British Pharmaceuticals: a cautionary tale

British pharmaccuticals is generally represented as a successful sector which illustrates the potential of knowledge-intensive, high-valve-added activities. This article presents a revisionist account based on evidence and argument. Pharmaceuticals is a small sector which combines high-value-added and average wages to benefit capital not labour. The knowledge base in the laboratory creates imitative product with marketing then applied to capture social expenditure. When product-market growth slows, the sector restructures defensively without solving its problems.     

Words as interventions: naming in the Palestine – Israel conflict

This paper examines the practice of naming events, actions, places and people in the Palestine?–?Israel conflict. It explores the way colonialism and the national project deploy transformations in naming to construct places and identities and craft widespread imaginaries about these places. Names form part of cultural systems that structure and nuance the way we imagine and understand the world. They embody ideological significance and moral attributes and can be consciously mobilised for various projects of power. Words and names reference a moral grammar that underwrites and reproduces power. As such, our analytical approaches to lexicons must be embedded in historical, political and cultural frameworks.     

Privatising the war on drugs

A defining feature of the ‘9/11 wars’ has been the prominent role played by private military and security companies (pmsc). The growth of this market for military and security services has not gone unnoticed. Yet the role pmsc have played in supporting the US-led war on drugs has largely gone under the radar, both literally and figuratively. The aim of this article is to look at the activities of pmsc funded by the USA in Latin America, and to consider the specific consequences that arise from employing them in the field of counter-narcotics. It is argued that the use of pmsc further entrenches a costly and unsuccessful way of dealing with drugs. There is a need to move from a strict prohibitionist stance and consider alternatives to the war on drugs approach, but the use of pmsc creates another strong vested interest in maintaining an increasingly problematic and costly status quo.     

Rapid assessment of existing HIV prevention programming in a community mental health center

In preparation for implementation of a comprehensive HIV prevention program in a Community Mental Health Center for persons with mental illness who are also abusing substances, a rapid assessment procedure (RAP) of existing prevention services that may have developed in the setting over time was undertaken at baseline. In addition to an ecological assessment of the availability of HIV-related information that was available on-site, in-depth interviews and focus groups were conducted with Center administrators, direct-care staff, and mental health consumers. Results indicated that responses regarding available services differed depending upon type of respondent, with administration reporting greater availability of preventive programs and educational materials than did direct-care staff or mental health consumers themselves. But overall, formalized training on HIV prevention by case managers is extremely rare. Case managers felt that other providers, such as doctors or nurses, were more appropriate to deliver an HIV prevention intervention.     

Hair analysis for diphenhydramine after surreptitious administration to a child

Diphenhydramine is one of the first effective antihistamine agents to have been discovered. The compound is also used for its sedative and antiemetic effects. The first case involving repetitive sedation linked to the use of diphenhydramine as a drug-facilitated crime and subsequent impairment of a 9-year-old female victim is reported. Due to the long delay between the alleged crime and clinical examination, collection of blood or urine was of little value. Hence, the laboratory developed an original approach based on hair testing by LC-MS/MS. A single strand of hair from the victim was sampled about 7 weeks after the last suspected administration and was cut into small segments. After cutting into small pieces, about 20 mg of hair per segment was incubated overnight in a phosphate buffer (pH 8.4). The aqueous phase was extracted with 5 ml of a mixture of methylene chloride/diethyl ether (80/20), in presence of diazepam-d5, used as internal standard (IS). The hair extract was separated on an XTerra MS C18 column using a gradient of acetonitrile and formate buffer. Detection was based on two daughter ions: transitions m/z 256.2-152.1 and 167.1 and m/z 289.9-154.0 for diphenhydramine and the IS, respectively. In the hair of the child, diphenhydramine was detected at concentrations in the range 33-39 pg/mg, depending on the segment.     

Fentanyl concentrations in 23 postmortem cases from the hennepin county medical examiner's office

The purpose of this study was to compare blood fentanyl concentrations in fentanyl-related deaths with fentanyl concentrations found incidentally at autopsy, as well as with fentanyl concentrations found in hospitalized patients receiving fentanyl. Between the years 1997 to 2005, 23 fentanyl-positive postmortem cases were identified. Nineteen of 23 (82.6%) cases were deemed to be drug overdoses. Fentanyl alone was responsible for 8 of the 19 (42.1%) overdose deaths. Mean and median fentanyl concentrations were 36 (SD 38) microg/L and 22 microg/L, respectively, range 5-120 microg/L. Seven of the cases were accidental, one undetermined. The remaining 11 of the 19 (57.9%) cases were mixed drug overdoses. Fentanyl concentrations in these cases were 31 (SD 46) microg/L, range 5-152 microg/L. All of the mixed drug overdoses were determined to be accidental. Four cases where fentanyl was considered an incidental postmortem finding were determined to be natural deaths. In hospitalized inpatients (n = 11) receiving fentanyl 2 of the patients receiving fentanyl for chronic pain for more than 3 months had concentrations of 8.5 microg/L and 9.9 microg/L. The other nine inpatient concentrations were less than 4 microg/L. In conclusion, blood fentanyl concentrations found in cases where fentanyl alone was determined to be the cause of death were similar to cases where fentanyl was part of a mixed drug overdose. There was also considerable overlap between fentanyl concentrations in fentanyl-related overdose deaths compared to hospitalized patients being treated for chronic pain. Fentanyl concentrations in postmortem cases must be interpreted in the context of the deceased's past medical history and autopsy findings.     

The recovery of illicit drugs from oral fluid sampling devices

Testing for drugs in oral fluid is a convenient procedure for determining recent drug use. A number of issues are still to be resolved and this paper investigates the effects of storage systems on drug stability and recovery using three different collection devices supplied by Cozart, Immunalysis and Microgenics (third party). Drugs were analysed using a range of immunoassay systems followed by MS confirmation and quantitation. The reproducibility of the weight of specimen collected was excellent (CV<10%) for the three collection devices tested. Of the three systems studied, only the Cozart product gave acceptable recovery of THC from drug-spiked oral fluid. A combination of Cozart, Immunalysis and Diagnostix immunoassays with the Cozart collection system gave the most sensitive and discriminating screening assays for the drugs studied, namely THC, benzodiazepines, methamphetamine and morphine. Storage at either 5 degrees C or room temperature had no significant effect on drug recoveries.     

System intervention problems in child sexual abuse investigations: the mothers' perspectives

On learning that her child was sexually abused, a mother must interact with professionals charged with the implementation of investigations, treatment, and legal remedies. This qualitative study, based on data from three focus groups (n = 19) and open-ended survey questions (n = 40), documents mothers' experiences with these professionals. Mothers report a lack of support from many professionals including receiving poor services, being criticized, insensitivity to their concerns, and being accused of false allegations and state that they have difficulty seeing the "system" as a positive future resource. Mothers reported appreciation for helpful professionals, whom they most often identified as therapists. Determining which mothers are reporting system problems and the effect of negative maternal-system interactions on mother and child outcomes are recommended as follow-up research.