Noteworthy News Articles on Mental Health Topics, August 20-26, 2001

Officer Charged with DWI Says Substance Abuse Is A Problem in NYPD
Donna De La Cruz, Associated Press- 8/20/2001

NEW YORK -- The police officer charged with killing three members of a Brooklyn family while allegedly driving drunk said Monday he believes there is an alcohol and substance abuse problem in the NYPD. ''I think it's bigger than the department wants to acknowledge,'' said Officer Joseph Gray. When asked to elaborate, Gray responded: ''It's just from hearing people talk about it and what I've seen over my career.'' Police officials declined to comment on Gray's remarks.
    Gray's attorney, Harold Levy, refused to let his client answer any more questions concerning alcohol. Levy also would not let Gray comment on what happened on the day of the accident. Gray was indicted earlier this month in Brooklyn Supreme Court on manslaughter and other charges in the deaths of 24-year-old Maria Herrera, her 4-year-old son Andy, and 16-year-old sister Dilcia Pena on Aug. 4. Herrera was eight months pregnant at the time and her son was delivered, but was declared stillborn. Gray called the news conference to apologize to the victims' families and to publicly declare he is ''not the monster'' portrayed in the media. He said his life has been an ''absolute nightmare'' since the accident.
    Gray, who also faces departmental charges, looked downcast throughout the brief news conference. His wife, Diana, and Levy sat on either side of him. ''I just think it's important that people see who I am,'' Gray said, ''not the way I've been portrayed in the media. I'm not the mindless drunk being portrayed by the media.'' ''I'm home everyday to take care of my children,'' he added, referring to his three daughters ages 5, 11 and 16. ''I have a daughter who was in preschool up until June. I was home every day to take her to school, pick her up, take my wife to work.'' Because of all the publicity, Gray's daughters have been sent to live out-of-state with relatives, Levy said. Gray, a Staten Island resident, also expressed his regret to the victims' families; he had previously apologized through his lawyer. He also said, ''I just want people to know that I'm not the monster that people think I am.''
    Gray, 40, has been suspended without pay until early September, and is awaiting a departmental trial on charges of manslaughter and other offenses. Gray, a 15-year veteran, acknowledged that his career is likely over. ''I'll find something else to do,'' he said sadly.  But Gray said the entire department should not be seen in a harsh light. ''In my career, I've always felt that the whole community shouldn't blame the police department for the actions of one or more individuals,'' he said. ''They're the most dedicated group of people in the world and they shouldn't be judged by the actions of one person.''
    The news conference was disrupted by one heckler, David Galarza, a Sunset Park community activist who described himself as a friend of the Herrera and Pena families. ''I came here out of justice. He should be in jail,'' he shouted. ''You're not a police officer, you're a murderer,'' he said and carried a sign that read: ''Jail, No Bail for Drunk Killer Cop.''
    Gray had allegedly been drinking for up to 12 hours prior to the accident. An NYPD investigation revealed that he and other officers drank beer in an NYPD parking lot, then moved on to a strip club declared off-limits to cops from the 72nd Precinct. After the outburst, Levy ended the news conference as Gray remained seated before a bank of microphones. His wife tried to comfort him as they left. ''We're holding up,'' she told reporters. ''We're taking it day by day.''

Massachusetts Group Homes Shortage Strands Mentally Ill
Alice Dembner, Boston Globe- 8/21/2001

MEDFIELD - Michael MacDonald's dreams are simple. A room of his own instead of a shared ''cell'' in a locked ward at Medfield State Hospital. A teaching job instead of make-work. A chance to go to graduate school. And eventually, a wife and children.  After 21/2 years of treatment for severe mental illness, MacDonald and his doctors agree that he is well enough to pursue those dreams. Instead, his life is on hold. Like approximately 260 other adults statewide, MacDonald is a virtual prisoner in a psychiatric hospital solely because there are not enough state-funded group homes or staffed apartments to provide a transition to private life. MacDonald, who will mark his 37th birthday tomorrow, has already been waiting three months to leave. Others with more specialized needs have been waiting as long as two years, and the list is growing. ''I needed to be here for a long time, but I don't need to be here anymore,'' MacDonald said last week. ''My room is a cell. I shouldn't be here. Why aren't there more places? I just want to have a life.''   Under the pressure of waiting, many patients find their symptoms worsen. But MacDonald's health is holding. The internal demons that led him to stab himself in the chest, lash out at objects, and even pretend he was Michael the Archangel have subsided.   Yet he feels the strain. Every day he does not get out, he said, he becomes ''a little more institutionalized, which takes away my skills. I'm at a crossroads, and I need a success right now in my life.''
    Officials at the hospital agree the long waits for discharge are hazardous to residents, but say there is little they can do. ''If people are ready to leave, then this becomes a regressive environment,'' said hospital administrator Joel Skolnick. The human logjam results from demand for state-funded mental health services in the community that far outstrips the supply. Like the gridlock that has seized the mental health system for children, the problem for adults is multifaceted, ranging from too few case managers to too few community beds. Although the state provides group homes and supported apartments for 6,200 mentally ill adults, more than 3,000 others in and out of the hospital are on a waiting list for residential services.
    The growing problem led advocates last November to notify the state of their intent to sue the Commonwealth, saying it is violating the civil rights of mentally ill adults. The advocates, from the Center for Public Representation and the Mental Health Legal Advisors Committee, said more than 1,500 adults had been hospitalized too long, had been inappropriately discharged to nursing homes, or were living in the community with so little support that they were at imminent risk of hospitalization. The advocates buttressed their demand for more community-based residential services by citing a 1999 US Supreme Court decision in a Georgia case that found the Americans with Disabilities Act provides a right to such services for people with mental disabilities. Advocates and mental health providers agree that, in the long run, the increase in community services is cheaper for the state. Mental health administrators say it costs the state more than $100,000 a year to hospitalize a patient, compared with $40,000 for a group home bed and community services.
    State officials have been negotiating with advocates, but they have not even agreed on how many adults are at risk. Last spring, however, the state House of Representatives and Senate each passed budgets containing different multimillion-dollar increases for community housing for the mentally ill. The Senate bill would also require a long-term plan to address the mental health care shortage. But seven weeks after the July 1 deadline for a new budget, a compromise version is not on the horizon. ''The budget could impact the lives of hundreds of people who aren't getting the services they need,'' said Robert Fleischner, a lawyer with the Center for Public Representation. ''It would be a very good start.''
    As the budget battle drags on, MacDonald counts each passing day. A big bear of a man with a toothy smile and a gentle manner, he shows few signs of the delusions and deep depression that brought him to the facility. But he speaks frankly of his illness. Since 1985, he said, he has been hospitalized 25 times for bipolar illness, schizophrenia, and schizo-affective disorder. In between short hospital stays, he managed to get a bachelor's degree and to work as a park ranger in Charlestown and a car salesman on the Automile in Norwood. But for most of the last 16 years, he said, ''the bipolar illness had me.''  In December 1998, he was involuntarily committed to Medfield in what he now calls ''the biggest favor anyone could have done for me.'' Through medication, counseling, and prayer, he has healed. ''It's been a rocky road, but I'm on the upswing now,'' he said.  He has gone through all the hospital's rehabilitation programs - including working at the patient-run coffee shop, the clerical center, and the piecework shop - as well as relearned housekeeping and social skills. ''Been there, done that,'' he said. ''I'm anxious to get discharged.''
    Now, the rigid structure that was helpful in his sickest days chafes. He shares a spare room on a locked ward where he is not even allowed to open a window himself. Meals are at fixed hours. Although he is free to roam the rural hospital campus when he is not in programs, he must check in at set times and get a doctor's signed permission for even a simple variation in activities. What bothers him most, he said, is that ''there's no privacy.'' A few days ago, he wanted a private spot indoors to read a novel and the Bible. When he disregarded a supervisor's warning to stay out of an empty room on his ward, he said, he found himself face to face with ''four males ready to drag me out and put me in the restraint room.''
    At the homey halfway house MacDonald hopes to move into, most of the eight residents have their own rooms. There is a comfortable living room, a TV room, and an exercise room. MacDonald would share cooking duties with the other residents, have easy access to his car, and be free to begin graduate courses in religion or volunteer with Catholic Charities.
    At least one-third of the 147 patients at Medfield State are ready or nearly ready for discharge on any given day, but typically only a couple of community beds are available. To cope with a situation that is as frustrating for many staff members as for the patients, the Department of Mental Health has scraped together enough money to convert several old employee houses on the hospital campus to group homes. Without rent to pay, the houses are cheaper to set up than those in the community, but not ideal for the patients. ''They're still living in the shadows of the wards. There's no easy access to jobs or relationships or the chance interactions that people need for full recovery,'' said Ted Kirousis, suburban metro area director for the department.
    But for patients such as Carol, who has been waiting longer than MacDonald, moving into a ''quarter-way'' house on hospital grounds is worthwhile, even if it is more restrictive than the supervised apartment her doctors say she is ready for. Carol, a 41-year-old who asked that her real name not be used, moved in last Tuesday after four years in Medfield hospital wards and a temporary worsening of her symptoms just a few months ago. Hospital staff members said it was linked to her long wait for a community bed. ''I was really looking forward to going into the community,'' Carol said. ''It's been very disappointing.'' ''The Legislature needs to do something about housing,'' she added. ''There are a lot of people who've been waiting too long.''

Halfway House Sought for Sex Offender
Monte Whaley, Denver Post- 8/21/2001

BOULDER - A man at the center of a notorious child sex-abuse ring in Boulder County will likely have a hard time finding a place to finish out his sentence, officials say. Some Colorado facilities shy away from treating sex offenders, especially those who have attracted headlines like 56-year-old Michael Hall Ballard. "The notoriety will cause some problems," prosecutor Pete Maguire said.  Ballard is facing eight years in a halfway house after serving nine years in prison for sexually abusing and torturing his seven children between 1987 and 1991. Ballard; his wife, Patricia; and their friends Marcia and Dennis Dunann forced the children to perform sex acts on them, neighbors, strangers and other children in Boulder County and California, according to court records and testimony.
    Boulder District Judge Roxanne Bailin last week ordered Ballard to serve the community-corrections sentence. But she barred him from going to a halfway house in the same county where any of his children now live. That rules out Adams, Arapahoe, Boulder, Larimer, Park and Weld counties, Maguire said.  Ballard's lawyer and the county Probation Department now will have to get him into a treatment program from about 30 available in the state. Most are in the Denver metro area. Others are in Grand Junction, Greeley, Fort Collins, Colorado Springs and Craig, said Ed Camp, Colorado's director of the Office of Community Correction. A local Community Corrections Board - usually composed of citizens, law enforcement officers, prosecutors, probation officials and a public defender - will decide whether to take Ballard. "A lot of communities wring their hands about bringing sex offenders into their towns and cities," said Joe Thome, Boulder County Community Corrections division manager. "The big word is that public safety comes first." Many boards reject taking sex offenders for a variety of reasons, including a fear that they may repeat their crimes, Thome said. Halfway houses are staffed around the clock and offer intensive supervision, Camp said. Boulder County will pay the $16,500 needed to house Ballard, but he will have to pay for therapy outside of the facility.
    Ballard reached a plea agreement in 1992 that called for him to serve 12 years in prison and eight years in community corrections. His prison time was cut short for good behavior. The other adults were either convicted or pleaded guilty. Prosecutors in 1992 said the deal spared the Ballard children the trauma of testifying against their father. In court Friday, Ballard's son said that once he and two of his brothers were chased around a couch by their father and a friend because they wanted to have sex. "To this day I can see his eyes and (see him) truly enjoying what he was doing," the boy said. Some of the sexual activity was videotaped and sold. Ballard, in a statement read to the court, said he was sorry. "I know I have made a lot of mistakes," his letter said. "I hope my children will be able to forgive me."

Web Sites Teach Women How to Become Anorexic
Deborah Amos, ABC News- 8/21/2001

"Dinner: 2 pieces of toast with low-fat, low-calorie jam, 181," reads one entry of an online diary recording the daily intake and calorie count of a girl who has asked ABCNEWS not to reveal her name. She is 16 and a top student at her high school. And she secretly runs a Web site that promotes anorexia nervosa, a "pro-ana" site, where she offers tips on starvation diets, pills and purges for drastic weight loss. "I've discovered that it's lonely 'cause you can't tell anybody about it, so you really have no one to talk to," she adds. "And [on] the Internet, you can be anonymous."
    Her site is one of as many as 400 locations on the Web devoted to anorexia nervosa, defined by the National Library of Medicine as an eating disorder associated with a distorted body image that may be caused by a mental disorder. The National Association of Anorexia Nervosa and Associated Disorders, estimate that 6 percent of serious cases end in death. After persistent complaints from health groups, Yahoo! recently "delisted" the most popular pro-anorexia sites from its Internet directory. However, it will be hard to shut off a Web community determined to find ways around the ban with a technology that gives girls a new way to talk about their diets.   Through her site, the girl has found a community to support her. She has made several new friends, and receives e-mails every day.  "I get people telling me they're really glad it's there," she says, "where they know there are people like them."
    Doctors are considerably less enthusiastic about the sites. "I was horrified. I was shocked. I couldn't believe it," says James Harris, lead therapist of the eating disorder program at the Presbyterian Hospital in Dallas. "How could someone promote a deadly disease?"  Those who treat the disease say it encourages vulnerable girls to starve themselves, and discourages them from getting help. "I'm sure at some level it is a cry for help, but the denial is so strong," says Ellen Davis, clinical director of the Renfrew Center of Philadelphia, a foundation that treats eating disorders. "They don't understand they are really in the grasp of a deadly disease."
    "I've just realized over the course of my years [of] having [anorexia], people like to consider it a disease," the Web designer says. "But I don't like saying that. I like considering it as a lifestyle." It would be a lifestyle of diminishing calories and an irrational fear of fat.  "I'm definitely obsessed with my weight," she says. "If I step on the scale in the morning and I haven't lost weight I'm a little upset. But if I've gained weight I go completely insane and I just hate myself for the rest of the day. And then I step on the scale the next day and I've lost a few pounds and I'm happy again."
    Three women in their mid-20s — recovering anorexics — can sympathize with the girl's plight. "You starve, you die. There's no middle ground," says Meridith Sivigoia. "We've all been down that road." Suz Dodd says, "Putting this on the Internet is just an example, another symptom of how sick somebody is." "I'd definitely say they are dangerous," agrees Becca Reitnauer. However, anorexic girls have other problems to worry about. "I don't want to be known as the big fat girl at my family reunion," says the girl.

Web Sites for Eating Disorders Seen As Both Danger and Therapy
Catherine Holahan, Boston Globe- 8/22/2001

When Yahoo quietly eliminated access to pro-anorexia Web pages and chat rooms on its server this month, national groups dedicated to ending eating disorders heralded it as a life-saving move for those who believe the sites' promotion of dangerous eating disorders is merely a ''lifestyle choice.'' But Silent Chaos, a 22-year-old Boston-area woman who runs a site promoting anorexia, said Yahoo severed a lifeline instead.
    Known only by her Internet handle even among some friends, Chaos, who says she is anorexic, considers her ''House of Sins'' Web site a therapy group. On the site, accessed through another Web server, she said visitors trade messages, weight-loss tips, and postings about the struggles and secrets they're determined to hide from the world: fasting, binging, purging, perfectionism, depression, and even thoughts of suicide. "No one gets it. No one wants to talk about their eating disorder in real life and the only people that want to hear about it charge a hundred bucks an hour,'' said Chaos, who insists the number of ''hits'' on her site has jumped significantly since Yahoo's tacit ban. ''We just need some friends out there who know what we are going through,'' she said.
    Specialists say people afflicted with anorexia and bulimia, often embarrassed and afraid of admitting they have a powerful mental disorder that could kill them, have turned to the anonymity of the Internet for support and acceptance among each other. Though they endanger and help destroy lives by normalizing potentially deadly behavior among young people with poor self-image, Web sites and chat rooms can give support to girls whose eating disorders have driven them to the verge of suicide, according to one specialist. ''The individuals who suffer from eating disorders are not malevolent; they are in a tough spot. This is painful business, lonely and some of it scary,'' said Dr. David Herzog, a Harvard professor of psychiatry and president of the Harvard Eating Disorder Center. ''They can be on the Net with these people and feel somewhat supported, like someone understands them, without getting too close to them,'' he said.
    Still, nearly 6 percent of the 7 million women and 1 million men nationwide who have serious eating disorders eventually die from them, according to the National Association of Anorexia Nervosa and Associated Disorders. According to the National Institute of Mental Health, most eating disorder-related fatalities result from cardiac arrest, caused by a lack of calories and nutrients needed to keep one's body running. Suicide is also a leading cause of death.
    Because of the suicide associated with eating disorders, Herzog said, any emotional support anorexics and bulimics can get from one another is better than none - even if it reinforces the very behavior that puts them at risk. ''I don't want to take people who don't want help and say, `If you don't want help, then just die,''' said Herzog. ''If these sites will support some people until they do seek help, there may be some value in them. But they are making people sicker and that's not a good thing.''
    On the Web, simply entering ''pro-anorexia'' into most search engines yields about 25 sites devoted to dangerous eating disorders, most targeting - and apparently run by - teenage girls and young women. Owners of eating-disorder sites on other servers say that Yahoo's ban has led to a flood of e-mails from visitors, some saying they are suicidal, looking for a way to reconnect with their ''community.''
    Though professional help is the primary cure, the high price of medical care to end an eating disorder - which takes an average of seven years to overcome - has become problematic. Most health plans cover such treatment, but health insurance premiums can cost upwards of $250 a month in Massachusetts. Typically, most eating disorders start in the teenage years among children living at home, but many anorexics and bulimics struggle well into adulthood, when they are responsible for their own care. ''The biggest problem I had trying to get over my disorder was the insurance,'' said Julie, a 27-year-old Boston woman who said she has battled anorexia for six years. ''I had one psychiatrist that charged me $200, and we only spoke for a little over 10 minutes and I didn't have insurance that covered it.'' Julie, who asked not to have her last name revealed, said she once grew sick enough to be hospitalized in a program that cost $1,000 a day for nearly a month. Though her insurance covered 80 percent of the bill, she still had to pay the difference: $200 a day.
    As a result of high medical costs, Web sites can seem like attractive, inexpensive therapy for those who can't afford professional help - or are not emotionally ready for it. One example: Virginia, age 14, who said she started her own pro-anorexia Web site six months ago. Speaking under the condition of anonymity in a telephone interview, the Austin, Texas, teenager said she might have inadvertently killed herself if not for the Web pages. In school health class, ''the teacher was talking about ipecac,'' she said, referring to an over-the-counter poison remedy that induces vomiting but can be toxic. ''I thought, great - I will just go to the pharmacy and pick some up.'' But before she drank it, she posted a query on a pro-anorexia Web site. ''I got all these e-mails saying don't do it and that it could kill me,'' said Virginia.

Catholics Are Shaken by Molestation Allegations
William Lobdell, Jean Pasco & Larry Stammer, Los Angeles Times- 8/22/2001

Leia Smith, a member of a Catholic poverty-relief agency, says some of the priests she works with have admitted to her that they now take off their Roman collar while not on official business. "I feel saddened for all of those priests who can't walk into a store with their clerical garb without being put under suspicion," said Smith, a member of the Catholic Worker of Orange County. Hers was typical of the sadness, outrage and a sense of inevitability voiced by priests and those in the Catholic community throughout Southern California Tuesday, the day after the church's Orange Diocese and Los Angeles Archdiocese announced a $5.2-million payout to an alleged victim of sexual abuse by a well-known priest. The settlement included a set of strict rules to guard against future assaults, some imposed in areas that the church until now has jealously guarded as its own. The news caused morale to plummet among many members of the clergy--men once described as "rumors of angels" who say years of controversial molestation cases have made them feel overworked and overly scrutinized. "This kind of publicity is hurtful to priests," said Orange Bishop Tod D. Brown. "But people will realize this is exceptional. . . . This doesn't reflect the ordinary life between people and their priests."
    In a civil lawsuit, Ryan DiMaria, a former student at Santa Margarita Catholic High School in Rancho Santa Margarita, alleged he was molested twice in 1991 by Msgr. Michael A. Harris, a priest whose charismatic style generated the name "Father Hollywood." The Catholic Church also apologized to DiMaria and four others who claimed Harris molested them. Harris has denied the allegations and angrily accused church officials of settling the case for "their own business reasons."
    As part of the settlement, the two dioceses agreed to 11 rules, including an independent victim assistance program, distributing an annual pamphlet on sexual molestation prevention to parishioners, and interrogation by an independent third party of all would-be priests who leave the seminary before ordination, presumably to ferret out sexual issues that may have been involved in their decisions. The rules say priests cannot be alone with minors in social situations, but do not apply to routine church activities. The guidelines dominated most of the conversation among priests working in the front lines of the church. Some of the rules underscored current policies; others were new. All will be monitored by Orange County Superior Court Judge James Gray, who approved the settlement.
    Father Andrew Greeley, a Chicago priest and Catholic columnist and author, said the settlement terms will erode morale among priests and respect for the church. "It certainly is one more savage blow to the public image of the priesthood," he said. "There's no getting away from that." The allegations "hurt us tremendously," said the Rev. Robert E. Howard of Transfiguration Church in Los Angeles, who warned of an inadvertent but chilling effect. "I hate the idea of not being able to go out to the playground, and children expect you to be able to take them in your arms and we can't do that anymore, because we would be accused of child molestation. That's very, very sad," Howard said.
    Two other aspects of the guidelines--a toll-free 800 telephone number and Web site that will take anonymous complaints--drew the most complaints from priests. "The 800 number is a little scary," said Father John McAndrew, pastor St. Angela Merici Church in Brea. "Of course, you don't need evidence to make an 800 call." Another priest, who spoke on the condition of anonymity, was even angrier. "It's so inflammatory--it's outrageous," he said. "Imagine if I'm a teacher and I give a person a poor grade, and then they can make an anonymous charge of molestation against me."
    Others have taken a practical approach to prevent allegations of molestation. The Rev. Michael Hanifin, the pastor of the new parish, St. Clara de Assisi in Yorba Linda, says he is constructing his new church with a sense of openness. "We're talking about putting windows on our doors so nothing's hidden [and we're putting] windows on doors of confessionals," Hanifin said. "Building a church that creates a safe and open environment will be very important to me."
    Watchdogs of the church said past precautions hadn't been heeded. "The problem of sexual violation by priests is constant because it's systemic," said Richard Sipe, a researcher and author on priest sexual abuse and an expert witness in the DiMaria case. "The church is being pushed to reform--reaction rather than proactive. The church has really done very little. They've done it on paper, but not in practice." David Clohessy, national director of the Chicago-based Survivors Network of those Abused by Priests, puts it another way: "It's like making speed limits with no cops" enforcing them.
    Chris Peters, 39, a Mission Viejo resident who has two children who have attended Santa Margarita High, where Harris was the founding principal, was troubled. "The church is ultimately responsible, and it looks like it has done the right thing," Peters said. "But . . . you feel like it's one of our own [who has fallen]. And people are always waiting for the Catholic Church to do something wrong." DiMaria, 28, said at a press conference Tuesday that "Father Harris should admit what he's done." DiMaria said the acts took place when he was 17 and a student at Santa Margarita. "He should be in jail." DiMaria said he hoped other victims would come forward as a result of the settlement and "get the help they need."
    Three other Harris accusers appeared at the press conference, including the mother of one man who revealed the alleged molestation as he was dying of AIDS. "I feel sad that all of this turmoil had to come after [church officials] didn't listen to us," said a tearful Lenora Colice on behalf of her son, Vincent. "I know he's here with me now." Larry Raheb said he was molested at age 21 when he went to Harris to seek counseling. "I had come out to him as a gay man," Raheb, of Monrovia, said. "He said the church was becoming more sensitive to the issue of homosexuality. [What he did was] unbelievable to me."
    Dr. Burr McKeehan, who has served on the board of nonprofit organizations started by Harris, defended him Tuesday. "I view him as I did prior to this: an excellent president of our group," said McKeehan, a retired doctor from Monarch Beach. "He's the most honorable person I've ever met." McKeehan said he was disappointed in the cash payout by the church resulting from "an unproven lawsuit." "It seems like he's a criminal and he didn't even go to trial," McKeehan said.
    An attorney representing the Roman Catholic Archdiocese of Los Angeles recently acknowledged that church officials received six child molestation complaints in the last five years, including two current allegations and four involving adults complaining of past misconduct. Overall, there were about 50 cases of "sexual misbehavior" reported to the archdiocese in the last five years, diocesan attorney John P. McNicholas of Los Angeles wrote in a letter last week to Sipe. McNicholas said he wrote the letter to refute a statement by Sipe during an Aug. 1 settlement conference. Sipe told Orange County Superior Court Judge James Gray that the archdiocese had received five molestation complaints a month for the last five years.
    An archdiocesan spokesman said he could not disclose the disposition of the 50 cases because of concerns about "confidentiality" rules. But he said the fact that the church accepted the reports and looked into them was evidence that it cared. Given that there are 5 million Catholics in the archdiocese and 292 parishes, "the vast majority of priests are good people who have healthy relationships and are involved in wonderful ministries."

Census Count of Gay Couples Up 300%
D'Vera Cohn, Washington Post- 8/22/2001

Nearly 1.2 million people say they are part of gay and lesbian couples in the United States, and though most live in metropolitan areas, nearly one in six lives in a rural community, according to 2000 Census numbers released today. Three Washington jurisdictions -- the District, Alexandria and Arlington County -- ranked among the top 10 in concentration of gay households, according to an analysis by Urban Institute researcher Gary Gates. The Washington metro area ranked fourth -- behind San Francisco, New York and Los Angeles -- in the number of heavily gay neighborhoods. The census counted nearly as many lesbian couples as gay male couples -- a change from 1990, when many more males were recorded. That helps explain the sharp increase in same-sex couples in rural areas, where, the census shows, lesbians are more likely to live.
    Despite the increase, though, advocates say the number of gay couples reported in the census figures was almost certainly low, because some people are reluctant to tell the government of their relationships, even on a confidential form. "I do believe it is the tip of the iceberg or an undercount, because while more people are comfortable being honest about their sexual orientation, the majority are not," said Jay Fisette (D), chairman of the Arlington County Board and Virginia's only openly gay elected official.
    The census figures released today for Arkansas, Mississippi and Texas also completed the publication of state-by-state statistics that are revealing broad changes in the makeup of American households. The figures have shown that there are now more households with single people than married-with-children households, that the two-parent family increasingly is Asian or Hispanic, and that single-father numbers rose sharply.
    The number of gay couples -- 594,391 -- rose more than 300 percent since the 1990 Census, which was the first to offer people the option to call themselves "unmarried partners." Of that number, 5,934 live in suburban Maryland, 4,992 in Northern Virginia and 3,678 in the District. Census Bureau officials say the increase stems partly from a change in the way the data were analyzed, but advocacy groups say most of it is because more gay couples feel comfortable reporting themselves to the government than they did a decade ago.
    Since the 1990 Census, domestic-partner benefits and local anti-discrimination laws have spread, and a recent Gallup poll concluded that most Americans have come to believe that homosexuality should be legal. But the decade also saw the passage of state and federal laws forbidding gay marriage. The census is not a count of the gay population, because it includes only those in couples, which other studies show is about a third of gay men and lesbians.
    All but 22 of the nation's 3,141 counties include at least one gay couple, according to Gates's analysis of the census figures, which was underwritten by the Human Rights Campaign, a gay rights advocacy group. But same-sex couples also are highly concentrated: Nearly 40 percent live in California, Florida, New York or Texas. According to the census data, same-sex couples are most likely to live in state capitals, college towns, resort communities and big-city areas with visible gay enclaves, such as Washington.
    Fisette said he and his partner checked off the unmarried partner box when the census form arrived last year. It was less a political statement, he said, than a reflection of his upbringing: "My mother taught me to be honest." Fisette, who was elected in 1997, said he is not surprised that his community ranks high in its concentration of gay couples. "There's a tradition of respecting and celebrating differences here," he said. He said he hopes the census numbers can provide ammunition when county officials argue for new laws in Richmond. In 1999, a county judge struck down Arlington's ordinance allowing insurance benefits to domestic partners of county employees, ruling that Virginia communities need General Assembly permission for such laws. So far, the legislature has rejected Arlington's request.
    The sharpest increases in the number of gay couples -- 900 percent or more -- were in the rural states of Idaho, Wyoming and South Dakota. In Idaho, there is now a Boise Gay Couple Supper Club, which sometimes draws guests from towns 100 miles away. "We're not married -- at least they won't let us be -- therefore we had to put down something," said the co-host of the club's most recent potluck dinner, a retired government worker. He asked not to be identified by his full name because he is concerned about being targeted by anti-gay neighbors. "I wasn't going to lie and say I'm single. I'm not ashamed of the fact that we are who we are." "I also wanted them to know," he said, "that there are people out here living this life. . . . This is a large segment of the population."
    A spokeswoman for the Family Research Council, an organization that opposes gay marriage laws and other rights for gay men and lesbians, said gay couples actually make up a very small proportion of the U.S. population. "This is a very small percentage of the total number of households," said Kristin Hansen. Gay couples account for less than 1 percent of the nation's 105 million homes, according to the census. Furthermore, she said, "What we've seen in the numbers thus far is that homosexuals are located by and large in urban areas. The fact that they are located mostly in cities does not indicate that homosexuality is widespread."

Small Towns Face Big-City Heroin Problem
Li Fellers- ABC News- 8/22/2001

The predominately white, middle-class town of nearly 17,000 people is in the heart of Carroll County, a rural but increasingly suburban area outside of Baltimore, with a population of around 140,000. Peter McIver and his friends — like other restless Westminster teenagers at the time — were seeking the kinds of thrills their town couldn't offer. And their escape from boredom involved drugs. They piled into a car and made the 30-minute drive to Baltimore, in search of the very things their parents had tried to protect them from by living in a small town. Cruising street by street, they shopped the open-air drug markets looking for dealers ready to do business. On this particular night — a night that forever changed the lives of these kids, their families and their town — they bought what they thought was cocaine. After snorting the white powdery substance, they realized it wasn't. It was heroin — and it was a new, more powerful version of heroin that was hitting streets across America.
    Drug Enforcement Agency officials say in the early '90s, smaller players in the drug world were trying to break the market domination of crack and powder cocaine with the introduction of a user-friendly version of heroin. It was powerful, it was cheap, and it could be snorted. In a few short years, heroin use spread far beyond Peter's circle of friends. Fueled by small-town boredom and curiosity, hundreds of teenagers throughout the county were introduced, and many became addicted. The county hospital ER staff, who had never before treated heroin overdoses were starting to see as many 15 a month. Local police were arresting an ever-increasing number of kids who were stealing, often from their own families, to support their habit. The users defied stereotypes: They were football players, cheerleaders and honor students — the "good kids" with "good parents" who believed they had done everything right.
    In 1996, a 16-year-old boy died of a heroin overdose. But it wasn't until the death of a 15-year-old boy in 1998, that the town realized how widespread heroin use had become. By then, it was a full-blown epidemic. Heroin was no longer a problem that happened to other parents in other places. It was happening here.
    At first, many parents privately struggled, unable to believe their children were addicted to a drug they associated with dirty needles and back alleys. But eventually, they rallied the community together orchestrating public education campaigns to warn parents and teens. In doing so, they found out they were not alone. What started in Westminster has spread to nearly every small town in Carroll County, destroying lives, families and futures regardless of social status, race, or geography. So far, there have been more than 20 overdose deaths and hundreds of heroin overdoses of young people in all of Carroll County. Across the country, there are other Westminster stories waiting to be told. Bored teens in the middle-class suburbs of cities like Chicago, Detroit, Orlando, Richmond, Newark and New York, are also bringing back heroin to their hometowns.
    Now in their mid-20s, Peter and some of his friends have been caught in a vicious cycle of jails, rehabilitation and clean time. The power of their heroin addiction has often overwhelmed their best intentions. "I just want to be the all-American dream," says Peter, whose mother says he is getting his life back together. "Big house, big car … successful, happy."

Psychiatrist's License Revoked After Sexual Misconduct
Associated Press, 8/23/2001

BOSTON -- The head of psychiatry at Marlboro Hospital has lost his license for engaging in sexual and inappropriate conduct with two clients, including one with multiple personalities. ''She had over 20 personalities, and he would encourage and give life to all of them,'' Stanley Spero of Spero & Jorgenson in Cambridge, the woman's lawyer, said of Dr. William A. Kadish. ''He did have sex with a couple of her different personalities.''
    The state medical board, which revoked his license Wednesday, did not mention such conduct. However the board said Wednesday that Kadish, 44, also an assistant professor at the University of Massachusetts Medical School, took nude photographs of one patient, and made 12 loans to another. The board said he committed ''gross misconduct'' in carrying on the two inappropriate relationships, one sexual and one involving many intimate dinners and conversations.
    Kadish, a Shrewsbury resident who has been married 16 years, had treated the 39-year-old woman who suffered from multiple personality disorder from 1994 through April of this year, records showed. The board said sometimes Kadish sent cards and letters to her different personalities one was addressed to the woman ''and her orchestra.'' In the other case cited by the board, Kadish had treated a 48-year-old woman from 1991 to last May. The two had exchanged gifts, and he gave her loans ranging from $50 to $600, the board said. Both women experienced emotional anguish and trauma as a result of their relationship with Kadish, the board said.
    In a letter to the board, Kadish wrote:
''It is astonishing to me ... that I was capable of the behavior for which I am being sanctioned. This aberration from my usual conduct is abhorrent to me, and I will never cease to regret it.''
    Regarding the patient with multiple personalities, Kadish wrote:
''I never had any intention of becoming sexually involved with this patient. I gradually developed severe distortions in my thinking and my judgment regarding her treatment, and succumbed to substantial psychological pressure to engage in physical intimacies.''   Kadish signed a copy of the board's order. A telephone call to a William Kadish Wednesday was not immediately returned. The decision does not prevent Kadish from reapplying to practice medicine in Massachusetts.

Ecstasy Warnings Unheeded
Jeff Coen, Chicago Tribune- 8/23/2001

Despite sitting through drug-education programs in some of the nation's most highly rated school districts, teens in suburban America are pushing the popularity of Ecstasy to stratospheric levels, Drug Enforcement Administration leaders said Wednesday at a club-drug summit in Oak Brook. DEA Administrator Asa Hutchinson said many teens--even those who have been receiving anti-drug messages since grade school--don't comprehend the potential hazards of using club drugs. Many treat Ecstasy as a risk-free relaxant intended to heighten their senses, he said.
    But experts at the conference said emergency rooms are seeing more cases involving methylenedioxymethamphetamine (MDMA), the active ingredient in Ecstasy. Many hospitalizations result when the effects of Ecstasy, a synthetic hallucinogenic stimulant that can rapidly raise body temperature, are exacerbated by conditions at dance parties. "Even when there's an overdose, teens say, `Well, there wasn't enough [air] circulation in the building,'" Hutchinson said. "Information is critical for them to know the real danger."
    The summit, at which Ecstasy use was trumpeted as a national crisis, attracted DEA agents and other law-enforcement personnel from across the Midwest. Also in attendance were drug-prevention specialists and rehabilitation professionals. Hutchinson, the former Arkansas congressman sworn in as DEA administrator Aug. 8, addressed the conference, as did Chicago Police Supt. Terry Hillard and Cook County Sheriff Michael Sheahan. Sheahan said parents need to learn about the popular substances and tell their children. "Kids think they're safe taking them and that's the bottom line," he said. "Some kids have paid the ultimate price." Hutchinson echoed that parents must get involved. "Parents represent our best opportunity to influence young people away from drugs," said Hutchinson."The government just can't control the actions of everybody."
    DEA leaders promised to continue the type of interdiction efforts that saw 9.3 million Ecstasy tablets seized from smugglers in the U.S. last year. Speakers also praised recent efforts to toughen federal laws against Ecstasy trafficking and new Illinois legislation that on Jan. 1 will make distributing as few as 15 Ecstasy pills a Class X offense that is punishable by at least 6 years in prison. DEA Chief of Operations Joseph Keefe said Ecstasy remains attractive to traffickers because of the tremendous profit margins. A single pill that costs a quarter to produce can be sold on the street for $25 and up, he said.
    MDMA production and pill pressing remains anchored in Europe, with Israeli and Russian organized-crime syndicates taking over the smuggling and distribution. Most of the pills, stamped with distinctive symbols so users can differentiate among them and seek favorites, enter the U.S. hidden in cargo or strapped to passengers on international flights. Faced with such a sophisticated drug network, local police should join forces to counter it, Hillard said. "You're crazy if you don't get involved in some kind of regional task force," Hillard said, "because it's going to hit your neighborhood and you cannot walk this path alone."

Teen ODs on Cold Pills
Kieran Nicholson & Erin Roth, Denver Post- 8/23/2001

A 17-year-old Arvada girl overdosed on over-the-counter medicine this week, sparking concerns from police and drug experts about the increasingly unique ways teenagers are getting high. "All the cold and cough preparations containing certain ingredients are widely abused," said Dr. Richard Dart, director of the Rocky Mountain Poison Center. "We've seen them do everything." The unidentified girl on Monday took several Coricidin HBP Cough and Cold pills, more than the recommended dosage, said Arvada police spokeswoman Susan Medina. After complaining at school of numbness in her face and arm, dizziness and disorientation, she was taken to Lutheran Hospital, where she was treated and released. Officials stress that Coricidin and other cold and cough medicines, when administered properly, are safe. However, when taken in large doses, some medications can cause hallucinations, delusions and giddiness, Dart said.
    "Kids try it because it's the closest thing to real alcohol they can get," said Wind Neal, 20, of Aurora, adding that he's tried over-the-counter medications to get high. Rohan Murray, 17, of Denver, said she knows kids who take cough medicines such as NyQuil and Robitussin for a buzz, sometimes drinking a whole bottle. Some teens may take a handful of Tylenol and then drink alcohol, too, she said. "It's popular depending on who you hang out with," Murray said.
    Coricidin contains dextromethorphan, also known as DXM. Other ingredients that abusers look for, and parents should be aware of, are ephedrine and diphenhydramine, Dart said. Adverse health risks can include dangerously high heart rates and blood pressure.  The high also endangers teens because it causes them to lose control, Dart said. For example, last winter, a metro-area teenager wandered away from a party after becoming disoriented during a cold-remedy high and wound up freezing to death after passing out in a puddle. Julie Brooks, a Golden police officer and the department's resource officer at Golden High School, said a teen student overdosed on Coricidin at that school last year. "She was pretty much passed out at the school, and they ended up taking her to the hospital," Brooks said.
    Brooks said Golden police talked with local merchants after the incident, warning them of the abuse. At the local King Soopers on Wednesday, a sign told customers that Coricidin, and some other cold remedies, had to be purchased at the service counter. And on Wednesday, Lauren Sims, a clinical director with the Mile High Council on Alcoholism and Drug Abuse, fielded a call from a Brighton parent about a 12-year-old who had abused Coricidin. "It was causing serious behavioral changes," Sims said. "We need to take this seriously."
    Compounding the problem is the ease with which teens can find out about the latest ways to abuse medications. Teenagers are using the Internet to research ingredients in medicines, keying in on stimulants and alcohol, and then using chat rooms to spread the word about the readily available drugs, police said. "That's a component of this," Medina said. "In addition to word of mouth, some of these kids are visiting chat rooms and websites to learn the effect of what the medication does."
    As in Golden, Medina said Arvada police were planning to talk with merchants about possible restrictions on certain over-the-counter medications. But until then, officials say one of the best ways to deter kids from abusing household medications is for parents to stay tuned in to what their children are trying. "There's always that reminder to parents, to be aware of what your kids are doing and what they are putting into their bodies," Medina said.

Meth Labs Spreading in Michigan
Amy Franklin, Associated Press- 8/23/2001

LANSING -- Police already have discovered and dismantled more home methamphetamine labs this year in Michigan than in all of 2000, but one law enforcement officer said Wednesday the state hasn't seen the worst of the problem. "We're just in the beginning stages of busts," said Michigan State Police Lt. Rick Aro, who leads the State Police's methamphetamine unit. "We're trying to get a hold on it before the drug has a hold here." The discovery of at least 60 drug labs by local and state authorities so far this year exceeds the 40 discovered all of last year, State Police Inspector Mike Bush said. That's still much lower than the 1,000 methamphetamine labs that have been discovered in Missouri this year. The methamphetamine phenomenon is sweeping Michigan from west to east after starting out in California and Arizona, Aro said. Authorities in mid-Michigan now are seeing the same increase in meth production that those on the western side of the state first saw a few years ago.
    Last week, State Police raided a meth lab in the tiny town of Pewamo on the Ionia-Clinton county line for the second time. Police trying to locate the home owner to arrest him for manufacturing the drug in June discovered the lab operating again. A meth lab was found in the rural Clinton County town of Eagle in July. In June, Scott Lee Tupper, 41, was arrested for having enough chemicals in his Grand Ledge home in Eaton County to make more than 10 pounds of the highly addictive meth. Eaton County Prosecutor Jeff Sauter said his office is investigating five methamphetamine cases. "I'd call it a noticeable increase," Sauter said. "At this time last year, I don't think we had any."
    The synthetic stimulant lasts much longer than cocaine and can be made in clandestine laboratories with relatively inexpensive over-the-counter ingredients, Bush said. The powdery white or brown drug can be smoked, snorted, injected or eaten. It causes increased activity, decreased appetite, and a general sense of well-being. The effects of methamphetamine can last six to eight hours. After the initial rush, there is typically a state of high agitation that in some individuals can lead to violent or psychotic behavior.
    Despite the increase of drug busts in mid-Michigan, the counties of Van Buren, St. Joseph and Allegan continue to lead the state in the number of methamphetamine labs discovered, Aro said. Raids on labs in Allegan County account for one-third of the state's total busts, Bush said. He's worried the spreading number of labs could overwhelm law enforcement officials in some areas of the state. Besides the cost of detecting meth labs and arresting those involved, meth labs can be expensive to clean up. It cost an average of $5,000 last year to outfit each officer in a hazardous material uniform so they could safely remove toxic chemicals from meth labs, Bush said. Among the toxic chemicals used to make the drug are anhydrous ammonia, starter fluid, lithium batteries and ephedrine.
    Authorities are getting some help controlling the labs from a toll-free hot line that allows callers to anonymously report meth production. A number of the tips received so far resulted in raids, said Jim McBryde, who works on drug policy for the Michigan Department of Community Health. Meth producers also face a new state law that makes it a 10-year felony to possess meth-making equipment or own or use a building or vehicle to manufacture the drug. The penalty increases to 20 years if the drug is manufactured near a school, church, business or residence.

Study: Heavy Drinkers Eat More, Wrong Things
Melanie Axelrod, ABC News- 8/24/2001

People who drink heavily, eat more — and often more — of the wrong things, which can in turn put them at risk for myriad health problems, a new study says. The study, published this week in the American Journal of Clinical Nutrition, finds a direct correlation between the amount a person drinks and her dietary choices. In the study, researchers analyzed questionnaire answers from about 73,000 French female schoolteachers born between the years 1925 and 1950, and adjusted dietary intake to omit calories from alcohol. The study, by French scientists and affiliates of a European cancer-prevention organization, split the respondents into groups based on their alcohol intake levels.
    The heavy drinkers — defined as anyone who drank more than 2 ½ alcoholic drinks a day — consumed almost 30 percent more calories from food than nondrinkers. Drinkers also tended to consume more cheese, processed meats, vegetable oil and coffee than the nondrinkers, and a lower percentage of their caloric intake was from carbohydrates. The heavy drinkers' cholesterol intake was 32 percent higher than in the nondrinking group. The heaviest drinkers in the study consumed more vitamins A, E and iron, but fewer foods that are rich in beta carotene. "Chronic alcoholics tend to have several vitamin deficiencies," said Dr. Arthur Klatsky, senior consultant in cardiology at the Kaiser Permanente Medical Center in Oakland, Calif.
    Dr. Joanne Larsen, who runs dietican.com, a Web site that gives nutritional advice, says it's long been known that alcohol is an appetite stimulant. "That's why they serve wine in nursing homes, to help stimulate appetite," she said. "However, people in nutrition have a very difficult time recommending alcohol, despite all of the studies."
    The bottom line: All drinking is not bad, but the more you regularly drink, the worse your lifestyle habits will likely be. In fact, light drinking can be to some extent be beneficial, especially for preventing heart disease, according to the study's lead author, Dr. Emmanuelle Kesse. "Moderate alcohol consumption (one to two) drinks daily can beneficially affect life expectancy, notably through a protective effect on coronary artery disease," she wrote.
    Previously, researchers blamed alcohol for a variety of health problems, including cancer, but through observation, they're finding that perhaps people who drink heavily make other bad lifestyle decisions. The study found that among the drinkers, particularly the heaviest drinkers, lower vegetable and fruit consumption was linked to greater risk of cardiovascular disease and also an increased breast cancer risk. The heaviest drinkers were the ones also most likely to develop cancer, notably of the mouth, esophagus and liver. Most likely, these groups of people were consuming less of the nutrients — notably folate — that are considered to be cancer-preventative foods. The researchers also found that wine was associated with healthier eating habits. And, in the study, the light to moderate drinkers had the best eating habits of all, even better than the nondrinking group.
    Larsen said while the study is important, it should be noted that the study's subjects were all French — not American — women, and their dietary habits are considerably different. "The research authors are French and this article should be considered within the context of French food and wine culture," she said. "These increased calories should lead to obesity over time, yet the 52-year-old heavy drinkers were not overweight for height." Plus, she says, "Americans don't eat as much protein and eat more carbohydrates than the French."
    Klatsky, who wrote an editorial about this study, believes some outcomes of dietary choices, such as thiamin deficiency, are directly connected to heavy drinking, while others, such as a genetic predisposition to metabolize alcohol slowly, are unrelated to diet, yet can result in the same negative health effects as dietary choices. "I think the heavier drinkers have unfavorable lifestyle habits," he said during a recent telephone conversation. "And they tend to smoke more, too."
    Larsen said she was a little confused by the study's initial results. Normally, when a person drinks, the liver stops processing carbohydrates and fats, and turns to processing the toxins from the blood that enter the body from the alcohol. Combine that with the fact that a person may not be eating that much while she is drinking, and the blood sugar drops. While a person drinks, glycogen stores in the liver are being depleted. By the next day — if not sooner — the person will want to replenish those stores with a high-carb, and often high-fat breakfast, like pancakes or French toast, says Larsen.

Boot Camp Teen's Death Ruled Accidental
Alisa Blackwood, Associated Press- 8/24/2001

PHOENIX -- The man who operated a ''tough love'' boot camp for troubled youth where a 14-year-old died will open another camp in early September. Charles Long, still under investigation in the July 1 death of Anthony Haynes at his private camp southwest of Phoenix, will run a camp in Scottsdale for 13 weekends.  In a final autopsy report released Thursday, the Maricopa County Medical Examiner's Office ruled Anthony's death accidental, saying the boy died of complications from near-drowning and dehydration from heat exposure.  Anthony had been made to stay in direct sunlight for up to five hours in 111-degree heat, the report said. When he became delirious, ''he was observed eating dirt,'' the report added. Long's attorney, David Burnell Smith, said he agreed with the determination that the death was an accident.
    But Maricopa County Sheriff Joe Arpaio said he was concerned that Long was going ahead with another camp while an investigation into abuse allegations continued. ''It doesn't matter if the coroner's report says it's an accident,'' Arpaio told The Arizona Republic. ''You can still have an accident and be negligent too.''  No one has been charged with any crime related to Anthony's death, but sheriff's investigators wrote in a search warrant affidavit that camp participants had said they were kicked and forced to put mud in their mouths. The investigators also wrote that Long and his group abused the campers, deprived them of adequate food and water, denied them medical care and caused Anthony's death. The document said Anthony began hallucinating on July 1 at the camp and refused to drink water. When he became nonresponsive, camp supervisors took him to a motel and left him in the tub with the shower running. They found Anthony with his face in the water when they returned. Supervisors were told to bring Anthony back to the camp because Long thought the child was faking, authorities said. When he was returned to the camp, he wasn't breathing. Then, camp supervisors called 911. The autopsy report said the teen-ager had broken ribs, likely from CPR, and multiple cuts and bruises on his head and torso from medical help he later received. Anthony's father, Gettis Haynes Jr. of Hannibal, Mo., filed a wrongful death lawsuit against the camp and its operators Long and America's Buffalo Soldiers Re-enactors Association in late July, alleging Anthony ''suffered various forms of physical and mental abuse.''
    The boy's death has renewed interest among lawmakers who argue states should exercise stricter oversight of privately run youth boot camps, which are often subject to little or no regulation. On the Net: America's Buffalo Soldiers Re-enactors Association: http://www.thebuffalosoldiers.com

Michigan Alcohol-Testing Program to Expand
Matt Helms, Detroit Free Press- 8/24/2001

An Oakland County program that forces people on probation for alcohol-related driving offenses to undergo frequent breath tests during key holidays is moving into Wayne County. The aim of the program, called CATCH, for Courts Acting Together for the Community at the Holidays, is intended to keep an eye on drivers the program considers most likely to be behind the wheel while impaired. CATCH started a year ago in Ferndale, Pontiac, Southfield, Troy and Rochester Hills. Entering its second year on the upcoming Labor Day holiday, the program will include district courts in Dearborn, Redford, Garden City and Plymouth.
    Roughly 1,500 people will be ordered to show up seven times over the holiday at testing sites throughout metro Detroit. They pay $5 for a breath test at each visit. A positive test for alcohol means they're violating probation. They are to be tested once on Friday night and twice daily for the following three days of the holiday weekend. "It's a very effective tool to make sure they're not drinking during the holidays," said 35th District Judge Ronald Lowe, whose court covers Plymouth, Canton and Northville.
    In 1999, 229 people nationwide died in alcohol-related crashes over the Labor Day holiday, according to Mothers Against Drunk Driving. MADD estimates that a third of all people arrested for driving while intoxicated are repeat offenders, and they're responsible for as many as 20 percent of alcohol-related traffic deaths. "When you look at people with those sorts of problems, you know they will drink and you know they will drive, and you know that the holidays are the most likely time that they'll do it," Novi District Judge Brian MacKenzie said Thursday. "The question is, how to you slow that, how do you stop that?"
    In addition to Labor Day, the CATCH program operates during Thanksgiving, New Year's, Memorial Day and the Fourth of July holidays. It began as a program called Y2CARE over the 1999-2000 New Year's holiday. More than 1,300 people were ordered into testing; 1,214 showed up, and only nine people tested positive, MacKenzie said. So far, 3,609 people have been ordered to undergo the holiday testing, and 92 percent showed up, MacKenzie said. Of them, 44 tested positive for alcohol. Those who drink or don't show up face jail sentences of 90 days to a year, depending on their initial conviction and terms of probation. MacKenzie, a founder of the program, said he's spoken with other judges interested in CATCH, so the program could expand to other areas of metro Detroit.  It costs taxpayers nothing beyond mailing notices to probationers that they've been ordered to participate. Organizers say the fees paid by participants cover the costs of the tests, which are administered by private companies and MADD volunteers.

Spankers Generate Few Rancors
Margie Mason, Associated Press- 8/25/2001

SAN FRANCISCO - Occasional, mild spankings of young children are OK and do not cause any lasting harm that carries into adolescence, according to a study released yesterday. Such discipline does not hurt youngsters' social or emotional development, the researchers reported.  ''A lot of people out there advocate that any spanking at all is detrimental, and that's not what we found,'' said a coauthor of the study, Elizabeth Owens of the Institute of Human Development at the University of California at Berkeley. ''We're not advocating this is a strategy that should be used with kids, but we object to people wanting to ban it when we see no evidence that it's harmful.'' The study was being presented at a meeting in San Francisco of the American Psychological Association.
    Owens and her coauthor, Diana Baumrind, analyzed data gathered from 100 middle-class white families from 1968 to 1980. The children and parents were interviewed, tested, and observed on three occasions by two teams of psychologists when the children were 4, 9 and 14. The study found the majority of families disciplined their preschool children by using mild to moderate spanking. The results showed no negative effects on cognitive, social, or behavioral skills of those youngsters and no difference between them and the 4 percent of children who were not physically disciplined.
    The study found that 4 percent to 7 percent of parents fell into the ''red zone'' by disciplining their children frequently and impulsively, by such means as verbal punishment, using a paddle, hitting their children in the face or torso, or throwing and shaking them. Those children were found to be not as adjusted socially and more likely to have behavioral problems or experience anxiety or depression, Owens said. She acknowledged that the children studied were from an earlier generation and the results could be different if the research were done on today's youngsters. A study released last August found that avoiding corporal punishment altogether increases the probability of the child being well-behaved and well-adjusted.

Meth Production Reaches 'Epidemic' Level on Coast
Rene Sanchez, Washington Post- 6/25/2001

LOS ANGELES – They stormed in after midnight, kicking down doors of homes and businesses around this county's desert fringe. More than 100 federal agents and local detectives took part in the raids, and by the time the sun came up they had nabbed yet another gang of suspected methamphetamine traffickers.
    The raids this week culminated an 18-month investigation dubbed "Operation Silent Thunder" that led to the arrest of nearly 300 people on drug or weapons charges. Hundreds of firearms and explosives have been seized. More than a dozen large makeshift laboratories for manufacturing methamphetamine have been closed and quantities of the drug worth more than $2 million worth of the drug – usually sold on the street in small cheap quantities amounts of powder or rock – have been confiscated.
    Law enforcement authorities acknowledge that the results are another sign of just how pervasive and sophisticated the illicit methamphetamine trade has become in many parts of the state. Once casually run, mostly by outlaw biker gangs, methamphetamine production is now a tightly managed big business, concentrated in California's hills and deserts and its vast, rural Central Valley.
    So much methamphetamine is produced in California that federal officials now consider the state a "source nation" for the highly addictive drug, which is also known as speed, ice or crystal. Meth labs are flourishing more than ever in other western states such as Arizona, Nevada and Washington. According to the Drug Enforcement Administration statistics, about 2,700 meth labs were discovered in California in 1999. The state with the second-highest total, Washington, had about 600. Arizona had nearly 400.
    After this week's raids, authorities said they were confident that they had crushed the last remnants of an elaborate criminal enterprise. But they said there would be many more to contend with. "We think we've put a huge dent in this organization," Lt. Ron Shreeves of the Los Angeles County Sheriff's Department said after the raids. "But is someone else going to fill its shoes? Absolutely. There's too much money involved."
    Federal narcotics officials say that use of the drug across the country has doubled in the past seven years. Much of the market, they say, is controlled by criminal groups based in Mexico that use California migrant workers to cook and transport the drug from shacks and trailers in the desert or barns in the farm fields of the state's agricultural midsection. As the operations have become more organized – some meth labs operate every day, authorities say – production of the drug has greatly increased. Ron Gravitt, the clandestine laboratory coordinator for the California Department of Justice, calls the state's methamphetamine problem "an epidemic." Law enforcement agencies in California are shutting down more than 2,000 meth labs each year, he said. And in some parts of the state, the tally has doubled or tripled over the past decade. "Right now, we're just inundated with meth," Gravitt said.
    California will spend $30 million this year to crack down on the methamphetamine trade, but just finding meth labs, some of which produce 50 pounds of the drug a week, is often difficult because of their remote locations because they are remote. Jose Martinez, a spokesman for the Drug Enforcement Administration DEA's office in Los Angeles, said that those sparsely populated areas are ideal places for drug organizations to set up operations. "Because it's wide open space, a person can go out there and cook and it's not easy to detect," he said. When law enforcement agents make a bust, they usually catch only front-line workers in the trade who know little about the larger criminal operation for which they work. Those workers, and the labs, are often quickly replaced. Officials say the proliferation of meth labs is also creating serious environmental problems. The state is spending millions of dollars to clean up the toxic chemical waste dumped in water or spilled on soil during or after the often-crude manufacture of the drug.
    The raids this week followed months of undercover investigation and targeted methamphetamine trafficking in the Antelope Valley on the eastern end of Los Angeles County, a high desert region that long has been a hub of the meth trade. At a news conference this week, Los Angeles County Sheriff Lee Baca said the suspects are members of a drug ring that distributed methamphetamine primarily in the West. He also said the organization is linked to Mexican drug traffickers and white supremacist groups in Southern California. Agents seized a half-million dollars in cash and more than 100 high-powered weapons in the early morning raids, which took place at nearly two dozen homes and small businesses in the area. The arsenal included assault rifles with bayonets and a grenade launcher. Authorities said that some suspects had tattoos of Nazi swastikas insignias and belong to a local gang called the "Untouchables." "They were stockpiling a huge cache of weapons along with drugs," Shreeves said. "This was a sophisticated organization."
    He said that investigators believe that nearly all of those arrested this week belonged to one of six drug distribution "cells" that are part of a large methamphetamine trafficking group. The other five cells, he said, also have been dismantled by the undercover operation. "We think this was the last and most dangerous one," Shreeves said. To avoid capture, some members of the alleged drug ring installed video surveillance equipment outside of their homes, spoke in code on telephones, and stayed in constant contact with each other about police activity in their neighborhood, authorities said. "We knew we had to go after them all at once," Shreeves said. Most of the methamphetamine seized in the raids was pure, he said, and would have been quite addictive had it been sold on the street.

Texas Doctors Fed Up With Insurers Drop Out
Susan Kreimer, Houston Chronicle- 8/25/2001

A few hours after Kristi Higginbotham ate takeout pizza, intense abdominal pain and swelling set in. She and her husband, Bruce, thought it could be food poisoning. Two months later, severe pain struck the 51-year-old geology professor on a trek with a colleague through the Smoky Mountains. It compelled her to visit the emergency room. That was the first time Higginbotham had seen a doctor for the symptoms. When she returned home to Houston, her primary care physician, Mary Campbell-Fox, gave her referrals to specialists at Memorial Hermann Southeast Hospital, who performed a battery of tests. Although the results proved inconclusive, doctors persisted. Finally, during exploratory surgery in March last year, they uncovered an advanced stage of ovarian cancer and later performed a hysterectomy. It's a difficult disease to detect in the early stages. Once it has spread beyond the ovary, only about one in four women survive as long as five years. While weathering the ordeal and subsequent chemotherapy, Higginbotham said, she came to believe in the half-dozen doctors at Memorial Hermann who showered her with attention. "I know they saved my life," she said. "If you can trust your doctors, then you're going to think a lot more positively about the outcome."
    Now, a dispute between Memorial Hermann Hospital System and the Higginbothams' health insurer, Blue Cross and Blue Shield of Texas, may stand in the way of continuing care with her group of doctors. This month, the hospital system and its physician organization terminated the first of several managed-care contracts with Blue Cross as they approached renewal over the coming months, claiming that its reimbursement rates are low compared with those of competitors. That leaves many of the more than 600,000 Texans insured by Blue Cross in a quandary. The standoff is part of a national trend of more patients finding themselves caught in the middle of managed-care disputes. An escalating number of contract squabbles among health plans, hospitals and physicians have erupted in the past two years, according to the Center for Studying Health System Change in Washington, D.C.
    "Physicians and hospitals are becoming increasingly dissatisfied with the health-plan contracts," said Cara Lesser, the center's director of site visits. "And market conditions have changed in many ways to give many physicians and hospitals more clout. The patient is definitely caught in the middle of this and, in many instances, is used as a pawn, as providers and plans try to work out contract terms." Last week, the Texas Children's Health Plan told the state's Children's Health Insurance Program that it will stop providing care for needy children if the two parties cannot agree to terms. The health plan, affiliated with Texas Children's Hospital, is asking for higher fees.
    After receiving the bad news that their doctor is no longer accepting patients from their particular health plan, patients have some tough choices to make. The Higginbothams decided that in the worst-case scenario, they would pay more to proceed with the same team of doctors and the same hospital. But, they said, they're worried that their share of the medical bills for out-of-network coverage will become unmanageable. "To have to start all over again, with a whole new cast of characters, would be awful for us," said Bruce Higginbotham, 54, a retired history teacher and volunteer at Memorial Hermann Southeast. "We don't want to do that at all. We're happy with what we have." They also can request that their insurer make an exception in their case. It can authorize care by the same doctors in special circumstances for patients with chronic conditions, and is legally required to do so for women in the third trimester of pregnancy.
    There are several related reasons, according to the center and other experts, why patients can no longer see the doctor of their choice:
· As negotiations between managed-care plans and providers have become more contentious, doctors have banded together in large groups to command more leverage.
· Insurers claim that physicians are clamoring for reimbursements above standard rates, while doctors insist that they're not being paid enough to cover their services and the costs of running a practice.
· Paperwork for billing and payment delays frustrate some providers to the point that they don't want to do business with a particular health plan.
· Consumers' negative perception of health maintenance organizations has spawned broader networks of doctors, who may drop out because they're unaccustomed to the rigid practices of managed care.
    Insurers walk a fine line between curbing spiraling health care costs and paying for the services that doctors say their patients need.  "We don't want to be viewed as an adversary to the physicians," said Ted Haynes, vice president and chief operating officer for Blue Cross' Southeast Texas business unit. "We want a collaborative role."
    From doctors' point of view, insurers sometimes send them on wild-goose chases for reimbursements. "When we're spending more time working on collecting fees from a payer than we are taking care of the patients involved, then it's time to quit that, to drop that plan," said Dr. William Gilmer, vice president of the Harris County Medical Society Central City Branch. "There are a number of doctors who are looking at the most difficult plans that they work with and deciding that it's not worth the fight." Texas doctors became so irate about unpaid bills that they lobbied the state for help. Earlier this month, the state levied $9.25 million in fines against delinquent insurance carriers and HMOs for failing to promptly pay doctors and other health care providers for services. The move by Insurance Commissioner Jose Montemayor also mandates that insurers pay millions of dollars in restitution for claims.  Gov. Rick Perry commended the measure, even though just a few weeks before he had vetoed a prompt-pay bill, which would have toughened a state law against delinquent payers.
    To make it easier on themselves, doctors often hire an independent practice association, or IPA, to negotiate contracts with health plans and take care of managed-care operations. These groups were supposed to allow doctors to concentrate on practicing medicine, but at times they have done just the opposite. Some have gotten into financial trouble -- plagued by rising costs and reduced reimbursements from the insurance industry -- leaving many doctors holding the bag.
    That's what happened last fall when North American Medical Management, which had overseen the business affairs of doctors associations for almost a decade, went under. It was a bitter pill to swallow for the 19 independent practice associations in Houston, representing about 1,800 physicians, that had hired NAMM to cut through red tape. A new group created in November, Renaissance Physician Organization, is working to regain the trust of doctors in this stretch of the Gulf Coast. "There were some failures," admitted Dr. Pat Pingitore, chief medical officer. "This organization is not going to repeat the mistakes of the past. IPAs have been effective in giving some physicians a voice and some leverage with the payers, mainly the HMOs."
    Sometimes doctors' reasons for leaving a network have nothing to do with compensation. Other explanations include retirement, relocation and career changes. Although the majority of doctors on any given plan may not have dropped out, it's nonetheless troubling for a patient with one among those who have thrown in the towel. When a patient has to transfer to a new doctor, it often requires a fee. Because a lot of effort goes into forwarding records, some offices charge for the staff time it takes to complete the paperwork, said Dr. Paul Handel, past president of the Harris County Medical Society. "If the doctor should try to bill for those services, there is a hue and cry about the greedy doctors," Handel said. Usually the turnover of physicians on a plan ranges from 2 percent to 3 percent a year, said Dennis McDowell, president of Humana in Houston. Most doctors, he said, simply live with the fact that no health insurance is ideal.
    The practice of medicine today remains a far cry from the 1969-76 TV series Marcus Welby, M.D., in which Robert Young played a sympathetic doctor who had ample time to spend with each patient. "That's the nirvana of health care," McDowell said. "It probably wasn't realistic back then."

More Michigan Doctors Leaving HMOs
David Wahlberg, Ann Arbor News- 8/26/2001

Before Dr. Ed Linkner dropped out of the Care Choices health maintenance organization last year, the Ann Arbor family practitioner sent a letter to his patients. "I truly believe that I cannot be a wholehearted and trustworthy advocate for my patients while also having the financial and political pressures to restrict their health care," he wrote. Linkner's letter - which also decried the "cookie-cutter" medicine of HMOs, saying decisions are often made by a "faceless, nameless person" - has become a manifesto for local doctors upset about managed care. They're reading it, sharing it, pinning it up on their walls.
    And some of them are also severing ties with HMOs. No medical or health care groups track the number of doctor defections, but stories of Washtenaw County doctors leaving HMOs are becoming common, many physicians say. Just last week, a group of six surgeons at St. Joseph Mercy Hospital announced it is pulling out of Care Choices, the HMO affiliated with St. Joseph. It joins a group of St. Joseph orthopedic surgeons who left Care Choices earlier this year.
    The resulting doctor shuffle has angered some patients since they are forced to switch doctors or follow their familiar and sometimes longtime family doctors into new insurance plans. "(HMOs) are more and more intrusive in the practice of medicine," said Marty Gleespen, a general practitioner in Chelsea who recently fled some HMOs. "Trying to get them to approve a basic drug for some patients is like undergoing major dentistry."
    About 86 percent of doctors statewide were in HMOs in 1999, according to a Michigan State Medical Society survey. The number who cited "loss of autonomy" as a disadvantage of managed care was 83 percent, up from 77 percent two years earlier. Nationally, 91 percent of doctors had at least one managed care contract in 1999, according to the American Medical Association. Anecdotal accounts suggest a subsequent backlash, an AMA official said, but no recent figures are available to back that up. Independent Doctors, a network of physicians who have decided to forgo managed care, started in California in 1997. It is forming chapters in five other states, including Michigan, according to its Web site, which features a shark fin labeled "HMO" that shifts across the screen.

Local doctors on the move
Several of Washtenaw County's 1,400 or so doctors not affiliated with the University of Michigan have dropped one or more HMOs in the past two years. U-M's 1,100 physicians are under a single contract and can't independently leave or join health plans. They all have two HMOs: Blue Care Network, an arm of Blue Cross Blue Shield, and M-CARE, the university's HMO. Some U-M doctors had Care Choices until the university pulled out in 1998. Those taking part in the exodus from HMOs say the plans force doctors to spend more time on paperwork than on patients. They say HMO decision-makers often don't have medical degrees and deny care based on formulas that don't take individual cases into account. And when HMOs do approve something, they often pay late or only in part, the doctors say.
    But what really galls them is an arrangement called capitation, often used by HMOs. It gives doctors a set fee per patient per month for medical care, usually about $10 or more. If patients are healthy, doctors make money. If patients need a lot of services, doctors take a hit on their bottom line. "That encourages you to refuse surgery or make it hard for patients to get into the office," said John Morris, one of the St. Joseph orthopedic surgeons who departed Care Choices this spring. "You get paid the same whether you give care or not. It's so unethical, I can't tolerate it."

HMO benefits
HMO supporters say physicians shape all policies of the plans and that doctor office mistakes on reimbursement forms often contribute to late payments. They say capitation encourages doctors to think more broadly about disease by giving them responsibility for an entire population. "It's about not just giving patients a diagnosis and medication, but making sure that, at the end of the week, they're better off than at the beginning of the week," said Howard Weinblatt, an Ann Arbor pediatrician who is board chairman of Care Choices. "Under (traditional, non-capitated medicine), there is no incentive for doctors to do anything other than have the patient come in. The more they see you, the more money you make."
    Zelda Geyer-Sylvia, president of M-CARE, said the U-M HMO is flexible with its guidelines, referring complex cases to an outside panel to review whether certain procedures should be covered for certain patients. "There's no book somewhere that says, 'If it's in here, that's what you must do,"' she said. "We do not encourage physicians in any way to withhold care. We want them to practice appropriate medicine and to use resources carefully."

The patients' response
Patients have mixed reactions to HMOs and doctors' decisions to leave them. Karen Meyer had been pleased with Care Choices when her doctor, Linkner, exited the plan. "You kind of panic at first," she said. "I didn't want to switch doctors, and I didn't want to switch insurance plans." The 50-year-old teacher at Forsythe Middle School in Ann Arbor ended up moving to a Blue Cross plan that allows her to keep seeing Linkner. The premiums are a little more, but the continuity with Linkner is worth it, she said.
    Dorothy Clary, 53, who lives near Tecumseh, has been angry at Care Choices for switching her primary care doctor three times in less than a year. But she was also upset when Morris, the St. Joseph orthopedic surgeon, pulled out of the plan this spring. Clary wears a leg brace prescribed by Morris, and her husband Ken recently had shoulder surgery by him. Both patients are in pain and want to see Morris. But they can't go to his office until January, after their workplace allows them to switch to another insurance plan. "It's really hard on us," Clary said. "We're in limbo."

Doctors 'worn out'
Linkner, who practices "holistic medicine," mixing acupuncture and herbs with antibiotics and X-rays, had about 20 percent of his patients in Care Choices. Like most area doctors, most of his business comes from Blue Cross and Medicare. Care Choices' introduction of capitation in 1996 gradually wore him out, Linkner said. Leaving the HMO took away a steady stream of revenue at first, but he has recovered. "You take a hit for a while, but then you're free," he said.
    Gleespen was in a group practice in Chelsea that was purchased by U-M. He left and now practices solo, focusing on patients with addictions. He has dropped Blue Care Network and Jackson-based Physicians Health Plan and plans soon to leave M-CARE and Care Choices. About 12 percent of his patients are in those two plans. "Medicine is very fear-driven today, and physicians worry that if they don't go with managed care and big organizations, they'll be left out and won't make it," he said. "That's just not true. If you give people what they need, you'll do fine."
    David Vallance has experienced the fear and the joy of leaving HMOs, he said. His group practice in Chelsea also was purchased by U-M and he also decided to go it alone, opening a practice in Scio Township that focuses on pain management. After he left the university two years ago, Vallance was told he couldn't be in M-CARE or Care Choices, the bread and butter of many Ann Arbor-area doctors. He was worried he wouldn't stay afloat. But he grew frustrated with the HMOs he was in: Blue Care Network, Select Care and Physicians Health Plan. He dropped the latter two, and when Care Choices invited him in last year, he declined. HMOs "bundle" their payments, collapsing a $10 blood draw, a $30 injection and a $70 physical exam into a $70 check for an office visit, Vallance said. The only way he can handle that is to see 40 or more patients a day, he said. "I aim to treat my patients like I treat my mother," Vallance said. "That means thoroughness and a certain level of concern that managed care prohibits."

Looking for compromise
Diane Howlin is another Chelsea physician who left U-M, this past January. She has dropped Blue Care Network but is still in M-CARE and Care Choices, somewhat begrudgingly. She kept those HMOs because she didn't want to abandon her patients. Also, Chelsea Community Hospital loaned her money to start her practice on Main Street, and the hospital asked her to stay in Care Choices, with which it has a contract. Through capitation, Care Choices gives Howlin about $120 a year for each patient, a sum exhausted in one physical exam, she said. "You have to have some healthy college students enrolled so you don't go under," Howlin said. "If I were brand new, I would set up a designer practice without HMOs and not deal with the hassles."
    Morris, the St. Joseph orthopedic surgeon, really bucked the system by fleeing Care Choices, his hospital system's own HMO. His business partners Michael Chrissos and Michael Masini joined him. St. Joseph doctors are not required to be in Care Choices, but nearly all of them are. Care Choices was denying and delaying physical therapy visits for patients at crucial times during their post-surgery recoveries, Morris said, and capitation was the last straw. "I want to be my patient's advocate, but (HMOs) create ugly behavior," he said.
    David Janda is another orthopedic surgeon based at St. Joseph. He and the eight other surgeons in his practice left M-CARE and Blue Care Network nearly two years ago and threatened to drop Care Choices at the same time. Care Choices has eased up on prescription drug restrictions and late payments, Janda said, but he's still not happy with the plan. "There's nothing more frustrating than to go through all of this training and then have these HMOs say, 'You're not going to provide high-quality care, you're going to provide cheap care,"' Janda said. "We sit in a room all day and try to take care of patients. They sit in a room all day and try to find ways to scheme, to help their bottom line."
    HMO representatives say the plans not only reduce costs by encouraging more efficient care, they also compile the latest research data and present it to doctors, to make sure they deliver the best care. "As a patient, I would want my physician to understand what the latest evidence is and to be practicing based on fact," said Geyer-Sylvia of M-CARE. Weinblatt, of Care Choices, said some of the doctors who resist HMOs just don't like change. "Those doctors have a certain hubris that says, 'Anyone who would like to discuss what I'm practicing, and offer some suggestions with good evidence behind it, is telling me what to do."'