色质联用技术在毒品检验中的应用

毒品检验是打击毒品违法犯罪的一种重要手段,特别是色质联用技术在毒品检验中的广泛使用,拓展了禁毒工作内涵。其优势:1.测定毒品中的各种成分和含量;2.推断藏匿毒品的重量;3.检验毛发中的毒品等。     

The rise and rise of fentanyl in postmortem casework

Forensic toxicology laboratories are navigating a period of time with increasing drug overdose deaths, an opioid epidemic, the impact of the COVID-19 pandemic, and the illicit drug market flooded with novel psychoactive substances. In New York City, the Department of Forensic Toxicology has experienced a 56% increase in postmortem casework in the past decade with fentanyl detected in 80% of all overdose deaths. Over a period of 2.5 years, 15,638 postmortem cases were tested for the presence of fentanyl and fentanyl analogs using liquid-chromatography tandem mass spectrometry (LCMSMS). Fentanyl was detected in approximately one third of cases and of these 4447 cases with femoral blood. A twofold increase in cases with high concentrations of fentanyl (>100 ng/mL) was observed between 2021 and 2022. The minor metabolite and precursor chemical, 4-ANPP (4-anilino-N-phenethylpiperidine) may help differentiate between illicit and licit fentanyl. 4-ANPP blood concentrations were <10 ng/mL in 98% of the cases and the 4-ANPP:fentanyl ratio was <0.67 for 99.1% of blood specimens. Only six cases had 4-ANPP concentrations higher than the corresponding fentanyl blood concentration. This study also highlights, the changing fentanyl analogs found in postmortem cases since 2016 in NYC with the emergence of fluorofentanyl initially identified in 2020 and continuing to dominate in comparison with the prevalence of other analogs, many of which are no longer detected in casework. The detection of one of the latest drugs to be mixed with fentanyl, namely xylazine, has also increased in prevalence by 36.7% in 2022 compared with 2021.     

Effects of cocaine and heroin,and their combination,on the development rate of Calliphora vomitoria (Diptera: Calliphoridae)

Insects present on or near decomposing bodies are collected by forensic entomologists and used to estimate the post-mortem interval. Drugs metabolized by a person before death may affect the rate of development of insects feeding on the corpse. This study aimed to determine the effects of cocaine and heroin main metabolites on the development rate of the Calliphora vomitoria (Diptera: Calliphoridae) and their implications on minimum post-mortem interval determination. Groups of 250 eggs each were placed into four separate pots of 150 g of minced pork meat being either un-spiked, or spiked with benzoylecgonine, morphine, or a combination of both. Larval length (mm) and weight (mg) measurements were taken twice daily and the rate of development of the insects’ life cycle was monitored until eclosion. Results show that cocaine-fed larvae developed less in length and weight than the control group. Heroin-fed larvae showed a more fluctuating pattern, being smaller and lighter than the control group for most of their larval cycle, but overtaking them in both parameters towards pupation. Combination-fed larvae seemed to favour the effects of cocaine. The three conditions also had a significant impact on the length of the insects’ life cycle. Cocaine and drug combination treatments increased the length of the second and third instar stages, but led to the shortening of pupation and accelerated eclosion. Conversely, heroin treatment led to lengthier pupation. Interestingly, the effects of the drug combination seemed to mirror more precisely those of cocaine.These findings indicate that both cocaine and heroin, singularly and in combination, have sizable effects on blowflies’ development rates, potentially biasing post-mortem interval estimations.     

Is it possible to have cheaper drugs and preserve the incentive to innovate? The benefits of privatizing the drug approval process

In this paper, we argue that lower prices for pharmaceuticals can be achieved by fostering a new type of competition in the pharmaceutical industry. Lower drug development costs, and hence prices, can be brought about by abolishing national drug administrations and replacing them with private certification boards that compete on the basis of safety, efficiency and cost of their drug approval process. A major benefit of this type of privatization is that it would not necessitate limits on data exclusivity in order to achieve lower prices. Drug approval privatization could achieve the same positive results as generic competition, in terms of lower costs and prices, without the negative effects of intellectual property rights violation and the consequent discouragement of innovative activities.

Improving the quality of drug court clinical screening: a call for performance measurement policy reform

Despite the widespread use of the drug court model, standardized performance measures for drug courts are not uniformly utilized, and rarely include process measures. To ensure that drug courts are being implemented in the most effective manner, the use of performance measurement tools should be considered for wide scale adoption. Drug court effectiveness is moderated by participant characteristics, and is most effective for individuals with the highest substance use needs. Therefore, having quality clinical screening processes is crucial to ensuring that drug courts are serving the population for which they are effective. This paper examines clinical screening in drug courts, to answer the following 1) what is the current state of screening, 2) what works, and 3) why measurement matters. It also proposes a clinical screening performance measure to improve fidelity and ensure appropriate participant enrollment. The creation of a performance measure would create opportunities to improve drug court outcomes, and leverage pay-for-performance models.     

有偿采供血或吸毒致艾滋病毒携带和艾滋病人群的舌象特点

目的 通过临床调查研究因有偿采供血、吸毒致艾滋病毒(human immunodeficiency virus, HIV)携带和(或)艾滋病(acquired immunodeficiency syndrome, AIDS)人群的舌象特点. 方法 运用舌象拍摄和专家分析相结合的方法,对有偿采供血或吸毒致HIV携带和(或)AIDS人群的舌象特点进行比较和分析. 结果 有偿采供血或吸毒致HIV携带和(或)AIDS人群中出现率较高的舌象有:热象舌色出现率分别为63.64%和65.71%,瘀象舌色出现率分别为33.64%和41.14%,胖大和(或)齿痕舌分别为40.45%和45.14%,裂纹舌分别为35%和26.86%;两类人群均以白苔居多,黄苔出现率分别是23.18%、28.00%,厚苔的出现率分别是40.45%和31.43%,腻苔出现率分别是65.91%和82.29%. 结论 两组人群的舌象表现较为一致,HIV携带者和(或)AIDS患者常见舌象特点是:舌质红;苔厚腻,以白腻居多;舌体胖大或有齿痕;有瘀象.