Changing patterns of drug and alcohol use in fatally injured drivers in Washington State

We have previously reported on patterns of drug and alcohol use in fatally injured drivers in Washington State. Here we revisit that population to examine how drug use patterns have changed in the intervening 9 years. Blood and serum specimens from drivers who died within 4 h of a traffic accident between February 1, 2001, and January 31, 2002, were analyzed for illicit and therapeutic drugs and alcohol. Drugs when present were quantitated. Samples suitable for testing were obtained from 370 fatally injured drivers. Alcohol was detected above 0.01 g/100 mL in 41% of cases. The mean alcohol concentration for those cases was 0.17 g/100 mL (range 0.02-0.39 g/100 mL). Central nervous system (CNS) active drugs were detected in 144 (39%) cases. CNS depressants including carisoprodol, diazepam, hydrocodone, diphenhydramine, amitriptyline, and others were detected in 52 cases (14.1%), cannabinoids were detected in 47 cases (12.7%), CNS stimulants (cocaine and amphetamines) were detected in 36 cases (9.7%), and narcotic analgesics (excluding morphine which is often administered iatrogenically in trauma cases) were detected in 12 cases (3.2%). For those cases which tested positive for alcohol c. 40% had other drugs present which have the potential to cause or contribute to the driver's impairment. Our report also considers the blood drug concentrations in the context of their interpretability with respect to driving impairment. The data reveal that over the past decade, while alcohol use has declined, some drug use, notably methamphetamine, has increased significantly (from 1.89% to 4.86% of fatally injured drivers) between 1992 and 2002. Combined drug and alcohol use is a very significant pattern in this population and is probably overlooked in DUI enforcement programs.     

Financing and administering health care

He is a former deputy assistant secretary of the U.S. Treasury Department.     

Political struggles on a frontier of harm reduction drug policy: geographies of constrained policy mobility

This article contributes to the conceptualization of how policy models circulate by analysing the ‘frontier politics’ that occurs when a mobile policy meets resistance and constraint. We argue that advocates of harm reduction drug policy operate within a constrained political–institutional environment, but one that is not closed or predetermined. We make the argument in reference to struggles over harm reduction drug policy in Surrey, BC, a suburban municipality in Greater Vancouver. Thus, even at frontiers, policy change may occur, even if slowly, incrementally, or cautiously. In conclusion, we reconsider questions of constrained mobility, policy assemblages, and frontier politics to reflect on the character of, and possibilities for, policy change.     

Narrative,Rhetorical Argument,and Ethical Authority

The great challenge of rhetorical argument is to make discourse ethical without making it less logical. This challenge is of central importance throughout the full range of practical argument, and understanding the relation of the ethical to the logical is one of the principal contributions the humanities, in this case the study of rhetoric, can make to legal scholarship. Aristotle’s Rhetoric shows how arguments can be ethical and can create ethical relations between speaker and hearer. I intend to apply Aristotle’s analysis to a phenomenon that did not yet exist for him, that of authority, by asking how the acts of asserting and accepting authority can be ethical acts. I take as a test case a peculiarly unfortunate and inept appeal to authority, that offered by the counsel for the District of Columbia in arguing Bolling v Sharp who cited Taney’s opinion in Dred Scott to clinch his point. By seeing just what goes wrong in such a maladroit appeal, I explore the rational, voluntary and ethical dimensions of a decision to accept a given commitment to authority. I use Joseph Raz’s analysis of authority and the relation of reason to authority, yet think I go beyond Raz by exploring the deliberate and voluntary nature of submission to authority. Choosing to be bound by an authority is an ethical act. As such it is always rational and yet never purely rational. The Supreme Court’s choice of authorities is part of its making itself into an authority, and is a paradigm of the ethical act of choosing to be obligated. Choosing to be committed or obligated is a central paradox of political theory and considerations of authority and obligation, at least since early social contract theorists. However, its importance for judicial reasoning, which at the same time chooses to submit to authority and itself becomes an authority, has not been noted. Consideration of the relations between the ethical and the logical can help us better to articulate the constitution of ethical authority. This revised version was published online in July 2006 with corrections to the Cover Date.     

Human capital report cards for American states

A theoretical and empirical basis for comparing stocks of human capital in the American states is developed. Human capital report cards are measurement tools allowing states to benchmark their production and retention of the knowledges, skills and abilities required by economic development and public education policy making. A prototype report card is created from 12 indicators — seven of which theoretically capture a basic dimension of human capital and five of which measure complex human capital. Principal component factor analysis reveals that for the 50 states in the 1980s the concept of human capital is a multi-dimensional construct rather than a unidimensional one and that basic and complex factors do in fact distinguish the major cleavages among human capital measures. A further finding is that the relative positions of the 50 states can be plotted on the two dimensions with practical payoffs accruing to state and local planners.