Tuesday, September 18, 2012

Carly Rousso Case Not So Clear Cut; Known Evidence Full of Obstacles.

Undisputed facts in this case are that 5-year-old Jaclyn Santos-Sacramento was killed when a vehicle drove onto a sidewalk as she was walking with her mother and two brothers on Central Avenue in Highland Park on Labor Day afternoon.  The car that hit and caused Jaclyn Santos-Sacramento's death was driven by 18-year old Carly Rousso of Highland Park.   

There is no denying that this situation is a tragedy for all concerned and that the lives of all involved have been altered.  In the wake of this tragedy emotions have run extremely high as to how it was handled and how blame and responsibility should be determined and what punishments meted out.   

Ken LaRue, the Lake County State's Attorney's Traffic Division chief believes huffing was involved and that "Eighteen-year-old Carly Rousso was driving a Lexus coupe eastbound in Highland Park. Either before she started driving or once she was underway, she grabbed the canister of dusting spray she'd brought along, put it to her nose, pushed down the nozzle and inhaled.  She was instantly filled with a euphoric sensation brought on by a chemical compound in the spray called difluoroethane. Commonly referred to as "huffing," inhaling this compound and others like it causes asphyxiation that users get high from.  "At some point," LaRue said, "she passed out."  She didn't stop the car as it drifted, first across the lanes going in the opposite the direction."

In a previous post I pointed out that absent any eyewitness accounts or admissions of guilt by Rousso herself, there are at least two problems with determining guilt and handing out punishment in this case.  The first is that unless there is an unimpeachable eye witness or other evidence as to how the difluoroethane entered Rousso's blood, the act of huffing on her part while driving is only speculation.  The second problem is Carly Rousso has a significant history of mental health troubles and diagnosis dating back years.  In fact she was under the treatment of mental health professionals at the time of Jaclyn's tragic death.

To understand how difficult DUI cases can be when substances other than alcohol are present, some pharmacology terms and their definitions have to be introduced.  First lets examine psychotropics versus psychoactives.  Psychotropics are substances (usually in medication form) that are prescribed to treat medical conditions which also produce changes in emotions, cognition's, and/or behavior (mood altering substances).  Psychoactives are also mood altering substances (emotions, cognition's or behavior) but they are not taken upon advice of a physician; they are normally voluntarily introduced into one's bloodstream most often (but not always) in an attempt to "get high."

Whether psychotropic or psychoactive, once introduced into the body these substances are then subject to pharmacokinetics (the bodys effect on the substance).  Pharmacokinetics are concerned with exactly how the body absorbs, distributes, metabolizes and excretes the mood altering substance.  We know a great deal about the pharmacokinetics of alcohol (a psychoactive substance), all medications (psychotropics), some about pot (psychoactive but in some cases psychotropic due to legal changes in some States) and almost nothing about the majority of the hundreds of other psychoactives currently in use illegally or in fashion other than intended.  In a courtroom much can be testified too regarding medications and alcohol; much less can be entered as evidence regarding psychoactives where very little is known about dosages, half life or actual nature of impairment in physical functioning.

Genetics also plays a significant role on Pharmacokinetics.  People of white European backgrounds metabolize psychotropics and psychoactives much differently than do African Americans, Asians or Latino's for example.  Because of this the side effects of psychotropics or psychoactives can be especially hard on minority cultures and normally exceed those side effects for whites of European ancestry.  For those who want to know more about the metabolic issues in minority groups search the P450 Enzyme

What all this sets the stage for is a informed discussion on the nature of the relationship between the difluoroethane that was reportedly found in Carly Rousso's blood after the tragedy, how it may have gotten there and what, if anything, is known about the amount found in her bloodstream and it's effect on behavior.


Anonymous said...

Dr. Conlin, I am under the impression you have violated one or more confidences that I believe your profession requires.

I would not be surprised to learn you had a personal relationship with Ms. Rousso and family.

Be certain that if the need arose, I would not seek you out for treatment.

This is so far removed from professional literature that perhaps it should be you under investigation.

John Conlin said...

Nope. Never met either family.

John Conlin said...

As far as professional literature goes try (non-APA style citations)

1. Introduction to Behavioral Pharmacology. (2000) Edited by A. Poling and T Byrne. Context Press, Reno, NV.

2. Handbook of Clinical Pharmacology for Therapists. (2008) 5th Ed. J. Preston, J. O'Neal and M. Talga. New Harbinger, Oakland, CA.

And Just for Grins lets say the 18 year old female driver was prescribed benzodiazepines ( a common script for PTSD). Whats the likelihood she was also on oral contraceptives? If so she would have higher blood levels of benzo's in her blood stream that many prescribers over look just on the basis of benzo and oral contraceptive interaction. I'm not sure why the four separate charges for four counts of aggravated driving under the influence of an intoxicating compound. For arguments sake lets say there were 4 psychoactive compounds found in her blood? One would have been the difluoroethane in the keyboard cleaner and three others (absent any other information) could have easily been prescribed for PTSD. If all the above turns out to be true, there's the reasonable doubt.

Tell you what. You expose your expert knowledge and background and I'll show you mine.

Anonymous said...

I could be wrong but I assume the 4 counts are for the four people who were struck by her car.

Anonymous said...

Why do you also look for drug interactions, including birth control pills, and different metabolism in Latinos? It sounds like you are looking to protect this girl or display your knowledge in a field, when in reality huffing is at issue and killing a child? You even make reference to the many reasons this girl could have been using computer dust cleaner in her car, but you make all kinds of statements without a broader knowledge of the actual facts. That's where courtroom evidence comes in. Who are we all on the Internet to make statements about this girl's fate? To show how smart we are? To me it is all our was to cope with a horrific tragedy.

Anonymous said...

It' s not about being an expert and showing what you know. You sound like everyone else on the Internet spouting away and thinking you know this girl's fate when in reality it is just everybody's way to cope with a horrific tragedy. I assure you that the Rousso family does not read these comments because they are untlimately hurtful during a time of unspeakable loss to many, many people. If more people respected that, we would not have to bed seeing postings of hundreds and hundreds of comments, and in your case a running blog.