scholarly journals Decriminalize Drug-Checking Technologies in Pennsylvania to Prevent Overdose Deaths

2020 ◽  
Vol 17 (02) ◽  
Author(s):  
Kyla Mace ◽  
Wisberty J. Gordián-Vélez ◽  
Aerin Wheeler ◽  
Victor Acero ◽  
Emily Cribas

Drug-checking technologies (DCTs), such as fentanyl test strips, prevent fatal overdoses caused by the adulteration of drugs. DCTs are currently classified as illegal drug paraphernalia in Pennsylvania (PA), but the recent and significant rise in fentanyl-related overdoses has prompted the PA House and Senate to propose exempting fentanyl test strips from the definition of drug paraphernalia. While fentanyl is currently the leading drug adulterant, other substances may be used to alter drugs. Therefore, we argue that broader reform is required to protect Pennsylvanians against all potential drug adulterants. We recommend that the PA House and Senate Judiciary Committees work to amend the PA Controlled Substance, Drug, Device, and Cosmetic Act to exempt all DCTs from the definition of drug paraphernalia. This proactive intervention will save countless lives by preventing adulterant-related overdoses.

1982 ◽  
Vol 92 (2) ◽  
pp. 213-223 ◽  
Author(s):  
A. I. FRANKEL ◽  
W. W. WRIGHT

A comprehensive study has been made of the hemicastrated rat from 2 to 12 months of age in order to define what might represent an ideal model in which to study testicular regulation. Although there was no compensatory hypertrophy in the remaining testis of the mature hemicastrated rat, levels of plasma testosterone fell significantly within 4 h after surgery in all age groups older than 3 months, and were restored to normal levels almost immediately, usually within 8 h. There were no significant changes in LH and prolactin, and the significant rise in FSH was sufficiently delayed (2 days or more) to suggest that none of these three hormones was implicated in any obvious way in the compensatory restoration of plasma testosterone levels. Although a single testis was capable of maintaining normal plasma testosterone concentrations, its response to human chorionic gonadotrophin at 24 h after hemicastration was significantly less than that of intact animals, suggesting that the single testis was functioning at near-maximal capacity. The hormonal responses to repetitive blood sampling and to sham-surgery simulated the response to hemicastration remarkably. However, these responses were never statistically significant in within-group analysis, and therefore did not obscure the significant fall of plasma testosterone levels in response to hemicastration. The basic mechanism by which plasma testosterone is restored in the hemicastrated rat is still unknown, but the options have been narrowed.


The aim of this contribution to the Meeting is to describe how the results of research work have been applied to the design of power stations in Britain. Before doing so, however, it is perhaps worth while giving an outline of the fundamental principles involved in the selection of air pollution control measures as they are seen by the engineers who must make practical decisions on plant design, and in this way define the specific objectives for the research work being undertaken. First, it must be appreciated that unless one accepts an exceedingly narrow definition of what constitutes air pollution, then clean air must be regarded as a matter of degree and not of kind. All sorts of naturally occurring gases and particulates pollute the atmosphere, even in places remote from mankind’s industrial and domestic activities. Volcanic dust and ashes, sulphur dioxide and other gases of geophysical origin, wind-blown dust, residues of sea-spray, pollen, spores, ozone, ammonia and many other substances exist quite naturally in the air we breathe. What constitutes an air pollution problem is the occurrence of pollutants in unduly high concentrations in a particular place or at a particular time. As a corollary of this, the aim of air pollution control measures is to prevent such high concentrations from occurring. This principle is fundamental to the whole concept of air pollution control, since once it is accepted then practical control measures need not necessarily be restricted to the prevention of the emission of pollutants, but can include also the manner of emission, in so far as this can influence subsequent concentrations of pollutants in the atmosphere


Criminology ◽  
2019 ◽  
Author(s):  
Robin Fletcher

There is no real definition of a “victimless crime” because crimes of this nature do not really exist. There are however a number of statutory offenses that if engaged in, may not have an obvious victim. The dichotomy of these statements is that the word “victimless” can be interpreted as widely or as narrowly as one wishes. The traditional view is that laws are created to protect social standards and are derived from moral and ethical values. Some of these offenses are of a minor nature and impact individuals rather than society in general and include illegal drug taking; prostitution; drunkenness; pornography; gambling; and various sexual acts. There is a debate that argues offenses of this nature are invariably committed by consenting actors; there are no injuries to non-participants; the offense is against the state rather than society; and only police officers make the complaint. While the act may be illegal, there is no obvious victim. In these circumstances it is easy to see how a crime could be considered “victimless.” There are however other circumstances where victims of crime are not aware of their victimhood and their ignorance of the fact is perceived to be an acceptance of their victimhood. The victimlessness in these circumstances therefore lies on the perception of the perpetrator who ignores culpability because of a lack of complaint or where there is a complaint, a denial of the facts. Because the victim is oblivious of these circumstances it is easy to see how such deviant business practices can be accepted as victimless. To counter this perception there is an assumption that corporations act with integrity and do not knowingly provide flawed goods or services, or at the very least will rectify the situation without fuss. However, in the competitive world of business, organizations continually seek ways to maximize profit sometimes at the expense of the oblivious customer. Within the business world, entrepreneurs seek innovative ways to improve their business and increase profit by bending or even breaking rules in a manner that could be considered reckless or even bordering on illegal. A third form of “victimlessness” is the non-payment of taxes, required by the state to support the infrastructures necessary for social welfare, whose lack will negatively impact sections of society.


2017 ◽  
Vol 7 (1) ◽  
pp. 19-35 ◽  
Author(s):  
David Dolinak

In recent years, there has been a substantial increase in opioid use and abuse, and in opioid-related fatal overdoses. The increase in opioid use has resulted at least in part from individuals transitioning from prescribed opioids to heroin and fentanyl, which can cause significant respiratory depression that can progress to apnea and death. Heroin and fentanyl may be used individually, together, or in combination with other substances such as ethanol, benzodiazepines, or other drugs that can have additional deleterious effects on respiration. Suspicion that a death is drug-related begins with the decedent's medical and social history, and scene investigation, where drugs and drug paraphernalia may be encountered, and examination of the decedent, which may reveal needle punctures and needle track marks. At autopsy, the most significant internal finding that is reflective of opioid toxicity is pulmonary edema and congestion, and frothy watery fluid is often present in the airways. Various medical ailments such as heart and lung disease and obesity may limit an individual's physiologic reserve, rendering them more susceptible to the toxic effects of opioids and other drugs. Although many opioids will be detected on routine toxicology testing, more specialized testing may be warranted for opioid analogs, or other uncommon, synthetic, or semisynthetic drugs.


2018 ◽  
Vol 6 ◽  
pp. 78-85
Author(s):  
Nenad Radović

[full article, abstract in English; abstract in Lithuanian] Drug trafficking is a very lucrative criminal activity, with a growing number of organized criminal groups from the Balkans. According to Europol’s report, about 5000 organized criminal groups are active in the European Union.2 According to the results of the National survey on the lifestyles of the citizens in the Republic of Serbia in 2014, the use of psychoactive substances and games of chance and illegal drug use at least once during a lifetime was recorded at 8.0% of the total population aged 18 to 64 (10.8% of males and 5.2% of females), with greater prevalence (12.8%) in the younger adult population aged 18 to 34. The number of heroin users who inject drugs in Serbia is between 10 000 and 25 000. The main estimated number is 20 000 heroin users who inject drugs, i.e., 0.4% of the population aged 15 to 64. Based on the analysis of data on drug-related deaths, it can be noted that there has been a decline in the number of deaths in the past five years, and most of these cases are related to opiates. In the territory of the Republic of Serbia, the production of heroin has not been recorded, and that gives trafficking a greater primacy, which is supported by the fact that high quality heroin is further trafficked in the form of a base that is mixed with other substances (paracetamol, caffeine, sugar etc.). In this way, such a high degree of purity of heroin allows the members of criminal groups to increase the quantity of narcotics by mixing substances suitable for this and, in that way, achieve greater profits. The most commonly used illegal drug among the adult population is cannabis (marijuana and hashish), and the use of the mentioned drugs has been recorded at least once during a lifetime in 7.7% of subjects aged 18 to 64 (10.4% of men and 4.9% of women). The use of other illegal drugs is very rare; 1.6% of questioned individuals (2.5% of the population aged 18 to 34) have used other illegal drugs.


2020 ◽  
Author(s):  
Dmitry Khodyakov ◽  
Shahla Jilani ◽  
Stephanie Dellva ◽  
Laura J. Faherty

UNSTRUCTURED Background: Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome that most commonly results from prenatal opioid exposure. Every 15 minutes, an infant is born in the United States with signs of NAS. The field lacks a standardized clinical definition of NAS, complicating discussions on programmatic and policy development to support opioid-exposed mothers and infants. The goal of this paper is to describe a protocol for a systematic expert panel process to inform the development of a clinical definition of NAS. Methods and analysis: We will conduct two three-round online modified-Delphi panels using the ExpertLensTM system and will follow recommendations for Conducting and REporting of DElphi Studies (CREDES). One panel will focus on developing key components of a clinical definition of NAS; the second panel will focus on neonatal opioid withdrawal syndrome (NOWS), which is a term that has come into use to differentiate opioid-exposed infants from infants exposed to other substances in utero. However, there is lack of agreement on the precise clinical definition of NOWS and how it is distinct from or overlaps with NAS. Each panel will complete two rating rounds and a discussion round using a similar protocol. We will analyze all rating data descriptively and determine the presence of agreement within and between the two panels; we will also perform thematic analysis of the qualitative comments to contextualize the panel findings. The results of these panels will be used to inform the clinical definition of NAS and will be disseminated and discussed at a national conference on NAS. Results: This study will inform the development of clinical definition of NAS based on input from clinical experts. Conclusions: A standardized clinical definition of NAS will help to better characterize NAS incidence and design effective clinical, public health, and policy interventions to support opioid-exposed mother-infant dyads.


Author(s):  
William M. Lewis

The virtue of soil is one of only a few axioms of American culture. Respect for soil, which can be instilled at an early age without rousing political or religious controversy, is the mark of agrarian origins. Nevertheless, or perhaps for this very reason, the average American knows more about asteroids than about soil. Even scientists, who are responsible for knowing pretty much everything, seem generally less aware of soil than of water, air, or even rock. Thus, this chapter requires a primer on the nature of soil. The USDA, which is the center of gravity for soil science in the United States, has defined soil as “earthy materials . . . on the earth’s surface . . . capable of supporting plants out-of-doors.” To the thoughtful novice, this may seem a woefully unsatisfactory definition. In fact, one might feel downright indignant upon consulting a dictionary only to find that “earthy” means “having properties of soil.” Thus, the USDA seems to be saying that soil is something that is like soil. This could be a simple case of cheating or perhaps a devilishly clever means of suppressing debate about the definition of soil. Further reflection, however, suggests that the reference to plants is more significant than it first appears to be. Plants do not grow on bare rock, shifting sand, or the bottoms of oceans, all of which are non-soil substrates. Thus, the USDA definition may say it all, but is masterfully understated in doing so. Soil science textbooks are also a source of definitions, some of which are gratifyingly descriptive. Birkeland’s (1984) textbook, which gives a geological perspective on soil, specifies that soil is a natural entity; is composed of mineral or organic constituents, or both; differs from the material from which it was originally derived; and reflects the operation of pedogenic processes. Pedogenic processes, in turn, include the addition of organic matter from plants and other substances from the atmosphere; removal of substances by water through erosion or leaching; and a variety of internal transformations and transfers involving organic matter and minerals.


1992 ◽  
Vol 26 (9-11) ◽  
pp. 2245-2248 ◽  
Author(s):  
Ma. del Carmen Doria-Serrano ◽  
S. González-Martínez ◽  
M. Hernández-Esparza

Although biochemical models for the Pi accumulation of Acinetobacter have been discussed in the literature, attention should be given to the fact that a wastewater treatment plant implies a mixed population of microorganisms and acetate and other low molecular weight fatty acids are not the only nor the most abundant carbon source available. Other microorganisms known to be present in activated sludge plants are able to accumulate polyP, PHB and/or carbohydrates. These bacteria (Pseudomonas, Aeromonas, Moraxella, Klebsiella, and others) may use acetate, but also glucose and other monosaccharides, amino acids, fatty acids and other substances as carbon sources, not only for a fermentation process, but also for the intracellular synthesis of polyP in an aerobic stage, and the release of Pj in the anaerobic one. Though most of the experimental work found in the literature was done using mixed cultures, it is proposed that the main differences in the biochemical models is due to the lack of the definition of the specific substrate transport mechanism across the cellular membrane.


2014 ◽  
Vol 19 (2) ◽  
pp. 102-106 ◽  
Author(s):  
Andrea D Furlan ◽  
Peter MacDougall ◽  
Denise Pellerin ◽  
Karen Shaw ◽  
Doug Spitzig ◽  
...  

BACKGROUND: Prescription monitoring or review programs collect information about prescription and dispensing of controlled substances for the purposes of monitoring, analysis and education. In Canada, it is the responsibility of the provincial institutions to organize, maintain and run such programs.OBJECTIVE: To describe the characteristics of four provincial programs that have been in place for >6 years.METHODS: The managers of the prescription monitoring/review programs of four provinces (British Columbia, Alberta, Saskatchewan and Nova Scotia) were invited to present at a symposium at the Canadian Pain Society in May 2012. In preparation for the symposium, one author collected and summarized the information.RESULTS: Three provinces have a mix of review and monitoring programs; the program in British Columbia is purely for review and education. All programs include controlled substances (narcotics, barbiturates and psychostimulants); however, other substances are differentially included among the programs: anabolic steroids are included in Saskatchewan and Nova Scotia; and cannabinoids are included in British Columbia and Nova Scotia. Access to the database is available to pharmacists in all provinces. Physicians need consent from patients in British Columbia, and only professionals registered with the program can access the database in Alberta. The definition of inappropriate prescribing and dispensing is not uniform. Double doctoring, double pharmacy and high-volume dispensing are considered to be red flags in all programs.CONCLUSIONS: There is variability among Canadian provinces in managing prescription monitoring/review programs.


1993 ◽  
Vol 32 (3) ◽  
pp. 142-146 ◽  
Author(s):  
Lynn W. Herzog ◽  
Lauren J. Coyne

To determine the normal temperature of healthy infants, we studied 691 infants less than 3 months of age being seen for regularly scheduled well-baby visits. All temperatures were taken rectally with an electronic thermometer. The mean temperature was 37.5°C ± 0.3°C. Using a cutoff of 2 standard deviations (SD) above the mean, fever would be defined as a temperature ≥ 38.1°C. The 95th percentile was 38.0°C, and ≥38.1°C would correspond to values above the 95th percentile. The most widely used definition of fever at present is a temperature ≥38.0°C; by this definition, 6.5% of these well infants would be considered to have a fever. A significant rise in temperature with age was noted. For infants from birth to 30 days old, 2 SD above the mean was 38.0°C; for those 31 to 60 days old, it was 38.1°C; and for those 61 to 91 days old, it was 38.2°C. Similarly, the 95th percentile was 37.9°C, 38.0°C, and 38.1°C, respectively. Temperature also varied significantly with the season of the year, being higher in the summer (2 SD above a mean = 38.3°C) than in the winter (2 SD above a mean = 38.0°C). Fever should be defined as a temperature ≥38.0°C in infants less than 30 days of age, ≥38.1°C in 1-month-olds, and ≥38.2°C in 2-month-olds.


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