Emergence of fentanyl-related deaths in Travis County,Texas and surrounding areas: A retrospective review of postmortem fentanyl-related drug toxicities from 2020 to 2022

The opioid epidemic has affected the United States (US) for decades with fentanyl and its analogs accounting for a recent surge in morbidity and mortality. Currently, there is a relative lack of information characterizing fentanyl-related fatalities specifically in the Southern US. A retrospective study was conducted to examine all postmortem fentanyl-related drug toxicities in Travis County, Texas, encompassing Austin (one of the fastest-growing cities in the US), from 2020 to 2022. Fentanyl contributed to 2.6% and 12.2% of deaths submitted for toxicology between 2020 and 2022, respectively, representing a 375% increase in fentanyl-related deaths over this 3-year period (n = 517). Fentanyl-related fatalities primarily occurred in males in their mid-30s. Fentanyl and norfentanyl concentrations ranged from 0.58 to 320 ng/mL and 0.53 to 140 ng/mL with mean (median) concentrations of 17.2 ± 25.0 (11.0) and 5.6 ± 10.9 (2.9) ng/mL, respectively. Polydrug use was present in 88% of cases, with methamphetamine (or other amphetamines) (25%), benzodiazepines (21%), and cocaine (17%) representing the most frequently identified concurrent substances. Co-positivity rates of various drugs and drug classes widely varied over time. Scene investigations reported illicit powder(s) (n = 141) and/or illicit pill(s) (n = 154) in 48% (n = 247) of fentanyl-related deaths. Illicit oxycodone (44%, n = 67) and illicit “Xanax” (38%, n = 59) pills were frequently reported on scene; however, toxicology only identified oxycodone and alprazolam in 2 and 24 of these cases, respectively. The results of this study provide a better understanding of the fentanyl epidemic in this region creating an opportunity to promote increased awareness, shift focus to harm reduction, and aid in minimizing public health risks.     

RETHINKING ASIAN MOBILITIES

ABSTRACT

Vietnam's economic reforms have generated much praise for the country's rapid “opening” of its markets, as if the Vietnamese nation had previously existed in a state of isolation, closed to broader global influences and exchanges. Such discourses overlook the importance of transnational circulations of people, goods, technologies, and expertise during the socialist era that were vital to Vietnam's postwar national reconstruction and continue to play a role in post-socialist economic transformation today. This article traces the socialist pathways of labor migration between Vietnam and the former Soviet Bloc (specifically, East Germany) in the 1980s, mobilities that are generally absent in studies of contemporary export labor industries. Based on multi-sited ethnographic and archival research, the author follows Vietnamese workers first to the East German factories where they labored as “contract workers,” and then through their subsequent return and reintegration into Vietnamese society after the collapse of the Soviet Union. These mobilities bespeak of an alternative history and formation of diasporic communities that are little acknowledged or addressed in literature on labor migrations, and yet are important to understanding emerging forms of stratification today in Vietnam. Moreover, an analysis of early non-capitalist experiences with overseas labor regimes in the 1980s provides insights into contemporary Vietnamese governance practices that promote—rather uncritically, similar to other “emerging countries” —export labor as a nation-building strategy to reduce endemic poverty and develop a late socialist country.     

EU Accession to the ECHR: Between Autonomy and Adaptation

After the European Union's accession to the European Convention on Human Rights the EU will become subject to legally binding judicial decisions of the European Court of Human Rights (ECtHR) and participate in statutory bodies of the Council of Europe (Parliamentary Assembly; Committee of Ministers) when they act under the Convention. Convention rights and their interpretation by the ECtHR will be directly enforceable against the EU institutions and against Member States when acting within the scope of EU law. This will vest the ECHR with additional force in a number of Member States, including Germany and the UK. All Member States will further be subject to additional constraints when acting under the Convention system. The article considers the reasons for, and consequences of the EU's primus inter pares position under the Convention and within the Council of Europe, and the likely practical effect of the EU's accession for its Member States.     

Family Dysfunction and Social Isolation as Moderators Between Stress and Child Physical Abuse Risk

Stress is a significant contributor to child physical maltreatment risk. Family and social supports are expected, but less studied, risk factors. Little empirical support clarifies the interactive influence on abuse risk for non-abusive parents. This study examined whether the stress-abuse risk relation was moderated by family dysfunction and social isolation. Subjective appraisals of these factors were administered to 95 community mothers. After creating composite scores using factor loadings from a CFA, multiple regression analyses were conducted to predict abuse risk. As expected, stress predicted abuse risk, with social isolation and, to a lesser extent, family dysfunction serving as moderators. Perceived stress and dysfunctional supports are important, interactive predictors of abuse risk. Future directions consider interactions within other ecological levels.