Treatment and Intervention for Opiate Dependence in the United Kingdom: Lessons from Triumph and Failure

The history of opiate treatment in the United Kingdom (UK) since the early 1980s is a rich source of learning about the benefits and pitfalls of drug treatment policy. We present five possible lessons to be learnt about how factors outside the clinic, including government, charities and researchers can influence treatment and outcomes. First, do not let a crisis go to waste. The philosophical shift from abstinence to harm reduction in the 1980s, in response to an HIV outbreak in injecting users, facilitated expansion in addiction services and made a harm reduction approach more acceptable. Second, studies of drug-related deaths can lead to advances in care. By elucidating the pattern of mortality, and designing interventions to address the causes, researchers have improved patient safety in certain contexts, though significant investment in Scotland has not arrested rising mortality. Third, collection of longitudinal data and its use to inform clinical guidelines, as pursued from the mid-1990s, can form an enduring evidence base and shape policy, sometimes in unintended ways. Fourth, beware of the presentation of harm reduction and recovery as in conflict. At the least, this reduces patient choice, and at worst, it has caused some services to be redesigned in a manner that jeopardises patient safety. Fifth, the relationship between the third and state sectors must be carefully nurtured. In the UK, early collaboration has been replaced by competition, driven by changes in funding, to the detriment of service provision.     

A new technique for three-dimensional ultrasound scanning of facial tissues

We report the development of an ultrasonic facial scanning technique that allows for the visualization of continuous contours without deforming surface tissues. Adhesive markers are placed on the face to enable measurement of facial tissue thicknesses at specific landmarks. The subject immerses the face in a clear plastic box filled with water for about 20 seconds while the researcher moves the transducer along the bottom of the box, guiding transducer movement by watching the facial image in a mirror placed below. 3D Echotech software (1) builds the images from sequentially acquired 2D frames. Reliability of repeat measurements at landmarks is good, and individual tissues (skin, subcutaneous, muscle) can be distinguished. The method is simple, reliable, less expensive and less time consuming than alternatives such as magnetic resonance imaging (MRI). It is applicable in both research and clinical contexts.     

Extent and characteristics of woman batterers among federal inmates

Efforts to identify men who batter women in clinical settings have increased in recent years, but batterer research in United States federal prisons is lacking; low security federal prisons are logical places to consider batterer screening and treatment given the number of men, the domestic violence "risk markers" associated with these men and the likelihood they will be released and return to female partners. This study examined intake assessment data for 115 low security federal inmates. The inmates evidenced high levels of risk markers for woman battering, one in three (33%) acknowledged recent physical violence against women partners, 1 in 10 (13%) admitted severe violence, and the self-identified batterers showed more substance use and personality problems than other inmates. The findings suggest that batterer screening and treatment may be needed in federal prisons and that more research is warranted with a burgeoning male population that ultimately returns to society.     

Patriarchal designs: The genetic engineering of human embryos

This paper describes medical research pertaining to the future potential for genetic engineering of human embryos, and considers some of the consequences that this technology may have for women's lives. It points to both the religious right and the medical profession as groups that could potentially benefit from human genetic engineering and emphasizes the need for feminists to monitor and respond to emerging reproductive technologies.