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The aim of this study was to investigate the incidence of benzodiazepines in opioid‐positive death investigations, including trends in frequency and combination of drugs, as well as demographic data and blood concentrations, where available. Additionally, naloxone concentrations in polysubstance compared to opioid‐only cases were analyzed. This was a retrospective study that consisted of all post‐mortem toxicology cases in Ontario, Canada, from January 01, 2017, to December 31, 2021, with an opioid finding in any analyzed autopsy specimen. There were 11,033 death investigations identified. The overall rate of benzodiazepine co‐involvement was 54.5%. Males accounted for the majority of cases (71%), and the most affected age group was 30‐ to 39‐year‐olds. The most frequently detected opioid was fentanyl and the most frequently detected benzodiazepine was etizolam, which was also the most frequently observed opioid/benzodiazepine combination. Findings related to differences in concentrations of opioids when naloxone was also present were mostly non‐significant, except for methadone. The rate of benzodiazepine detection with opioids grew faster than opioid detections overall, potentially due to the increasingly toxic drug supply. Detection of novel psychoactive drugs fluctuated more unpredictably than opioids and benzodiazepines associated with clinical use. These findings can help inform policy decisions by public health agencies in exploring harm reduction efforts, for example, education and drug‐checking services. [ABSTRACT FROM AUTHOR]

A study among Fortune 500 companies was conducted to better understand the standards and uses of e-mail and the Internet among leading businesses of the nation. The survey was distributed by e-mail, and e-mail responses were analyzed for specific answers to four survey questions and .for qualities of content and format. Results indicated that a disproportionately large number of companies did not have a CIO, did not place restrictions on employee use of email or the Internet, and were unable to provide an estimate of employees using e-mail on a daily basis. Companies indicated that e-mail messages were preferred over the use of hard copy memo or telephone calls for certain reasons of economy or convenience. However, evidence that e-mail has become apart of the organizational culture was not well supported by the results. Qualities of content and formatting indicated that standards used for more formal business writing were also maintained for e-mail messages. The study was useful for clarifying e-mail practices and expectations among major corporations and is expected to be of interest to business educators. Future studies were recommended to better identify messaging trends., INTRODUCTION The use of electronic mail (e-mail) as a communication tool for businesses coincides with the rapid expansion of computers in the workplace. A review of literature associated with communication [...]

Changes in and stability of hostility characteristics and their relationship to age, sex, and family support were examined among 108 10-18-year-olds in a 4-year longitudinal study. Clinical ratings of Structured Interview potential for hostility, self-reported Minnesota Multiphasic Personality Inventory-derived hostile attitudes, and perceptions of family support were obtained at study entry and at follow-up when subjects were ages 15-21. Results showed relative stability of hostility rankings across 4 years, with males being more hostile than females. Both sexes increased in hostility over time, with the greatest increase in Ss who perceived low family support at follow-up and whose parents perceived high family support at study entry. Results are consistent with notions that early signs of hostility are risk factors for later development of coronary disease and that family environment influences development of hostility.

The purpose of this study was to determine the prevalence of cannabis, alcohol and other drug use in drivers of motor vehicles who died in crashes in the Canadian province of Ontario from January 2016 through December 2018 along with the characteristics of these drivers and some of the circumstances of the crash in which they were involved. Toxicological tests were performed on blood samples obtained from 921 driver fatalities for whom postmortem blood samples were submitted to the Center of Forensic Sciences for analysis. The results were coded into a database along with basic demographic and crash characteristics and examined for prominent characteristics and patterns. Overall, among the 921 cases examined, 495 (53.7%) tested positive for alcohol, cannabis (tetrahydrocannabinol or THC), or another psychoactive drug. The number of cases that tested positive for THC (251) exceeded the number of cases that tested positive for alcohol (241) as well as the number that tested positive for a drug other than THC (235). In 38% of positive cases, more than one substance was detected. Alcohol and THC were most commonly detected among males; females most frequently tested positive for a drug other than THC, notably medications with depressant effects. Alcohol-involved driver fatalities were most common on weekends and most likely involved single vehicle crashes. Driver fatalities that tested positive for THC or another drug were more evenly distributed throughout the week and were more likely to have been in multi-vehicle crashes. The present study highlights the use of cannabis and other drugs by drivers. The patterns of crashes and the characteristics of drivers involved indicate that the characteristics of driver fatalities involving cannabis and/or other drug use differ from those of alcohol and require new, innovative approaches targeting high-risk times, groups and behaviors. Continued monitoring of the toxicological findings from blood samples obtained from drivers killed in motor vehicle crashes will be a key element in efforts to reduce the impact of drug use by drivers on road safety. [ABSTRACT FROM AUTHOR]

In order to increase the understanding regarding the oral abuse and potential toxicity of fentanyl patches seven cases were identified over a 3-year period where fentanyl, either alone or in combination with other factors, contributed to death following the oral abuse of Duragesic® patches. The decedents comprised three females and four males with ages ranging from 20 to 51 years. Postmortem blood fentanyl concentrations were determined in all cases and ranged from 7 to 97 ng/mL. Two deaths were classified as a fentanyl overdose, three deaths were classified as a fentanyl and ethanol overdose, one death was considered a mixed drug intoxication and the remaining death was determined to be a combination of fentanyl and medical causes. These cases represent the largest reported series of deaths following the oral administration of transdermal fentanyl patches and provide detailed information on the potential for the abuse of transdermal Duragesic® patches via this route. The postmortem blood fentanyl concentrations detected for each of the decedents demonstrate the potentially fatal blood concentrations that can arise after this relatively rare route of administration. [ABSTRACT FROM AUTHOR]

The article focuses on toxicological findings and circumstances of death in 112 cases of fentanyl-related deaths in Ontario, Canada from 2002 to 2004. Fentanyl was quantitated in blood. The routes of administration of fentanyl include transdermal application of Duragesic patches, intravenous injection of patch contents and volatilization and inhalation of Duragesic systems.

Changes in and stability of hostility characteristics and their relationship to age, sex, and family support were examined among 108 10-18-year-olds in a 4-year longitudinal study. Clinical ratings of Structured Interview potential for hostility, self-reported Minnesota Multiphasic Personality Inventory-derived hostile attitudes, and perceptions of family support were obtained at study entry and at follow-up when subjects were ages 15-21. Results showed relative stability of hostility rankings across 4 years, with males being more hostile than females. Both sexes increased in hostility over time, with the greatest increase in Ss who perceived low family support at follow-up and whose parents perceived high family support at study entry. Results are consistent with notions that early signs of hostility are risk factors for later development of coronary disease and that family environment influences development of hostility. [ABSTRACT FROM AUTHOR]

Over the last 20 years there has been a significant increase in fentanyl related deaths in Ontario, Canada. This report examines toxicological findings in a series of death investigations in which fentanyl was quantitated to identify the prevalence, trends and demographic data associated with fentanyl in Ontario, Canada, and to highlight the changes in these trends since fentanyl began appearing in casework in Ontario in the early 2000s. A retrospective study of all cases in which fentanyl was quantitated in blood, using liquid chromatography-tandem mass spectrometry, was conducted for the time period between January 1, 2020, and December 31, 2022. A total of 4395 cases were included, 77% of the decedents were male and 23% were female with ages ranging from 0 to 95. The most frequently classified cause of death was mixed drug toxicity (69%) followed by fentanyl intoxication at 19%. Less than 10% of cases where fentanyl was quantitated were classified as non-drug related deaths. Fentanyl concentrations in all cases ranged from 1.3 to > 2000 ng/mL. Other drugs were frequently detected with fentanyl. In mixed drug toxicity cases, stimulants were the most frequently encountered class of drugs: cocaine was identified in 51.8% and methamphetamine was observed in 43.0% of cases, respectively. Detailed reports for select cases were included to provide additional insight into the different case types and to show the difficulty in interpreting blood concentrations without additional detailed case histories. This study provides valuable information for the scientific and medical community regarding the continued use of fentanyl and how patterns of fentanyl use have evolved since it began to appear in forensic casework., (© The Author(s) 2024. Published by Oxford University Press.)