At California Rape Center, Technology Is State-of-the-Art
Anna Gorman, Los Angeles Times- 11/1/2002

Nurse practitioners at the Rape Treatment Center in Santa Monica take digital photographs of victims' injuries and analyze slides with a high-definition microscope. They use state-of-the art technology to examine sexual assault victims and then present comprehensive rape kits to police investigators. Unusual for its advanced forensic capabilities, the nonprofit facility serves more than 1,000 victims a year, offering free medical treatment, professional counseling and legal assistance. The clinic is within Santa Monica-UCLA Medical Center, but treats rape victims exclusively and is in a separate part of the hospital from the emergency room. Rape center staff members also advocate for legislation, testify in criminal cases and train police in the preservation of time-sensitive evidence.
   The clinic's work has become even more important since the LAPD recently revealed that detectives had mistakenly destroyed evidence in 1,000 unsolved rape cases. Biological evidence gathered from victims is compared to DNA profiles on police computer databases and can be key in solving cases.
   Center director Gail Abarbanel said the detailed rape kits her staff collects increase the possibility of rapists being found -- if those kits are tested by police. "This is the first time there has been a real breakthrough" in the collection of rape evidence, she said. "That's why it's criminal not to be able to use what we've collected."
   In most cities, rape victims go to hospital emergency rooms, where they are treated after patients with life-threatening injuries or illnesses. During that wait, evidence deteriorates and the chance of catching attackers decreases, Abarbanel said. LAPD Officer Rashad Sharif, who has taken more than 10 rape victims to the center, said handling such cases used to be a nightmare, because it involved spending endless hours at an emergency room. But at the clinic, he said, the victims are attended to right away. "We know that everything is going to be top-notch with the way evidence is collected and packaged," he said. "They are very careful with it. They know the procedures as well as or better than some officers."
   The Rape Treatment Center started treating victims in 1974 and opened its new facility in 1999 with funding from film producer Verna Harrah. The center is open 24 hours a day, staffed with one counselor and one nurse practitioner at all times. A doctor is also on call.
   Abarbanel said she believes that victims are more willing to seek medical help and report their attacks to police if they are made a priority and cared for with respect. "How victims are treated initially has a huge impact on their willingness to participate in or not participate in the criminal justice system," she said. "This is a very supportive environment for them."
   Anna, an actress who was raped in Canoga Park three years ago, said she believes that her healing began as soon as she arrived at the center. "They treated me like a queen," said Anna, who did not want her last name used. "I felt like I was a human being and not just a victim." She said she was walking through a parking lot in May 1999 when a man pointed a gun at her and forced her into her car. He drove her around and stopped in an empty lot, where he raped her in the back seat, she said. Several minutes later, the attacker jumped out of the car and ran off. Shaking, Anna put her clothes back on and started the car.
   When she got to her Westside home, she called police, who recommended that she go to the clinic because of its reputation. Anna remembers sitting down with a counselor in a cozy room with a couch, pillows and tissues on the coffee table "I can't tell you how significant even that was," she said. "It was a soft place to rest. It's like being a little kid on an airplane and the stewardess hands you a teddy bear because you are traveling alone." She explained what happened during the attack and then was led into the medical room, where she said the staff members acted sensitively as they examined her. Throughout the process, she said, they told her what to expect and frequently checked to make sure she was OK. "When you feel like you are being well taken care of and your evidence is being treated with the best technology, it is also a way of someone taking what happened to you seriously," Anna said.
   She also attended individual and group counseling through the center and continues to meet with the other three women in her group. Her rapist was never caught. "That's always hard," she said. "It helps that I have some sense of personal resolution, but it's never quite the same as resolving it in reality."
   That's where the scientific equipment at the center comes into play, Abarbanel said. Staff members can never guarantee that a case will be solved, but they can ensure that evidence is collected thoroughly. Then they place the case in the hands of the criminal justice system. In the clinic, nurse practitioners use a lamp that illuminates semen on the skin with ultraviolet light and a video colposcope that magnifies injuries to 16 times their normal size. They also use a forensic microscope that makes sperm on a slide appear bright yellow against a blue background.
   But the digital photographs may be the most valuable technological tool because they show extreme detail of lacerations or bruises. Before the cameras became available, injuries were simply marked on a piece of paper on a body diagram. "The forensic ability we have to observe, document and preserve evidence is really specialized for our setting," said Amie Tishler, who coordinates the nurse practitioners at the center.
   In cases in which victims are reluctant to report the rapes to authorities, the center still collects the evidence and stores it in freezers in case they change their minds. Abarbanel said her center is doing everything possible to make sure that no more kits are destroyed and that the evidence they send is analyzed in a timely way. "It's a simple public safety issue," she said. "Women are being raped because these kits are not being opened."

Ohio to Vote on Drug Treatment Issue
John McCarthy, Associated Press- 11/1/2002

COLUMBUS, Ohio -- Mansour Bey credits a drug treatment program for helping him kick a crack cocaine addiction. Nola Tinkey says a tough love approach that briefly sent her to jail got her off drugs. The two are on opposite sides of an Ohio ballot initiative pushed by three billionaires - and strongly opposed by the Republican governor and much of the criminal justice establishment. The proposal, listed as Issue 1 on Ohio's Nov. 5 ballot, would require judges to impose treatment, not jail time, for nonviolent first- and second-time offenders who request it. The maximum sentence under current law is 18 months for a second offense. Issue 1 would cap jail time at 90 days. Issue 1 "saves money and it saves lives. That's the bottom line," said Ed Orlett, a former legislator who is director of the Ohio Campaign for New Drug Policies. "We can treat six people for what it costs to keep one in prison."
   Three billionaires -- University of Phoenix founder John Sperling, New York financier George Soros and Ohio insurance executive Peter Lewis -- have spent millions over the past four years backing similar ballot initiatives, which they depict as a referendum on the war against drugs. Voters approved treatment-instead-of-jail proposals backed by the three men in Arizona in 1996 and California two years ago. The reformers are backing a similar proposal this year in Washington, D.C., and in recent elections backed successful medical marijuana laws in several states.
   Drug reformers also are taking aim at marijuana laws in this election. If ballot measures pass Tuesday, possession of small amounts of marijuana would be legalized in Nevada and decriminalized in Arizona. The Arizona measure also would require police to distribute the drug to seriously ill people to alleviate pain.
   Backers of the Ohio proposal say passage would help offenders kick their habits and avoid turning to more serious crimes. They say treatment costs about $4,000 a year for each offender versus about $22,000 for incarceration. "Without treatment, a person never truly understands the nature of the disease of addiction," said Bey, 60, a Toledo minister recovering from addictions to crack, heroin and amphetamines. He supports Issue 1.
   Opponents say Issue 1, if approved, would circumvent the justice system, putting criminals on the street and removing any incentive for quitting drugs. Gov. Bob Taft, a Republican running for re-election, has called the drug issue an assault on Ohio's criminal justice system that is "seductive, deceptive and dangerous."
   The federal government has not actively opposed Issue 1, but both John Walters, President Bush's drug czar, and Drug Enforcement Agency director Asa Hutchinson spoke against the proposal during unrelated visits to Ohio this year. Both men have campaigned vigorously against the Nevada and Arizona marijuana proposals.
   Both camps in the Ohio campaign have been looking at the impact of the Arizona treatment law adopted in 1996. According to 1999 report by the Arizona Supreme Court, 64 percent of drug offenders diverted under the law completed their treatment program, compared with 62 percent of those who received treatment but were not charged with a drug crime. Judges have become frustrated with drug offenders sentenced under the 1996 law who fail to show up for treatment because they know they won't be imprisoned, said Jerry Landau, a special assistant Maricopa County attorney in Phoenix. But supporters of the initiative say the 64 percent success rate is positive. "That's a pretty good indicator that people want treatment," said Dave Fratello, political director for the Campaign for New Drug Policies, the parent group of the Ohio backers. Independent statistics are not available for California, which just began studying the effects of its Proposition 36, passed in November 2000.
   Tinkey, 53, ended up in an Ohio drug court after 13 years of cocaine addiction that led to conviction on a possession charge. Drug courts require participation in treatment programs and carry the threat of jail time. Tinkey spent six days in jail after a relapse and could have faced prison time. Yet she asked to go back to the same program. "It took all the measures that they could do to bring me to where I am now, but it finally opened up my eyes that this isn't where I want to be," said Tinkey, a caterer for industrial work sites.
   Bill Zimmerman, executive director of the pro-reform Drug Policy Alliance, said the movement is gaining strength. "Win or lose, we believe we have injected the need for reform into the mainstream political debate," he told a news briefing Thursday. "We are not going away."
   On the Net:
Ohio Campaign for New Drug Policies: http://www.ohiodrugreform/org
Ohioans Against Unsafe Drug Laws: http://www.unsafedruglaws/org

Case Tests Reliability of Sweat Patches for Drug-Testing
Denise Lavoie, Associated Press- 11/2/2002

BOSTON -- A man who challenged the reliability of sweat patches used for drug-testing lost his bid to be released from jail after a federal judge ruled Friday that five of his six positive tests for cocaine use appeared reliable. Henry Alfonso, 32, of Fall River, was arrested in December on charges of dealing the prescription painkiller OxyContin. He was released on bail, but in July, after repeated sweat patch tests showed the presence of cocaine, he was sent back to jail.
   Alfonso's case was the first in Massachusetts to challenge the reliability of the sweat patches, which are used in more than 40 federal court districts across the country to test crime suspects for various drugs, including cocaine, heroin, marijuana and methamphetamines. U.S. District Judge William Young said the number of times Alfonso tested positive persuaded him to keep Alfonso in jail. But the judge also criticized court officials for not always following the proper protocol for applying the patches. The adhesive patches, usually placed on a defendant's arm, absorb sweat on the skin, which is then tested for the presence of drugs.
   On the witness stand Friday, Alfonso said he had not used cocaine in the last 3½ years. He claimed his six positive test results were caused either by cocaine residue left in his apartment by a previous tenant or by traces of the drug on cash his wife brought home from her job as a stripper. Assistant U.S. Attorney Laura Kaplan said the six positive tests speak for themselves. ''These results are commensurate with someone who has used drugs,'' she said.
   Alfonso's lawyer, Matthew Feinberg, argued that federal courts in at least two districts in New York and Nevada have stopped using the patches because of questions about reliability. Feinberg said court employees had not followed proper procedures in placing the patches on Alfonso's arm. The employees, in earlier testimony, acknowledged that in some cases, they did not wear rubber gloves and that they also allowed Alfonso to swab his own arm with rubbing alcohol. ''This decision is obviously very disappointing to Mr. Alfonso,'' Feinberg said after Young's ruling. ''I think that the sweat patch does raise some very serious questions as to its reliability.''
   Judge Young agreed with Feinberg that court employees had not uniformly followed standard protocol in applying the patches. He said one of the six tests appeared to be unreliable because the patch was left on too long and had started to come off Alfonso's arm. But he cited the additional positive results on the remaining five tests in his decision to keep Alfonso in jail. ''What persuades this court is five different positive cocaine results over a period of time,'' he said.
   PharmChem Inc., a Texas-based firm that makes the sweat patches, said its technology is reliable. A spokesman said it would require large quantities of drugs placed on the patch to go through the membrane and create a positive result, not the trace amounts of residue described by Alfonso. Alfonso is scheduled to stand trial next month on the OxyContin charges.

Texas Schizophrenic Set to Die Wednesday
Mike Tolson, Houston Chronicle- 11/3/2002

James Colburn has long struggled with delusions brought on by paranoid schizophrenia. Many are religiously oriented, as he revealed in a 1995 interview with a clinical psychologist in which he said the voices he heard made it appear he was being followed: "The voices more or less whisper it to me. They're like illusions, coming to me from some other world, from somewhere close to God. I'd be scared if I actually saw God. "These voices come from somewhere around him. They're real. If they weren't, I wouldn't be here. It's like God is trying to get across to everyone in the world that it's all some kind of game. God's controlling my mind. "I feel that these voices led me to find this woman and kill her. It was wrong ... wrong in God's eyes and wrong in everyone else's eyes. That's why I should get the lethal injection. All these voices want me to do is get the lethal injection. They just want to shut me up. They just want me to kill people. "They're never going to let up until I die. They haunted me until I did kill someone. They're not going to be happy until I'm dead and a lot of other people are dead. I don't like talking about these things. They just get me more and more upset. "They tried to get me to kill someone before when I was out on parole -- my mother and my brother and my grandparents. They are bothering me even now. God created me. He should get rid of me."
   As James Colburn sees it, the worst thing that could happen to him is not the execution that looms Wednesday evening. There is a logic that even he understands: He murdered a woman near Conroe eight years ago and now must pay with his life. The worst thing will come in the days following, when his lifeless body is placed in the ground. "He has told me his biggest fear is to be buried because he thinks the demons will dig him up," said Colburn's sister, Tina Morris. "That's why he doesn't want a name on his headstone, so they won't know where he is."
   Demons have long been a concern for the 42-year-old Colburn. Two decades of living with paranoid schizophrenia have made him fear many things, none more than the agents of Satan whose voices he said periodically speak to him. If there is an upside to his execution Wednesday, he said in a recent death row interview, it may be to remove one more tool from the devil's disposal. "Some goodness will come from this," Colburn said. "Maybe the Lord will be able to win more battles with Satan."
   Were Colburn's intellect impaired to the point of retardation, he could not be executed. In a June ruling in the case of Atkins v. Virginia, the U.S. Supreme Court banned capital punishment for the mentally retarded. But mental illness was left unaddressed. No matter how impaired a defendant or inmate, so long as he can meet the minimal threshold of appreciating the wrongfulness of his act and understanding why he is being punished, he can be tried and executed like anyone else.
   Mental health advocates believe that is unfair. They argue that a mental illness such as schizophrenia can be as debilitating as low intellect and that often it will play a role in criminal acts, even if it does not keep the sufferer from knowing right from wrong. "There are very compelling reasons why Atkins ought to apply," said Ron Honberg, legal director for the National Alliance for the Mentally Ill. "The court talked about the functional limitations the retarded have ... the inability to reason, inability to concentrate, all the things that apply to people who are mildly mentally retarded. The same argument can be made strongly for someone with schizophrenia."
   Yet there is reluctance for legislators, prosecutors and many juries to accept the notion that people with mental illness should get any sort of break. In the case of Colburn, prosecutors acknowledged that he had suffered from schizophrenia and had spent half of his life dealing with voices, hallucinations, numerous suicide attempts, and a lengthy roster of medications and their side effects. But none of that mattered, they argued. If millions of people with schizophrenia live law-abiding lives, then Colburn could have, too. "Attributing this violence, this horrible cruelty and this long string of crime to paranoid schizophrenia is naive and over-simplistic," prosecutor Jay Hileman told a Montgomery County jury. "He did it because he's mean. That's why he did it."
   Some states have statutes that lessen the potential punishment if a defendant suffers from a mental condition. Texas does not. Defendants such as Colburn are left only with the insanity defense, which was always dicey and made more so in the 1980s after John Hinckley successfully used it when tried for the attempted assassination of President Reagan. At that time, defense attorneys could try to show that either their clients did not know right from wrong or could not control their behavior because of their illness. If a person knew that killing was wrong but thought he was hearing voices from God commanding him to shoot someone, he could still be found insane, as was Hinckley.
   Laws were changed around the country after Hinckley's acquittal. There was a broad feeling that he had escaped justice. Advocates for the mentally ill are under no illusion there is popular support to change the laws back, much less extend the Atkins ban. One big reason, they point out, is that the mentally retarded enjoy a benign image that the mentally ill have never known. "We have never had the idea that the mentally retarded were a real threat," said Alan Stone, a professor of law and psychiatry at Harvard University. "It was easy to say that it no longer fits our standard of decency to execute them. But if we think of the mentally ill ... we feel that's someone we should be executing rather than forgiving." In other words, the mentally ill are seen as scarier.
   Colburn's sister feels she lost her brother years ago. He has not smiled since he was a boy growing up near Greenspoint. When illness hit him in adolescence, he withdrew to his room. He constantly fretted. He talked about the little man who lived in his stomach. It was soon apparent that Colburn's life was never going to improve. He dropped out of school to work but could not hold a job. He married but could not maintain a normal relationship. He drank, took drugs and committed foolish crimes for which he was always caught. Finally he committed one that went well beyond foolish.
   Though a string of family members testified that he was never a mean person, the prosecution had only to point out his criminal history to paint him as a danger. He had served time in prison for burglary, arson, handgun possession and armed robbery. Then there was the sudden and inexplicable killing of Peggy Louise Murphy on June 26, 1994. Murphy was hitchhiking near Colburn's apartment when he saw her crying and went to ask what was wrong. She asked for a drink of water. In his confession, Colburn said he gave her the cup of water, then got a beer from a neighbor when she asked for one. He then asked her to look at some pictures. When she followed him into the bedroom, he made a sexual advance. She rebuffed him. "Next thing I know I got this flash that I was gonna hurt her, and I did, you know," he told detectives. Colburn strangled her with his hands. After she collapsed and made gurgling noises, he stabbed her in the neck with a steak knife.
   Colburn went to the neighbor from whom he borrowed the beer and told him to call the police because he had just killed someone. Then he sat down, smoked a cigarette and waited for sheriff's deputies to arrive. During interrogation, Colburn said he did not specifically hear voices commanding him to kill her. In later interviews with psychologists, he described the impulse or flash as more like a voice that said killing Murphy and returning to prison was his only hope.
   Whether an auditory hallucination was involved in his act or he added that later in an attempt to lessen the impact of what he had done is a matter for conjecture. Colburn today says there was a little more to it than the police got out of him. He says that he had been worried for weeks that he was going to do something bad to a family member because voices were telling him his only hope was to be sent back to prison.
   Speaking in a soft, flat monotone, Colburn often does not make sense. And then, like sunlight emerging from broken clouds, lucidity returns. He readily admitted he was suicidal at the time of his trial and told his lawyers that he wanted to get the death penalty. He knew he had done wrong. He is less eager to die now but seems resigned to the execution taking place on schedule. His sister, however, is incensed at the sentence, given his mental history. "My brother didn't ask for this disease," Morris said. "He was born with it. People need to be more educated about it."
   In a belated twist, one of the jurors who sentenced him to die agreed. In a recent affidavit, Kimberly Queener said she had no idea at the end of the trial how serious schizophrenia is. "Defense counsel, in my opinion, completely failed to present testimony that explained to the jury what paranoid schizophrenia is, how difficult it is to treat and above all, how the long-term effects of the disease affect a person's appearance and demeanor," Queener wrote. She said she never understood why Colburn appeared to be so emotionless as he confessed to police and so uncaring in the courtroom. The prosecutor argued that it was because he was so mean and remorseless. Psychiatrists attribute it to the effect of antipsychotic drugs and other medications. Queener also said she didn't understand why Colburn should be considered seriously ill if he was taking his medicines. It is a common misconception, mental health professionals point out. Medications help; they do not cure. "With mental illness, medication does not work like penicillin on a strep throat," said James Rytting, one of Colburn's current lawyers. "It does not knock out the bug."
   Murphy's sister, Mirah Fielden, said mental illness alone should not keep Colburn from getting what he deserved. Fielden said the death sentence was God's doing. "He was sane enough to know exactly what he was doing," she said. "I prayed and I asked God the very day that it happened to never allow him on the streets again to harm another person. His life is being taken. I did not request that. But that is the Lord's will."
   Rytting and co-counsel Phil Hilder have pinned much of their appeals on the fact that Colburn was so heavily medicated for the trial that he often fell asleep during the proceedings. They say this rendered him incompetent to be tried in the first place. "This is the flip side of the sleeping lawyer case," Hilder said. "A defendant has to be able to help in his effective defense. He was induced to sleep by intramuscular injections of this antipsychotic drug. He can't assist in his sleep." So far the argument has found little traction, in part because Colburn's trial attorneys have sworn that he was aware of what was going on and was able to help them in his defense.

High Court to Rule In Psychiatric Case
Charles Lane, Washington Post- 11/5/2002

The Supreme Court announced yesterday that it will determine whether the government may force a mentally ill defendant to take medication so he will be competent to stand trial on nonviolent criminal charges. The case pits the government's interest in holding an individual accountable for alleged wrongdoing against the individual's right to decide what goes into his or her own body.
   The case, Sell v. U.S., No. 02-5664, involves Charles Sell, a dentist who was indicted on charges that he defrauded the federal Medicaid program and private health insurers. Diagnosed by government psychologists with a delusional disorder, he became uncontrollable in court and spat at a judge. For the past 31/2 years, he has been confined at a federal medical facility in Missouri.
   Earlier this year, the St. Louis-based U.S. Court of Appeals for the 8th Circuit ruled 2-1 that the government could require Sell to take antipsychotic medication, because it would help him medically and the government had an "essential" need to try him on what the court considered serious charges.
   But in their petition to the Supreme Court, Sell's attorneys argued that, under this decision, "a mentally incompetent individual will lose his right to refuse medication based solely on the government's unproven assertion that he is guilty of a non-violent crime." The 8th Circuit's ruling clashes with a decision by the Cincinnati-based U.S. Court of Appeals for the 6th Circuit in a different case, proving the need for Supreme Court clarification, the petition added.
   Urging the court not to take the case, the Justice Department argued that the 8th Circuit Court's ruling was "amply supported by the record." The case is also complicated by the fact that Sell has separately been indicted on charges that he tried to hire a hit man to kill an FBI agent and a prosecution witness.
   Thanks to recent progress in psychiatric medication, the question of how the legal system should handle offenders who are mentally ill and can understand -- or, in some cases, sit through -- the proceedings against them only if they are medicated has repeatedly cropped up in the context of violent crime and the death penalty, forcing difficult decisions on courts and medical professionals.
   "The government has a legitimate interest in bringing alleged wrongdoers to trial, particularly where the crime is serious enough that it may outweigh whatever interest defendants have in avoiding treatment," said Paul Appelbaum, president of the American Psychiatric Association. "But where's the line? Can you treat someone to make him competent to stand trial for jaywalking? Petty theft?"
   In past cases involving violent offenders, the Supreme Court has held that authorities may require prison inmates to take medicine if they would otherwise pose a danger to themselves or other people. And it has said that a pretrial detainee may be forcibly medicated if a court finds that it is in the defendant's medical interest and there is no less intrusive means of making a trial possible.
   A Texas inmate, James Colburn, has asked the Supreme Court to overturn his death sentence because the antipsychotic medications he was given made it impossible for him to stay awake, thus rendering him incapable of understanding his trial. The court has given no indication of what it may do in that case.

Illinois Problem Gamblers Sign on to Blacklist
Douglas Holt, Chicago Tribune- 11/5/2002

By the time Jim Keegan, a compulsive gambler, signed papers barring himself from Illinois casinos, it was too late to change his history of embezzling big bucks to feed a $20,000-per-day blackjack habit. But the Illinois Gaming Board's self-exclusion program was a crucial step toward ending his out-of-control gambling. "It's a roadblock," Keegan said, sitting in his suburban Chicago home. "It also brings home the reality of all the damage my behavior has caused."
   On Aug. 30 Keegan became the 34th participant in a statewide program that lets gamblers put themselves on a voluntary casino blacklist. It is the board's first effort to address problem gambling since it provided seed money for a gambling hot line in 1995. Since July, 116 people have signed up, a number officials expect to rise after six new sites began processing applications last week. Illinois casino companies flag excluded gamblers' names, refuse to cash their checks or lend them money and strip them from mailing lists.
   Gaming Board rules say casinos cannot "knowingly allow" self-excluded gamblers to enter but specify no sanctions for failing to spot them. If a self-excluded gambler does gamble, winnings are subject to confiscation and the money goes to agencies providing aid to compulsive gamblers. If casinos win money from a gambler who eludes a self-imposed ban, the house keeps the cash.
   Coming 11 years after the first Illinois casino opened, the program stands as awkward recognition by regulators and the industry that a certain number of customers gamble not for fun but because they're addicts. Missouri, Michigan and New Jersey have similar state-run programs. Gaming Board Administrator Phil Parenti said, "We ought to try to help compulsive gamblers, especially with the fantastic profits being reaped by casinos."
   Susan Gouinlock, former executive director of the Illinois Casino Gaming Association, characterized pathological gambling as a "complex illness that can have devastating consequences." The consequences are not hard to find:
- In Elk Grove Village, former youth baseball commissioner George Lycos pleaded guilty last summer to stealing $77,000 from the league and bilking investors out of more than $800,000--money he largely gambled away, prosecutors say.
- Children were left alone in parked cars or outside casinos while parents or caregivers gambled in 59 incidents since 1999, Gaming Board records show.
- Typical was an incident at 4:30 a.m. Aug. 20, when guards at the Empress Casino in Joliet found two 13-year-old boys wandering in the parking lot. One of the boys' mothers had been gambling since 1:30 a.m. She left her keys with the boys and said "if they got cold, they were to start the car to warm up," according to an incident report.
- Last December, Empress Casino Hotel workers found the body of a 63-year-old Chicago man in his room after he had shot himself. He had lost $1,700 at the casino, according to the office of Will County Coroner Patrick O'Neil.
   The National Research Council, a non-profit Washington-based group that serves Congress, estimates that pathological gamblers make up about 1.5 percent of the general population, or about 186,000 people in Illinois. Hundreds of thousands more in Illinois show less severe signs of problem gambling.
   Before casinos came to Illinois, there were a dozen Chicago-area Gamblers Anonymous meetings. Now there are 60. A 1995 survey of Gamblers Anonymous members in Illinois found 1 in 5 had filed for bankruptcy. Two-thirds had contemplated suicide. More than half admitted stealing to gamble, according to a separate survey of the gambling recovery group. The state budgeted $1.3 million this year for compulsive gambling prevention and education programs, with no funds to treat gamblers. The state spends $240 million for drug and alcohol abuse prevention and treatment.
   As a bookkeeper and collection manager, Keegan siphoned nearly $800,000 from Fisher Container Corp. in Buffalo Grove and Butler Specialty Co., a Chicago furniture maker. He said he used the money to support an addiction to gambling that twice took him to the brink of suicide. He is awaiting sentencing on felony theft charges in Lake and Kane Counties. "Everything went for gambling," he said of the stolen money. "Whenever I gambled I always felt whole. I felt incredible."
   A 1999 study by the Louisiana Gaming Control Board found that 30 percent of casino revenue came from problem and pathological gamblers. In Illinois, casinos took in $1.8 billion last year and turned over $555 million in taxes to state and local governments. Illinois has never studied how much revenue problem gamblers produce.
   Gambling-related crime prompted Kane County Circuit Judge James Doyle to begin a gambling rehabilitation court this year. Defendants must plead guilty and accept a strict anti-gambling regimen to stay out of jail, including reporting to him once a week. "The easiest thing for all of us to do is to close our eyes," Doyle said of problem gambling. "Regular probation is not going to work with an addict."

Minneapolis School Enrolls Only Recovering Teen Addicts
ABC News, 11/6/2002

In many ways, the Minneapolis high school looks like any other high school across the country, with books, teachers, lockers and a lunchroom ... even time for fun and games in the halls. But its name is Sobriety High, and it is a high school set up specifically for teens who are addicted to drugs or alcohol. It is one of only 18 so-called "sober schools" or "dry highs," set up across the country.
   The school, featured in a recent edition of YM magazine, is filled with students who are admitted addicts. Each has a disturbing story to tell. One is 15-year-old Caitlin, who says that she is marking off just under seven months of sobriety. "I started drinking and smoking weed when I was 11 years old," Caitlin said. "It progressed from me trying every drug to eventually I was drinking every day." Then there is 14-year-old Leah. "When I was 11, I started using alcohol, and by age 13, I was doing pot, cocaine, heroin, and anything I could get my hands on," Leah said. "And I got sober later in the year, when I was 13."

'You're a Person Here'
The student body is much smaller than most high schools, with only 48 students in attendance. Judi Hanson, who has been the school's director for the past 11 years, keeps a watchful eye over the students, and says that small class size is one of the keys to the program's success. "I'm going to know your mother's name, your grandmother's name, and your dog's name, because you're a person here," Hanson said
   More than 95 percent of the seniors graduate, and after leaving the school, more than 50 percent of Sobriety High's graduates remain drug- and alcohol-free for years to come. The rate for teenagers who stay on the wagon after treating their addiction at a treatment facility alone is less than 10 percent.

Three Strikes Policy
But not every student attending the school manages to stay clear of drugs and alcohol. An average of seven students a year fall back into addiction, and they are not coddled. For those students there is a tough "three strikes, and you're out" policy. Judi Hanson said the importance of carrying out that tough policy was a lesson she had to learn. "I always had this feeling that if I just gave them one more chance and if I just gave them more love and more attention, everything would be fine," Hanson said. "But I found out that that's really slowing down their recovery, because enabling them to continue the same behaviors is not going to teach them anything."
   Students seem to enjoy the teamwork involved in many classes, and the chance to socialize, but the mandatory discussion sessions led by Judi Hanson may be the most important part of each day. It's the time when students can share experiences, and lean on one another for support.
   When Hanson asked them about the drug scene at their previous schools, the students had plenty to say. "High school's just swarming with drugs," Jeremy said. "It's like everywhere you go." "If I couldn't find a drug that I wanted anywhere in the city, I could go to school, and they'd have it there for me," said Pat.

From a 'Normal' Family
Another student, 17-year-old Natalie Warner, said that her self-esteem was an issue in her drug use. She is from an upper-middle-class suburban home with two parents and a so-called "normal" family. "Once middle school hit, right away, I just started putting myself down," she said. "If I didn't think I was good at anything, I was good at using drugs." Support from her fellow students has helped her stay sober for 11 months now, she said. "All the kids there, they have a genuine care for you, because we all know what it's like to be not accepted or not feel good about yourself or have family problems," Natalie said. "It's like a family away from your own family."
   Natalie started drinking heavily in seventh grade, and began smoking marijuana the following year. By 10th grade, her substance abuse had gotten worse. "I got new friends, and I started using cocaine in January of my sophomore year," she said. "And then all of a sudden, before I knew it, I was in head over heels."

Hardest Thing for Parents
Tom and Sue Warner, Natalie's parents, say her drug and alcohol abuse hit a crisis point in the summer of 2001 when she ran away from home. "Well, the day that she ran away was rock bottom for us because it was so horrifying that she was gone," Sue Warner said. "And then she was gone for four days and we did an intervention. And we decided that she was going to go into treatment." If she refused to go to treatment, they were prepared to make her leave the house, and call the police so that she would have to go through the juvenile court system. "Which was probably the hardest thing that we've ever had to do as parents," Sue Warner said. When Natalie returned home, they brought her to an in-patient drug treatment center in Pennsylvania, where she began to develop a more positive outlook. "All morning, I felt so homesick, and just want to go home," she wrote in her journal.
   Once Natalie was in treatment, her parents realized how blind they had been to the signs of her substance abuse. "Every parent I spoke with had the same story, and every parent had previously said, 'not my kid,'" Tom Warner said. "Every story right from the bad grades in school, to the sloppy dressing, to lack of hygiene, to the sleepiness, to the change in friends, the change in attitudes, the lying, every single story was the same."
   Now Natalie Warner has been at Sobriety High since January, almost a year, and she is student council president. Her parents are proud of her for what she has gone through. "We're closer, honest, and Natalie can really talk to us," Sue Warner said. But after the past two years, they are wary about the future, and Natalie worries about the drinking she will confront in college. "Life is scary now that we have to face it," she said. "Before, we were just running from it, and we didn't have to deal with it because we were always high. All of a sudden I have to learn to live again."

Study Rebuts Autism Concerns
Stephen Smith, Boston Globe- 11/7/2002

An exhaustive review by Danish researchers concludes that there's no basis to the widely publicized assertion that the childhood vaccine for measles, mumps, and rubella is responsible for the increase of autism, dismissing the latest health scare to grip anxious parents. The autism study is the most recent example of independent scientific review debunking public fears. Some of the largely discredited concerns are so widely repeated that they become accepted as fact: A pesticide called alar makes apples cancerous. Radiation from microwave ovens can kill you. Invisible electromagnetic fields from power lines spawn tumors. But all those beliefs have been debunked by extensive scientific studies.
   But some specialists said yesterday that this newest study probably will not end concern about vaccinations causing autism. ''We develop a sense of treating these risks in a precautionary way, because of the imperative of survival,'' said David Ropeik, director of risk communication at the Harvard School of Public Health. ''When the facts come along, they have to compete with what our first impressions were, and they're fighting against that `hey, I need to protect myself' response.''
   Released today, the Danish study is the latest piece of evidence strongly suggesting there is no correlation between childhood inoculations and autism, a neurological disorder that impairs communication and the ability to form healthy relationships. An earlier report from the Institute of Medicine, which advises Congress, also declared there is no basis for a link. Yet the fears persist, with advocacy groups arguing passionately for more detailed, biological studies of the potential interplay between vaccines and autism. Those groups trace a reported increase in autism cases to the melding of vaccines for three childhood ailments into a single shot, which, they argue, resulted in unexpected immune-system reactions.
   Those demands for further scientific studies, in many respects, show how perceptions of risk become deeply ingrained. The debate over childhood inoculations also speaks to how humans engage in a constant calculation of risk and benefit, with the benefit of immunizations no longer as dramatically evident as they were decades ago, when children regularly died from measles and mumps. ''When measles and mumps were around a lot,'' Ropeik said, ''the benefit of the vaccine clearly outweighed the risk. And you never heard this debate.''
   Scientists at the Danish Epidemiology Science Center examined medical reports on more than half a million Danish children born from 1991 to 1998 and tracked whether there was an association between autism and the vaccine against measles, mumps, and rubella. About 82 percent of the children had received immunizations, according to their findings, which are published in today's New England Journal of Medicine. ''We went into this with an open mind that if there's anything to these fears, then that's a real problem because we're inducing harm in healthy children,'' said Dr. Kreesten Meldgaard Madsen, the study's lead author.
   The Danish research team found that the incidence of autism was essentially identical for the children who had been vaccinated and those who had not, with about three cases for every 1,000 children in both groups. The scientists also found no evidence that autism diagnoses tended to cluster in the period soon after receiving immunization, a finding, they believe, that further suggests that the shots do not cause the medical condition. ''I feel totally confident in vaccinating my own children,'' Madsen said.
   But the founder of an organization devoted to reforming immunization practices remained unpersuaded yesterday. Barbara Loe Fisher, president of the National Vaccine Information Center, said that the experience of families with autistic children conflicts with what researchers report. ''I can tell you this has not put everything to rest for the parents of kids who are functioning perfectly well and then get vaccinated and start to regress,'' Fisher said. ''The experience of the people is coming up against this wall of denial by science and medicine.'' Fisher's group and others cite complex biological studies conducted by a British gastroenterologist as proof of a relationship between vaccines and autism.
   But the chairwoman of the Institute of Medicine panel reviewing vaccine safety said yesterday that just because a study is complicated doesn't mean it is right. ''When people start talking about some of these molecular mechanisms, it sounds very scientific, and it's very hard to critique these studies unless you're an expert in these fields,'' said Dr. Marie McCormick, a Harvard School of Public Health professor and chairwoman of the Institute of Medicine committee.

Most Americans Favor Corporal Punishment
Julie Crandall, ABC News- 11/8/2002

Spanking has its place, most Americans say - but not in school. The public by a 2-1 margin approves of spanking children in principle, and half of parents say they sometimes do it to their own kids, an ABCNEWS poll found. But an overwhelming majority disapproves of corporal punishment in schools.
   Sixty-five percent of Americans approve of spanking children, a rate that has been steady since 1990. But just 26 percent say grade-school teachers should be allowed to spank kids at school; 72 percent say it shouldn't be permitted, including eight in 10 parents of grade-schoolers. Indeed, even among adults who spank their own child, 67 percent say grade-school teachers should not be permitted to spank children at school.

At Home
Among parents with minor children at home, 50 percent report that they sometimes spank their child, while 45 percent do not. That's about the same as it was in a Gallup poll a decade ago. There are big regional differences in spanking. Among Southerners, 62 percent of parents spank their kids; that drops to 41 percent in the rest of the country. Similarly, 73 percent of Southerners approve of spanking children, compared to 60 percent elsewhere. Even in the South, though, just 35 percent think spanking should be allowed in the schools. Support for spanking in the schools is about the same, 31 percent, in the Midwest, falling to 19 percent in the West and 13 percent in the East. One other difference in spanking is among education groups. Among parents with college degrees, just 38 percent spank their kids; among less-educated parents, it's 55 percent.
   The U.S. Department of Education has reported that school-sanctioned spanking is most prevalent in Southern states -- Mississippi, Arkansas, Alabama, Tennessee, Oklahoma and Louisiana. There are no state laws against spanking, although 27 states have policies against the practice and this year Pennsylvania is debating becoming the 28th. Spanking in schools is currently allowed in 23 states (although parents who object usually can withhold permission for school personnel to spank their kids).

The Right Way to Spank
Spanking seems like a simple proposition, but states that allow it in school actually have numerous rules and restrictions on how it's done. In Alabama, for instance, while the state leaves the specifics up to school districts, it requires districts to go though a careful process in setting rules that must be carefully followed. The policies are designed through public hearings at which parents, business people, and others outside the school system are brought in to help shape the guidelines. "It's not meant to embarrass a child. It's meant as a tool of last resort," said Tom Salter, a spokesman for the Alabama State Department of Education. Although parents are aware of the school's corporate punishment policy, Salter said many teachers still fear that their jobs will be in jeopardy when they are forced to implement a spanking to a student. "If you ask teachers or administrators what they fear the most, it's lawsuits," he said. "You can be assured that teachers go out of their ways to follow the required procedure."
   However, there's still a risk that something will go wrong for the teacher. "There's sill the possibility for them to be attacked personally in either a civil or criminal suit," Salter said. Salter said he could not recall an incident where a teacher was hit with a lawsuit, or faced the possibility that their certificate was revoked. However, if abuse of corporal punishment is suspected, local authorities, and law enforcement would be asked to investigate and prosecute if necessary.

Schizophrenia Drugs Linked to Heart Attack Risk
Reuters News Service, 11/8/2002

LONDON-Drugs used to treat patients with schizophrenia can increase the risk of heart attack, American researchers said Friday. Scientists at the University of Pennsylvania in Philadelphia found that schizophrenics who had been prescribed drugs were more likely to have experienced heart problems than patients with other illnesses. "Our findings clearly link patients with treated schizophrenia to higher rates of cardiac arrest, ventricular arrhythmia (irregular heart beats) and death," said epidemiologist Sean Hennessy.
   The scientists examined data on 120,000 patients in the United States to compare the frequency of heart problems in schizophrenics treated with thiordazine and haloperidol, two antipsychotic drugs, with two control groups of patients with skin or eye disorders. "Overall, the risk with thioridazine was no worse than that with haloperidol. Thioridazine may, however, represent an elevated risk at high doses," Hennessy added in a statement. Thioridazine is manufactured by Swiss drugs and chemicals group Sandoz AG under the trade name Mellaril. Haloperidol is a generic medicine sold by Johnson & Johnson as Haldol. Hennessy, who reported the findings in The British Medical Journal, said physicians should prescribe the lowest doses of thiordazine possible to minimize the risk of irregular heart beats and heart attacks.
   Schizophrenia, which is characterized by hallucinations, delusions and disordered thinking, afflicts about 45 million people worldwide. The causes of the illness are unknown but scientists know it affects chemicals in the brain and they believe there is a biological link that can predispose a person to the disorder. First signs of the illness usually appear in the late teens and early 20s. Men and women are equally affected. Scientists are using brain imaging techniques to detect changes in the brain in the earliest stages of the illness. Early detection will allow doctors to start treatment early and may improve the chances of recovery.

Marital Problems, Stress Cited in 5 Killings at Base
Estes Thompson, Associated Press, 11/8/2002

FORT BRAGG, N.C. -- Five killings this summer involving couples at Fort Bragg were probably the result of existing marital problems and the stress of separation while soldiers were away on duty, US Army investigators said yesterday. But the investigators also said that military culture discourages soldiers and their families from seeking help when domestic problems can potentially be resolved. The conclusions were in the summary of a report from a 19-member team, including mental and physical health workers and military clergy, who visited the base in August and September. The team also said that the antimalaria drug Lariam, given to troops sent overseas, was unlikely to have been at fault. Side effects of the drug, also known as mefloquine, have been known to include psychotic episodes.
   Authorities say that four Fort Bragg soldiers killed their wives in June and July. Two of the men committed suicide, and the other two are charged with murder. Three of those cases involved special operations soldiers who had served in Afghanistan. In a fifth case, a woman is charged with killing her husband, a Special Forces major.
   Investigators interviewed military leaders, doctors, leaders of family support groups, military and civilian law enforcement, and civilian public health officials. They also conducted focus groups with soldiers, spouses, and other people on the post. The report found that family support groups were inconsistent in the help they provided and that the Army's program for soldiers returning from deployment also varied from unit to unit. The full report was to be released later yesterday. Soldiers from Fort Bragg, the headquarters of the 82d Airborne Division and the Army's John F. Kennedy Special Warfare Center and School have figured prominently in ground operations in Afghanistan. Local police have said that the couples involved in each of the slayings had a history of marital problems.
   After the slayings, the military announced that soldiers will be screened for psychological problems before they leave Afghanistan. Commanders will be ordered to watch out for symptoms of depression and anxiety among their troops. Officials also are developing an intervention policy to protect spouses from domestic violence.

Army Report: Mental Health Workers Needed in Combat Units
Estes Thompson, Associated Press, 11/8/2002

FORT BRAGG, N.C. -- Mental health workers must be assigned to combat units if the military is to head off problems like those that led to five marital murders this summer, an Army report says. The report, released Thursday, said the killings were likely due to existing marital strife made worse by frequent separations of military families as the soldiers trained and fought. It said early intervention is the way to prevent future tragedies.
   Col. Dave Orman, a psychiatrist who led the study team, said a pilot program is being created to put mental health workers in combat battalions so ''the troops can access us casually.'' ''We're not doing what we need to be doing yet,'' he said. ''There was a prevalent attitude that seeking behavioral health care was not career safe.'' If mental health workers, now available at clinics, were in combat units, they might gain the confidence of soldiers and help them before problems escalate, he said.
   The report also said getting mental health care to soldiers before serious problems develop also might dispel the attitude that seeking help is a sign of weakness. ''The bottom line is trying to create a different culture so soldiers and their families understand that seeking help is what we want you to do,'' said Lt. Col. Yvonne Tucker-Harris, director of the Army's family advocacy programs.
   The report recommended the Defense Department study the impact of increased military operations on family stress. It also said distrust of military family care and mental health programs ''may contribute in rare cases to tragedy.'' Work already is being done to make sure each unit actually forms a family support group when the unit deploys for training in the United States or overseas, said Col. Tad Davis, garrison commander at Fort Bragg.

Excuse for Teens to Forgo Drugs
Claire Luna, Los Angeles Times- 11/10/2002

As a golf cart ferried him from physics class to the office, Matt Nejad thought his frequent tardies finally had caught up with him. Instead, the lanky San Clemente High School senior found himself urinating into a plastic cup. Five minutes later, he was back in class, having snagged a fleeting reprieve from his studies and confirmation for his parents that he's drug-free.
  San Clemente High's unusual voluntary random-testing program is part of a new -- and much-debated -- approach to fighting teen drug use. Most schools conduct drug tests as a condition of participating in extracurricular activities or in exchange for rewards. Testing at San Clemente -- where about 1,000 students participate -- and at two other southern Orange County high schools is different. Results are known only to the student and parents; neither school officials nor police are notified if a test result is positive for drugs.
   Principal Charles Hinman and his counterparts at Laguna Beach and Trabuco Hills high schools say the program protects teenagers from peer pressure, empowering students to just say no and still be cool. Students enrolled in such programs -- and those who want to pretend they are -- have an excuse at parties to pass on smoking a joint or snorting a line of cocaine, saying they would but their parents have signed them up for drug testing. "Most of the middle-of-the-road kids are looking for a reason to say no and still maintain their coolness," said Robert DuPont, president of the Institute for Behavior and Health and the first director of the National Institute on Drug Abuse. "Drug testing gives them an out."
   Administrators believe the program's voluntary nature -- parents enroll their children for testing at the beginning of the school year -- allows them to skirt sensitive privacy concerns. Although some students and parents have questioned the efficacy and logic of a program that has no school- or law enforcement-related consequences, Hinman said testing tries to address drug use in a deeper way. "It's the purest moral effort to help kids say no," he said. "When there is no punishment, there can be no confusion. All we're trying to get out of this program is a tool against peer pressure if kids want it, and treatment if kids need it."
   A study by the University of Michigan found that 54% of U.S. teens surveyed said they had tried an illicit drug by the time they finished high school, with 6% of seniors reporting daily marijuana use. The same study showed that those students who had used drugs were less likely to go to college and more likely to drop out. For that reason, schools have a responsibility to help parents intervene before the problem escalates, many education and law enforcement officials say. "Oftentimes, parents only find out their kids use drugs when we've arrested them for stealing or prostitution or they're in the hospital with an overdose," said Sgt. Roger Neumeister, who heads the Orange County Sheriff's Department's Juvenile Services Bureau.
   The Drug and Alcohol Testing Industry Assn. estimates about 500 public school districts nationwide have some sort of drug-testing program at one or more of their schools. The vast majority require testing for students involved in athletics or certain other extracurricular activities. Only about 15 districts nationally offer voluntary programs open to all students. Some of those, however, offer tangible incentives to boost participation -- such as discounts for school dances or backpack patches.
   The school board of the Dublin Unified district in Northern California, for example, is considering a voluntary program that would give gold stars and discounts at local businesses to those who enroll. Principals of the three Orange County schools, which are among a handful that have voluntary programs without incentives, say such visible markers of participation make it impossible for students not enrolled in the program to use it as an excuse to refuse drugs.
   Some educators, however, argue that a testing program available to all students is perilously close to requiring every child to be tested -- a step that inevitably would bring invasion-of-privacy lawsuits. Those lawsuits are less likely if parental consent is required, "but it's better to have it as a formal program tied to something concrete like extracurricular activities so that no student can quibble with their right to refuse to take the test," said Edwin Darden, senior staff attorney for the National School Boards Assn.
   Other critics say the voluntary testing program neglects the rights of students. Peter Eliasberg, managing attorney for the American Civil Liberties Union of Southern California, praised the programs for the punishment-free approach to dealing with teen drug use. But he cautioned that parental consent should be irrelevant if the students themselves do not want to be tested. "If they said free speech at school is banned if parents consent, there would be an uproar," he said. "That consent doesn't get around student rights." The largest trial of a program similar to those in Orange County was in Miami, where high schools offered off-campus testing for randomly selected students. It ended in 1999 after six months because only a few dozen enrolled.
   For some schools, paying for a drug-testing program -- which will cost San Clemente High an estimated $10,000 a year -- is an issue. Los Angeles Unified spokeswoman Cricket Bauer said it would be difficult for strapped urban districts such as hers to consider launching programs not directly related to academic improvement.
   Schools in affluent suburban regions such as Orange County have an advantage over urban districts in that community support is easier to mobilize, Darden said. Across the country in suburban Long Island, the Glen Cove School District is considering a voluntary testing program that already has strong backing among parents. "Some districts are so sprawling it would be impossible to ever arrive at a consensus about something as divisive as drug testing," he said. "Parents in suburban schools have a tendency to trust whatever the district recommends and the time to back it actively and make sure it succeeds."
   Participation at San Clemente ranges from 55% of freshmen to 20% of seniors. Of the 70 tests completed there this year, one student has refused to take the test and four have tested positive for marijuana use. At Trabuco Hills and Laguna Beach high schools, where school officials do not even see summaries of test results, principals said they do not know how many students have enrolled.
   San Clemente senior Lesley Navarro doubts the program reaches the students who need it most, saying that kids she knows with serious drug problems often lack parents who are interested in their welfare. "Most of the kids that are signed up for it aren't the ones doing drugs," said Navarro, who is enrolled in the testing program. "My friends who do drugs said they never turned it in, or put 'No' and forged their parents' signature." Others, such as senior Andrew Kartunen, say tests will provide a wake-up call to those parents who mistakenly assume their children don't use drugs. "A lot of parents think their kids are perfect," he said. "If I were a parent, this would be a service the school provides that would let me know for sure if they used drugs or not."
   For each test at San Clemente, the testing company's computer randomly selects students, who are called out of class and brought to the health office by golf cart, both to expedite transportation at the sprawling campus and ensure they don't stop anywhere first to snag a clean sample. Tests are given nearly every four weeks, and the 30 or so students chosen must use the office bathrooms, where sinks are plastic-wrapped and with trash cans removed so kids can't water down their samples or leave clean ones for fellow test-takers. The testing company tells parents of negative results by phone the same day. If the results are positive, parents are notified by mail and given counseling referrals and paperwork for the child to take a suggested follow-up test at company headquarters to determine frequency of use. A school psychologist also is available if parents want free counseling for the student. San Clemente pays for the program with funds from school support groups and a state safety grant. At Trabuco Hills and at Laguna Beach High, parents return permission slips with $30 checks for the testing fee.
   Many San Clemente parents have embraced the voluntary approach, saying it has sparked greater communication. "We have talked about drugs several times because of this program," said Peggy Griffin, whose son Stephen, a senior, is signed up. "I credit this program for that because we had never talked about drugs before." Back on campus, as Matt Nejad washed his hands after being tested, he said he hadn't even thought about the program since turning in his permission slip in September. "It only affects me in a positive way," he said. "I get out of class, and my parents know for sure that I'm drug-free."

Two Die in Six Weeks at Texas Psychiatric Hospital
Associated Press, 11/11/2002

WICHITA FALLS -- A man's death at a state psychiatric hospital in Wichita Falls is the second death of a patient there in six weeks, officials said. The man was killed in his sleep at about 12:30 a.m. Saturday at the Wichita Falls campus of the North Texas State Hospital, Officer Jimmy Hodges said. The victim's name and cause of death were not released. Police arrested the victim's roommate, whose name was not released.
   "What we basically deal with ... is all of our patients are there because they are a danger to themselves or to others," hospital spokesman Jerry McLain said. "We deal with hundreds of patients on a daily basis, and we don't have a problem with things to be concerned about. It seems in this one, it was unexpected." Police and hospital officials are doing separate investigations.
   The facility is finishing its probe of the Sept. 30 death of Teresa Penninger, who walked out of the hospital and set herself on fire at a gas station. Penninger had been listed as being at risk of an unauthorized departure and was supposed to be watched at all times. But as she began to improve, the monitoring requirements were slowly relaxed, McLain said. "We need to be more security conscious that we're aware of where patients are at all times," McLain said.
   The North Texas State Hospital is one of seven operated by the Texas Department of Mental Health and Mental Retardation. The hospital's Wichita Falls site provides general psychiatric services to 31 counties and treats about 330 patients. The 362-bed maximum-security campus in nearby Vernon treats adult and juvenile offenders sent by the criminal court system.

A World of Endless Ritual, Paralyzing Anxiety
William Branigin, Washington Post- 11/12/2002

The air in Martha Miner's one-bedroom apartment is thick with Lysol. The chemicals catch in the back of the throat as you step into the living room, past the plastic bags filled with her clothing, laundry and trash. Boxes and bags in the dining area overflow with legal papers, junk mail, old newspapers and her deceased mother's possessions. A table against the wall is covered with magazines in neat stacks. Miner says she is unable to put them away, or even go through them to throw some out.
   The 47-year-old Fairfax City resident is afflicted with obsessive-compulsive disorder, or OCD, a mental illness that she says keeps her from holding a job and now has her on the verge of eviction. Hers is a world wrapped in anxiety. She fears coming into contact with germs and being in crowded places. She obsesses over getting rid of something she might need and feels compelled to perform certain rituals before leaving home. "Sometimes I can't even open the door to go out," said Miner, a slight woman with reddish-brown hair and round glasses. "I don't know why. Maybe it's the fear of going out into the open."
   Now she faces a new struggle as she tries to get help. She was fired from her job as a legal secretary recently because of problems related to her condition. As a result, she lost her health insurance. Locally, community mental health programs are being cut back sharply, have long waiting lists and lack specialized help for OCD patients anyway, advocates say. Miner is applying for federal disability benefits, but she fears being turned down because of a lack of understanding about her illness. "I'm worried that the people making the decisions are not really educated about OCD," she said.
   Her disorder is one of the most common mental illnesses -- afflicting up to 3 percent of the U.S. population -- and one of the least recognized. According to the Obsessive-Compulsive Foundation, a nonprofit group based in Connecticut, people with the disorder on average see three to four doctors and spend at least nine years seeking treatment before they receive a correct diagnosis. It takes an average of 17 years to obtain appropriate treatment, the foundation says.
   "Many people have obsessive-compulsive behaviors that don't interfere with their lives and might even help them in their work," said Richard C. Baither, a psychologist who treats OCD patients in Fairfax. Such people can be exceptionally well organized and meticulous. But others, he said, are so restricted by the disorder that they are "pretty much house-bound," requiring two to 12 hours a day to complete all their rituals. This "certainly can make people nonfunctional." One of the worst cases he has seen was that of a man who collected 10 years' worth of his stools in jars in his Fairfax house because he feared that flushing them would contaminate other people.
   Fear of harming others is a common obsession among people known as "checkers," OCD sufferers who, for example, repeatedly drive around the block or stop and check under their cars to make sure they haven't run over someone. Others with the disorder include "hoarders," who collect things compulsively; "orderers," who might spend hours arranging their belongings; "counters," who are obsessed with certain numbers or with counting everything; and "washers," who endlessly wash and rinse their hands.
   OCD is believed to be caused by a chemical imbalance that short-circuits information processing in the brain and has been described as a case of "mental hiccups" that won't go away. The condition, which may be hereditary, is related to "tic disorders" such as Tourette's syndrome, but is distinct from psychotic illnesses such as schizophrenia. Unlike those with delusional mental illnesses, people with OCD are generally aware of their condition, although they may be unable to do anything about it. Antidepressant drugs can mitigate some obsessive-compulsive behaviors but usually do not eliminate them. Even if Miner could get into a local mental health program, "it's very hard to find therapy that's specific to that disorder," said Diane Yolton, secretary of the Northern Virginia Mental Health Consumers Association.
   In addition to her fear of germs and her compulsive hand-washing, Miner is plagued by an obsessive need to arrange her belongings before leaving home, which made her chronically late for work. Since losing her job as a legal secretary at a Fairfax law firm in September, she has been struggling to make ends meet. Medication she began taking in April "takes the edge off" some of her symptoms, but it makes her sleepy, contributing to her problems at work, she said. At home, simple tasks are an ordeal. She could put some of her belongings in a storage area in her apartment complex, she said, but doesn't feel the area is clean enough. She has to clean the building's washing machines and spray them with disinfectant before using them. She relies on a friend to take out the trash. Her various fears are "all connected," Miner said. "It's an invisible, powerful thing."
   The disorder contributed to the breakup of her marriage in 1988, leaving her alone to raise a son who is now 23. But her toughest setback came in 1994 when she lost custody of a daughter by another relationship. She had put the girl in foster care during a particularly difficult bout with her disorder. A court battle ensued when Miner tried to get her daughter back, and a Fairfax judge ended up terminating her parental rights. "She turned 10 in September of this year," Miner said of her daughter. "I think she has been adopted." The loss is a source of endless sorrow -- but one that Miner chooses not to forget. On the door of her refrigerator, whose contents she arranges obsessively so that nothing touches, is a picture of the girl when she was about 2. In Miner's bedroom, a few feet from her bed, stands an empty white crib.

The Not-So-Crackpot Autism Theory
Arthur Allen, New York Times Magazine- 11/10/2002

Neal Halsey's life was dedicated to promoting vaccination. In June 1999, the Johns Hopkins pediatrician and scholar had completed a decade of service on the influential committees that decide which inoculations will be jabbed into the arms and thighs and buttocks of eight million American children each year. At the urging of Halsey and others, the number of vaccines mandated for children under 2 in the 90's soared to 20, from 8. Kids were healthier for it, according to him. These simple, safe injections against hepatitis B and germs like haemophilus bacteria would help thousands grow up free of diseases like meningitis and liver cancer.
   Halsey's view, however, was not shared by a small but vocal faction of parents who questioned whether all these shots did more harm than good. While many of the childhood infections that vaccines were designed to prevent -- among them diphtheria, mumps, chickenpox and polio -- seemed to be either antique or innocuous, serious chronic diseases like asthma, juvenile diabetes and autism were on the rise. And on the Internet, especially, a growing number of self-styled health activists blamed vaccines for these increases.
   Like all medical interventions, vaccines sometimes cause adverse reactions. But unlike pills, vaccines come packaged with high expectations, which make them particularly vulnerable to public criticism. Vaccines don't cure people, and they are administered to healthy children, which gives them few opportunities for good press. When they work, nothing happens. When vaccinated children become ill, their parents are grief-stricken and often enraged, even if vaccines aren't proved to be at fault. All of this puts public health advocates like Halsey on the defensive. Most attacks on vaccines, they say, are based on hysteria, bad science and dubious politics.
   Halsey, 57, has green eyes, a white beard that makes him look like a ship's captain and an air of careful authority. As chairman of the American Academy of Pediatrics committee on infectious diseases from 1995 through June 1999, he often appeared in the media administering calm reassurance. "Many of the allegations against vaccines," Halsey said in one interview, "are based on unproven hypotheses and causal associations with little evidence." And then suddenly in June 1999, during a visit to the Food and Drug Administration, a squall appeared on the horizon of Halsey's confidence. Halsey attended a meeting to discuss thimerosal, a mercury-containing preservative that at the time was being used in several vaccines --including the hepatitis B shot that Halsey had fought so hard to have administered to American babies. By the time the dust kicked up in that meeting had settled, Halsey would be forced to reckon with the hypothesis that thimerosal had damaged the brains of immunized infants and may have contributed to the unexplained explosion in the number of cases of autism being diagnosed in children.
   That Halsey was willing even to entertain this possibility enraged some of his fellow vaccinologists, who couldn't fathom how a doctor who had spent so much energy dismantling the arguments of people who attacked vaccines could now be changing sides. But to Halsey's mind, his actions were perfectly consistent: he was simply working from the data. And the numbers deeply troubled him. "From the beginning, I saw thimerosal as something different," he says. "It was the first strong evidence of a causal association with neurological impairment. I was very concerned."
   The investigation into mercury vaccines was instigated in 1997 by Representative Frank Pallone Jr., a New Jersey Democrat whose district includes a string of shore towns where mercury in fish is one of many environmental concerns. Pallone, who had been pressing the government to reevaluate its overall guidelines on mercury toxicity, attached an amendment to an FDA bill requiring the agency to inventory all mercury contained in licensed drugs and vaccines. The job of adding up the amount of mercury in vaccines and assessing its risk fell to Robert Ball, an F.D.A. scientist, and two FDA pediatricians, Leslie Ball, Robert's wife, and R. Douglas Pratt. Thimerosal, which is 50 percent ethyl mercury by weight, had been used as a vaccine preservative since the 1930's in the diphtheria-tetanus-pertussis shot, known as DTP; and it was later added to some vaccines for hepatitis B and haemophilus bacteria, which by the early 1990's had become routine immunizations for infants.
   The FDA team's conclusions were frightening. Vaccines added under Halsey's watch had tripled the dose of mercury that infants got in their first few months of life. As many as 30 million American children may have been exposed to mercury in excess of Environmental Protection Agency guidelines -- levels of mercury that, in theory, could have killed enough brain cells to scramble thinking or hex behavior.
   "My first reaction was simply disbelief, which was the reaction of almost everybody involved in vaccines," Halsey says. "In most vaccine containers, thimerosal is listed as a mercury derivative, a hundredth of a percent. And what I believed, and what everybody else believed, was that it was truly a trace, a biologically insignificant amount. My honest belief is that if the labels had had the mercury content in micrograms, this would have been uncovered years ago. But the fact is, no one did the calculation."
   Making matters worse, the latest science on mercury damage suggested that even small amounts of organic mercury could do harm to the fetal brain. Some of the federal safety guidelines on mercury were relaxed in the 90's, even as the amount of mercury that children received in vaccines increased. The more Halsey learned about these mercury studies, the more he worried.
   "My first concern was that it would harm the credibility of the immunization program," he says. "But gradually it came home to me that maybe there was some real risk to the children." Mercury was turning out to be like lead, which had been studied extensively in the homes of the Baltimore poor during Halsey's tenure at Hopkins. "As they got more sophisticated at testing for lead, the safe level marched down and down, and they continued to find subtle neurological impairment," Halsey says. "And that's almost exactly what happened with mercury."
   Halsey was beginning to think that it would be prudent to limit thimerosal-containing vaccines and urge pediatricians to use thimerosal-free shots when possible. But his decision inflamed some of his peers. After all, although the thimerosal data was worrisome to Halsey, the available science offered no clear proof that the preservative posed a genuine danger to children when given in parts per million. Moreover, it wasn't clear that there were enough thimerosal-free vaccines available for diseases like pertussis and hepatitis B. Should an unproven fear justify the cessation of a procedure that protected children from proven dangers?
   Halsey looked into the matter further and found only complexity. In the medical literature, most cases of acute mercury poisoning result from doses hundreds or thousands of times higher than what infants received with thimerosal-laden vaccines. And although the thimerosal lev-els in vaccines exceeded the E.PA.'s guidelines for methyl mercury, thimerosal contained ethyl mercury, a compound that behaves somewhat differently in the body. The EPA based its guidelines on a series of studies of 917 children born in 1987 in the Faeroe islands, a windswept North Atlantic archipelago, to women who ate methyl-mercury-tainted whale meat. The Faeroes children, whose umbilical cord blood averaged four times the E.PA.'s daily "safe" dose -- which was 0.1 micrograms per kilo -- exhibited small but measurable neurological deficits seven years later. They had slower reaction times and diminished attention spans and their word choice and memorization were less keen than those of their classmates who had been exposed to less mercury, according to Philippe Grandjean, a Danish researcher who leads the continuing Faeroes study and teaches at Boston University.
   During most of the 90's, many American 6-month-olds received a total of 187.5 micrograms of ethyl mercury through vaccination. While the Faeroes children were exposed to mercury as developing fetuses, and therefore were more vulnerable than the vaccinated American infants, the American babies included about 60,000 each year who had already been exposed to high mercury levels because their mothers had eaten a lot of contaminated fish. What's more, hundreds of thousands of Rh-negative pregnant women and their unborn Rh-positive babies received additional thimerosal each year through injections designed to keep the mothers' immune systems from attacking the fetuses.
   The Faeroes studies, though they dealt with methyl mercury, unnerved Halsey. Other researchers were troubled, too. George Lucier, a toxicologist who led a 1998 White House review of mercury's dangers, went so far as to say it was "very likely" that thimerosal had damaged some children. There was precious little data to back up that precise suspicion -- and little to dismiss it -- because of the lack of toxicology research on ethyl mercury.
   On July 7, 1999, at Halsey's urging, the American Academy of Pediatrics and the Public Health Service released a statement urging vaccine manufacturers to remove thimerosal as quickly as possible and advising pediatricians to postpone giving most newborns the birth dose of the hepatitis B vaccine. The decision, which helped to create vaccine shortages and led some babies to become infected with hepatitis B, out-raged some senior vaccine experts. Walter Orenstein, director of the National Immunization Program at the Centers for Disease Control and Prevention, would charge that the rush to remove thimerosal-containing vaccines was "precipitous." Stanley Plotkin, a renowned vaccine developer, said that it was fruitless to try to soothe vaccination critics. "If anti-vaccinationists did not have mercury, they would have another issue," he said at one meeting. "One cannot prevent them from making hay regardless of whether the sun is shining or not."
   In Halsey's view, however, thimerosal wasn't simply a bone for rabid vaccine opponents to gnaw on. In the middle of that hectic summer he took a vacation in Maine. Canoeing on a lake, he came across posters that advised fishermen to "protect your children -- release your catch." Halsey took that message to heart. If the government was warning people against eating fish with mercury, he asked his colleagues, "does it make sense to allow it to be injected into infants?"
   Although other vaccinologists criticized Halsey, many of his colleagues rallied around him. "Neal put kids ahead of the vaccination program, which was gutsy," says Lynn Gold-man, a former E.P.A. official who has been on the Hopkins faculty since 1999 and worked with Halsey on thimerosal. "It would have been easier for him to line up on the other side."
   Few scientists believe that the spike in autism could have been caused solely by the thimerosal in vaccines, but in October 2001, a vaccine safety committee at the starchy Institute of Medicine confirmed that it was "biologically plausible" -- though by no means proved -- that thimerosal could be related to neurodevelopmental delays in some children. The committee recommended that thimerosal be removed from vaccines and called for extensive research to determine any damage it had caused.
   Halsey's fellow researchers were right about one thing. Antivaccine advocates immediately seized upon the thimerosal theory, and Halsey became something of an unwilling hero to the vaccine-safety advocates with whom he had so often sparred. In fact, thousands of parents with autistic children have responded to the Institute of Medicine report by filing lawsuits. Michael Williams, who has won millions in toxic tort settlements from pharmaceutical companies, was among the first lawyers to sue vaccine manufacturers, on behalf of William Mead, a 4-year-old Portland, Ore., boy with autism. Williams also filed a separate class action lawsuit with William's healthy older sister, Eleanor, as lead plaintiff, demanding that vaccine makers also pay for studies to determine thimerosal's effects on millions of children who might have lower I.Q.'s or other less obvious signs of mercury poisoning. Past studies have shown that mercury's effects vary tremendously from person to person, presumably because of genetic differences in the body's capacity to protect delicate organs from it.
   "In order to win the Eleanor lawsuit you need to establish liability, but I don't think that is going to be that hard," Williams said in a recent chat in his Portland office. "Organic mercury is a very serious neurotoxin." Williams embodies the vaccine establishment's worst fear about Halsey's course of action -- which is that taking the precautionary step of eliminating thimerosal would be read as an admission of fault. "The agenda was set by the lawyers and the antivaccine activists," a source close to a number of manufacturers complained to me. "The scientists responded to it scientifically, and that put them behind the eight ball right away. You had Neal Halsey running around saying: `We've got to do something! We've got to show we're concerned!"'
   Paul Offit, a vaccinologist at the Children's Hospital of Philadelphia, takes it a step further. "In some instances I think full disclosure can be harmful," he says. "Is it safe to say there is zero risk with thimerosal, when it is remotely possible that one child would get sick? Well, since we say that mercury is a neurotoxin, we have to do everything we can to get rid of it. But I would argue that removing thimerosal didn't make vaccines safer-- it only made them perceptibly safer."
   For Halsey, thimerosal injury is a possibility that must be addressed -- but by science, not by the courts. The scientific agenda, however, is already deeply politicized. From the start, the C.D.C.'s efforts to examine the possibility of thimerosal damage became snarled in acrimony. Critics of the vaccination system don't trust the C.D.C., which monitors evidence of adverse reactions to vaccines through the Vaccine Safety Datalink, a computerized set of 7.5 million medical records. Safe Minds, an advocacy group of parents who believe that their autistic children were damaged by thimerosal, has used the Freedom of Information Act to obtain documents showing that as early as December 1999 the C.D.C. had reason to believe that thimerosal caused developmental delays in some children. It was far from conclusive evidence, but vaccine critics charged that the C.D.C. tried to play it down. One of those critics was Dan Burton, a Republican congressman from Indiana, who says he firmly believes that his grandson's autism is a result of vaccines. "I'm so ticked off about my grandson, and to think that the public health people have been circling the wagons to cover up the facts!" Burton fumed at a June hearing. "Why, it just makes me want to vomit!"
   What comes through in an examination of the documents uncovered by Safe Minds is less a coverup than an impression of scientists anxiously watching over their shoulders as they work. One document, for example, records comments made by Robert Brent, a Philadelphia pediatrician who served as a consultant for the thimerosal study. "The medical-legal findings in this study, causal or not, are horrendous," Brent said. "If an allegation was made that a child's neuro-behavioral findings were caused by thimerosal-containing vaccines, you could readily find a junk scientist who would support the claim with a reasonable degree of certainty. But you will not find a scientist with any integrity who would say the reverse with the data that is available. . . . So we are in a bad position from the standpoint of de-fending any lawsuits if they were initiated."
   More research is in the works. The C.D.C. is setting up a study of neurodevelopmental effects based in part on the Faeroe Islands model. The N.I.H. is financing studies of thimerosal metabolism in animals and children. (An early University of Rochester study was reassuring: it indicated that children eliminate thimerosal much more quickly than expected.) Clearly, a lot is riding on this research, and pressure is being brought to bear on both sides.
   Can the vaccine authorities accept a positive answer? Can the vaccine opponents accept a negative one? "No one wants to think that harm might have been done," Halsey says. "I don't want to think harm might have been done." American children still receive up to 20 vaccines in the first two years of life. The first symptoms of autism often appear between the ages of 12 and 24 months. Most autism experts say that the two facts are coincidental, but as a major California study recently confirmed, autism is being diagnosed in numbers far higher than ever before, suggesting that a nongenetic cause may be partly to blame. In some children, the behavioral traits of autism present themselves along with physical problems like sensory dysfunction and motor disorders that have rough correlates in the mercury poisoning literature. For some parents, thimerosal provides a grand unifying theory that squarely points the finger at the government and vaccine makers.
   During much of the 20th-century, children suffered from an ailment called pink disease, which caused peeling skin on the extremities as well as regressive behavior. In 1948, a keen-eyed Cincinnati pediatrician named Josef Warkany noticed a common risk factor in these children: they had all been given teething powders containing calomel, a mercury derivative. Only about 1 in 500 children whose parents gave them calomel got pink disease -- suggesting that a constitutional vulnerability to mercury was part of the clinical picture. Soon after the powders were taken off the market, pink disease disappeared.
   Autism is a global phenomenon that was first reported in America in 1943, long before the potential dangers of thimerosal vaccines were raised. Removing the preservative won't -- even in the best case --eliminate the illness. But scientists estimate that the current rate of autism in its various forms might be as high as 1 in 500. If the autism trend begins to recede now that thimerosal has been removed, it could certainly suggest a cause. If it does decline, we might have Neal Halsey to thank. If it doesn't, his colleagues in the vaccine establishment may blame him for stoking an irrational protest from the public.
   Halsey, who still heads the Hopkins Institute for Vaccine Safety, which he was a founder of in 1997, is on the fence. "I don't believe the evidence is convincing now that there has definitely been harm done by thimerosal," he says, absently stroking his balding head. But to keep the vaccine program on a steady keel, Halsey says, the public health authorities simply must follow through with the studies and face the consequences without flinching. If there is damage, he says, "there should be some kind of compensation, though I don't know how" He pauses, and sighs. "I empathize with families of children with these disorders. How are you going to put dollar values on that?"