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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Former Navy SEAL on Coming Out of Shadows

It used to be that Navy SEALs didn't just operate in the shadows. They trained in them too. Their whole story stayed shrouded in mystery. Their secret missions stayed secret to the rest of us.

But when they got Osama Bin Laden, snatched back an American cargo ship taken by pirates and rescued two air workers held hostage in Somalia, then suddenly, it seemed that SEALs were headline-makers.

Add to that some SEALs wrote books about SEAL adventures and even acted in a movie about the SEAL experience using live ammunition when they made "Act of Valor." They can't quite be called "the military unit that no one ever talked about" any longer.

Watch the full story on "Nightline" TONIGHT at 12:35 a.m. ET

Rorke Denver played Lt. Commander Rorke in "Act of Valor," a film that used dozens of SEALs and went on to gross $80 million at the box office. Now, with the help of a writer, Denver is doing some pretty decent storytelling in a new book, "Damn Few: Making the Modern SEAL Warrior."

He agrees that with SEALs like him telling their stories that these guys are out in the open like never before.

"We are, at this moment in our history, when the heat is on, the missions are getting press and coverage," Denver said.

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When asked if it was a good thing, he said, "time will tell."

"We are in the public eye and I think that mythology is something that people are hugely, hugely interested in and they have an appetite for it," Denver said. "So for us with the movie and then also with 'Damn Few' I had an opportunity, I feel, to authentically represent and hopefully do it from an honorable point of view and accurately do so."

It's mostly his own story Denver tells in "Damn Few," how he joined the SEALs after college -- they didn't want him at first.

"I put in my first application and they said no, and I am glad it went that way. I think the community really values resiliency and toughness and focus and a 'never quit' attitude. For me, when they said no I thought, that ain't going to cut it."

Denver didn't quit. He reapplied and went on to survive the SEALs brutal Hell Week and training, joined the team and deployed all over the world, including the deadly Al Anbar province in Iraq when the war there was at its hottest. His family waited for him to return stateside.

"The families, I feel, are the ones who pay the price of our choices," Denver said. "But I didn't appreciate how much I was asking my family to bear and experience it with me. They really are every bit a part of our experience and frankly they are the ones who are back home and praying and believing that you are going to come home."

But even his family didn't quite know what Denver did at work every day.

"I never ask questions about what he does," said his wife, Tracy.

But "Act of Valor" was revealing in that way, and Denver's wife watched the film.

"For me it was incredibly eye-opening to actually see a submarine mission or running around in the jungle, jumping out of a plane, shooting his weapons," she said. "For me, it was like, oh, so this is what you are doing when you are away. I appreciated it actually."

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Chavez back in Venezuela, on Twitter with four million followers

CARACAS (Reuters) - After Hugo Chavez spent two months out of the public eye for cancer surgery in Cuba, the Venezuelan government hailed his homecoming on Monday and said the president had achieved another milestone - four million followers on Twitter.

The 58-year-old flew back from Havana before dawn and was taken to a military hospital. No new details were given on his health, and there were no images of his arrival. Officials say his condition remains delicate.

The normally loquacious socialist leader, who is struggling to speak as he breathes through a tracheal tube, took to Twitter with a passion back in April 2010, tweeting regularly and encouraging other leftist Latin American leaders to do likewise.

His @chavezcandanga account quickly drew a big mixed following of fans, critics and others just curious to see how his famously long speeches and fiery anti-U.S. invective would work within the social media network's 140-character limit.

But as he fought the cancer and underwent weeks of grueling chemotherapy and radiation therapy, he began to tweet less and less frequently, before stopping altogether on November 1.

Early on Monday morning, he made his reappearance.

"It was 4:30, 5 a.m. He got to his room and surprised everyone: rat-tat-tat, he sent three or four messages, and at that moment fireworks began to go off around the country," Vice President Nicolas Maduro said in a televised cabinet meeting.

During the day, Maduro added, the president's number of followers had shot up to well over four million.

"It's incredible, in just a few hours ... he's the second most-followed president in the world (after Barack Obama), and the first if we make the comparison by per capita," he said.

Obama has more than 27 million Twitter followers and is No. 5 most followed globally. Chavez is Twitter's No. 190 globally.

4TH MILLION FOLLOWER

Maduro said Chavez's four millionth follower was a 20-year-old single Venezuelan woman named Alemar Jimenez from the gritty San Juan neighborhood in downtown Caracas, near the military hospital where the president arrived earlier in the day.

"She's one of the golden generation of youth who support the fatherland and have been waiting with growing love for commander Hugo Chavez," Maduro said, before presenting a dazzled-looking Jimenez to the cameras and giving her a bunch of flowers.

"We were really emotional" she said, recounting how she was with her mother when they heard Chavez had returned. "I sent him a message on Twitter saying he must get better."

There are still big questions over the president's health. He could have come back to govern from behind the scenes, or he may be hoping to ease political tensions and pave the way for a transition to Maduro, his preferred successor.

Chavez has often ordered followers to fight back against opposition critics of his self-styled revolution by using social media, leading from the front himself on Twitter and referring to the Internet as a "battle trench."

As his ranks of followers grew, Chavez said he hired 200 assistants to help him respond to messages - which he said were a great way to receive first-hand the requests, demands, complaints and denunciations of citizens in the thousands.

During his re-election campaign last year, the government launched an SMS text message service that forwards his tweets to cellphones that lack Internet service, broadening their reach to the poorest corners of the South American country.

"He's a communication revolution!" Maduro said, later unbuttoning his shirt on TV to show he was wearing a T-shirt bearing Chavez's eyes emblazoned across his chest.

For the tens of thousands who signed up on Monday to follow Chavez on Twitter, it is unclear how much will be posted there in the weeks and months ahead. Venezuela's 29 million people are mostly wondering something similar.

(Additional reporting by Diego Ore; Editing by Todd Eastham)

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Cricket: Injured Jayawardene out of Bangladesh series

COLOMBO: Former Sri Lanka captain Mahela Jayawardene has been ruled out of the forthcoming home series against Bangladesh because of a finger injury.

Jayawardene, 35, who is Sri Lanka's highest run-getter in Tests, dislocated a finger in his left hand while fielding during a domestic first-class match in Colombo on Sunday.

Scans of the injury have been sent to Australia for further analysis, Sri Lanka Cricket said in a statement, adding that the batsman could be out of action for four to six weeks.

Bangladesh are due to play two Tests, three one-dayers and one Twenty20 international during their month-long tour of Sri Lanka in March.

Jayawardene, who resigned as captain after the recent Australian tour, has scored 10,806 runs in 138 Tests at an average of 49.56 with 31 centuries.

He also has 10,892 one-day runs from 391 matches with 15 hundreds, and 1,293 runs in 46 Twenty20 internationals.

All-rounder Angelo Mathews replaced Jayawardene as Test and one-day captain, while Dinesh Chandimal will lead in Twenty20 matches.

- AFP/de

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Akhilesh Yadav presents deficit budget for Uttar Pradesh

LUCKNOW: Uttar Pradesh chief minister Akhilesh Yadav on Tuesday presented a Rs 23,913 crore deficit budget for the state for 2013-14 at Rs 2,21,201.19 crore.

The budget tabled in the assembly showed a 10% increase from the last year's size of Rs 2,00,110.61 crore.

While no new tax has been imposed in the budget, the fiscal deficit has been estimated at Rs 23,913 crore -- 2.9% of the gross domestic product (GDP).

The government has estimated revenue receipts at Rs 2,15,919.82 crore and revenue savings at Rs 9,856.01 crore for the next financial year.

After deducting from the consolidated fund, the actual deficit would be Rs 5,281.37 crore, Yadav said in his address.

After adjusting Rs 3,550 crore from the PLA (personal ledger account), the net deficit is of Rs 1,731.7 crore.

While the opening balance is at Rs 2,957.9 crore, the expected closing balance has been shown at a surplus of Rs 1,226.53 crore.

Earlier, the BSP members staged a walk-out from the House.

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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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Obama's Speech on Guns Doesn't Stop Ill. Killing

A Chicago teenager was shot and killed Friday only hours after her sister attended President Obama's speech on the city's rampant gun violence.
Janay McFarlane, 18, was killed while walking with a friend during a visit to her dad, Herbert McFarlane, in North Chicago.

"All this gun violence going on, you never think it would be your child," he told ABC's Chicago station WLS. "This is the hardest thing for me in my life."

Herbert McFarlane told WLS that the loss of Janay is especially hard because she leaves behind a 3-month old son, who likes to wear an "I love Mommy" shirt. The shooting occurred in Lake County, a northern suburb miles from the epicenter of the gun violence on the city's South Side.

"I'm in Lake County to get away from violence and now it happened in Lake County where I moved to," he told WLS.

McFarlane and her child spent time both in Lake County and on the South Side where her mother lives.

Janay Proudmommie Mcfarlane/Facebook

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Only hours before McFarlane was shot and killed, President Obama returned to his hometown to speak on the South Side at a Hyde Park high school. McFarlane's sister, Destini Warren, 14, sat behind the president during the speech.

More than 500 people were shot and killed here last year, and this year the situation has worsened with the most deadly January the city has seen in over a decade. The shooting death of Hadiya Pendleton, a 15-year old who performed in Washington, D.C. at events connected to the president's inauguration last month, garnered national attention.

"Too many of our children are being taken away from us," Obama said in Hyde Park, with McFarlane's sister in the audience.

"Last year there were 443 murders with a firearm on the streets of this city, and 65 of those victims were 18 and under," he said. "So that's the equivalent of a Newtown every four months." He was referring to Newtown, Conn., where 20 first graders were gunned down by Adam Lanza along with seven adults.

Only hours later in Chicago, another 18-year old was shot and killed.

"I felt like someone took a knife and stabbed me in the heart, and a piece of my heart I will never get back," Angela Blakely, Janay McFarlane's mother, told WLS.

North Chicago Police on Sunday reportedly questioned two people in connection to McFarlane's death. Her family said McFarlane was an unintended target of the shooting.

Messages left by ABC News with the North Chicago Police Department and the Lake County Coroner's Office went unreturned Monday.

Another Chicago teenager, Frances Colon, was also shot and killed Friday just hours after she had told her father that she saw President Obama's helicopter fly over her neighborhood.

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Ecuador's Correa in re-election triumph, eyes investment for growth

QUITO (Reuters) - Ecuadorean President Rafael Correa reveled in a sweeping re-election victory that allows him to deepen his socialist revolution even as he seeks to woo foreign investment in the resource-wealthy Andean nation.

The pugnacious 49-year-old economist trounced his nearest rival by more than 30 percentage points on Sunday to win a new four-year term. He has already been in power for six years, winning broad support with ambitious social spending programs.

Correa's resounding victory on Sunday could set him up to become Latin America's most outspoken critic of Washington as Venezuelan President Hugo Chavez is locked in a battle with cancer and may be unable to stay in power.

"We will be present wherever we can be useful, wherever we can best serve our fellow citizens and our Latin American brothers," Correa told supporters who celebrated in front of the presidential palace in Quito, waving the ruling Alianza Pais party's neon-green flags.

"This is not just a victory for Ecuador, this is a victory for the great homeland of Latin America," the beaming Correa said.

Correa is now the loudest voice in Latin America arguing against the free-market reforms promoted by Washington and in favor of state-driven economies and expanding ties with China.

Still, the continued success of Latin American socialism will depend on strong commodities prices that underpin generous social spending, and Correa needs to both improve Ecuador's stagnant oil production and spur a nascent mining industry.

In a sign he wants to deepen socialist reforms, Correa's legislative agenda includes a new law that would regulate television and newspaper content, part of his ongoing confrontation with opposition media.

He also plans a land reform campaign to redistribute idle land to the poor.

"Our Ecuador needs a president like Rafael Correa. He has been strong and has not allowed anyone to intimidate him," said Julieta Moira, an unemployed 46-year-old as she celebrated outside the presidential palace. "I'm very excited, happy and thankful."

Correa is also expected to seek changes to a mining law that would help close a deal with Canada's Kinross to develop a large gold reserve.

That will be a major test of his ability to offer investment security while ensuring the state keeps a large portion of revenue.

LEFTIST ALLIES

Chavez, in a statement sent by Venezuela's government, celebrated Correa's re-election as a triumph for the ALBA bloc of leftist nations in Latin America and the Caribbean. The group has been left rudderless since Chavez was sidelined with cancer.

"It is a victory for ALBA, for the Bolivarian and socialist forces of our America, and will help to consolidate an era of change," the statement said, referring to Venezuelan-born South American independence hero Simon Bolivar.

Correa dedicated his victory to Chavez, who is still in a Cuban hospital after undergoing his fourth surgery for cancer on December 11.

Correa's closest rival, Guillermo Lasso, became the face of Ecuador's opposition on Sunday after winning about 23 percent of votes.

The opposition fielded six other candidates including former Correa ally Alberto Acosta, former President Lucio Gutierrez and banana magnate and five-time presidential hopeful Alvaro Noboa.

Critics call Correa a dangerous authoritarian who has curbed media freedom and controlled state institutions. Even some supporters disapprove of his tempestuous outbursts, fights with media and bullying of adversaries.

Ecuadoreans also chose a new Congress on Sunday, and Correa said he expected the ruling Alianza Pais to win a majority.

That would let him avoid negotiating with rivals to pass proposed legislation, including the new media law and land reform measures.

Correa needs to lure investors to diversify the economy and finance the investment in social welfare and infrastructure that helped him win another four-year term.

Ecuador has been locked out of capital markets after a 2008 debt default on $3.2 billion in bonds, and Correa's government has taken an aggressive stance with oil companies to squeeze more revenue from their operations.

PRAGMATIC APPROACH

Foreign investment will be key to boosting oil production that has been stagnant for five years and to expanding a mining industry that has barely begun to tap the country's gold and copper reserves.

"We can't be beggars sitting on a sack of gold," is a catch phrase Correa has used in recent months to argue that Ecuador needs to better exploit its natural resources despite opposition from rural communities to some projects.

In that vein, U.S.-educated Correa appears to be cautiously willing to cut deals and soften his image as an anti-capitalist crusader.

"The advantages of our country for foreign investment are political stability, a strong macroeconomic performance ... and important stimulus to new private investment," he said last week while hosting Sheikh Hamad bin Khalifa al-Thani, the emir of gas-rich Qatar.

But in comments after his win on Sunday, he stressed that investment was not an end but a means to ensure growth. He promised Ecuador would not "mortgage" itself for foreign cash.

Foreign direct investment has generally been less than $1 billion a year since Correa took office in 2007. By comparison, neighboring Peru and Colombia last year received $7.7 billion and $13 billion, respectively.

"There is still a risk that Correa will seek to change terms for the mining sector once it is more developed, but for now, Correa will show signs of pragmatism as a means of kick-starting the sector," the political risk consultancy Eurasia Group said in an analysis anticipating his victory.

His government is also in talks with China to secure funding for the $12.5 billion Pacifico refinery, which would allow Ecuador to save up to $5 billion a year in fuel imports.

(Editing by Andrew Cawthorne, Kieran Murray and Mohammad Zargham)

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Assange sees freedom in Australia senate seat

SYDNEY: WikiLeaks founder Julian Assange believes winning a seat in Australia's upper house would extricate him from his prolonged asylum inside Ecuador's London embassy, a report said Monday.

In an interview published on Australian website The Conversation, Assange outlined a scenario that would set him free to return to home.

If he takes a senate seat in the September 14 elections, "the US Department of Justice won't want to spark an international diplomatic row", The Conversation paraphrased Assange as saying.

"It will drop its grand jury espionage investigation. The Cameron government will follow suit," it added.

If Britain failed to back off "the political costs of the current standoff will be higher still", Assange said.

He added that sex crime allegations against him in Sweden were "falling apart".

A new WikiLeaks Party is to be launched soon with a 10-member national council and field candidates for the senate. Queensland-born Assange is expected to stand in Victoria state.

He has been holed up in the Ecuadoran embassy in London since June, after claiming asylum in a bid to avoid extradition to Sweden. Britain has refused to grant him safe passage out of the country.

The former computer hacker fears Sweden will allow him to be extradited to the United States to be questioned over the WikiLeaks release of thousands of US diplomatic cables.

Despite the swirl of allegations against him, Assange is a popular figure in Australia.

WikiLeaks angered the United States in 2010 by publishing hundreds of thousands of classified documents on the wars in Iraq and Afghanistan, as well as a huge cache of US diplomatic cables that embarrassed governments worldwide.

Ecuadoran President Rafael Correa called on Europe on Sunday to find a snap diplomatic solution for Assange.

"It's a diplomatic situation for which a solution must be found... as quickly as possible," Correa said shortly after declaring victory in presidential elections.

"There can't be a problem due to asylum, it's neocolonialism," he said, reiterating Quito's demands -- safe passage or questioning of Assange by a Swedish judicial official in London.

-AFP/gn

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Supreme Court stays execution of Veerappan's aides till Wednesday

NEW DELHI: The Supreme Court has stayed the execution of Veerappan's aides till Wednesday.

The apex court said though the petition filed by an advocate on behalf of the convicts is not maintainable, the case of 4 condemned prisoners were similar to the case of other death row convicts pending consideration of the Supreme Court.

SC's decision came after the defence advocate informed the court that he has now got authorization from all 4 convicts as well as their families.
Four aides of sandalwood smuggler Veerappan had moved the Supreme Court against the execution of their death penalty in connection with a landmine blast that had killed 22 policemen in Karnataka nearly 20 years ago.

Veerappan's elder brother Gnanaprakash, Simon, Meesekar Madaiah and Bilavendran were awarded death sentence in 2004 in connection with a landmine blast at Palar in Karnataka in 1993 in which 22 police personnel were killed.

Their mercy petition was rejected by President Pranab Mukherjee on February 13.

On Saturday, the apex court had refused urgent hearing on the plea of four aides of sandalwood smuggler Veerappan seeking stay of execution of their death penalty.

The matter was mentioned before Chief Justice of India Altamas Kabir but he did not give a hearing to it, said a staff from his office when contacted.

Senior advocate Colin Gonsalves, who had mentioned the matter at the CJI's residence, said the Chief Justice did not hear the matter on Saturday evening on the ground that there was no proof that execution will take place on Sunday as was being feared.

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