Submitted in fulfilment of the requirements for the degree of Masters of Science in Medicine in the Health Science Faculty University of Witwatersrand Johannesburg 10 April 2019 / The Forensic Chemistry Laboratories in South Africa have, between the year 2014 and 2017, endured a lot of media scrutiny surrounding a backlog of specimens for blood alcohol and toxicology analyses and the poor environmental and storage conditions in which these specimens are kept. Many studies have been performed on the stability of alcohol in blood, since environments are not standard, to gain a better understanding on whether the backlog issues significantly impact on the integrity of the blood-alcohol concentration (BAC) results by evaluation of conditions, especially variables such as temperature and headspace. The aim of this study was therefore, to assess the stability of ethanol concentrations in post-mortem blood specimens by evaluating temperature (room and refrigerator) and headspace (4mL and 8mL) variables at 3 months and 6 months respectively. Blood from 119 decedents was collected, analysed and subjected to the varied volumes and storage conditions. Blood alcohol was determined and quantified using a G1888 Headspace Auto sampler (Agilent Technologies®) coupled to a 6890N Agilent® Gas Chromatography instrument utilising a Flame Ionization Detector on an Agilent HP-Innowax® column. A general decrease in alcohol concentration was observed over a storage period of 6 months regardless of the storage temperature, whilst headspace was found to have no significant effect on the BAC results. It is, therefore, important that Forensic Pathologists, investigators and scientists are aware of factors such as temperature and headspace and consider them when interpreting blood alcohol results from a post-mortem environment. / E.K. 2019

Syftet med denna studie är att undersöka varför många i Sverige betraktar missbruk avsubstanser såsom alkohol och narkotika men även sexmissbruk, spelmissbruk m.m.som en sjukdom, samt vad detta synsätt grundar sig i. Studien är inriktad på en kritiskgranskning av den litteratur, texter och forskning som finns i ämnet. Studiensempiriska material bygger främst på den litteratur som tillhandahålls av anonymaalkoholister och anonyma narkomaner, och ställer deras syn mot forskningsresultatinom medicin och socialvetenskap. Analysen av materialet har gjorts utifrånsocialkonstruktivism och diskursens makt, i enlighet med Foucault. Resultatet avlitteraturstudien är att majoriteten av tillgängliga behandlingar för missbrukare,speciellt inom tolvstegprogrammen tillskriver beteendet fel kausalitet, dvs isubstanserna. Därför missar de att se bortom symtomen, och den underliggandeförklaringen till beroendet går förlorad tillsammans med dess lösning. / The main objective of this study is to investigate why many view addiction to alcoholand narcotics as well as sex addiction, gambling etc. as a disease, and the origins ofthis explanation. This study aims to critically look at the texts and science produced bythose who claim that addiction is a disease. The empirical material for this study ismainly that which is provided by Alcoholics Anonymous and Narcotics Anonymous.This material is compared to updated science and our knowledge regarding addictiontoday. The analysis of this material has been made using theories based in socialconstructivism and discourse analysis, as presented by Foucault. The results from mystudy is that a majority of the available treatments for addicts, especially within thetwelve-step programs seem to treat the wrong thing, i.e. the substance, and thereforefailing to see beyond the symptoms and missing the bigger picture, that is theunderlying explanations of addiction and its solution.

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In an effort to assess whether the craving for sweets experienced by some abstaining alcoholics is physiologically based, 48 Wistar rats were divided into 4 groups. Groups 1 and 3 were fed a liquid diet containing 35.5 percent energy as alcohol; groups 2 and 4 were fed a control diet with dextrins substituted for alcohol, all for 24 days. Group 4 was pair-fed to group 3. For the next 10 days, all rats were provided with sucrose and water ad libitum and all groups were continued on their liquid diet except that alcoholic group 3 was placed on the control diet and pair-fed group 4 was no longer pair-fed. Urine was collected at the end of the baseline, alcohol-induction, and recovery periods and analyzed for L-ascorbic acid. The mean consumption of sucrose was highest for rats still receiving alcohol and declined in all groups during the 10 days. The mean consumption of sucrose (% kcal as sucrose) for the first 4 days was 33.2, 19.5, 19.0, and 13.8% for groups 1, 2, 3, and 4 declining to 24.6, 11.2, 9.0, and 8.5 percent, respectively by the last 4 days. The sugar intake of alcoholic group 3 animals was significantly higher than pair-fed control group 4 during the first 4 days. L-ascorbic acid excretion was significantly increased in the groups receiving alcohol and declined during the recovery period. This study has raised the possibility that increased urinary excretion of ascorbic acid may suppress glycogen synthesis, leading to hypoglycemia. / Master of Science