Parent and Metabolite Opioid Drug Concentrations in Unintentional Deaths Involving Opioid and Benzodiazepine Combinations,,

Effects of benzodiazepines on postmortem opioid parent and parent/metabolite blood concentration ratios were determined for fentanyl‐, hydrocodone‐, methadone‐, or oxycodone‐related accidental deaths. These opioids are partially metabolized by the CYP3A4 enzyme system, which is also affected by diazepam and alprazolam. Opioid/metabolite combinations examined were as follows: fentanyl/norfentanyl, hydrocodone/dihydrocodeine, methadone/EDDP, and oxycodone/oxymorphone. Parent opioid concentrations were analyzed for 877 deaths. Parent/metabolite concentration ratios were analyzed for 349 deaths, excluding cases with co‐intoxicants present known to interfere with opioid elimination. Alprazolam in combination with diazepam significantly decreased median hydrocodone concentrations by 48% (p = 0.01) compared to hydrocodone alone. The methadone parent/metabolite concentration ratio was reduced by 35% in the presence of diazepam compared to methadone alone (p = 0.03). Benzodiazepines did not statistically significantly affect fentanyl or oxycodone concentrations. Possible factors affecting opioid concentrations and possible toxicity development, including any differential effects on specific opioids, should continue to be explored.     

Identification of 2‐(ethylamino)‐1‐(4‐methylphenyl)‐1‐pentanone (4‐MEAP), a New “Legal High” Sold by an Internet Vendor as 4‐Methyl Pentedrone

Online vendors are offering a new legal high, 4‐methylpentedrone (4‐MPD). Information for potential users provided by internet vendors of 4‐MPD includes incorrect structures and nonexistent CAS numbers. A sample of 4‐MPD was obtained and analyzed using GC‐MS, NMR, and LC‐EIS. The fragmentation data from the GC‐MS and LC‐EIS produced an M‐1 ion that suggested the molecular mass was 219 amu, rather than 205 amu as calculated for 4‐methylpentedrone. The difference in molecular mass corresponded to the addition of a methyl group. Based on the mass and fragmentation pattern, two standards were synthesized, 2‐(ethylamino)‐1‐(4‐methylphenyl)‐1‐pentanone and 1‐(4‐methylphenyl)‐2‐(propylamino)‐1‐butanone. The synthesis involved bromination of the appropriate ketone followed by the reaction with ethylamine or propylamine. Based on the NMR data and unique fragmentation patterns produced by these molecules, the sample was identified as 2‐(ethylamino)‐1‐(4‐methylphenyl)‐1‐pentanone, not 4‐methylpentedrone.     

The Effects of Dextromethorphan on Driving Performance and the Standardized Field Sobriety Test

Dextromethorphan (DXM) is abused most commonly among adolescents as a recreational drug to generate a dissociative experience. The objective of the study was to assess driving with and without DXM ingestion. The effects of one‐time maximum daily doses of DXM 120 mg versus a guaifenesin 400 mg dose were compared among 40 healthy subjects using a crossover design. Subjects’ ability to drive was assessed by their performance in a driving simulator (STISIM^® Drive driving simulator software) and by conducting a standardized field sobriety test (SFST) administered 1‐h postdrug administration. The one‐time dose of DXM 120 mg did not demonstrate driving impairment on the STISIM^® Drive driving simulator or increase SFST failures compared to guaifenesin 400 mg. Doses greater than the currently recommended maximum daily dose of 120 mg are necessary to perturb driving behavior.     

Evaluating Simulant Materials for Understanding Cranial Backspatter from a Ballistic Projectile

In cranial wounds resulting from a gunshot, the study of backspatter patterns can provide information about the actual incidents by linking material to surrounding objects. This study investigates the physics of backspatter from a high‐speed projectile impact and evaluates a range of simulant materials using impact tests. Next, we evaluate a mesh‐free method called smoothed particle hydrodynamics (SPH) to model the splashing mechanism during backspatter. The study has shown that a projectile impact causes fragmentation at the impact site, while transferring momentum to fragmented particles. The particles travel along the path of least resistance, leading to partial material movement in the reverse direction of the projectile motion causing backspatter. Medium‐density fiberboard is a better simulant for a human skull than polycarbonate, and lorica leather is a better simulant for a human skin than natural rubber. SPH is an effective numerical method for modeling the high‐speed impact fracture and fragmentations.     

A Rigorous Quasi‐Experimental Design to Evaluate the Causal Effect of a Mandatory Divorce Education Program

All couples with minor children who filed for divorce within a specific 6‐week period (N = 191 couples) in one jurisdiction were ordered to attend a divorce education program. The control group included about 20 couples randomly selected from each of six 6‐week intervals before and six 6‐week intervals after the treatment interval (N = 243 couples). Archival records were searched for variables such as legal and residential custody award, visitation percentage, and relitigation. The impact of the program was assessed by evaluating, for each variable, whether the data for program interval departed from the straight (regression) line drawn through all the control group intervals. Only the visitation time award significantly differed: 27.75% for treatment couples and 22.46% for control couples. Analyses show that the father's attendance at the program primarily accounts for the difference.

Key Points for the Family Court Community
• There are considerable methodological weaknesses in most of the existing evaluations of divorcing parent education programs.
• Stronger, more scientifically rigorous—and thus persuasive—designs are possible in court settings, such as the regression discontinuity quasi‐experimental design we feature here.
• Archival records, such as various court filings, are a rich and relatively untapped source of data.
• Being mandated to attend a single 2‐hour divorcing parent education class caused an increase in the visitation time award in divorce decrees.
• There is a disconnect between being mandated by a judge to attend a program and actual attendance.

     

Cognitive‐Behavioral Methods in High‐Conflict Divorce: Systematic Desensitization Adapted to Parent–Child Reunification Interventions

Children who are triangulated into their parents' conflicts can become polarized, aligning with one parent and rejecting the other. In response, courts often order families to engage mental health professionals to provide reunification interventions. This article adapts empirically established systematic desensitization and flooding procedures most commonly used to treat phobic children as possible components of a larger family systems invention designed to help the polarized child develop a healthy relationship with both parents. Strengths and weaknesses of these procedures are discussed and illustrated with case material.

Key Points for the Family Court Community
• Family law and psychology agree that children should have the opportunity to enjoy a healthy relationship with both parents
• Adult conflict can polarize a child's relationships, including rejection of one parent
• Existing clinical and forensic “reunification” strategies often prove inadequate
• Reliable and valid cognitive behavioral methods can be adopted to facilitate this process
• A cognitive‐behavioral “exposure‐based” reunification protocol is discussed

     

Unbundled Services to Enhance Peacemaking for Divorcing Families

Unbundling, also known as limited‐scope representation, has been adopted by judges, the organized legal profession, and divorcing parties. Unbundling is a legal access approach to better and more affordably serve unrepresented divorce litigants as well as to assist overburdened and underfunded courts. This article will focus on another critical benefit of unbundling: the ability of divorcing professionals to provide information and support to divorcing families to help reduce family conflicts. This article shall discuss four unbundled peacemaking roles that lawyers can play: (1) Collaborative Lawyer; (2) Lawyer Coach for Self‐Represented Litigants; (3) Lawyer for Mediation Participants; and (4) Preventive Legal Health Care Provider.

Key Points for the Family Court Community:
• Overview of limited‐scope lawyering roles
• Impact of unbundled representation on peacemaking
• Best practices of noncourt lawyering

     

The Interdisciplinary Settlement Conference: A Grassroots Alternative for Resolving High‐Conflict Parenting Disputes in Lean Times

This article describes a court‐connected alternative dispute resolution program, the Interdisciplinary Settlement Conference. The key feature of this program is the participation of two volunteer panelists, one a family law attorney and the other a mental health professional experienced in parenting disputes, who assist the judicial officer in working with the parties and their attorneys (if any) to reach a resolution of their parenting dispute. Significantly, in addition to addressing the parties’ legal issues, the panelists also address the parties’ psychological and emotional issues relevant to the dispute on an as‐needed basis. Findings from six years of experience with the program are discussed, including evidence of high satisfaction with the program, a high rate of settlement, a decrease in relitigation, and a concomitant savings of scarce judicial resources.     

INITIAL DEVELOPMENT OF A PSYCHOLOGICAL MODEL FOR JUDICIAL DECISION MAKING IN CONTINUING RESTRAINING ORDERS

Probate and family court judges are increasingly called upon to make rapid decisions regarding the continuance of restraining orders. These decisions are often made without the benefit of adequate background information or an awareness of which psychological and behavioral factors are most relevant. This action‐oriented research project develops a model that brings psychosocial factors to consideration for judges making decisions regarding the continuance of restraining orders. While further evaluation of the model is needed, the project's unique methodology highlights the value of interdisciplinary collaboration, multiple methods of inquiry, and the consideration of real‐world needs and constraints in developing decision‐making tools.