Methadone-related deaths in Hennepin County,Minnesota: 1992-2002

Methadone maintenance therapy (MMT) is the only currently established medical therapy for heroin addiction. However, MMT still remains controversial. In Hennepin County, Minnesota, methadone is one of the top ten drugs reported in medical examiner investigated deaths and one of the most commonly diverted pharmaceuticals. This report reviews the role of methadone in medical examiner deaths over a 10-year period, 1992-2002. We compare cause and manner of death (accidental, natural, suicide) and methadone blood concentrations for decedents who were members of MMT programs with illicit users and those prescribed methadone for chronic pain. Findings reveal that 65% of decedents with measurable blood methadone concentrations were not participating in MMT programs. A total of 96 cases were identified, with the majority white (90.5%) and male (76.8%). MMTP program members were the minority (34.7%) of the methadone positive deaths and 39% were illicit users. Fifteen percent were chronic pain patients with almost half of this group dying from overdose. Methadone concentrations of drug caused/related deaths (0.18-3.99 mg/L) overlapped with those of deaths not attributable to methadone (0.18-3.03 mg/L) with no definable lethal level. Interpretation of methadone blood concentrations must be done in the context of the clinical history for determining cause of death, and may be confounded by postmortem redistribution.     

Was ``V' for Victory or Votes? A Public Choice Analysis of World War II Federal Spending

Several studies on the New Deal have found that politicalfactors played a significant role in determining 1930s federalspending. This suggests that federal spending was not capturedby special interest groups and self-interested politiciansrecently, but rather, that it has been affected by thesefactors since the ``era of big government'' began. We examinethe military emergency of the 1940s to determine whetherfederal spending during this crisis was similarly affected bypolitics.     

Global Governance: Prospects and Problems

The 50th anniversary of the UN in 1995 occasioned a widespread international discussion of 'global governance'. This term is understood to denote not just conventional bodies of international security and economic management but the overlapping and interlocking of institutions found in all issues and regions, and the increasing body of non-state actors, broadly termed 'international civil society'. This article discusses the functions and reform of global governance, and then examines these in the light of five central issues of the 1990s: the role of the great powers, peace-keeping, economic nationalism, a crisis of NGOs, and global values. It argues that advocacy of global governance must be matched by political realism on the one hand, and the recognition of the need for difficult ethical choices on the other.     

One voter, two first-order elections?

Conventional wisdom has it that elections other than national ones are “second-order elections,” driven by political conditions in the “first-order” national arena. It has not yet been shown that a sub- or supra-national election can exhibit qualities similar to those of first-order elections. This paper uses the 2003 Ontario Election Study, from a provincial election in extremely decentralized federation, to demonstrate that a sub-national election can be a first-order election. Aggregate evidence shows voters' interest and turnout is comparable to national elections. Individual-level evidence shows vote choice is determined by arena-specific factors. And dynamic evidence shows that this sub-national campaign had its own homegrown events that influenced voters, just as campaign events influence national elections.     

Public administration theory a futurist vision

As the world becomes increasingly interdependent, Americans interested in public administration will begin to realize that it is a universal phenomenon and field of inquiry that attracts the attention of researchers and teachers in all countries of the world. This will lead them to stop equating American governance with Public Administration. They will come to see that, in a comparative frame of reference, American bureaucracy, its administrative practices and political functions are quite unique. Comparative Public Administration as a special focus of study will disappear because all administrative studies must be comparative, and “American Public Administration” will gain recognition as one of many parochial foci for research as a country-specific emphasis.

Before this shift in perspective can gain widespread acceptance in America, however, the relevant work of non-American scholars will have to become more generally read in America, and the distinctively American conditions that led to the origin of this field and its subsequent dissemination on a global basis must be recognized.

Among the specific points that this paradigmatic shift will highlight are the following: the reasons why bureauphilia and bureauphobia persist in a context marked by pressure to make administrative studies and performance non-political and to divorce “politics” from “public administration;” the vain effort to gain recognition for Public Administration as either a profession or a discipline; the institutional implications of this false dilemma; the effects of focusing on career civil servants while paying scant attention to other bureaucrats, namely military officers, partisan appointees, retainers and consultants; and the causes and consequences of the American bureaucracy's semi-powered status.     

Making Sense of Hell: Three Meditations on the Holocaust

This essay is an inquiry into the epistemology of the holocaust. It contests organic explanations of the event in favour of an interpretative pluralism . Different questions are seen as demanding different forms of inquiry: what made the holocaust possible requires a political analysis, the issue of its uniqueness calls for a sociological perspective, while an anthropological approach is necessary in order to illuminate its enduring symbolic significance. The essay will deal with these matters in an innovative manner. Thus, in concert with one another these three meditations will provide a new constellation for viewing the holocaust even as they confront certain prevailing prejudices and assumptions.