Drug overdose deaths up for 11th consecutive year

CHICAGO (AP) — Drug overdose deaths rose for the 11th straight year, federal data show, and most of them were accidents involving addictive painkillers despite growing attention to risks from these medicines.

"The big picture is that this is a big problem that has gotten much worse quickly," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which gathered and analyzed the data.

In 2010, the CDC reported, there were 38,329 drug overdose deaths nationwide. Medicines, mostly prescription drugs, were involved in nearly 60 percent of overdose deaths that year, overshadowing deaths from illicit narcotics.

The report appears in Tuesday's Journal of the American Medical Association.

It details which drugs were at play in most of the fatalities. As in previous recent years, opioid drugs — which include OxyContin and Vicodin — were the biggest problem, contributing to 3 out of 4 medication overdose deaths.

Frieden said many doctors and patients don't realize how addictive these drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs.

They're useful for cancer, "but if you've got terrible back pain or terrible migraines," using these addictive drugs can be dangerous, he said.

Medication-related deaths accounted for 22,134 of the drug overdose deaths in 2010.

Anti-anxiety drugs including Valium were among common causes of medication-related deaths, involved in almost 30 percent of them. Among the medication-related deaths, 17 percent were suicides.

The report's data came from death certificates, which aren't always clear on whether a death was a suicide or a tragic attempt at getting high. But it does seem like most serious painkiller overdoses were accidental, said Dr. Rich Zane, chair of emergency medicine at the University of Colorado School of Medicine.

The study's findings are no surprise, he added. "The results are consistent with what we experience" in ERs, he said, adding that the statistics no doubt have gotten worse since 2010.

Some experts believe these deaths will level off. "Right now, there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin," said Don Des Jarlais, director of the chemical dependency institute at New York City's Beth Israel Medical Center.

"But at some point, people using these drugs are going to become more aware of the dangers," he said.

Frieden said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" — doctor offices and pharmacies that over-prescribe addictive medicines.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be subjected to the same restrictions as other narcotic drugs like oxycodone and morphine. Meanwhile, more and more hospitals have been establishing tougher restrictions on painkiller prescriptions and refills.

One example: The University of Colorado Hospital in Aurora is considering a rule that would ban emergency doctors from prescribing more medicine for patients who say they lost their pain meds, Zane said.

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Stobbe reported from Atlanta.

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Online:

JAMA: http://www.jama.ama-assn.org

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com

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Appeals court revives women inmates' bid for Wiccan chaplain

At the Central California Women's Facility in Chowchilla, shown, inmates are contending in a lawsuit that California prison policy favors mainstream religions in violation of the establishment clause of the 1st Amendment. (Los Angeles Times)

By Maura Dolan, Los Angeles Times

February 19, 2013, 3:48 p.m.

A federal appeals court revived a lawsuit Tuesday by female prisoners who contend that the California prison system is violating their rights by refusing to hire a full-time Wiccan chaplain.

A district court rejected the inmates' suit, but a three-judge panel of the U.S. 9th Circuit Court of Appeals ruled that the inmates may have a valid claim.

The California Department of Corrections and Rehabilitation hires chaplains for five faiths: Protestant, Catholic, Jewish, Muslim and Native American. Inmates of other religions are permitted to worship with those chaplains or with volunteer chaplains.

In their lawsuits, inmates at the Central California Women's Facility in Chowchilla contend that the prison policy favors mainstream religions in violation of the establishment clause of the 1st Amendment. The inmates said there were more Wiccans at the women's prison than there were Jewish, Muslim or Catholic prisoners.

Wicca is a pagan religion that involves witchcraft. If the inmates' allegations are true, the appeals court said, "The prison administration has created staff chaplain positions for five conventional faiths, but fails to employ any neutral criteria in evaluating whether a growing membership in minority religions warrants a reallocation of resources."

The court stressed that it was not suggesting the lawsuit should succeed. A lower court must now evaluate the evidence, including a survey of the religious affiliations of inmates at the prison, the panel said.

maura.dolan@latimes.com

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Briefs | Middle East: Iran: Rivals Forced to Apologize to Supreme Leader

Rival politicians apologized to Ayatollah Ali Khamenei over the weekend for having been embroiled in an unusually public feud involving secret tapes and a tit-for-tat impeachment. On Sunday, President Mahmoud Ahmadinejad; the Parliament speaker, Ali Larijani; his brother, Sadegh Larijani; the chief of Iran’s judiciary; and all members of Parliament sent letters expressing sorrow and promising renewed allegiance to Ayatollah Khamenei, the supreme leader of Iran. The written apologies, reported by the state-run press, came a day after the ayatollah had criticized both Mr. Ahmadinejad and the Larijanis for letting their own mutual animosity become public, raising speculation of irreparable rifts. The ayatollah had said in a speech that the whole matter “made me feel sad.”

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Mindy McCready: Under Police Scrutiny at Time of Suicide?

By Steve Helling and Mike Fleeman

02/18/2013 at 06:00 PM EST

Mindy McCready and David Wilson

Courtesy Mindy McCready

When Mindy McCready talked to police in recent weeks, her account of how her boyfriend came to be found with a fatal gunshot wound to the head concerned police, a law enforcement source tells PEOPLE.

"At first, she said she hadn't heard the gunshot because the TV was too loud. Then she said she had heard the gunshot," the source says. "So obviously there were a lot of questions, and the Sheriff was asking for clarification."

But before investigators could re-interview her, the long-troubled country singer also would die under eerily similar circumstances, her body discovered at the same Heber Springs, Ark., house just feet away from where David Wilson died.

McCready's death was blamed on what "appears to be a single self-inflicted gunshot wound," the Cleburne County Sheriff's Office said in a statement.

This differed from how the sheriff characterized Wilson's case. His cause and manner of death still have not been established by the coroner. It was McCready's publicist, and not a law enforcement official, who announced that Wilson had died of a self-inflicted gunshot wound.

After Wilson's death, McCready, 37, spoke to investigators three times, but they didn't feel as if they were through with her.

"At no point did [police] tell her she was a suspect, and she wasn't officially one," says the source. "But she knew that some of her answers didn't stand up to questioning. She was very cooperative, but she just wasn't making a lot of sense."

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Hip implants a bit more likely to fail in women

CHICAGO (AP) — Hip replacements are slightly more likely to fail in women than in men, according to one of the largest studies of its kind in U.S. patients. The risk of the implants failing is low, but women were 29 percent more likely than men to need a repeat surgery within the first three years.

The message for women considering hip replacement surgery remains unclear. It's not known which models of hip implants perform best in women, even though women make up the majority of the more than 400,000 Americans who have full or partial hip replacements each year to ease the pain and loss of mobility caused by arthritis or injuries.

"This is the first step in what has to be a much longer-term research strategy to figure out why women have worse experiences," said Diana Zuckerman, president of the nonprofit National Research Center for Women & Families. "Research in this area could save billions of dollars" and prevent patients from experiencing the pain and inconvenience of surgeries to fix hip implants that go wrong.

Researchers looked at more than 35,000 surgeries at 46 hospitals in the Kaiser Permanente health system. The research, published Monday in JAMA Internal Medicine, was funded by the U.S. Food and Drug Administration.

After an average of three years, 2.3 percent of the women and 1.9 percent of the men had undergone revision surgery to fix a problem with the original hip replacement. Problems included instability, infection, broken bones and loosening.

"There is an increased risk of failure in women compared to men," said lead author Maria Inacio, an epidemiologist at Southern California Permanente Medical Group in San Diego. "This is still a very small number of failures."

Women tend to have smaller joints and bones than men, and so they tend to need smaller artificial hips. Devices with smaller femoral heads — the ball-shaped part of the ball-and-socket joint in an artificial hip — are more likely to dislocate and require a surgical repair.

That explained some, but not all, of the difference between women and men in the study. It's not clear what else may have contributed to the gap. Co-author Dr. Monti Khatod, an orthopedic surgeon in Los Angeles, speculated that one factor may be a greater loss of bone density in women.

The failure of metal-on-metal hips was almost twice as high for women than in men. The once-popular models were promoted by manufacturers as being more durable than standard plastic or ceramic joints, but several high-profile recalls have led to a decrease in their use in recent years.

"Don't be fooled by hype about a new hip product," said Zuckerman, who wrote an accompanying commentary in the medical journal. "I would not choose the latest, greatest hip implant if I were a woman patient. ... At least if it's been for sale for a few years, there's more evidence for how well it's working."

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Online:

Journal: http://www.jamainternalmed.com

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Surfers, Marines in a tussle over Trestles

A disagreement over a well-known slice of the Southern California coast is threatening to drive a wedge between Marines and surfers, groups that had recently set aside differences and become political allies.

At issue is the 2.25-mile stretch of surf and sand known as Trestles, between the San Onofre nuclear plant and the San Diego County-Orange County line. The name comes from two train trestles that parallel the ocean.

To wave riders, Trestles represents seven of the primo surf breaks in the world. To Marines, the middle section of the 2.25 miles is an ideal location to teach grunts how to fight their away from ship to shore and inland.

With the San Clemente-based Surfrider Foundation in the lead, surfers petitioned to have Trestles listed on the National Register of Historic Places, for its role in the rise of "surf culture." Surfers hope the listing will ensure that nothing will disrupt the site's isolation and lack of "commercial growth."

The Marine Corps, which owns the beach and the paths leading to it, opposes having Trestles listed, out of concern that the designation might lead to civilian oversight that crimps training.

The skirmish is not over, but so far the surfers appear to be winning.

Despite opposition from the Marine Corps and the Navy, the State Historical Resources Commission voted unanimously Feb. 8 to forward a recommendation to Washington that Trestles be listed.

The decision now rests with the civilians who run the National Register, which is part of the National Park Service.

The recommendation "does not and will not impose any additional requirements for consultation for military training and operational use," according to documents supporting the Trestles nomination.

"This is a historic designation, it does not change the use of the property," said Amy Crain, a state historian.

But military brass and two state senators aren't buying the assurances that nothing will keep the Marines from using what is called Green Beach for mock assaults, or for other exercises involving heavy vehicles traveling between the beach and the open spaces of Camp Pendleton.

Military officials "believe these assurances to be unenforceable," Brig. Gen. Vincent Coglianese, commanding general of Camp Pendleton, wrote to the state historic preservation officer before the commission vote.

State Sens. Mimi Walters (R-Irvine) and Mark Wyland (R-Escondido), in a joint statement, warned that listing Trestles will "put state bureaucrats and surfers in control of Marine Corps training near Trestles."

From World War II to 1971, the Marine Corps was in control of the entire 2.25 miles. But after prodding from then-President Nixon, a part-time resident of San Clemente, the military leased the property to the state to establish San Onofre State Beach.

Of course, even before the Trestles breaks — Uppers, Lowers, Middles, Church, the Point, Old Man's and Dog Patch — were open to the public, intrepid surfers were attracted by the near-perfect waves.

"For well over 25 years, surfers carried on guerrilla warfare with U.S. Marines," according to a California Department of Parks and Recreation history of the area. "Trespassing surfers were chased, arrested and fined."

One of those who fondly remember those days is Bruce Johnston, later a member of the Beach Boys singing group.

"We even had to outrun 18-year-old Marines from Oklahoma trying to chase us away," Johnston wrote in support of listing Trestles as a historic place. "… It was a great experience!"

In 1963, Trestles was mentioned in "Surfin' USA," the Beach Boys song that became an anthem for a suddenly surf-obsessed generation. Beach Boy Mike Love has joined Johnston in supporting Trestles as a historic site.

Trestles would be the first surf spot to be listed as such, state officials said. Before its vote, the state commission received more than 1,300 letters about Trestles — 1,235 in support, 112 in opposition, a record for any proposed historic designation.

With the opening of San Onofre beach, relations between surfers and Marines have mellowed. Surfers have enjoyed the breaks and, for the most part, have stayed away from Green Beach, which is posted with "keep out" signs.

The two sides had united in opposition to extending the 241 Toll Road south through Camp Pendleton to Interstate 5. The California Coastal Commission has nixed the extension, but the proposal remains alive for possible reconsideration.

Much of the dispute over Trestles involves whether it can be considered Southern California's preeminent surf spot — or whether that distinction belongs to Huntington Beach, Santa Cruz or perhaps Blacks Beach in La Jolla.

Trestles "appears to be just one of hundreds of such relative nondescript good surfing beaches around the U.S." and thus does not qualify for historic status, wrote Donald Schregardus, deputy assistant secretary of the Navy and a federal preservation officer.

The surfers disagree, on grounds that are more aesthetic than legalistic.

"Trestles still rocks in 2013," Johnston wrote.

tony.perry@latimes.com

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In Russia, Property Ruined and Spared by Meteor Share Space

CHELYABINSK, Russia — The shock wave from a meteor that exploded above Siberia last week somehow sheared the roof off a brick and steel factory building while leaving a nearby glass facade unscathed.

In some high-rises in this city, the first modern urban community to have felt the breath of a cosmic close encounter, every window blew out on the top floor; elsewhere, the ground floors suffered.

More ominously, reports came in to local news media over the weekend of stranger phenomena: behind unshattered apartment windows, glass jugs were said to explode into shards, dishes to crack, electronics to die. Balconies rattled. One man said a bottle broke right in his hand.

Anna V. Popova was at home with her daughter when she saw the flash, then heard explosions, then found the windows of her enclosed balcony blown in; her neighbor, with identical windows, escaped without property damage.

“A lot of people suffered, not us alone,” Ms. Popova said, but added that there seemed to be randomness in whose property was damaged. “Who are we supposed to blame for all this? Nobody of course.”

Scientists believe the space rock that tore through the atmosphere on Friday morning and blew apart here was the largest to have entered the atmosphere since 1908 and that it was unusual as well for the scale of its effects: more than 1,200 people injured and broad property damage.

Indeed, the event is providing a first indication of the type of structural and infrastructural costs meteors can exact from a highly industrialized society. NASA scientists say a meteor of this size strikes the Earth about once every hundred years.

Shattered glass caused most of the damage and injuries here in Chelyabinsk, a sprawling industrial city of about a million people.

What shattered the glass, scientists say, was both the explosion as the meteor fragmented and the waves of pressure created as it decelerated. Such low-frequency waves — called infrasound — are sometimes detected by cold-war era nuclear blast sensors in remote parts of the Pacific Ocean or Alaska, according to meteor experts.

The waves can bounce off buildings and be stronger in some places than others; they can also resonate with glass, explaining why bottles and dishes might have shattered inside undamaged kitchens, as if crushed by the airy hand of the meteor itself.

“A shock wave is like a ball,” Aleksandr Y. Dudorov, director of the theoretical physics department at Chelyabinsk State University, said in an interview. “Throw a ball into a room and it will bounce from one wall to another.”

Russia has mobilized 24,000 emergency officials to inspect roads, railroads, hospitals, factories and military facilities. Most are undamaged, including 122 sites identified as particularly critical, including nuclear power plants, dams and chemical factories, and a space launching site called Strela.

Also Sunday, Russia’s consumer safety inspection agency, Rospotrebnadzor, released a statement saying the water in Lake Chebarkul, where a hole in the ice appeared on Friday, was not radioactive.

It was unclear why the agency released this finding only Sunday, or whether the tests were conducted to assuage popular concerns or out of any real official uncertainty over what happened on Friday. In any case, the agency said a mobile laboratory quietly dispatched to the lake tested for but did not discover cesium 137 and strontium 90, isotopes created in nuclear explosions.

Infrasound waves have not previously been studied in a cityscape, Richard P. Binzel, a professor of planetary science at the Massachusetts Institute of Technology and an author of a textbook on asteroids and meteorites, said in a telephone interview. But he noted that the apparent randomness of the damage was consistent with the way such waves function.

“A shock wave can be coming from a particular direction, and if you face that direction you are more susceptible,” Dr. Binzel said.

“One building might shadow another, or you may have a street that is optimally aligned to channel the wave, either in a fortunate or unfortunate way.”

Peter Brown, a professor of physics at the University of Western Ontario, wrote in an e-mail that an infrasound wave “is very efficient at traveling long distances,” and that “windows, structures or even glass jars susceptible to resonate at this frequency could be a factor to seemingly random damage at widely disparate locations.”

Dr. Brown studied a similar, though smaller, explosion of a meteor over the Pacific Ocean on Oct. 8, 2009, which also sent out low-frequency waves, though too remote to affect homes or industry.

They were, though, registered by a network of infrasound sensors established to monitor compliance with the international ban on nuclear tests, according to Dr. Brown.

Alekdander V. Anusiyev, the spokesman for the governor of Chelyabinsk region, characterized the damage here as without a discernible pattern. “It is impossible to say more glass broke in one part of the city or another,” he said. “Glass broke everywhere.”

The roof of the zinc factory that collapsed was reinforced with a lattice of steel beams and supported by concrete joists that are now broken, jutting upward with mangled re-bar protruding. Windows on a neighboring house blew in with such force that the frames went with them.

Yet a few yards away on Sverdlovsky Street, the cosmos spared a seemingly vulnerable Hundai dealership, a three-story cube sheathed in glass, with glistening display models inside. Not a window broke.

“People can consider Feb. 15 their second birthday,” the governor of Chelyabinsk, Mikhail Yurevich, told reporters, referring to the day of the meteor strike. “God directed danger away.”

Ellen Barry contributed reporting from Moscow.

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See The Dress Only Jennifer Lopez Could Wear

Stylewatch
Style News Now

02/15/2013 at 06:00 PM ET

Dave Allocca/Startraks; Amanda Edwards/WireImage; Jason LaVeris/FilmMagic

Judging by the red carpet looks seen at the Grammys and the creations sent down the runways at New York Fashion Week, we have a sneaking suspicion we’ll be spotting a lot more navy and a lot more menswear-inspired getups in the coming weeks. But there’s one style you can pretty much write off (and don’t expect to see much of it at the Oscars): Studio 54-esque dresses.

Up: Navy Instead of Black. The LBD and LWD better watch out: There’s another shade gunning for the spotlight. This week everyone from Emmy Rossum and Anne Hathaway to Oprah Winfrey and Miranda Lambert slipped into midnight blue. And we totally understand the appeal of the color. It’s a bit more interesting and unexpected than black, but equally flattering on all shapes and sizes.

Up: Menswear-Inspired Looks. Beyoncé wore a pantsuit to the Grammys and a number of other stars (including Jessica Alba, Julianne Hough and Solange Knowles) quickly followed, well, suit. We doubt that tons of actresses will forgo gowns for dude duds at the Oscars, but our money is on at least one woman in menswear on that red carpet.

Down: Disco Ball Dresses. They had their moment, but that moment seems to have passed. So, take a long look at Jennifer Lopez in her printed sequin Preen dress (sparkly enough to be hung from the ceiling over any dance floor) because as amazing as it is, the creation is probably the last you’ll see of its kind for some time.

For more on which trends to follow check out our thoughts on platforms, polka dots, and furry accents.

Tell us: Which trend do you hope to see more of? Vote in our poll below! 

PHOTOS: SEE OUR FAVORITE DRESSES OF AWARDS SEASON — SO FAR!

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UN warns risk of hepatitis E in S. Sudan grows

GENEVA (AP) — The United Nations says an outbreak of hepatitis E has killed 111 refugees in camps in South Sudan since July, and has become endemic in the region.

U.N. refugee agency spokesman Adrian Edwards says the influx of people to the camps from neighboring Sudan is believed to be one of the factors in the rapid spread of the contagious, life-threatening inflammatory viral disease of the liver.

Edwards said Friday that the camps have been hit by 6,017 cases of hepatitis E, which is spread through contaminated food and water.

He says the largest number of cases and suspected cases is in the Yusuf Batil camp in Upper Nile state, which houses 37,229 refugees fleeing fighting between rebels and the Sudanese government.

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Former O.C. attorney suspected of killing ex-wife on cruise

A former Orange County attorney has been arrested on suspicion of killing his ex-wife for financial gain in 2006 by strangling her and throwing her overboard while on a cruise along the Italian coast, authorities said.

Lonnie Kocontes, 55, a former Mission Viejo resident, was arrested Friday at his home in Safety Harbor, Fla., in connection with the death of Micki Kanesaki, 52, of Ladera Ranch, authorities said. He is charged with one felony count of special circumstances for financial gain.

If convicted, he would face a maximum sentence of life in state prison without the possibility of parole and would be eligible for the death penalty, authorities said. Kocontes, who is being held without bail, faces extradition proceedings at a date to be determined.

He is accused of financially benefiting from Kanesaki's death because he was the beneficiary of several of their bank accounts and was receiving the proceeds from the sale of their home, authorities said.

The couple divorced in 2001 and were in the midst of a court battle when they decided to put aside their rancor and take a Mediterranean vacation together.

Kocontes is suspected of killing his wife on the night of May 25, 2006, or the morning of May 26, by strangling her and throwing her body overboard, authorities said.

At the time, Kocontes reported his wife missing. He told authorities that the couple had been in bed when about 1 a.m. Kanesaki stepped out to get a cup of tea to help her relax and never returned.

Her body was found on the morning of May 27 by the Italian coast guard, floating in the sea near Reggio di Calabria.

"I wish I knew what happened," Kocontes was quoted as saying at the time. He told authorities that his former wife had previously talked of suicide.

But an autopsy revealed Kanesaki had been strangled, authorities said.

Kocontes is accused of attempting to transfer $1 million between various banks accounts with his new wife, Katherine, in 2008, authorities said. The FBI began investigating the money transfers for possible illegal activity and the U.S. attorney's office ultimately seized the money from Kocontes' bank account. A civil asset forfeiture case was subsequently filed in U.S. District Court in California.

The Orange County district attorney's office was contacted about the case and subsequently the county Sheriff's Department relaunched its criminal investigation, authorities said.

On Wednesday, the district attorney's office filed its murder case against Kocontes.

The FBI and the Sheriff's Department are continuing the investigation.

andrew.blankstein@latimes.com

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