Parents of Runaways Fend for Themselves
Avis Thomas-Lester, Washington Post- 1/18/2005

It was the scariest call Tonya Wingfield had ever received. Her daughter Ashleigh, 14, had disappeared shortly after Wingfield dropped her off at her private school the morning of Jan. 10, the headmaster told her. The girl had last been seen talking to a 16-year-old boy from another school. Apparently they left together. For more than 24 hours, Wingfield searched for her daughter. She called Ashleigh's cell phone but got no answer. She called the cell phone carrier and found that the phone had been used several times to call the boy's friends. She called 911 but was told that police wouldn't search for Ashleigh because it appeared that she had left school voluntarily. So Wingfield called in her own network: civic leaders, school activists, police officers she had met through years of involvement in her Prince George's County community. Ultimately, it was one of her contacts who found Ashleigh in the District on Tuesday morning. Wingfield's experience underscored the difficulty that parents often face when they seek help from law enforcement finding a child who might have run away. Unlike child abduction cases, where police mobilize immediately, runaway cases draw less effort, authorities said.
      The U.S. Justice Department estimates that 800,000 children are reported missing to police agencies each year -- about 2,200 each day. Ben Ermini of the National Center for Missing and Exploited Children in Arlington said that the majority of the cases reported to his agency involve runaways. Most return home within 24 to 48 hours, Ermini said, leading law enforcement officials to eschew searches that are costly and take officers away from other tasks. Ermini said federal legislation was passed 15 years ago directing police to take reports immediately on any missing children under age 18, including runaways. Under the law, that information must be entered into the National Crime Information Center, a computerized database of victims and criminals maintained by the FBI.
      That doesn't mean they start to search immediately. Retta Williams Jeffers had to mobilize her own search when her 11-year-old son went missing in Southeast Washington in October 1994. D.C. police refused to initiate a search for 72 hours, saying the boy probably had run away. So she recruited neighbors, including residents of a nearby halfway house, to look for him. The halfway house residents found him 2 1/2 days after he disappeared, less than 100 yards from where he had been snatched by convicted child molester Contee Stevenson. "They can't assume that every child who disappears ran away just because someone didn't see them get abducted," Jeffers said in an interview last week.
      Even if her daughter left voluntarily, Wingfield said, that doesn't mean she is safe. "You don't know who she is going to encounter," said Wingfield, who runs a computer consulting company in Upper Marlboro. "They may have made the choice to go on their own, but acting on that choice could mean that they come upon a murderer or a molester or someone else who could victimize them."
      When she discovered that her daughter was not at Lanham Christian School, Wingfield immediately conducted a search of the area around the school and canvassed the neighborhood trying to find her. Prince George's police did not come to her home to take a report until she contacted a friend on the police force who called a supervisor, she said. At that point, officers interviewed her and visited the home of the boy with whom Ashleigh had last been seen. The boy said he didn't know where she was. Wingfield then mobilized friends to search for her daughter. Phil Lee, a community activist and former police officer, helped coordinate with law enforcement. Wingfield's mother and nephew called acquaintances. Friends rode through neighborhoods. An e-mail was sent to hundreds of people. Fliers were posted and disseminated to businesses.
      Lt. Edward Walters, investigative commander of the police district involved in Ashleigh's case, said more than half of the 650 missing person cases reported to his station last year involved young runaways. While police officers are required to take a report and assess every missing child case, only the children who are believed to be in danger or are under age 13 or mentally or physically disabled are classified as "critical missing persons." Police said the sheer numbers limit their ability to search for suspected runaways. "It would be very difficult to search for all of those kids," Walters said.
      Ashleigh Wingfield knew her mother was trying to reach her: The cell phone kept ringing. The boy she left school with urged her to answer it, "but I was afraid that I would be in trouble," she recalled in an interview Tuesday. She said she spent Monday with her friend, hanging out at his school in Laurel and meeting his friends. When the boy's father picked him up, Ashleigh went home with a group of his friends. Afraid to face her mother, she said, she ended up sleeping in a cold van. The next morning, she boarded the Metrorail and started riding, unsure about what she should do next, she said. At about 8:20, she was standing on the platform at L'Enfant Plaza when a friend of her mother's walked by. Aware of the search for Ashleigh, he took the girl into his office cafeteria for breakfast and called her mother, Tonya Wingfield recounted. At home later, Ashleigh said she wouldn't advise anyone to do what she did. "I would tell them to think it through really carefully -- where they're going to stay, what they're going to eat, what they would do," she said. "Because if they really think it through, they would realize it is really stupid."

The Tics of Tourette's Often Go Undiagnosed
Jane Brody, New York Times- 1/18/2005

A woman who lived for years in my neighborhood periodically appeared at a window and shouted obscenities into the street. Passers-by were appalled, but I felt what had to be the painful humiliation of someone who had no ability to control this seemingly antisocial behavior. I realized that the woman was afflicted with Tourette's syndrome, a lifelong neurological disorder with symptoms that contrary to popular belief, only rarely include the involuntary shouting of obscenities. I now know that the disorder is associated with a wide range of confusing symptoms that often result in delays in diagnosis and treatment that can last years. The problem was eloquently described in a two-part article last August in Contemporary Pediatrics.
      In his report, Dr. Samuel H. Zinner, a pediatrician at the University of Washington specializing in developmental and behavioral problems, points out that the syndrome "often goes undiagnosed or misdiagnosed." "Misconceptions about this tic disorder are customary," he adds, "with the syndrome often perceived as characterized by bizarre, fitful behaviors or comical outbursts of uncontrollable profanity." The fact is that "relatively few patients yell out obscenities," Dr. Zinner said, adding that "most patients are affected only mildly and usually escape notice," even by their doctors. Complicating the diagnostic puzzle is the ability of patients, consciously or otherwise, to suppress their tics when expressing them could be embarrassing, as would occur in visits to the doctor.
      Dr. Zinner adds that the tics of Tourette's "range widely in their severity, form, frequency and intensity" and are associated with other disorders that "are usually more serious or disabling than the tics themselves." These may include attention deficit hyperactivity disorder, obsessive-compulsive disorder, learning disabilities, anxiety or mood disorders and difficulty sleeping. These associated problems are often what first brings the problem to medical attention and may result in doctors' overlooking the underlying tic disorder.
      The disorder was first medically described in 1885 by the French neurologist Georges Gilles de la Tourette. But until the 1960's it, like other conditions later found to have neurological bases, was incorrectly viewed as a psychological problem. Psychotherapy cannot cure it and, despite what doctors and therapists sometimes tell parents of patients, people do not outgrow it.
      Dr. Zinner says the disorder is far more common than is generally recognized, even by the Tourette Syndrome Association, which estimates that 1 person in 2,000 is affected. Rather, recent studies suggest that the real number of those with chronic tics is more like 1 in 100, suggesting that 750,000 children in this country have Tourette's. The disorder affects four times as many boys as girls and often runs in families. Despite having chronic brain disorders that often interfere with learning, children with Tourette's do not quality for coverage in most states under the Individuals With Disabilities Education Act, which helps finance special education.

A Wide Variety of Tics
People with Tourette's are often ridiculed and stigmatized as weird, scary or even crazy, depending on the nature of their tics and how obvious, complex and uncontrollable they may be. Tics come in many forms, both "phonic" (sound-producing) and "motor" (abnormal movements), and each can be either simple or complex. Simple phonic tics include chronic sniffing, grunting, throat clearing, clicking and screaming. Complex ones include speech interruptions like stuttering and repetition of single words or phrases and coprolalia, the expression of socially unacceptable words or phrases. Simple motor tics may manifest as eye blinking, nose wrinkling, jaw thrusting, shoulder shrugging or neck jerking, or the tics may involve more complex movements like jumping, touching, twirling when walking, retracing steps, imitating someone else's movements or making sudden obscene gestures.
      Symptoms typically become more complex with time. They usually first appear in early childhood, by age 6 or 7, as simple motor tics, with phonic tics and more complex motor tics developing in the next few years or perhaps not until adolescence. Expression of tics typically occurs in bouts that may be separated by seconds or minutes, weeks or even months. Their expression is often preceded by a premonitory urge, not unlike a worsening itch that finally demands to be scratched. Performing the tic brings temporary relief.
      Consciously or otherwise, people with Tourette's often learn to suppress their tics, but there is a cost. The discomfort and distraction caused by the unfulfilled urge can be more disruptive than the tic itself. When suppressed tics are finally released, they are often more intense and frequent. Certain stimuli -- like noise, a word or an image -- may provoke the urge for tics, and conditions like stress, anxiety, fatigue and intense emotional excitement can prompt their expression.
      More than half of Tourette's patients have attention deficit hyperactivity disorder, and signs of it may appear even before the tics. Other neurological problems associated with the disorder include loss of impulse control, obsessive thoughts and compulsive behaviors, learning disabilities and difficulty organizing, planning, making decisions and following rules. People with Tourette's may also suffer from generalized anxiety, phobias, panic attacks, depression and sleep disorders. A few experience sudden explosive attacks of rage.

Suppressing Symptoms
Some people with Tourette's saw a glimmer of hope in a recent report of one man with debilitating symptoms of Tourette's that were immediately relieved by deep brain stimulation. This treatment involves the implantation of electrodes into the part of the brain that controls movements. The electrodes are attached by wires to a pacemaker implanted in the chest, a technique used with some success to curb the abnormal movements of Parkinson's disease. The technique has been tried on several patients with Tourette's, but it is still highly experimental, with no data yet on its overall effectiveness, possible complications, side effects or duration of benefit. Another relatively new approach for severe, very specific tics involves temporarily paralyzing the affected muscle group by injecting it with Botox (botulinum toxin), which can suppress the tic for several months.
      Meanwhile, depending on the nature and severity of a patient's symptoms, medications are available to treat them. They include alpha-adrenergic agonists like guanfacine (Tenex), neuroleptics like haloperidol (Haldol) and benzodiazepine clonazepam (Klonopin). As with all drugs, there are side effects, and Dr. Zinner urges the use of the lowest dosages and fewest drugs needed to help a person function effectively. Because tics may wax and wane, months of therapy may be needed when trying new medications to accurately determine their effectiveness. Dr. Zinner, however, cautioned against a common tendency for families to use a variety of alternative remedies and dietary restrictions, since none have proved useful.

Lawyers Cite Killer's Brain Damage as Execution Nears
Dean Murphy, New York Times- 1/18/2005

SAN FRANCISCO -- With California's first execution in three years scheduled for just after midnight on Wednesday, lawyers for the condemned killer are challenging the method and arguing that he is brain damaged. The inmate, Donald J. Beardslee, 61, has been on death row at San Quentin State Prison for nearly 21 years since confessing to taking part in the killing of two young women in 1981. At the time, he was on parole for killing a woman in Missouri in 1969.
      Mr. Beardslee's lawyers say they have new evidence that he was born with a brain defect that allowed him to be easily swayed and contributed to his criminal behavior. At the least, his lawyers have argued in requesting clemency from Gov. Arnold Schwarzenegger, the execution should be delayed to allow further analysis of the brain damage.
      In a separate legal battle, Mr. Beardslee's lawyers have asked the United States Supreme Court to declare his execution by lethal injection to be cruel and unusual punishment and a violation of his right to free speech. They argue one of the drugs he is to receive, a paralyzing agent, will make it impossible for him to cry out if in pain. Opponents of the death penalty, in a brief in Mr. Beardslee's case, say the drug also violates the First Amendment rights of witnesses to the execution by concealing any "physical or verbal manifestations" of his pain.
      On Saturday, the United States Court of Appeals for the Ninth Circuit, which has a history of looking sympathetically upon challenges in capital punishment cases, denied a request for a new hearing on the matters. A three-judge panel of the court had earlier turned down an appeal by Mr. Beardslee's lawyers.
      Prosecutors in San Mateo County, where Mr. Beardslee was sentenced to death, and friends and relatives of the murdered women dismiss the last-minute efforts on his behalf as far-fetched and unfounded. At a clemency hearing in Sacramento before the Board of Prison Terms, Martin T. Murray, an assistant district attorney in San Mateo County, disputed the new medical claims on Friday. "He is an intelligent, capable, high-level functioning individual both in and out of prison," Mr. Murray said of Mr. Beardslee.
      Tom Amundson, whose sister, Stacey Benjamin, was one of the two victims in 1981, said Mr. Beardslee's lawyers were "not fooling me." Ms. Benjamin and a friend, Patty Geddling, were killed in retaliation for a drug deal that had gone bad with associates of Mr. Beardslee, prosecutors argued at his trial. "I wonder about my sister every day," Mr. Amundson told the prison board. "I wonder what she was thinking when this person had her tied up and gagged." He added: "It's time to say goodbye to Mr. Beardslee. That's what I want. It's what the family wants."
      A juror from the death-penalty phase of Mr. Beardslee's trial in 1983 says the new medical testimony "would have been very important" to the panel's deliberations. The juror, Robert Martinez, has joined a former warden at San Quentin and several other people in asking that Mr. Beardslee's life be spared.
      The former warden, Daniel B. Vasquez, said in a letter to Governor Schwarzenegger that Mr. Beardslee had been "a model prisoner" and had shown an unusual "commitment to institutional safety and efficiency" during his incarceration. "Donald Beardslee is the rare inmate," Mr. Vasquez wrote. He ended the letter, "Killing him would be a shame." A former corrections officer at the prison in the 1980's said clemency for Mr. Beardslee would send an important message to others on death row. "It appropriately promotes the safety of officers, when, in the rare case, an inmate's exceptional behavior is recognized by an act of clemency," the officer, Ben Aronoff, wrote to the governor.
      A medical expert for Mr. Beardslee's lawyers, Dr. Ruben C. Gur, a professor of psychology and the director of the Brain Behavior Laboratory at the University of Pennsylvania, said at the clemency hearing that Mr. Beardslee had suffered brain damage and that his actions were strongly influenced by others. Two other people were convicted in the 1981 killings, including the purported mastermind, neither of whom received a death sentence. "He couldn't really understand people's emotions," Dr. Gur said. "He couldn't himself know how to behave, so he would rely on others to interpret things for him. He would mimic people's behavior."
      Mr. Beardslee's younger brother Richard said the doctor's assessment had filled a missing piece in the puzzle of his life. "His entire life he has been a scapegoat or patsy," Richard Beardslee said. "He does have a mental problem, but this explains to me why Don has been unable to function in our society."
      Ten people have been executed in California since the death penalty was reinstated in 1977. The last scheduled execution, of Kevin Cooper in February 2004, was blocked by the Ninth Circuit court hours before it was to take place to allow more examination of evidence.

Older Addicts Face Uncertain Twilight
Michelle Boorstein, Washington Post- 1/18/2005

James Gulick looks around at the recovering drug addicts in the room and thinks: Yeah, I fit in here. He has the whole sad list of credentials: the estranged family, the drained bank account, the regrets. But he doesn't look the part. The 62-year-old crack cocaine addict stands out among the dozens of people in his Fredericksburg treatment group, with his full head of white hair and bifocals in a sea young men with goatees and young women in tight jeans.
      Unlike many of them, Gulick, a retired food distributor, isn't here to rebuild a career or a marriage or save his house; those things went up in the smoke of a crack pipe long ago. All he wants now is a peaceful place to watch stock car racing on television and to reconcile with his son. So Gulick is trying to get used to baring his soul in group therapy and undergoing regular drug screening. And the counselors are trying to adjust to him.
      As unusual as Gulick seems -- the others have nicknamed him "Gramps" -- experts say he represents a larger, unseen wave of addicts who came of age before it was common to admit addiction and seek treatment. They say the numbers, growing for a decade, will swell as baby boomers -- the first generation in which recreational drug use was widespread -- reach old age. With age, they say, can come more isolation, more free time and changing body chemistry, all of which can help turn a weekend habit into a daily compulsion. Although there are few geriatric addiction specialists, the subject is starting to appear on conference agendas. The National Institute of Drug Addiction held its first forum on the issue in September, and the Department of Health and Human Services recently released a study predicting that the number of seniors with substance abuse problems will rise 150 percent by 2020.
      Addicts of all ages have traits in common, but seniors have some distinguishing ones. Their systems may be less tolerant of drugs than those of younger people. They have more free time, and no small children or bosses to be accountable to. And they have lost more in their lives, according to Margaret Anne Lane, a counselor at Sentara Williamsburg Community Hospital, who recently began a substance abuse counseling program for people older than 60.
      But when they are ready to quit, they often have more success, according to David Oslin, a psychiatrist at the University of Pennsylvania's medical school. Although they may regard therapy with suspicion, having grown up before it was common, they are highly motivated and keep appointments. Their age often means that sessions must be tailored for them, Lane said. "There's a greater need for respect and privacy, good manners, and logistically, things like having sessions during the day since they don't like to drive at night, shorter sessions, good lighting, people speaking louder," she said.
      Generally, people older than 60 make up less than 3 percent of the millions who seek treatment each year, though the number of senior addicts is estimated to be higher. Few older addicts seek treatment, but when they do decide to quit, they are generally more successful than younger ones are, Oslin said. "They are trying to maintain their independence and their health," he said. "They realize, 'If I want to be around for my grandkid to graduate from high school, I need to get my act together.' "
      In 1992, 77 percent of people older than 50 being treated for substance abuse were alcoholics; the rest had a drug problem or an alcohol and drug problem, according to Health and Human Services. By 2002, half of people older than 50 being treated had a drug problem. But only 2 percent of people older than 50 are considered addicts, compared with 4 percent to 5 percent of the general population, so little is known about addiction among the elderly -- including whether they are more or less likely to relapse after treatment.
      Gulick's counselors at the Rappahannock Area Community Services Board say they do not see enough people his age to draw conclusions about them. One case manager says some older addicts serve as mentors to the younger ones in drug courts, where 1 percent of participants nationwide are older than 60. Gulick, reluctant to preach, isn't one of them. But he couldn't contain himself during a recent session when the counselor threw out this question: Is it worth your time to warn young people to stay off drugs? "Maybe some of these young people should learn the hard way!" Gulick said, folding his arms across his chest and smiling a surprised smile -- as though he couldn't believe he had ventured an opinion.
     Gulick's voyage into treatment began the way it began for the other members of the group -- in the back of a police cruiser. After being arrested one December night two years ago as he bought cocaine at a Spotsylvania hotel, he was given a choice by prosecutors: spend six months in jail or make a commitment to drug court, a treatment program for addicts. Treatment would require him to learn things about himself that he wasn't eager to know. "I can't think about why I've done drugs; there's no answer," Gulick said in the low drawl of his native southeastern Virginia, nervously wiping imaginary crumbs off the Denny's restaurant table for the fourth time in a half-hour. "I just know the life I had before drugs, I know the life I had on drugs, and I know the life I have now. It was time to come off it."
      Eighteen months after starting drug court, he hasn't delved very deeply into the whys. He took the first pipe from a friend when he was in his forties and, during a decade, lost his marriage, his home and contact with his son and brother. When he retired from a sales management job in 2000 with $238,000 in savings and a pension, he began pouring money into crack, spending $1,000 a day by the end, he says. He dropped 30 pounds.
      He spent the first several months of treatment in denial. At weekly check-in sessions with Fredericksburg Circuit Court Judge John W. Scott Jr. -- who chats briefly with each participant and often jails those who have failed surprise drug tests -- Gulick would lean back in his pew and let an easy smile rest on his weathered face. He looked like the rebellious student who laughs when he is sent to the principal's office. But in recent months, Gulick and his counselors agree, his outlook began to change. Broke and required by drug court to work or volunteer, Gulick went nearly a year ago to the local day-labor office and struggled through construction work. After a few months, a friend gave him a job at a publishing house, where he packs boxes. On weekends, he tries to stay busy, barbecuing or fishing.
      Settling into a new life at his age hasn't been easy. He moved from Caroline County to Fredericksburg to be closer to drug court, and it took three months to find a roommate who wanted to live with an older man with special requirements. "I'd say, 'Look, I don't drink, I don't do drugs.' They'd say, 'I'll call you back and let you know if you got the apartment,' and then you never hear from them," he said. "That's how you know."
      If Gulick is all laid-back pragmatism, Richard Butler is the opposite, bouncing off walls one minute with tear-choked regret and the next with elation over the life he has reclaimed in his seventh decade. The burly carpenter embraces the self-examination that came with drug court, carrying self-help books and churning with analysis. "No, no, no!" he responds to Gulick's suggestion. "If only someone would have told me that freedom comes from living life today as honestly as possible!"
      With his tousle of sandy brown hair and puppylike grin, Butler, 62, looks as if he should be organizing a family touch football game, not smoking crack alone in the Fredericksburg motel where he was living when he was busted in 2003. "It was the right time," Butler said one morning, a book about "the pursuit of happiness" on the restaurant table next to his Marlboros. "I needed to travel all those little side roads and ravines. I just wish the right time would have happened earlier."
      His decades of addictions -- of crack, scratch lottery cards, bowling, women -- cost him four marriages and estranged him from his three children and 11 siblings. Butler grew up in a large family in which there was a lot of drinking, violence and transience. "We'd stay somewhere as long as people could tolerate us," he said. He joined the Navy, where he became a health worker, giving sailors information about alcohol and drugs. He smoked pot for the first time at 32 at a port in Africa, after a sailor challenged his lectures by noting that Butler had never tried drugs. "I wasn't going to accept that," he said, shaking his head at what identifies now as deep insecurity and anger. After the Navy, Butler drifted through Ohio and Texas before winding up in the Fredericksburg area, where he was offered crack in 1991 by a man who was always accompanied by attractive women. In the three years before his arrest, he said, he smoked crack every day.
      Next month, Butler and Gulick are set to leave drug court for an uncertain future. Both are optimistic. Before a recent session, Gulick was elated over what he said was a recent milestone; he had called his son for the first time in years, he said, and planned to see him over the holidays. But David Gulick, 32, of King George, Va., said he hadn't received any message from his dad. "But I'd be more than happy to talk to him," he said. "Everyone makes mistakes." Butler was excited about plans to expand his carpentry business. Despite two heart attacks, he works seven days a week. His goal, he said, "is to get clean to the point that I can live without fear of falling back in." With the zeal of a convert, he tells his younger peers: "Look at me, I've missed 62 years." A 19-year-old group member said his sermons are "annoying" -- but she's listening. "That's not going to be me," said the woman, who spoke on condition of anonymity. "I wouldn't be alive if I'm still using at that age."

Michigan Cuts 54 Jobs at Psychiatric Hospital
Associated Press, 1/20/2005

CARO, Mich. -- The state Department of Community Health has eliminated 54 jobs at Caro Center, a state psychiatric hospital in Tuscola County. Officials said the cuts are needed to help balance the state budget, but area residents voiced concern that less staff will mean more patient escapes, The Bay City Times reported in a Thursday story.
      T.J. Bucholz, spokesman for the state Department of Community Health, said the cuts will allow the state to keep funding Medicaid. "When you're choosing between very important things -- and patient care and staffing at the Caro Center are very important things -- and comparing them to very vital things, such as making sure a grandparent or pregnant woman or child isn't left without health insurance, you choose the very vital things," Bucholz said.
      State officials announced the 54 job cuts -- which amount to 12 percent of the center's 450 workers -- last week. All the jobs will be gone by the end of this month, though Bucholz said none of the center's security personnel will lose their jobs. About 80 of Caro Center's 187 patients are forensic patients -- living there because they have been ruled not guilty of crimes by reason of insanity, or because they've been found mentally incompetent to stand trial.
      According to police, Corbin A. Thomas, a forensic patient at the center, walked away from the facility last June and attacked four people at a nearby alternative high school several days later with a knife and hammer. Thomas, 28, of Saginaw, is scheduled to stand trial in March. Forty of Caro Center's fired workers were resident-care aides. "That means you have less direct-care staff watching these patients, so ... patient escape is more than likely going to happen, for sure, because of this," said Janine Ewald, who lives a mile from the center.

Smoking Is Best Battled From Two Fronts
Devin Rose, Chicago Tribune- 1/20/2005

A tip for anyone who already has called it quits on that New Year's quit-smoking resolution: Don't tough it out, try a plan. "We now have a great deal of evidence about what works and what doesn't, so don't waste time on what doesn't," said Robin Mermelstein, a smoking cessation expert at the University of Illinois at Chicago. "We know that what works the best is a combination of specific approved medications meant for stopping smoking and behavioral treatments."
      Of the 40 million U.S. smokers, about 20 million say they want to quit, Mermelstein said. Here's the plan she recommends: "With Nicoderm, the over-the-counter patch, there's a new program that combines the medication and behavioral approach. You buy the patch and get a personal code number that gives you access to a free, Web-based, tailored program." Mermelstein signed on as a spokeswoman for Nicoderm CQ after finding the product and its program successful. The new program also is available to those who use sister products Nicorette Gum or the Commit Lozenge. The Web site, www.committedquitters.com, asks users a series of questions to find out their smoking patterns and motivations. Then it offers tips for breaking those particular patterns. Users also receive periodic e-mails that check in and offer support.
      Mermelstein also suggests that smokers puff away while they're reading the initial tips and getting their stop-smoking plan in place. "When smokers quit, that's not the time to problem-solve; you can't stop and think things through." So get that "bag of tricks" ready for when the urge to light up strikes, "whether it's sipping water, getting up and stretching or cleaning out your environment by getting rid of cigarettes and ashtrays." And forget going cold turkey all alone, she said. "Some say you just have to put yourself in the throes of temptation and gut it out. . . . But studies show that doesn't work."
      Registered nurse Carol Southard, a smoking cessation specialist at Northwestern Memorial Hospital, agreed. "I've seen people trying to quit on their own, and it breaks my heart. What the medical community has said is, `What you're doing is dangerous, now just stop it.' But self-quit rates are terrible, around 5 to 10 percent." She suggests getting support from a therapist or group. (For more on her group at Northwestern, go to www.nmh.org/wellness.) Combine the support with use of a patch or gum, both of which come in generic forms; a lozenge; or, by prescription, a nasal spray, inhaler or the medication Zyban (bupropion).
      But, she said, "my biggest focus is on the behavioral, because the hardest part of quitting is psychological. Smoking becomes a part of you, part of your self-image. It becomes a coping mechanism, your best friend." Also, she encourages smokers to pick a quit date and, as that date nears, to start changing their relationship with cigarettes. "The product has so much control, and you need to stop giving it so much power," she said. "Start talking to the cigarettes, telling them goodbye, start to sever the relationship. Quitting is way more than willpower; quitting is about taking control."

Toy's Message of Affection Draws Anger and Publicity
Pam Belluck, New York Times- 1/22/2005

HELBURNE, Vt., Jan. 20 - The Vermont Teddy Bear Company believed it had a winner of a Valentine gift: its "Crazy for You" teddy bear, a cuddly bundle of fur - with paws restrained by a straitjacket and the outfit accompanied by commitment papers. But when the company, a nationally known retailer and tourist attraction much loved in Vermont, started selling the teddy bear this month, it created an uproar. Gov. Jim Douglas, a Republican who considers the company's president a friend, called the bear "very insensitive" at a news conference, saying: "Mental health is very serious. We should not stigmatize it further with these marketing efforts."
      Pleas to stop selling the bear have come from state legislators, medical professionals and mental health advocates, who say they object not to the "crazy for you" sentiment but to the straitjacket and commitment papers because they represent such an extreme and painful image of mental illness. The mother of a mentally ill teenager in Massachusetts started a petition drive, helped by students in local public schools. And both the president and the chairman of Vermont's only teaching hospital, Fletcher Allen Health Care, criticized the company, significant because the president of Vermont Teddy Bear, Elisabeth Robert, sits on the hospital's board. Mental health advocates want Ms. Robert removed from her hospital position, and the board chairman, William Schubart, is considering the request. "That kind of lighthearted depiction of illness is just not something I tolerate," Mr. Schubart said.
      Vermont Teddy Bear said it would keep its original plan of selling the bear, which costs $69.95, in its stores and on its Web site through Valentine's Day, its busiest season. (In its Shelburne store, little straitjackets are also sold separately so customers can accessorize other bears.) In a statement, the company said, "We recognize that this is a sensitive, human issue and sincerely apologize if we have offended anyone." It added, "This bear was created in the spirit of Valentine's Day" and "was designed to be a lighthearted depiction of the sentiment of love."
      Company officials have agreed to meet with the National Alliance for the Mentally Ill. Bob Carolla, an alliance spokesman, said the company first resisted meeting before Valentine's Day but then agreed to meet on Feb. 8. Mr. Carolla said that his group had fought the use of straitjackets in advertisements, but that this was the first straitjacketed product he could recall.
      Ms. Robert (pronounced roh-BEAR) said in an interview that the company, based in Shelburne, made the 15-inch bear after a customer survey yielded "overwhelmingly positive feedback." When complaints started, Ms. Robert said, she reflected on the matter "for virtually an entire day." She said she talked to employees and the board of directors, and reviewed public feedback. "I listened to our customers -- they were buying the bear," Ms. Robert said. She concluded that "there were many business reasons not to pull the product off the market -- profit wasn't the only one."
      The bear has upset many Vermont residents because the company, like the ice cream maker Ben and Jerry's, is a Vermont mascot of sorts and has popular community programs like providing teddy bears for injured children. Also, Vermont is considered a state with progressive mental health laws. "Vermont Teddy Bear has a reputation for being socially responsible and sensitive," Jason Gibbs, a spokesman for Governor Douglas, said. "And you would think that someone who sits on the board of trustees of Vermont's only academic medical center would have an exceeding degree of respect for the need to treat the mental health community with parity." "We're also concerned about the reputation of this particular company," Mr. Gibbs said. "They are a valued employer; they are a tourist attraction."
      Nicole L'Huillier, a company spokeswoman, said that despite making a product associated with children, Vermont Teddy Bear advertised to adults, often on radio shows like Howard Stern's. In addition to bears dressed as princesses and Superman, it also has a Playboy bear. "The majority of our customers are men at Valentine's Day," Ms. L'Huillier said. The company has received about 150 supportive e-mail messages and phone calls regarding its "Crazy for You" bear and about 400 in opposition, she said. Fueled by the uproar, about 2,000 bears were sold last week, she said, a volume considered "very high," but sales have recently "leveled off."
      Supporters of the company's decision to keep selling the bear say opponents are too politically correct. Ken Schram, a commentator for KOMO-TV in Seattle, said on the air that "the National Alliance for the Mentally Ill is bouncing around its round rubber boardroom." And Robert Paul Reyes, a columnist for The Lynchburg Ledger, a weekly newspaper in central Virginia, advised the head of the Vermont chapter of the National Alliance for the Mentally Ill chapter to "take a Valium, or better yet buy a 'Crazy for You Bear.' "
      Some Vermont residents also dismiss the objections. "It's a lovey, huggy little bear," said Al Bounds, 74, of Shelburne, which is a Burlington suburb. "Who cares what it's wearing?" Mr. Bounds said he thought the controversy was "good for the company because it will put them on TV, so that will bring money into the community."
      But others say a straitjacket on something as cute as a teddy bear trivializes a traumatic experience and reinforces a stereotype of mentally ill people as violent. "If Vermont Teddy Bear had produced a bear with a noose around its neck saying, 'I'd love to hang with you,' and called it a Ku Klux Klan teddy bear, the response would be overwhelming disgust and horror," said Anne Donahue, a Republican state representative.
      Flip Brown, a management consultant in Burlington, said that "I know that marketing departments need to be creative and even edgy, and you want products that grab attention," but that "if you buy this bear and you have a child who sees it and asks: 'What is that bear doing? Why can't it move its arms?' how do you answer that question?" Maureen McNamara of Westboro, Mass., whose 13-year-old son has been committed to psychiatric hospitals and put in a straitjacket, started a petition drive against the bear. "You wouldn't have a bear in a wheelchair saying, 'I'm rolling over the hill in love with you,' " she said.
      On Thursday, at the company's store here, Irene Brimicombe, 81, of Shelburne, looked at the prominently displayed bears and said, "They should take it off the market, so many people are against it." But her friend, June Quinn, 76, who recently moved from Virginia, bought one. "I'm tired of being politically correct," Ms. Quinn said. "I'm tired of balancing what comes out of my mouth. And, he's cute as all get out." Ms. Quinn also bought an American flag sweater for her bear. "Well, he can't sit around all the time in this," she said, gesturing to the straitjacket. "See," Ms. Brimicombe said, "that proves it isn't right."



Prosecutors Appeal Yates Order
Andrew Tilghman, Houston Chronicle- 1/22/2005

Harris County prosecutors are urging an appeals court to reconsider its order for a new trial for Andrea Yates, the Clear Lake-area woman convicted in the drownings of her children. In a motion filed Thursday, prosecutors say the 1st Texas Court of Appeals erred Jan. 6 when it ordered a new trial, citing an expert prosecution witness who gave erroneous testimony about a TV program. In Yates' March 2002 murder trial, forensic psychiatrist Park Dietz told jurors that she might have patterned the killings after an episode of Law & Order, in which a mother drowned her children and was found not guilty by reason of insanity. It later was found that no such episode existed.
      Prosecutors say the remark about the TV show had no bearing on Dietz's assertion that Yates was sane when she killed her five children in June 2001. Dietz's remark "does not impact in any degree upon the jurors' determination as to whether (she) knew what she was doing was wrong at the time that she committed the offenses," prosecutors said in court papers.
      Psychiatrists determined that Yates, who twice tried to commit suicide in 1999 after giving birth to her fourth child, suffered from schizophrenia and postpartum depression. She told police that Satan made her drown her children — Noah, 7; John, 5; Paul, 3; Luke, 2; and Mary, 6 months — in a bathtub. Dietz testified that, although Yates was psychotic on the day of the drownings, she believed her thoughts were coming from Satan and, therefore, must have known they were wrong.
      Citing 23 other cases, prosecutors contend the law cited by the appeals court about false testimony requiring a new trial applies only if the testimony had a direct bearing on the defendant's guilt or innocence. They said the testimony arguably could have helped Yates' insanity claim. "If (Yates) had watched a Law & Order episode, (her) expert witnesses clearly would have viewed that as just another ingredient to (her) increasingly psychotic thoughts," prosecutors said.
      Yates is in the Skyview prison psychiatric facility in Rusk. Her lawyers say they do not plan to seek her release on bail, but want a new trial in the hope of getting her transferred to a non-prison facility. The confusion about the TV program may have resulted from information prosecutors received from a woman who told them about a rerun of L.A. Law from the 1980s. She said one episode was about a woman who drowned her children and claimed mental illness.

Attorney: Mom Who Cut Off Baby's Arms Unfit for Trial
Associated Press, 1/22/2005

DALLAS -- A court-appointed psychiatrist has found a woman accused of killing her 10-month-old baby by cutting off her arms unfit for trial, her attorney said. Psychiatrist David Self determined that Dena Schlosser, 35, suffers from bipolar disorder and postpartum onset, said her attorney, David Haynes. The psychiatrist also said shunts implanted in Schlosser's brain during a series of childhood surgeries for hydrocephalus could have contributed to her actions. Schlosser, a housewife with a history of mental illness, was charged with capital murder Nov. 22 after she told a 911 operator that she had severed baby Margaret's arms. Police and paramedics found Dena Schlosser in her living room, covered in blood and still holding a knife.
      Haynes said Self wrote in his report that Schlosser could become competent if she receives the proper treatment. A jury will decide Feb. 14 whether Schlosser is fit to stand trial. "I think he did a good, thorough job," Haynes said in today's Dallas Morning News. "We believe a jury will be convinced she is not competent." The newspaper could not reach Self for comment. Prosecutors declined to comment on the report.
      Schlosser's stepfather, Mick Macaulay, a mental health counselor in Canada, said Self reached the right decision. Macaulay said he and Schlosser's mother "believe she is unable to understand the magnitude and the reality of what is happening." Medical records show Schlosser was diagnosed with postpartum psychosis last January after she gave birth to Margaret. They also show she tried to kill herself the day after the baby was born. Schlosser's two surviving daughters, ages 6 and 9, were returned to their father this week after living in foster care since their mother's November arrest.

Jackson Jurors to Hear Abuse Expert
Sally Ann Connell, Los Angeles Times- 1/22/2005

SANTA MARIA, Calif. — The prosecution in the molestation case against pop star Michael Jackson will be allowed to bring in an expert to describe how children behave after abuse, the judge ruled Friday. Santa Barbara County Superior Court Judge Rodney S. Melville granted the motion Friday morning over defense objections in a pretrial session. Jackson's attorney, Thomas A. Mesereau Jr., said that the prosecution was making a desperate attempt to bolster what he described as a "horrific problem" with its case. Jackson, 46, has pleaded not guilty to charges that he sexually abused a boy in 2003 and conspired to cover it up. The alleged victim, now 15, is expected to take the witness stand, as is his 14-year-old brother. "What if they are flat-out liars?" Mesereau said of the alleged victim and his family. "What if they have a history of lying? What if the boy lied in the past to help his mother obtain money through the legal process?"
      Ron Zonen, a deputy district attorney, argued that such an expert was important to "dispel myths commonly associated with child sexual abuse trauma." Zonen said four issues often cause confusion among jurors and are played up by the defense: the delayed reporting of child abuse by victims; how children relate the story of abuse bit by bit; why the report of abuse wasn't made to a close relative or adult; and why victims continue to display affection, even love, toward their abusers. The unnamed expert would testify to how such confusing behavior is the result of a "grooming process" by the abuser, Zonen said.
      Melville granted the motion but said strict limits would be discussed before the expert testifies. In other pretrial matters, Melville decided to keep the questionnaires that will be given to prospective jurors out of public view. The judge also said he was dissatisfied with the lengthy questionnaire, which had been submitted by both legal teams, and he made major changes to the document. "Quite frankly, I've gutted it," Melville told attorneys. "I don't know how many pages you gave me. But there are about seven pages left."
      Outside the courthouse, authorities have been preparing for the onslaught of media and visitors expected to descend when the trial starts Jan. 31 with jury selection. Cyclone fencing and other barriers have been placed around the building that will keep crowds off the courthouse property and limit them to adjacent streets.



Inhalant Abuse on the Rise Among Children
Shankar Vedantam, Washington Post- 1/22/2004

Diane Stem of Old Hickory, Tenn., vividly remembers the day she was called home by her distraught husband and daughter: Her 16-year-old son, Ricky Joe Stem Jr., had been found dead in the house with a plastic bag over his head. He had been sniffing Freon from the house's air-conditioning system. Marissa Manlove of Indianapolis got a call from a friend in June 2001 who told her that her 16-year-old son David Jefferis Manlove had dived into a swimming pool and not come up. The teenager died after breathing from a can of computer duster, using the nozzle as a straw to suck the chemical toluene inside. Toy Johnson Slayton of St. Simon's Island, Ga., remembers the police coming to her home in December 2001 after her 17-year-old son Johnson Bryant was found dead in his truck after going into cardiac arrest and hitting a tree. A can of butane and a surgical glove were found with the body -- police told her they believed her son had been "huffing." "I looked at the man and said, 'What does that mean?' " she said. "I am so angry because this was not on my radar screen. We had discussed the dangers of drugs and alcohol, but never, ever in my wildest dreams had I known to look at a can of butane with fear."
      A hidden epidemic is gaining momentum in America, experts say. Children as young as fourth-graders are deliberately inhaling the fumes of dangerous chemicals from a variety of household and office products. Inhalants, as they are known, are widely available and hard to detect, and are fueling a dangerous trend: The most reliable annual survey of drug use among children has found that inhalants are the one group of drugs in which abuse is on the rise.
      The chemicals travel rapidly to the brain to produce highs similar to alcohol intoxication. Unlike the effect of alcohol, these highs disappear within minutes, making it hard for parents to detect the abuse. The products, which can range from gasoline to cigarette lighter fluid, cleaning supplies to adhesives, are often highly toxic and addictive. New brain imaging research has shown that the chemicals can produce lasting changes in the brain, as well as heart, kidney and liver damage. The new brain imaging research also shows that different inhalants affect different parts of the brain, which might be why children report preferences. "Some kids like to huff acetone, some like to huff toluene and some like butane," said Stephen Dewey, a researcher at the Brookhaven National Laboratory in New York.
      Some indications suggest the problem may be growing faster among girls. Overall, nearly one in five eighth-graders has tried an inhalant, usually by breathing from a rag or a bag doused with the chemical. The increase in abuse has tracked a sharp drop in youngsters' perceptions of the risks of inhalants, said Lloyd Johnston, a researcher at the University of Michigan who helps conduct the annual "Monitoring the Future" survey of eighth-, 10th- and 12th-graders.
     Parents seem to know little about the trend. "It completely caught us off guard," said Diane Stem of Ricky's death. "He was a great kid, a great athlete; we have a loving supportive home; we had warned him about drugs and alcohol, but we didn't know to warn him about inhalants." In retrospect, say these parents, they ought to have been more worried.
"Not every family has crack cocaine under their sinks, but every family has cleaning products under their sinks," Stem said.
      Data show that inhalant abuse among children is growing in all parts of the country. Use is highest among whites, followed closely by Hispanics, and is lower among blacks. The problem afflicts children from all socioeconomic backgrounds, and from families with both high and low levels of parental education. But stereotypes about who abuses inhalants and the stigma associated with the practice have kept many parents from believing that the problem could affect them and blinded them to warning signs, said Slayton, Johnson Bryant's mother. "Looking back, there was an episode where I went in a playroom and found a surgical glove and thought, 'What is the cleaning service leaving a glove for?' " she said. Her son Johnson was filling the gloves with butane and inhaling from them. "He had a heavy cough. He had bouts of belligerence. The stigma of inhalants is what kept me from being aware."
      Harvey Weiss, executive director of the nonprofit National Inhalant Prevention Coalition in Austin, said that increasing the visibility of inhalant abuse could reduce abuse. Such campaigns in the early 1990s in Texas brought abuse rates down, but the prevention programs were eliminated in 1995. "Inhalant rates in Texas went back up again," he said. "We've seen a significant increase in inhalant use by eighth-graders in this country," agreed Nora D. Volkow, director of the National Institute on Drug Abuse, at a recent meeting in Washington organized by the Community Anti-Drug Coalitions of America.
      Abuse often starts early. By the fourth grade, about one in 25 children has tried an inhalant; by the sixth grade, the rate is one in 10; by eighth grade, it is nearly one in five, Johnston and other researchers report. Inhalant use among eighth-graders is second only to cigarettes and alcohol in drug use. Although rates seem to be increasing for both boys and girls, experts are especially worried about the sharp increase among girls. But surveys show that boys are more likely to become heavy users.
      No single test can detect all of the inhalants, and experts believe that many deaths linked to abuse go unreported or are listed as accidents. Abuse can lead to cardiac arrest, which some experts call "sudden sniffing syndrome." "If a young person is breathing from a rag or a bag and they get grossly intoxicated within seconds, they then may pass out, fall forward with their face in the bag or in the rag, and then they are going to continue to breathe these fumes and overdose," said Robert Balster, a scientist at Virginia Commonwealth University in Richmond. "It is like turning on an anesthesia machine in an operating room and then walking away."
      Some parents fear that anti-inhalant campaigns might unintentionally suggest the idea, or specific techniques, to children who do not know about them. But ignorance may be the bigger problem, said Weiss and parents whose children had died. It is the parents, not the children, who seem to be in the dark, they said.

Other States Look to Oklahoma in War on Meth
Kelly Kurt, Associated Press- 1/22/2005

TULSA, OKLA. - After years of locking up methamphetamine makers only to see homemade drug labs multiply on urban stovetops and country roads, Oklahoma got tough. It locked up the meth makers' cold medicine. Two months after the state ordered common nasal decongestants including Sudafed and Claritin-D placed behind pharmacy counters, law officers were finding half as many labs. Ten months later, meth lab seizures are down more than 80 percent. State officials believe many clandestine cooks have closed their kitchens for good now that pseudoephedrine, the key ingredient in meth, cannot be sold over the counter. "To see the sort of diminution we've seen, there is absolutely no other reason," said Lonnie Wright, who heads Oklahoma's drug agency and fields the calls from other states where leaders are looking to lock up pseudoephedrine, too.
      Several states have tried to limit the amount of pseudoephedrine sold at one time, but Oklahoma's law went further by requiring the drug to be dispensed by a pharmacist and that consumers sign for it. Oklahoma averaged 105 meth lab busts a month before the law took effect last April, said Wright, director of the Bureau of Narcotics and Dangerous Drugs Control. By November, the number had dropped to 19. Those numbers persuaded Missouri Attorney General Jay Nixon to push for a largely identical measure there. "This is a relatively small discomfort for the public," said Nixon, whose state limited how much pseudoephedrine a customer could buy but only saw the number of labs surge.
      The nasal decongestant can no longer be sold in Oklahoma grocery and convenience stores, along with other retail outlets. Signs on empty drugstore shelves direct people looking for relief from stuffy heads to the pharmacist. Oklahoma's law applies only to pills containing pseudoephedrine. Gel and liquid forms, which normally are not found in meth making, are available over the counter. Some people grumble when told they'll also have to show an ID to receive their tablets, said Jim Brown, owner of Freeland-Brown Pharmacy in Tulsa. "But when you tell them why," he said, "they really don't object."
      Rough-and-ready meth making has left ugly scars on communities large and small in Oklahoma. Children have been found playing among the volatile and highly toxic waste of their parents' drug making. Addicts haunt farmland looking to steal anhydrous ammonia fertilizer, which they use to convert pseudoephedrine into a potent high.
      Oklahoma's law bears the names of three state troopers who were killed in situations involving suspected meth users. Trooper Nik Green used to weep for the people he had arrested who were caught in meth's iron grip, his widow said. "He said, 'I really feel like this is one of Satan's tools,' " said Linda Green, who helped push for the law soon after Green was shot while investigating a vehicle on a rural road.
      Along with Missouri, lawmakers in neighboring states of Arkansas, Kansas and Texas also are looking to restrict over-the-counter pseudoephedrine. Arrests and police intelligence indicate Oklahoma meth makers are crossing the state line to buy the drug, said Tom Cunningham, drug task force coordinator for the Oklahoma District Attorneys Council. "When you see Arkansas, Kansas, Missouri and Texas get on board with the controls," he said. "I think you'll see Oklahoma's numbers drop again."
      Leaders in Washington, Idaho, Minnesota, Indiana, Iowa, Kentucky, Connecticut and Georgia have advocated laws requiring pharmacists to dispense pseudoephedrine or will be considering such legislation this year. In October, Oregon's pharmacy board approved new cold medicine restrictions that are patterned after the Oklahoma law. Illinois began requiring retailers this month to lock pseudoephedrine tablets in cabinets or behind counters.
      Pfizer Inc., the maker of Sudafed, does not oppose limiting access to the medication, spokesman Jay Kosminsky said. "Every state has got to get the balance right between access to legitimate consumers and preventing access to criminals," he said. But the company believes it's possible to secure the drug in grocery stores and other outlets — not just pharmacies, he said. Meanwhile, Pfizer plans to introduce a new form of Sudafed this month made without pseudoephedrine.
      The National Association of Chain Drug Stores doesn't "necessarily think the Oklahoma law is the way to go," said Mary Ann Wagner, the group's vice president of pharmacy regulatory affairs. Consumers miss out on hundreds of pseudoephedrine products that can't be displayed behind the pharmacy counter, she said. The group contends the law's apparent success may have more to do with impeding backdoor sales of cases of pseudoephedrine by rogue retailers, she said.
      The head of the U.S. Drug Enforcement Administration has referred to Oklahoma's "hard-hitting" law in urging states to help fight small labs. But a spokesman said the agency wants more data before drawing conclusions about the approach's success. Oklahoma is working on a computer network that will enable authorities to catch people who try to exceed the state's 30-day 9 gram pseudoephedrine limit by pharmacy-hopping.
      Investigators who were once overwhelmed by scattered mom-and-pop meth labs are now focusing on busting traffickers of Mexican meth, Wright said. No one knows for sure where the former cooks are turning for their supply, but because meth is so powerfully addictive the search for a new recipe is likely on, he said.