Alprazolam-related deaths in Palm Beach County

Alprazolam is a commonly prescribed benzodiazepine. The abuse of benzodiazepines is most frequently seen in conjunction with the abuse of other drugs. Only rare fatalities have been attributed to alprazolam alone. We undertook a retrospective review of cases investigated by the Palm Beach County Medical Examiner's Office in which postmortem toxicologic studies indicated the presence of alprazolam, to further study the pattern of alprazolam abuse. Our review consisted of 178 cases, including 87 in which death was attributed to combined drug toxicity, 2 to alprazolam toxicity alone, 44 to trauma, 12 to natural causes, and 33 to another drug or drugs. Cocaine and methadone were the most common cointoxicants in the cases of combined drug toxicity, while heroin was less frequently detected. There was considerable overlap in the postmortem blood alprazolam concentrations among the groups. The overlapping ranges of concentrations of alprazolam detected indicate that it may be difficult to define a lethal alprazolam range, and that it may not be possible to determine the actual role of alprazolam as a causal factor in cases of combined drug toxicity. This study confirms that alprazolam alone is rarely a cause of death, and that alprazolam abuse usually occurs within a polydrug use pattern. The high incidence of cocaine as a cointoxicant has not been previously reported.     

PRODUCTIVITY MEASUREMENT AND THE PUBLIC ORGANIZATION

This article applies a broad theoretical framework identifying factors which provide an understanding of the relationship between electoral politics, organizational reform and institutional change. In focusing upon product i v i t y reforms undertaken in the 1970's and early 1980's. the authors find that political conflicts over measures of public performance may contribute to a life cycle in which organizational structures are reconstituted and subjects of regulation o r services redefined in ways that are potentially inconsistent with the demand for public accountability. The conjunction of such factors may contribute to a crisis of legitimacy resulting in the redefinition of the boundaries between public and private realms of responsibility, as expressed in the electoral process. Today liberal reformers are confronted by a dilemma of productivity and legitimacy involved in the cycle of reform and retrenchment in which the goal of public accountability is undermined by erosion of the rights of the subject. The attempt to break this bind requires, in part, an explicitness on the part of liberals about the presuppositions regarding the subject underpining the measures and strategies by which organizational reforms are undertaken.     

Relationship between depressed mood and sex-typed personality characteristics in adolescents

The current study investigated the relationship between self-reports of depressed mood, self-esteem, and endorsement of sex-typed personality characteristics in a normal adolescent population. For positively valenced (socially desirable) sex-typed characteristics, masculinity was inversely related to depression while femininity was not significantly related. In contrast, for negatively valenced sex-typed characteristics the masculine and feminine scales showed similar effects: all were positively correlated with depression. Self-esteem was the best single predictor of depression and none of the sextyped characteristics contributed significantly beyond that accounted for by self-esteem. The results support previous findings with younger children and high school students by demonstrating that sex-typed characteristics in adolescents are significantly associated with depression, although this relationship is accounted for by the variance shared with self-esteem, a more general measure of mental health. However, the presence of negative feminine-typed characteristics was as highly correlated with depression as the absence of positive masculine characteristics and both relationships were stronger for females than males. Thus the linkages between sex-role socialization, sex-typed characteristics, self-esteem, depressed mood, and clinical depression bear further investigation, and may prove useful in understanding the development of depression in males and females.Received Ph.D. in clinical psychology from the Pennsylvania State University in 1976. Current research interests include the development of depression and eating disorders.Received Ph.D. in Counseling Psychology from the Pennsylvania State University in 1981. Current research interest is childhood depression.     

Equality or lasting inequality?

Jan H. Blits teaches in the University Honors Program at the University of Delaware and was previously Secretary of the Navy Distinguished Fellow at the U.S. Naval Academy. He has published two books and numerous articles on educational and political philosophy.