Morphine to codeine concentration ratio in blood and urine as a marker of illicit heroin use in forensic autopsy samples

A morphine to codeine ratio greater than unity (M/C>1) has been suggested as an indicator of heroin use in living individuals. The aim of this study was to examine the morphine to codeine ratio in a large population (N=2438) of forensically examined autopsy cases positive for 6-monoacetylmorphine (6-MAM) and/or morphine in blood and/or urine. Blood and urine concentrations of 6-MAM, morphine and codeine were examined using GC-MS and LC-MS/MS methods. In 6-MAM positive samples, the M/C ratio was greater than unity in 98% (N=917) of the blood samples and 96% (N=665) of the urine samples. Stratification of 6-MAM negative cases by M/C above or below unity revealed similarities in morphine and codeine concentrations in cases where M/C>1 and 6-MAM positive cases. Median blood and urine morphine concentrations were 8-10 times greater than codeine for both groups. Similarly to 6-MAM positive cases, 25-44 year-old men prevailed in the M/C>1 group. In comparison to cases where M/C ≤ 1, the M/C ratio was a hundred times higher in both 6-MAM positive and M/C>1 cases. The range of morphine concentration between the lowest and the highest quintile of codeine in M/C>1 cases was similar to that in 6-MAM positive cases. This range was much higher than for M/C ≤ 1 cases. Moreover, linear regression analyses, adjusted for age and gender, revealed a strong positive association between morphine and codeine in 6-MAM positive and M/C>1 cases. The M/C ratio appeared to be a good marker of heroin use in post-mortem cases. Both blood and urine M/C>1 can be used to separate heroin users from other cases positive for morphine and codeine.     

DISTINGUISHING FACTS AND ARTIFACTS IN GROUP-BASED MODELING*

Group-based methodology (SPGM) has been presented as suitable to test for the existence of subpopulations not directly observable. Several criminological studies have used this methodology, and it is fair to say that typological theorizing has been spurred by its development. In particular, much of the empirical support for Moffitt's taxonomy (1993, 2006) is from studies using SPGM. In a small simulation experiment, I investigate whether SPGM is suitable for such tests, and I examine the extent to which similar trajectories might equally well result from mechanisms suggested by general theories. I conclude that, as it is usually applied, SPGM cannot provide evidence either for or against a taxonomy and that the usual findings can be explained by competing theories. I argue that this result is not only because of the methodology characteristics but also because of the modeling strategy applied.     

Social Support from Parents and Friends and Emotional Problems in Adolescence

In a sample of 2918 adolescents aged 12 to 24 years, the relation between parental and friends' social support was studied, specifically with regard to emotional problems. In addition, age and sex differences were examined. Results indicated that parental and friends' support seem to be relatively independent support systems. Although the degree of perceived support changes in the expected direction (with parental support decreasing and friends' support increasing) during early adolescence, parental support remains the best indicator of emotional problems during adolescence. The effect of friends' support appeared to depend slightly on the level of perceived parental support, with the high parental support group showing a slightly positive effect of friends' support, and the low parental support group showing a negative effect of friends' support.     

Contacts with public services, with special reference to mental health care, preceding a serious crime: a retrospective study of 268 subjects of forensic psychiatric investigations

Between July 1995 and June 1996, 533 subjects underwent forensic psychiatric investigation I Sweden. Odd case numbers (n = 268) were included in the study. Of these 268 people, 50% had been in contact with psychiatric services during the six-month period preceding the crime leading to forensic psychiatric assessment. Contacts with psychiatric services during the six-month period preceding the crime were significantly more common in three categories of individuals than others. These were: women, individuals who were diagnosed as having a psychotic disorder during the forensic psychiatric investigation, and individuals found to suffer from a serious mental disorder as defined in the legislation. Subjects who were found not to suffer from a serious mental disorder and were thus not eligible for special sanctions on medicolegal grounds had significantly less psychiatric contacts before the crime, as did subjects under 20 years of age. However, these two groups still had considerably more psychiatric contacts than the general population. The present results suggest that the patient category studied requires special monitoring and case management in general psychiatry in Sweden. To this end, we call for closer studies of high-risk individuals, particularly of previously violent offenders and potentially violent offenders, and closer studies of their psychiatric contacts. This will provide a basis for the development of adequate programs and guidelines for effective care and treatment within the psychiatric sector.     

Going nuclear in Northeast Asia: a global view

Northeast Asia (NEA) is on the international security agenda for a lot of reasons. The historical legacy, territorial disputes, the region’s growing importance as an economic actor and a trading partner accompanied by increasing defence expenditures and acquisition of high tech weaponry and the political isolation of a “rogue” North Korea have all contributed to fear that NEA could open a Pandora’s box of a nuclear arms race. In this paper, I analyse recent strategic trends in Asia and try to evaluate the main motivations and objectives of a country like North Korea behind Weapons of Mass Destruction proliferation and the impact of this “nuclear diplomacy” on the evolution of defence policy of major military power like Japan.

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"No way out": Russian-speaking women's experiences with domestic violence

This article explores the experience of domestic violence and utilization of domestic violence resources among immigrant women who were Russian speaking. Participants, many of whom came to the United States as so-called mail-order brides, reported diverse forms of abuse, including isolation and financial restrictions, and were reluctant to get outside help because of embarrassment about their circumstances. Survivors stressed the importance of language- and culture-appropriate outreach and services and urged that women receive information about domestic violence services and laws on immigration. Assistance with housing, child care, and job searches is integral to safe transitions out of abusive relationships.     

"Like a bird in a cage": Vietnamese women survivors talk about domestic violence

In recent years, a growing literature has emerged that explores the role of culture in domestic violence for ethnic minority populations, including immigrants and refugees. This article presents qualitative data collected from Vietnamese refugee women through a research project in partnership with the Refugee Women's Alliance in Seattle, Washington. Through the women's stories, their own self-awareness of domestic violence as Vietnamese women residing in the United States is available for reflection and review. Issues of acculturation, changing gender roles, examples of strength, and cultural persistence constitute the thematic structure within which these women articulate their needs for creating and sustaining a life free of abuse for themselves and their children.