From the L.A. Daily News
Parents fear redefining autism will lead to exclusion from therapies
by Lindsay Tanner - The Associated Press
CHICAGO - One child doesn't talk, rocks rhythmically back and forth and stares at clothes spinning in the dryer. Another has no trouble talking but is obsessed with trains, methodically naming every station in his state.
Autistic kids like these hate change, but a big one is looming.
For the first time in nearly two decades, experts want to rewrite the definition of autism. Some parents fear that if the definition is narrowed, their children may lose out on special therapies.
For years, different autism-related labels have been used, the best known being Asperger's disorder. The doctors working on the new definition want to eliminate separate terms like that one and lump them all into an "autism spectrum disorder" category.
Some specialists contend the proposal will exclude as many as 40percent of kids now considered autistic. Parents of mildly affected children worry their kids will be left out and lose access to academic and behavioral services - and any chance of a normal life.
But doctors on the American Psychiatric Association panel that has proposed the changes say none of that would happen.
They maintain the revision is needed to dump confusing labels and clarify that autism can involve a range of symptoms from mild to severe. They say it will be easier to diagnose kids and ensure that those with true autism receive the same diagnosis.
With new government data last week suggesting more kids than ever in the U.S. - 1 in 88 - have autism, the new definition may help clarify whether the rising numbers reflect a true increase in autism or overdiagnosis by doctors.
There is no definitive test for autism. The diagnosis that has been used for at least 18 years covers children who once were called mentally retarded, as well as some who might have merely been considered quirky or odd. Today, some children diagnosed with autism may no longer fit the definition when they mature.
The revision is among dozens of changes proposed for an update of the psychiatric association's reference manual, widely used for diagnosing mental illnesses.
The group's board of trustees is expected to vote on the proposals in December, and the updated manual is to be published next year.
Among the proposed changes:
A new "autism spectrum disorder" category would be created, describing symptoms that generally appear before age 3. It would encompass children with "autistic disorder," now used for severe cases, plus those with two high-functioning variations.
A diagnosis would require three types of communication problems, including limited or no conversation and poor social skills; and at least two repetitive behaviors or unusual, limited interests.
Autistic disorder and high-functioning variations - Asperger's disorder and PDD-NOS, or "pervasive developmental disorder not otherwise specified" - would be eliminated, but their symptoms would be covered under the new category.
Asperger's kids often have vast knowledge about a quirky subject but poor social skills; PDD-NOS is notoriously ill-defined and sometimes given to kids considered mildly autistic.
Another new category, "social communication disorder," would include children who relate poorly to others and have trouble reading facial expressions and body language. A small percentage of children now labeled with PDD-NOS would fit more accurately into this diagnosis, autism panel members say.
They say the changes make scientific sense and are based on recent research.
Opponents include older kids and adults with Asperger's who embrace their quirkiness and don't want to be lumped in with more severe autism, and parents like Kelly Andrus of Lewisville, Texas. Her son, Bradley, was diagnosed with mild autism a year ago, at age 2.
"I'm really afraid we'd be pushed out of the services we get," she said. That includes a free preschool program for autistic kids and speech and occupational therapy, which cost her $50 a week. The family has no medical insurance.
Opponents also include a well-known Yale University autism researcher, Dr. Fred Volkmar, who was on the revision panel but says he was unhappy with the process and quit. "I want to be sure we're not going to leave some kids out in the cold," he said.
ADDICTED TO PAIN: Pill sales soar across U.S. fueling addiction
by Chris Hawley
NEW YORK - Sales of the nation's two most popular prescription painkillers have exploded in new parts of the country, an Associated Press analysis shows, worrying experts who say the push to relieve patients' suffering is spawning an addiction epidemic.
From New York's Staten Island to Santa Fe, N.M., Drug Enforcement Administration figures show dramatic rises between 2000 and 2010 in the distribution of oxycodone, the key ingredient in OxyContin, Percocet and Percodan. Some places saw sales increase sixteenfold.
Meanwhile, the distribution of hydrocodone, the key ingredient in Vicodin, Norco and Lortab, is rising in Appalachia, the original epicenter of the painkiller epidemic, as well as in the Midwest.
The increases have coincided with a wave of overdose deaths, pharmacy robberies and other problems in New Mexico, Nevada, Utah, Florida and other states. Opioid pain relievers, the category that includes oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 alone, and the death toll is rising, the Centers for Disease Control and Prevention says.
Nationwide, pharmacies received and ultimately dispensed the equivalent of 69 tons of pure oxycodone and 42 tons of pure hydrocodone in 2010, the last year for which statistics are available. That's enough to give 40 5-mg Percocets and 24 5-mg Vicodins to every person in the United States. The DEA data records shipments from distributors to pharmacies, hospitals, practitioners and teaching institutions. The drugs are eventually dispensed and sold to patients, but the DEA does not keep track of how much individual patients receive.
The increase is partly due to the aging U.S. population with pain issues and a greater willingness by doctors to treat pain, said Gregory Bunt, medical director at New York's Daytop Village chain of drug treatment clinics.
Sales are also being driven by addiction, as users become physically dependent on painkillers and begin "doctor shopping" to keep the prescriptions coming, he said.
"Prescription medications can provide enormous health and quality-of-life benefits to patients," Gil Kerlikowske, the U.S. drug czar, told Congress in March. "However, we all now recognize that these drugs can be just as dangerous and deadly as illicit substances when misused or abused."
Opioids like hydrocodone and oxycodone can release intense feelings of well-being. Some abusers swallow the pills; others crush them, then smoke, snort or inject the powder.
Unlike most street drugs, the problem has its roots in two disparate parts of the country - Appalachia and affluent suburbs, said Pete Jackson, president of Advocates for the Reform of Prescription Opioids.
"Now it's spreading from those two poles," Jackson said.
The AP analysis used drug data collected quarterly by the DEA's Automation of Reports and Consolidated Orders System. The DEA tracks shipments sent from distributors to pharmacies, hospitals, practitioners and teaching institutions and then compiles the data using three-digit ZIP codes. Every ZIP code starting with 100-, for example, is lumped together into one figure.
The AP combined this data with census figures to determine effective sales per capita.
A few ZIP codes that include military bases or Veterans Affairs hospitals have seen large increases in painkiller use because of soldier patients injured in the Middle East, law enforcement officials say. In addition, small areas around St. Louis, Indianapolis, Las Vegas and Newark, N.J., have seen their totals affected because mail-order pharmacies have shipping centers there, said Carmen Catizone, executive director of the National Association of Boards of Pharmacy.
Many of the sales trends stretch across bigger areas.
In 2000, oxycodone sales were centered in coal-mining areas of West Virginia and eastern Kentucky - places with high concentrations of people with back problems and other chronic pain.
But by 2010, the strongest oxycodone sales had overtaken most of Tennessee and Kentucky, stretching as far north as Columbus, Ohio and as far south as Macon, Ga.
Per-capita oxycodone sales increased five- or six-fold in most of Tennessee during the decade.
"We've got a problem. We've got to get a handle on it," said Tommy Farmer, a counterdrug official with the Tennessee Bureau of Investigation.
Many buyers began crossing into Tennessee to fill prescriptions after border states began strengthening computer systems meant to monitor drug sales, Farmer said.
In 2006, only 20 states had prescription drug monitoring programs aimed at tracking patients. Now 40 do, but many aren't linked together, so abusers can simply go to another state when they're flagged in one state's system. There is no federal monitoring of prescription drugs at the patient level.
In Florida, the AP analysis underscores the difficulty of the state's decade-long battle against "pill mills," unscrupulous doctors who churn out dozens of prescriptions a day.
In 2000, Florida's oxycodone sales were centered around West Palm Beach. By 2010, oxycodone was flowing to nearly every part of the state.
While still not as high as in Appalachia or Florida, oxycodone sales also increased dramatically in New York City and its suburbs. The borough of Staten Island saw sales leap 1,200 percent.
New York's Long Island has also seen huge increases. In Islip, N.Y., teenager Makenzie Emerson says she started stealing oxycodone that her mother was prescribed in 2009 after a fall on ice. Soon Emerson was popping six pills at a time.
"When I would go over to friends' houses I would raid their medicine cabinets because I knew their parents were most likely taking something," said Emerson, now 19.
One day she overdosed at the mall. Her mother, Phyllis Ferraro, tried to keep her daughter breathing until the ambulance arrived.
"The pills are everywhere," Ferraro said. "There aren't enough treatment centers and yet there's a pharmacy on every corner."
The American Southwest has emerged as another hot spot.
Parts of New Mexico have seen tenfold increases in oxycodone sales per capita and fivefold increases in hydrocodone. The state had the highest rate of opioid painkiller overdoses in 2008, with 27 per 100,000 population.
Many parts of eastern California received only modest amounts of oxycodone in 2010, but the increase from 2000 was dramatic - more than 500 percent around Modesto and Stockton.
Many California addicts are switching from methamphetamine to prescription pills, said John Harsany, medical director of Riverside County's substance abuse program.
Hydrocodone use has increased in some areas with large Indian reservations, including South Dakota, northeastern Arizona and northern Minnesota and Wisconsin. Many of these communities have battled substance abuse problems in the past.
Experts worry painkiller sales are spreading quickly in areas where there are few clinics to treat people who get hooked, Bunt said.
In Utica, N.Y., Patricia Reynolds has struggled to find treatment after becoming dependent on hydrocodone pills originally prescribed for a broken tailbone.
The nearest clinics offering Suboxone, an anti-addiction drug, are an hour's drive away in Cooperstown or Syracuse. And those programs are full and are not accepting new patients, she said.
"You can't have one clinic like that in the whole area," Reynolds said. "It's a really sad epidemic. I want people to start talking about it instead of pretending it's not a problem and hiding."
AP Interactive Graphic: http://hosted.ap.org/interactives/2012/painkiller-nation /
From the Washington Times
Conn. on track to be 17th state sans death penalty
by Shannon Young
HARTFORD, Conn. (AP) The state Senate voted Thursday to abolish the death penalty in Connecticut , a state that has executed only one prisoner in a half-century and is now on track to join a national trend away from capital punishment.
In an early morning vote that followed more than 10 hours of debate, the Senate approved legislation that would set life imprisonment as the maximum punishment for all future cases. The bill, which has the support of the state's Democratic governor, now goes to the Democrat-controlled House of Representatives, where it's expected to win approval.
In the past five years, four other states have abolished the death penalty New Mexico, Illinois, New Jersey and New York. Connecticut would become the 17th state without a death penalty .
Repeal proposals also are pending in several other states, including Kansas and Kentucky, while advocates in California have gathered enough signatures for an initiative to throw out the death penalty that is expected to go before voters in November.
I think with the revelations of so many mistakes, aided by DNA testing, it's been made clear that the death penalty risks (innocent) lives, said Richard Dieter, executive director of the Death Penalty Information Center, a nonprofit capital punishment tracking organization in Washington.
Executions in the U.S. have declined from a high of 98 in 1999 to 43 last year, Mr. Dieter said. The number of people sentenced to death each year has also dropped sharply, from 300 a decade ago to 78 last year, he said.
Connecticut state Sen. Eric Coleman, a Democrat, called the 20-16 vote a pivotal step.
It moves us towards a more enlightened posture on the issue and puts us more in line with other New England states, he said.
The legislation wouldn't affect sentences of the 11 inmates now on Connecticut's death row. Many officials insisted on that as a condition of their support for repeal in a state where two men were sentenced to death for a gruesome 2007 home invasion that killed a woman and her two daughters and evoked comparisons to Truman Capote's In Cold Blood.
Similar legislation never made it to the Senate floor for a vote last year after some senators voiced concern about acting when the second of two suspects in that case was still facing trial. Two paroled burglars, Steven Hayes and Joshua Komisarjevsky, were convicted of killing Jennifer Hawke-Petit and her daughters, 17-year-old Hayley and 11-year-old Michaela, in their suburban home in Cheshire. The girls' father, Dr. William Petit, was beaten but survived.
Now that both men have been sentenced to death, some lawmakers who previously opposed the penalty including state Sen. Edith Prague, a Democrat shifted their support.
I cannot stand the thought of being responsible for somebody being falsely accused and facing the death penalty , she said. For me, this is a moral issue and realizing that mistakes are obviously made.
A Democratic amendment to the bill, which also passed the Senate , would require that inmates convicted under the new law face harsh prison conditions replicating those on death row, including separate inmate housing, non-contact visitation and mandated cell movement every 90 days.
During the Senate debate on the repeal bill, opponents questioned its constitutionality. They predicted the repeal would be the basis for numerous legal appeals by lawyers for death row inmates.
What I do know is that the appeals won't stop, said Sen. John McKinney, the chamber's Republican leader. What I do know is that the legal process will continue and be lengthy even after the death penalty is repealed. It will just be different arguments made in the appeal.
Connecticut has carried out only one execution in 51 years, when serial killer Michael Ross was administered lethal injection in 2005 after giving up his appeal rights.
From Google News
Man pleads guilty in botched 'Fast and Furious' US gun-running sting
Apr 5 2012
by Tim Gaynor
PHOENIX (Reuters) - A man pleaded guilty on Thursday to two felony counts of purchasing and running high-powered rifles to Mexico from Arizona under the botched "Fast and Furious" federal sting operation tied to the murder of a U.S. federal agent.
Jaime Avila Jr. was among a ring of 20 defendants charged with buying high-powered firearms including Kalashnikov type assault rifles and Barrett sniper rifles to run to the Mexican cartels.
The purchases were made in the Phoenix area from 2009 to 2010 when a bungled U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) operation allowed more than 2,000 U.S.-bought weapons to slip across the border to Mexico.
Two of those weapons were found at the spot near the Arizona-Mexico border where U.S. Border Patrol agent Brian Terry was killed during a shootout with illegal immigrants in December 2010. It was not clear, however, if those weapons fired the fatal shots.
Fast and Furious was run by the Phoenix field office of the ATF and the U.S. Attorney. Its goal was to try to track guns being smuggled from the initial purchaser to senior drug cartel members.
According to court documents, Avila was recruited in November 2009 by a co-conspirator, Juan Jose Martinez-Gonzalez, to make third party straw purchases from licensed dealers. He bought 52 firearms, including powerful .308 caliber rifles and two .50 Barrett sniper rifles.
During his involvement with the ring he became aware that the guns were intended for export to Mexico, where drug cartel violence has killed more than 50,000 people since late 2006.
Avila pleaded guilty to charges of dealing firearms without a license, making false statements in acquiring a firearm and smuggling guns out of the United States. He faces up to ten years in jail upon sentencing.
Calls to Avila's attorney and the Justice Department on Thursday seeking comment were not immediately returned.
President Barack Obama's administration has been under fire over Fast and Furious, which has been under investigation by the U.S. Congress.
Republicans have questioned who in the administration knew about and approved the operation and its tactics and when. They have issued subpoenas for documents and for witnesses to testify.
Terry's family, meanwhile, has filed a $25 million wrongful-death claim against the U.S. government, saying he was killed because federal investigators allowed guns to fall into the hands of violent criminals.
Hackensack offers citizens police academy
April 6, 2012
by MARK J. BONAMO
HACKENSACK For those in Hackensack who wonder what it's like to wear the badge, the Police Department and Bergen Community College have teamed up for the sixth year in a row to give civilians the opportunity to learn what police work is all about.
The Citizens' Police Academy is a nine-week program designed to provide the citizens of Hackensack and the surrounding area an understanding of the training, education and experiences of the law enforcement community.
The program will meet every Thursday from March 29 to May 24 from 6:30 to 9:30 p.m. The sessions will be held at Bergen Community College's Hackensack campus at the Ciarco Learning Center on Main Street.
The course curriculum includes subjects such as self-defense, personal safety, gang awareness, surviving an armed encounter, homeland security, Internet safety, juvenile laws, liability laws related to DWI offenses and motor vehicle stops.
The course will also include trips to the Bergen County Medical Examiner's Office in Paramus and the Bergen County Jail Annex in Hackensack .
Academy instructors come from the ranks of the Hackensack Police Department and other local law enforcement agencies. Attorney Steven Benvenisti of the law firm of Davis, Saperstein & Solomon, P.C will teach the subject of liability laws.
For more information, contact Police Officer Edmund Meneses of the crime prevention/community policing unit at 201-646-3977 or email at email@example.com. For applications visit www.hackensack.org.
For information about Bergen Community College's Ciarco Learning Center, call the director, Paul Ragusa, at 201-301-1299.