Differential pharmacological treatment of paraphilias and sex offenders

This article gives an overview of current pharmacological treatment of paraphilias and sex offenders focusing on the situation in Germany. Information about selective serotonin reuptake inhibitors (SSRI) is followed by data about established antihormonal substances (cyproterone acetate/CPA, and medroxyprogesterone acetate/MPA), as well as a more detailed account on luteinizing hormone-releasing hormone agonists (LHRH agonists). The results of open, uncontrolled clinical studies with SSRIs (n = 16) and LHRH agonists (n = 11) in paraphilic outpatients confirm the positive effects of these substances. A survey about the use of CPA and LHRH agonists in forensic hospitals in Germany shows that half of the patients treated with any kind of (anti-) hormonal agents received an LHRH agonist. The authors present a protocol on side effects, contraindications, and monitoring of CPA and LHRH agonists and develop an algorithm for differential pharmacotherapy of paraphilias.     

The importance of a urine sample in persons intoxicated with flunitrazepam--legal issues in a forensic psychiatric case study of a serial murderer

The sedative-hypnotic benzodiazepine flunitrazepam (FZ) is abused worldwide. The purpose of our study was to investigate violence and anterograde amnesia following intoxication with FZ, and how this was legally evaluated in forensic psychiatric investigations with the objective of drawing some conclusions about the importance of urine sample in a case of a suspected intoxication with FZ. The case was a 23-year-old male university student who, intoxicated with FZ (and possibly with other substances such as diazepam, amphetamines or cannabis), first stabbed an acquaintance and, 2 years later, two friends to death. The police investigation files, including video-typed interviews, the forensic psychiatric files, and also results from the forensic autopsy of the victims, were compared with the information obtained from the case. Only partial recovery from anterograde amnesia was shown during a period of several months. Some important new information is contained in this case report: a forensic analysis of blood sample instead of a urine sample, might lead to confusion during police investigation and forensic psychiatric assessment (FPA) of an FZ abuser, and in consequence wrong legal decisions. FZ, alone or combined with other substances, induces severe violence and is followed by anterograde amnesia. All cases of bizarre, unexpected aggression followed by anterograde amnesia should be assessed for abuse of FZ. A urine sample is needed in case of suspected FZ intoxication. The police need to be more aware of these issues, and they must recognise that they play a crucial role in an assessment procedure. Declaring FZ an illegal drug is strongly recommended.     

Contracting Out and Public Values: A Symposium

The three papers that constitute this symposium were first commissioned for a workshop entitled Citizenship and Contractualism held in October 2000. The theme of that workshop centred on the contractualisation of the relationship between service deliverers and their clients. 1 They have been published elsewhere in a special issue of Law in Context, March 2001, co‐edited by Terry Carney, Gaby Ramia and Anna Yeatman.
These three papers did not fit that theme. They are concerned more with the general use of contracting out as a tool of contemporary governance. I have used the title contracting out and public values because all three of these papers raise fundamental questions about the implications of contracting out for public values.     

Isotope ratio mass spectrometry as a tool for forensic investigation (examples from recent studies).

The versatility of isotope ratio mass spectrometry is demonstrated by reference to diverse case studies. Variations in the natural isotopic composition of non-biological, organic materials are compared as a means by which samples may be associated or discriminated. These techniques may be used to augment or compliment conventional forensic methodologies. delta13C analysis was used to demonstrate that different masking tape had been recovered in two, apparently similar cases, involving the smuggling of money. Visually similar ecstasy tablets were compared by consideration of the delta13C and delta15N composition of MDMA extracted from the tablets. Although only a limited number of tablets were analysed, the isotopic similarity between two different seizures was sufficient to induce a guilty plea from a person suspected of possessing both. A combination of delta2H, delta13C, delta15N and delta18O together with GC-MS analyses were applied to small samples of seized heroin. Although GC-MS analysis indicated differences between the chemical composition of two of the heroin samples, isotopic analysis suggested similarities, which were confirmed by further delta2H, delta13C and delta18O isotopic analysis of the clingfilm in which the samples were wrapped.     

Potential impact of the Draft Money Laundering Regulations 2007 on trusts

Representative bodies, including the Law Society of Englandand Wales and the Society of Trust and Estate Practitioners,have raised concerns on the Draft Money Laundering Regulations2007 released on 22 January. They are intended to implementthe Third European Money Laundering Directive in England. However,many are fearful about the impact of Part 2 of the Draft Regulationswhich deals with customer due diligence (CDD) and, in particular,how the requirements will apply to trusts.     

Hair analysis for cocaine: Factors in laboratory contamination studies and their relevance to proficiency sample preparation and hair testing practices

Hair samples were contaminated by rubbing with cocaine (COC) followed by sweat application, multiple shampoo treatments and storage. The samples were then washed with isopropanol for 15 min, followed by sequential aqueous washes totaling 3.5 h. The amount of drug in the last wash was used to calculate a wash criterion to determine whether samples were positive due to use or contamination. Analyses of cocaine and metabolites were done by LC/MS/MS. These procedures were applied to samples produced by a U.S. government-sponsored cooperative study, in which this laboratory participated, and to samples in a parallel in-house study. All contaminated samples in both studies were correctly identified as contaminated by cutoff, benzoylecgonine (BE) presence, BE ratio, and/or the wash criterion. A method for determining hair porosity was applied to samples in both studies, and porosity characteristics of hair are discussed as they relate to experimental and real-world contamination of hair, preparation of proficiency survey samples, and analysis of unknown hair samples.