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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Tunisian PM quits after failing to form new government

TUNIS (Reuters) - Tunisian Prime Minister Hamadi Jebali resigned on Tuesday after failing to replace a government pulled apart by acrimony between his Islamist allies and their secular opponents.

Jebali had threatened to quit if his plan for a non-partisan cabinet of technocrats to lead the north African country into early elections foundered.

In the end it was his own party, Ennahda, that rejected the proposal, prolonging the political stand-off that has cast a shadow over Tunisia's fledgling democracy and deepened an economic crisis.

"I vowed that if my initiative did not succeed, I would resign and ... I have already done so," Jebali told a news conference after meeting with President Moncef Marzouki.

Tunisia's deepest political crisis since the 2011 Arab Spring uprising that toppled President Zine El Abidine Ben Ali began when leading secular opposition politician Chokri Belaid was gunned down outside his home in Tunis on February 6.

No one claimed responsibility for the killing, but it deepened the misgivings of secularists who believe Jebali's government has failed to deal firmly enough with religious extremists threatening the country's stability.

Protesters poured onto the streets in the following days and Marzouki's secularist party threatened to quit the coalition government.

Jebali said he would try to form a cabinet of apolitical technocrats to restore calm and take Tunisia to elections, but did not consult his Ennahda allies or their secular coalition partners before making the proposal.

Several secular politicians backed the plan but Ennahda, winner of most parliamentary seats in elections that followed Ben Ali's overthrow, opposed the idea, fearing it would be sidelined from power.

Jebali bet his own job on the outcome, saying he would quit if he was rebuffed, and lost.

He quits 15 months into the job, although political experts said Marzouki was likely to re-appoint him as caretaker premier before a new leader is appointed.

Ennahda leader Rached Ghannouchi has said he wants to see Jebali head a new coalition. President Marzouki was due to meet Ghannouchi on Wednesday to ask him to name a prime minister.

But Jebali, announcing his resignation late on Tuesday, said he would not lead another government without assurances on the timing of fresh elections and a new constitution.

No government would be viable without Ennahda's blessing given its strength in parliament.

Ghannouchi has said it is essential that Islamists and secular parties share power now and in the future, and that his party was willing to compromise over control of important ministries such as foreign affairs, justice and interior.

"Ennahda is in negotiations with political parties to form a national coalition government", said Fethi Ayadi, a senior Ennahda official.

Iyed Dahmani, a leader of the secular Republican Party, said some kind of agreement was vital.

"We are in real trouble, politically and economically," he said.

The crisis has disrupted efforts to revitalize an economy hit hard by the disorder that followed the overthrow of veteran strongman Ben Ali.

Tunisia has been negotiating with the International Monetary Fund for a $1.78 billion loan and politicians said Jebali's inability to re-establish a functioning government had slowed efforts to restore normality.

Credit rating service Standard and Poor's said on Tuesday it had lowered its long-term foreign and local currency sovereign credit rating on Tunisia, citing "a risk that the political situation could deteriorate further amid a worsening fiscal, external and economic outlook".

(Reporting By Tarek Amara; Editing by Tom Pfeiffer)

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Swimming: Trickett urges healing after "toxic" Games

SYDNEY: Australian swimmer Libby Trickett called for healing within the sport after reports exposed a "toxic" atmosphere at the London Olympics including drunkenness, deceit and bullying.

Swimming Australia has vowed to restore its standing with the public after the country's much vaunted swimmers disappointed at the 2012 Olympics and inquiries into its culture revealed discipline was loose and the squad lacked leadership.

Trickett, who has won four gold medals at three Olympics, welcomed the news that officials would further investigate allegations against the team, including that some athletes misused prescription drugs as a prank in London.

"That issue has been left unresolved and it needs to be dealt with in order for us to move on," she told the Australian newspaper.

"It probably has gone too long without being dealt with. It certainly does need to be addressed because... if we let this one go, it's a precedent for the future."

She said all swimmers had been "under a cloud" because no individuals had so far been named.

"But if names are named, we will need to support them through the difficult times that lie ahead for them -- and they will be difficult," she said, The Australian reported.

"We need to come together again as a team and what better way to do that than by embracing these swimmers?"

Australia endured its worst swimming haul in decades in London, winning just one gold medal, six silver and three bronze for its lowest tally in the pool since Barcelona in 1992.

The lacklustre performance, in which no individual swimming gold medal was won for the first time since the 1976 Montreal Games, resulted in the commissioning of two independent reports released on Tuesday.

They revealed that morale within the swimming team was so low one athlete referred to London as the "lonely Olympics" as individuals looked after themselves ahead of the team.

- AFP/al

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Britain's Cameron visits Jallianwala Bagh massacre site, Golden Temple

AMRITSAR: British Prime Minister David Cameron laid a wreath on Wednesday at a memorial for the notorious Jallianwala Bagh massacre where he is reportedly set to express regret for the loss of life.

Cameron, dressed in a dark suit and bowing his head, laid the flowers at the Jallianwala Bagh memorial in Amritsar, where hundreds of unarmed protesters were gunned down by British troops in 1919.

Earlier, he paid obeisance at the holiest shrine of Sikh religion Golden Temple where he was presented a robe of honour.

Amid tight security arrangements, Cameron paid obeisance inside the sanctum sanctorum at 10:25am.

Clad in a dark suit and a tie with head covered with a blue-coloured cloth, Cameron was presented a robe of honour inside the sanctum sanctorum of Harmandir Sahib, popularly known as the Golden Temple.

The British prime minister also mingled with a couple of devotees and chatted with them for a brief period as Gurbani played in the backdrop. This is the first visit by a high-profile British dignitary to Amritsar after 1997, when Queen Elizabeth II and her husband Prince Philip, the Duke of Edinburgh, had visited the holy City.

Inside the temple, he was accompanied by Punjab chief minister Parkash Singh Badal, who earlier received the British dignitary at the Sri Guru Ram Dasji International Airport, Shiromani Gurdwara Prabandhak Committee (SGPC) President Avtar Singh Makkar, among others.

The British prime minister reached the Golden Temple at about 9:50am and spend nearly an hour inside.

Before paying obeisance by bowing his head inside the sanctum sanctorum, the British leader was taken around the temple by officials of the SGPC, apex religious body of the Sikhs, and was also shown Shri Guru Ram Dass Langar Hall.

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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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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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S'pore, Malaysia agree on high-speed rail link

SINGAPORE: Singapore and Malaysia have agreed to build a high-speed rail link between Kuala Lumpur and Singapore, with a target to complete it by 2020.

This was announced by Prime Minister Lee Hsien Loong and Malaysian Prime Minister Najib Razak on Tuesday during their annual Leaders' Retreat.

With the new link, it will take about 90 minutes to get from Singapore to KL and vice versa.

The two leaders described the high-speed rail system as a strategic development in the bilateral relations, saying it will dramatically improve the connectivity between Malaysia and Singapore.

Mr Lee said: "It is a strategic project for the two countries. It will change the way we see each other. It is the way people in London and Paris are able to think of it -- as twin cities, where you can commute, go up there, do business, meet friends, have a meal and come back, all within two thirds of the day.

"And I think it is going to be a game changer. It will transform the way people interact, the intensity of our cooperation and the degree to which we become interdependent on each other and therefore have stakes on each other's success."

The leaders added that it will usher in a new era of strong growth, prosperity and opportunities for both countries.

The link will also facilitate seamless travel between KL and Singapore, enhance business links, and bring peoples of Singapore and Malaysia closer together.

The leaders added that ultimately the project will give both countries greater stakes in each other's prosperity and success.

Mr Najib said: "Our two cities will complement each other. Our two countries will look at each other differently and the opportunities are boundless between our two countries.

"So I am excited about the project. We will certainly do our level best to meet the 2020 deadline. It may go slightly beyond that, but those are details in implementation."

The prime ministers have tasked a joint ministerial committee to look into the details and modalities of the high-speed rail link.

"The modalities will be offered to Singapore. Basically, we want Singapore to participate in this based on the different kinds of options that we will offer to the Singapore government," added Mr Najib.

- CNA/al

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Nagaland home minister resigns after Rs 1cr cash, arms found in his car

KOHIMA, NAGALAND: Home minister Imkong L Imchen has resigned from the ruling Naga People's Front (NPF) government, a party official said Tuesday.

Imchen put in his papers after the Election Commission authorities seized cash amounting to more than Rs one crore and weapons from his vehicle on Monday by troopers of Assam Rifles.

"I felt imperative to tender my resignation from the Council of Ministers with immediate effect, owning moral responsibility while holding public office, even though I have committed no wrong over the incident under the law," Imchen said in his resignation letter, which he submitted to chief minister Neiphiu Rio.

On the other hand, the opposition Congress has sought disqualification of Imchen from contesting the assembly election for violating the model code of conduct.

The offence committed by Imchen is a very serious crime under Arms Act and the case should be investigated by the National Investigation Agency.

On Monday, troopers of the Assam Rifles seized Rs 1.10 crore in cash, five pistols, two 7.65 mm calibre rifles and 140 round of 303 rifle ammunition from Imchen's vehicle at Sathupang area in Wokha district while he was on his way to his Koridanga constituency in Mokokchung district.

This is the second big cash seizure in poll-bound Nagaland.

On Saturday, election officials seized Rs.one crore in cash from NPF candidate H. Nyemli Phom after his helicopter landed at the Assam Rifles helipad in Longleng district.

Phom, who is seeking re-election from Tamlu constituency, later claimed that the money was given to him by the party and was part of NPF funds.

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