adopt is alleged to be motivationally deficient, politically ineffectual and blind to its own decisionistic partiality. Here I indicate that the force of Newey's critique is neutralised once one attends to the important differences between Habermas' moral theory and his discourse theory of law and democracy. I argue, furthermore, that Newey's critique is insufficiently attuned to the institutional context of my argument, and that his line of reasoning has troubling political implications.     

In Person

Shane Smyth is a popular and well-known personality in internationaltrade mark circles, where his friendly face and amicable demeanourprovide the frontage for a mordant