Bombing at political rally kills 9 in Pakistan


PESHAWAR, Pakistan (AP) — A suicide bomber in Pakistan killed nine people including a provincial government official at a political rally held Saturday by a party that has opposed the Taliban, officials said.


The rally in Peshawar, the capital of northwestern Khyber Pakhtunkhwa province, was held by the Awami National Party, whose members have been repeatedly targeted by the Taliban.


Among the dead was Bashir Bilour, the second most senior member of the provincial Cabinet, said Ghulam Ahmed Bilour, the politician's brother and federal railways minister.


Over 20 others were wounded by the blast, said local police officer Sabir Khan.


Bilour was leaving the rally after delivering the keynote speech when the attack occurred, said Nazir Khan, a local Awami National Party leader.


"There was smoke and dust all around, and dead and wounded people were lying on the ground," he said.


The suicide bomber was on foot, said another police officer, Imtiaz Khan.


Mohammed Afridi, a spokesman for the Pakistani Taliban, claimed responsibility for the attack in a telephone call with The Associated Press. He said the militant group has formed a special wing to attack members of the Awami National Party and the Muttahida Quami Movement, another political party that has opposed the Taliban.


Mian Iftikhar Hussain, the Khyber Pakhtunkhwa information minister and a member of the Awami National Party, said both he and Bilour had repeatedly received threats from militants. He condemned the attack and said the government needed to intensify its battle against the Taliban.


"Terrorism has engulfed our whole society," said Hussain. "They are targeting our bases, our mosques, our bazars, public meetings and our security checkpoints."


Ten Taliban militants attacked the military area of an international airport in Peshawar with rockets and car bombs a week ago, killing four people and wounding over 40 others. Five of the militants were killed during the attack, and five others died the next day in a gunbattle with security forces.


Also Saturday, police said a mob in southern Pakistan stormed a police station to seize a mentally unstable Muslim man accused of burning a copy of Islam's holy book. The crowd beat him to death, and then set fire to his body.


The case is likely to raise further concerns about the country's harsh blasphemy laws, which can result in a death sentence or life in prison to anyone found guilty. An accusation or investigation alone can lead to deaths, as people take the law into their own hands and kill those accused of violating it. Police stations and even courts have been attacked by mobs.


Police arrested the man on Friday after being informed by residents that he had burned a Quran inside a mosque where he had been staying for a night, said local police official Biharud Deen.


An angry mob of more than 200 people then broke into the police station in the southern town of Dadu and took the accused man, who they say was under questioning. Deen said police tried their best to save the man's life but were unable to stop the furious crowd.


Police have arrested 30 people for suspected involvement in the attack, said Deen. The head of the local police station and seven officers had been suspended, he said.


Past attempts by governments in predominantly Muslim Pakistan to review these laws have met with violent opposition from hardline Islamist parties.


In southwestern Pakistan, gunmen late Friday killed 11 Pakistanis and Afghans who were trying to cross into neighboring Iran to travel on to Europe as illegal immigrants, said local government official Zubair Ahmed. The shooting took place in Sunsar town in Baluchistan province, he said.


It was not immediately clear who was behind the attack, but hundreds of Pakistanis and Afghans are captured by Iranian border guards every year for illegally trying to travel to Europe to find better jobs.


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Associated Press writers Abdul Sattar in Quetta, Pakistan, and Adil Jawad in Karachi, Pakistan, contributed to this report.


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Ashton Kutcher files for divorce from Demi Moore


LOS ANGELES (AP) — Ashton Kutcher filed court papers Friday to end his seven-year marriage to actress Demi Moore.


The actor's divorce petition cites irreconcilable differences and does not list a date that the couple separated. Moore announced last year that she was ending her marriage to the actor 15 years her junior, but she never filed a petition.


Kutcher's filing does not indicate that the couple has a prenuptial agreement. The filing states Kutcher signed the document Friday, hours before it was filed in Los Angeles Superior Court.


Kutcher and Moore married in September 2005 and until recently kept their relationship very public, communicating with each other and fans on the social networking site Twitter. After their breakup, Moore changed her name on the site from (at)mrskutcher to (at)justdemi.


Kutcher currently stars on CBS' "Two and a Half Men."


Messages sent to Kutcher's and Moore's publicists were not immediately returned Friday.


Moore, 50, and Kutcher, 34, created the DNA Foundation, also known as the Demi and Ashton Foundation, in 2010 to combat the organized sexual exploitation of girls around the globe. They later lent their support to the United Nations' efforts to fight human trafficking, a scourge the international organization estimates affects about 2.5 million people worldwide.


Moore was previously married to actor Bruce Willis for 13 years. They had three daughters together — Rumer, Scout and Tallulah Belle — before divorcing in 2000. Willis later married model-actress Emma Heming in an intimate 2009 ceremony at his home in Parrot Cay in the Turks and Caicos Islands that attended by their children, as well as Moore and Kutcher.


Kutcher has been dating former "That '70s Show" co-star Mila Kunis.


The divorce filing was first reported Friday by People magazine.


___


Anthony McCartney can be reached at http://twitter.com/mccartneyAP.


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Predicting who's at risk for violence isn't easy


CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.


Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.


But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.


"They're yellow flags. They only become red flags once the blood is spilled," he said.


Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.


Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)


Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.


Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.


"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."


The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."


In a guidelines for families, the academy lists several risk factors for violence, including:


—Previous violent or aggressive behavior


—Being a victim of physical or sexual abuse


—Guns in the home


—Use of drugs or alcohol


—Brain damage from a head injury


Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.


Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.


Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.


According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.


Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.


Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.


And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.


All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.


Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.


Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.


Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.


___


Online:


American Academy of Child & Adolescent Psychiatry: http://www.aacap.org


___


AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner


Read More..

Predicting who's at risk for violence isn't easy


CHICAGO (AP) — It happened after Columbine, Virginia Tech, Aurora, Colo., and now Sandy Hook: People figure there surely were signs of impending violence. But experts say predicting who will be the next mass shooter is virtually impossible — partly because as commonplace as these calamities seem, they are relatively rare crimes.


Still, a combination of risk factors in troubled kids or adults including drug use and easy access to guns can increase the likelihood of violence, experts say.


But warning signs "only become crystal clear in the aftermath, said James Alan Fox, a Northeastern University criminology professor who has studied and written about mass killings.


"They're yellow flags. They only become red flags once the blood is spilled," he said.


Whether 20-year-old Adam Lanza, who used his mother's guns to kill her and then 20 children and six adults at their Connecticut school, made any hints about his plans isn't publicly known.


Fox said that sometimes, in the days, weeks or months preceding their crimes, mass murderers voice threats, or hints, either verbally or in writing, things like "'don't come to school tomorrow,'" or "'they're going to be sorry for mistreating me.'" Some prepare by target practicing, and plan their clothing "as well as their arsenal." (Police said Lanza went to shooting ranges with his mother in the past but not in the last six months.)


Although words might indicate a grudge, they don't necessarily mean violence will follow. And, of course, most who threaten never act, Fox said.


Even so, experts say threats of violence from troubled teens and young adults should be taken seriously and parents should attempt to get them a mental health evaluation and treatment if needed.


"In general, the police are unlikely to be able to do anything unless and until a crime has been committed," said Dr. Paul Appelbaum, a Columbia University professor of psychiatry, medicine and law. "Calling the police to confront a troubled teen has often led to tragedy."


The American Academy of Child & Adolescent Psychiatry says violent behavior should not be dismissed as "just a phase they're going through."


In a guidelines for families, the academy lists several risk factors for violence, including:


—Previous violent or aggressive behavior


—Being a victim of physical or sexual abuse


—Guns in the home


—Use of drugs or alcohol


—Brain damage from a head injury


Those with several of these risk factors should be evaluated by a mental health expert if they also show certain behaviors, including intense anger, frequent temper outbursts, extreme irritability or impulsiveness, the academy says. They may be more likely than others to become violent, although that doesn't mean they're at risk for the kind of violence that happened in Newtown, Conn.


Lanza, the Connecticut shooter, was socially withdrawn and awkward, and has been said to have had Asperger's disorder, a mild form of autism that has no clear connection with violence.


Autism experts and advocacy groups have complained that Asperger's is being unfairly blamed for the shootings, and say people with the disorder are much more likely to be victims of bullying and violence by others.


According to a research review published this year in Annals of General Psychiatry, most people with Asperger's who commit violent crimes have serious, often undiagnosed mental problems. That includes bipolar disorder, depression and personality disorders. It's not publicly known if Lanza had any of these, which in severe cases can include delusions and other psychotic symptoms.


Young adulthood is when psychotic illnesses typically emerge, and Appelbaum said there are several signs that a troubled teen or young adult might be heading in that direction: isolating themselves from friends and peers, spending long periods alone in their rooms, plummeting grades if they're still in school and expressing disturbing thoughts or fears that others are trying to hurt them.


Appelbaum said the most agonizing calls he gets are from parents whose children are descending into severe mental illness but who deny they are sick and refuse to go for treatment.


And in the case of adults, forcing them into treatment is difficult and dependent on laws that vary by state.


All states have laws that allow some form of court-ordered treatment, typically in a hospital for people considered a danger to themselves or others. Connecticut is among a handful with no option for court-ordered treatment in a less restrictive community setting, said Kristina Ragosta, an attorney with the Treatment Advocacy Center, a national group that advocates better access to mental health treatment.


Lanza's medical records haven't been publicly disclosed and authorities haven't said if it is known what type of treatment his family may have sought for him. Lanza killed himself at the school.


Jennifer Hoff of Mission Viejo, Calif. has a 19-year-old bipolar son who has had hallucinations, delusions and violent behavior for years. When he was younger and threatened to harm himself, she'd call 911 and leave the door unlocked for paramedics, who'd take him to a hospital for inpatient mental care.


Now that he's an adult, she said he has refused medication, left home, and authorities have indicated he can't be forced into treatment unless he harms himself — or commits a violent crime and is imprisoned. Hoff thinks prison is where he's headed — he's in jail, charged in an unarmed bank robbery.


___


Online:


American Academy of Child & Adolescent Psychiatry: http://www.aacap.org


___


AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner


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Coalition soldier missing in Afghanistan


KABUL, Afghanistan (AP) — A search is under way in southern Afghanistan for a soldier from the NATO-led coalition, believed to be the first to have gone missing since a U.S. Army sergeant was captured by the Taliban more than three years ago, a military spokesman said Friday.


U.S. Army Maj. Martyn Crighton said the soldier was among the 1,560 troops from the former Soviet republic of Georgia serving in the country.


A statement from Georgia's Defense Ministry on Thursday said an intense "search and rescue" operation was being mounted in Helmand and Nimroz provinces, describing the soldier as a military officer who went missing on Wednesday.


The last known coalition soldier to go missing was U.S. Army Sgt. Bowe Bergdahl, 26, who was taken prisoner on June 30, 2009 in Paktika province in southeastern Afghanistan.


Bergdahl, who turned 26 in captivity on March 28, was the subject of a proposed prisoner swap in which the Obama administration was considering the transfer of five Taliban prisoners long held at the U.S. military prison at Guantanamo Bay, Cuba, to Qatar.


That plan collapsed, but a new proposal would transfer some Taliban fighters or their affiliates out of full U.S. control. The prisoners would go to a detention facility adjacent to Bagram air field, the largest U.S. military base in Afghanistan, officials of both governments have said.


Eighteen Georgian soldiers have been killed since the country joined the international military operations in Afghanistan in August 2009. Georgia is not a member of NATO but has significant presence in Afghanistan relative to its population of 4.5 million.


There are currently more than 102,000 coalition troops in the country, including 66,000 from the United States. Only a residual force is slated to remain past 2013.


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Investors shed shares of Blackberry maker






NEW YORK (AP) — Shares of Blackberry maker Research in Motion slumped more than 16 percent Friday with future revenue coming into question and a declining number of subscribers.


RIM’s stock jumped initially Thursday when the Canadian company released better-than-expected third-quarter results and a stronger cash position.






Shares reversed course during a conference call later, when executives said that the company won’t generate as much revenue from telecommunications carriers once it releases the new BlackBerry 10.


RIM’s stock had been on a three-month rally in which the stock more than doubled from levels not previously seen since 2003.


“Despite a solid quarter, the stock is trading down due to the introduction of a lower enterprise service tier and fears that RIM will not receive monthly services revenues for consumer BB10 subscribers,” said Jefferies analyst Peter Misek. He thinks RIM has offered carriers a lower-priced option in exchange for a bigger purchase commitment for the new device. He kept his “Hold” rating.


Sterne Agee analyst Shaw Wu kept maintained a “Neutral” rating on the stock, but lowered his earnings estimates, saying he continued to be concerned about RIM’s ability to compete with Apple and Google.


Shares of Research in Motion Ltd. fell $ 2.29 to $ 11.83 in morning trading.


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Country singer Tate Stevens wins Fox's 'X Factor'


NEW YORK (AP) — Tate Stevens, who was mentored by music exec L.A. Reid on the second season of "The X Factor," has won the Fox singing competition.


The 37-year-old country singer from Belton, Mo., beat runner-up Carly Rose Sonenclar, a 13-year-old schoolgirl from Westchester, N.Y., and teenage girl group Fifth Harmony on the finale that aired live Thursday night.


Stevens wins a $5 million recording contract.


More than 35 million votes were cast by viewers after Wednesday's performance show.


Besides Reid, judges this season included Demi Lovato, Britney Spears and series creator Simon Cowell.


Thursday's show was also the grand finale for Reid. Earlier this month, he said he wouldn't be returning to "The X Factor" next year. No replacement has been announced.


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AP IMPACT: Big Pharma cashes in on HGH abuse


A federal crackdown on illicit foreign supplies of human growth hormone has failed to stop rampant misuse, and instead has driven record sales of the drug by some of the world's biggest pharmaceutical companies, an Associated Press investigation shows.


The crackdown, which began in 2006, reduced the illegal flow of unregulated supplies from China, India and Mexico.


But since then, Big Pharma has been satisfying the steady desires of U.S. users and abusers, including many who take the drug in the false hope of delaying the effects of aging.


From 2005 to 2011, inflation-adjusted sales of HGH were up 69 percent, according to an AP analysis of pharmaceutical company data collected by the research firm IMS Health. Sales of the average prescription drug rose just 12 percent in that same period.


___


EDITOR'S NOTE — Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.


___


Unlike other prescription drugs, HGH may be prescribed only for specific uses. U.S. sales are limited by law to treat a rare growth defect in children and a handful of uncommon conditions like short bowel syndrome or Prader-Willi syndrome, a congenital disease that causes reduced muscle tone and a lack of hormones in sex glands.


The AP analysis, supplemented by interviews with experts, shows too many sales and too many prescriptions for the number of people known to be suffering from those ailments. At least half of last year's sales likely went to patients not legally allowed to get the drug. And U.S. pharmacies processed nearly double the expected number of prescriptions.


Peddled as an elixir of life capable of turning middle-aged bodies into lean machines, HGH — a synthesized form of the growth hormone made naturally by the human pituitary gland — winds up in the eager hands of affluent, aging users who hope to slow or even reverse the aging process.


Experts say these folks don't need the drug, and may be harmed by it. The supposed fountain-of-youth medicine can cause enlargement of breast tissue, carpal tunnel syndrome and swelling of hands and feet. Ironically, it also can contribute to aging ailments like heart disease and Type 2 diabetes.


Others in the medical establishment also are taking a fat piece of the profits — doctors who fudge prescriptions, as well as pharmacists and distributors who are content to look the other way. HGH also is sold directly without prescriptions, as new-age snake oil, to patients at anti-aging clinics that operate more like automated drug mills.


Years of raids, sports scandals and media attention haven't stopped major drugmakers from selling a whopping $1.4 billion worth of HGH in the U.S. last year. That's more than industry-wide annual gross sales for penicillin or prescription allergy medicine. Anti-aging HGH regimens vary greatly, with a yearly cost typically ranging from $6,000 to $12,000 for three to six self-injections per week.


Across the U.S., the medication is often dispensed through prescriptions based on improper diagnoses, carefully crafted to exploit wiggle room in the law restricting use of HGH, the AP found.


HGH is often promoted on the Internet with the same kind of before-and-after photos found in miracle diet ads, along with wildly hyped claims of rapid muscle growth, loss of fat, greater vigor, and other exaggerated benefits to adults far beyond their physical prime. Sales also are driven by the personal endorsement of celebrities such as actress Suzanne Somers.


Pharmacies that once risked prosecution for using unauthorized, foreign HGH — improperly labeled as raw pharmaceutical ingredients and smuggled across the border — now simply dispense name brands, often for the same banned uses. And usually with impunity.


Eight companies have been granted permission to market HGH by the U.S. Food and Drug Administration, which reviews the benefits and risks of new drug products. By contrast, three companies are approved for the diabetes drug insulin.


The No. 1 maker, Roche subsidiary Genentech, had nearly $400 million in HGH sales in the U.S. last year, up an inflation-adjusted two-thirds from 2005. Pfizer and Eli Lilly were second and third with $300 million and $220 million in sales, respectively, according to IMS Health. Pfizer now gets more revenue from its HGH brand, Genotropin, than from Zoloft, its well-known depression medicine that lost patent protection.


On their face, the numbers make no sense to the recognized hormone doctors known as endocrinologists who provide legitimate HGH treatment to a small number of patients.


Endocrinologists estimate there are fewer than 45,000 U.S. patients who might legitimately take HGH. They would be expected to use roughly 180,000 prescriptions or refills each year, given that typical patients get three months' worth of HGH at a time, according to doctors and distributors.


Yet U.S. pharmacies last year supplied almost twice that much HGH — 340,000 orders — according to AP's analysis of IMS Health data.


While doctors say more than 90 percent of legitimate patients are children with stunted growth, 40 percent of 442 U.S. side-effect cases tied to HGH over the last year involved people age 18 or older, according to an AP analysis of FDA data. The average adult's age in those cases was 53, far beyond the prime age for sports. The oldest patients were in their 80s.


Some of these medical records even give explicit hints of use to combat aging, justifying treatment with reasons like fatigue, bone thinning and "off-label," which means treatment of an unapproved condition. In other cases, the drug was used "for an unknown indication," meaning that the reason for treatment wasn't clear.


Even Medicare, the government health program for older Americans, allowed 22,169 HGH prescriptions in 2010, a five-year increase of 78 percent, according to data released by the Centers for Medicare and Medicaid Services in response to an AP public records request. And nearly half the increase came in one year: 2007.


"There's no question: a lot gets out," said hormone specialist Dr. Mark Molitch of Northwestern University, who helped write medical standards meant to limit HGH treatment to legitimate patients.


And those figures don't include HGH sold directly by doctors without prescriptions at scores of anti-aging medical practices and clinics around the country. Those numbers could only be tallied by drug makers, who have declined to say how many patients they supply and for what conditions.


The AP approached every U.S.-authorized manufacturer to ask what efforts they make to market responsibly and prevent abuse. Only one HGH supplier, Novo Nordisk, agreed to an interview.


"We're doing our level best to make sure that the right patients are getting the right medicine at the right time," said company spokesman Ken Inchausti.


He said the company is aware of the abuse issue. He said if patients apply for assistance from the company's patient-support hub, prescriptions will be flagged for review if they are missing the most rigorous test or an endocrinologist's signature. He said the company won't sell HGH directly to doctors accused of bad practices and does not deal with anti-aging clinics.


Representatives of other FDA-approved HGH makers insist they do not encourage use by bodybuilders or athletes or wealthy baby boomers trying to recapture their youth. But some said they are largely powerless to control who uses their medications or why.


"Lilly cannot restrict the actions of distributors, pharmacies or doctors," Eli Lilly spokeswoman Kelley Murphy said in a written statement.


That argument doesn't fly for critics like Dr. Peter Rost, a retired Pfizer executive who filed a whistleblower lawsuit over the HGH marketing practices of Pharmacia, which later merged with Pfizer. He said drug companies are simply looking the other way and betting that their profits will eclipse the cost of any fines.


They view it as "good business," he said.


___


PEDDLED ON INTERNET


Type "human growth hormone" into any Internet search engine, and it will spit back countless websites with overblown promises of smoother skin, better sex, weight loss and even renewed body organs.


Any doctor who actually prescribes the drug for those purposes is taking a legal risk.


FDA regulations ban the sale of HGH as an anti-aging drug. In fact, since 1990, prescribing it for things like weight loss and strength conditioning has been punishable by 5 to 10 years in prison.


Such marketing claims are routinely made at hormone clinics like Palm Beach Life Extension, whose owners are among 13 people now awaiting trial on federal charges in Florida in a steroids and HGH distribution case brought last year.


"Grow YOUNG with Us!" screamed a banner on the company's now-defunct website, which advertised that HGH can reduce body fat, improve vision, strengthen the immune system, aid kidney function, lower blood pressure and enhance memory and mood.


The clinic arranged to have its clients' prescriptions filled at Treasure Coast Pharmacy, in Jensen Beach, Fla.


In 2009, the FBI recorded a phone call between the pharmacy's owner, Peter Del Toro, and a doctor in Elkton, Md., who was cooperating with agents after being implicated in a related steroid-distribution case.


Their talk, documented in a court filing, illustrates how things often work in the networks of pharmacies and clinics that drive HGH sales.


Patients submitted a medical history form by mail and took a blood test. But in most instances, the indictment said, the evaluation was a sham: One doctor was charged with giving a clinic a pad of blank, signed prescriptions to save him the chore of signing off on each diagnosis. He got $50 for every drug order bearing his name, the indictment said.


Dr. Rodney Baltazar, the Maryland physician cooperating with the FBI, sometimes consulted briefly with patients via webcam. But he made it clear in the call that those evaluations were perfunctory at best.


Baltazar was a gynecologist, not an endocrinologist. He said he knew "a little bit" about HGH and testosterone, which are often prescribed in tandem, but he relied largely on clinic salespeople to set doses.


The pharmacist coached the doctor: Keep detailed medical charts documenting that patients are taking the drug for at least some kind of health problem, just in case the U.S. Drug Enforcement Administration ever came calling.


"Because somebody questions you, you want to be able to say, 'Here, look at his chart. You know, he's got fatigue. He's got, you know, a decreased sex drive. He's got increased body fat. He has some -- some slight depression, probably.' Whatever his signs and symptoms are."


None of these conditions is a legal reason to prescribe HGH. But the pharmacist said that most investigators will be satisfied and move on "because there's guys that are just selling stuff basically like a boiler room."


Del Toro was arrested along with 12 other people in September 2011 on charges that they distributed steroids and human growth hormone to people who had no legitimate medical need. He is awaiting trial. His lawyer declined to comment. Baltazar was sentenced to six months in prison for involvement in steroid distribution schemes.


At the height of the crackdown in 2007, the federal government went after Pfizer in a case involving anti-aging clinics. The company paid $34.7 million in fines to settle the case — 11 percent of the company's annual revenue from the drug.


___


TROUBLED HISTORY


Blockbuster U.S. sales of HGH represent the latest frustration in 25 years of government efforts to control abuse of the growth drug made infamous by sports scandals.


First marketed in 1985 for children with stunted growth, HGH was soon misappropriated by adults intent on exploiting its modest muscle- and bone-building qualities. Congress limited HGH distribution to the handful of rare conditions in an extraordinary 1990 law, overriding the generally unrestricted right of doctors to prescribe medicines as they see fit.


Despite the law, illicit HGH spread around the sports world in the 1990s, making deep inroads into bodybuilding, college athletics, and professional leagues from baseball to cycling. The even larger banned market among older adults has flourished more recently.


For years, cheaper supplies from unauthorized foreign factories, particularly in China, fed the market via direct and Internet sales that sidestepped the medical establishment.


Though such shipments were banned under other law, the imports initially attracted little attention because they were usually labeled as raw pharmaceutical ingredients, which compounding pharmacies are allowed to bring into the country.


That flow began to be curtailed in 2006, when U.S. drug authorities stepped up efforts to block shipments at the border.


A handful of pharmacies across the country were hit with criminal charges over their handling of HGH. Federal prosecutors charged China's biggest HGH maker, GeneScience Pharmaceutical, with illegally distributing its Jintropin brand in the U.S. The company's CEO pleaded guilty in 2010.


With illicit supplies crimped, many pharmacies stopped selling unauthorized HGH. But tens of thousands of adult abusers began buying pricey U.S.-approved HGH that remained available in abundant supply, the AP found in its analysis of sales data.


Thus, pushed by a powerful demand, sales of U.S.-approved brands have swelled far beyond expected levels for a drug approved in just a handful of rare conditions.


Dr. Robert Marcus, a retired hormone specialist who left HGH manufacturer Eli Lilly and Co. in 2008, said that company was bent on stopping foreign counterfeits, not on cutting off abusers. "That's where their major level of frustration was — pharmaceutical fraud — rather than focusing on people who were using growth hormone illegitimately," he said.


Dr. Jim Meehan, of Tulsa, Okla., who has used HGH to treat aging problems and sports injuries, said the federal clampdown "never seemed to affect my patients and their ability to get Omnitrope, Tev-Tropin" and other government-approved brands.


The big drug companies have applauded the foreign crackdown and urged the government to do even more to combat sales of fake or fraudulently labeled HGH. In 2004, Bruce Kuhlik, speaking for the Pharmaceutical Research and Manufacturers of America, told a federal task force that unauthorized drug importation "is inherently unsafe" and industry representatives used Chinese HGH imports as their poster child.


In 2007, as the HGH embargo gained momentum, authorized makers picked up 41 percent more HGH orders, raising their annual total from 245,000 to 345,000, according to the analysis of the IMS Health data. Similarly, most of the drug's sales boom happened in the first two years of the crackdown, with 46 percent inflation-adjusted growth in yearly sales to $1.1 billion.


Steve Kleppe, of Scottsdale, Ariz., a restaurant entrepreneur who has taken HGH for almost 15 years to keep feeling young, said he noticed a price jump of about 25 percent after the block on imports. He now buys HGH directly from a doctor at an annual cost of about $8,000 for himself and the same amount for his wife.


Despite higher prices, the business has expanded in recent years largely on the strength of sales to healthy adults who can afford to indulge their hope of retaining youthful vigor.


___


GROWING OLD


Many older patients go for HGH treatment to scores of anti-aging practices and clinics heavily concentrated in retirement states like Florida, Nevada, Arizona and California.


These sites are affiliated with hundreds of doctors who are rarely endocrinologists. Instead, many tout certification by the American Board of Anti-Aging and Regenerative Medicine, though the medical establishment does not recognize the group's bona fides.


The clinics offer personalized programs of "age management" to business executives, affluent retirees, and other patients of means, sometimes coupled with the amenities of a vacation resort.


The clinics insist there are few, if any, side effects from HGH. Mainstream medical authorities say otherwise.


A 2007 review of 31 medical studies showed swelling in half of HGH patients, with joint pain or diabetes in more than a fifth. A French study of about 7,000 people who took HGH as children found a 30 percent higher risk of death from causes like bone tumors and stroke, stirring a health advisory from U.S. authorities.


For proof that the drug works, marketers turn to images like the memorable one of pot-bellied septuagenarian Dr. Jeffry Life, supposedly transformed into a ripped hulk of himself by his own program available at the upscale Las Vegas-based Cenegenics Elite Health. (He declined to be interviewed.)


These promoters of HGH say there is a connection between the drop-off in growth hormone levels through adulthood and the physical decline that begins in late middle age. Replace the hormone, they say, and the aging process slows.


"It's an easy ruse. People equate hormones with youth," said Dr. Tom Perls, a leading industry critic who does aging research at Boston University. "It's a marketing dream come true."


Some scientific studies of HGH have found modest benefits: some muscle and bone building, as well as limited fat loss, but nothing like the claims of the anti-aging industry. And some of the value credited to HGH may instead come from testosterone, which is routinely provided with HGH by anti-aging doctors and sports suppliers.


Endocrinologists say it's natural for the body to produce less growth hormone as people age beyond their early 20s, because they aren't growing anymore. Only a tiny number of adults with extraordinarily low HGH levels — perhaps several thousand of them — are believed to suffer real deficiencies that can properly be treated with the hormone.


Still, anti-aging doctors routinely diagnose otherwise healthy middle-aged people with an HGH deficiency, simply because their levels are lower than in young adults. "Basically anyone going through midlife," can benefit from the drug, declared one prescriber, Dr. Howard Elkin, of Whittier, Calif., who has himself competed as a bodybuilder.


Dr. Kenneth Knott, of Marietta, Ga., said HGH helps his older patients feel "more vibrant" and look "more alive."


Like many anti-aging doctors, he diagnoses patients by testing for a blood component called insulin growth factor, which is indirectly tied to HGH. Endocrinologists use a more authoritative test that stimulates the pituitary gland to make HGH itself. Nearly all insurers insist on this stimulation testing, and that's why clinic patients almost always pay for HGH out of their own pockets.


Bob Vitols, a 50-year-old lab assistant at a veterinary medicine company in Lincoln, Neb., is a rare exception. His unusually generous health plan isn't allowed to challenge a doctor's prescription.


Four years ago, Vitols began feeling run down. So he Googled his symptoms on the Internet, decided he had a hormone deficiency, and sought out a clinic.


One doctor put him on testosterone replacement therapy. A second clinic added HGH after diagnosing him with osteopenia, a mild bone thinning common in aging adults. It is not, however, a condition that can properly be treated with HGH.


Despite the diagnosis, the treatments — which can cost $10,000 per year — have been covered by his health insurance, he said. He takes Genotropin, the HGH made by Pfizer. His prescriptions are filled via mail order by CVS Caremark Corp., one of the largest dispensers of prescription drugs in the U.S.


Vitols said the drug changed his life: his mood is better, and he isn't burning out every day at 2 p.m. "I feel like I could walk outside and just walk through a fence — and come out fine on the other side," he said.


His experiences with the drug haven't all been positive, though. Vitols said he initially developed elevated liver enzymes and went to a specialist, who told him to stop taking hormones immediately.


Instead, Vitols said, he adjusted his dosage, and the problem disappeared.


He also dumped the specialist:


"I could tell he was against hormones right at the start," Vitols said.


___


Associated Press Writer David Caruso reported from New York and AP National Writer Jeff Donn reported from Plymouth, Mass. AP Writer Troy Thibodeaux provided data analysis assistance from New Orleans.


___


AP's interactive on the HGH investigation: http://hosted.ap.org/interactives/2012/hgh


___


The AP National Investigative Team can be reached at investigate(at)ap.org


EDITOR'S NOTE _ Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the second of a two-part series.


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A somber moment for 26 victims of Sandy Hook school massacre


NEWTOWN, Conn. (AP) — The chiming of bells reverberated throughout Newtown on Friday, commemorating one week since the crackle of gunfire in a schoolhouse killed 20 children and six adults in a massacre that has shaken the community — and the nation — to its core.


Gov. Dannel P. Malloy gathered with other officials in rain and wind on the steps of the Edmond Town Hall as the bell rang 26 times in memory of each life lost at Sandy Hook Elementary School. The gunman also killed his mother before the massacre, and himself afterward.


Officials didn't plan any formal remarks Friday morning, and similar commemorations took place throughout the country.


Though the massacre does not rank as the deadliest school shooting in U.S. history — that happened at Virginia Tech — the tender age of the victims and the absence of any apparent motive has struck at Americans' hearts and minds. The gunman used a military-style assault rifle loaded with ammunition intended to inflict maximum damage, officials have said.


The White House said President Barack Obama privately observed the moment of silence.


Just a week after the attack, gun control has taken a front burner in Congress, where previous mass shootings produced only minimal legislative reaction. Vice President Joe Biden said Thursday that the Obama administration would push to tighten gun laws.


The National Rifle Association plans a Friday morning news conference, its first public event since the shootings. The nation's largest gun-rights lobby with 4.3 million members has said it will offer "meaningful contributions to help make sure this never happens again."


Traffic stopped in the streets outside the town hall in Newtown as bells rang out to honor the dead.


Malloy, taking deep breaths with his hands folded in front of him, was joined by the Newtown superintendent of schools, lawmakers and other officials as bells rang out at the nearby Trinity Episcopal Church.


"When I heard the 26 bells ring it just melted my soul," said Kerrie Glassman of Sandy Hook who said she knew seven of the victims. "It's just overwhelming. You just can't believe this happened in our town."


Among those who came out to observe the ceremony was Edie Hardwick, 66, of Middlebury, Conn.


"It's such a horrific thing. Such a horrible thing." she said.


When the bells tolled mournfully to honor the victims of last week's shooting rampage, they did so 26 times, for each child and staff member killed.


Rarely do residents mention the first person police said Adam Lanza killed that morning: his mother, Nancy, who was shot in the head four times while she lay in bed.


That makes 27.


A private funeral was held Thursday in New Hampshire for Nancy Lanza, according to Donald Briggs, the police chief in Kingston, N.H., where her funeral was held. About 25 family members attended the ceremony.


In Newtown, where makeshift memorials of stuffed animals, angels, candles, flowers and balloons have blossomed on patches of grass throughout town, there is only one noticeable tribute to Nancy Lanza. It's a letter written by a friend on yellow paper affixed, screwed and shellacked onto a red piece of wood.


"Others now share pain for choices you faced alone; May the blameless among us throw the first stone," it reads in part.


No one outwardly blames Nancy Lanza for the rampage. But authorities have said the gunman, her 20-year-old son Adam, used the guns she kept at their home to carry out a massacre that became the second-deadliest school shooting in U.S. history and has stirred lawmakers to call for gun control laws.


Some view her as a victim, but one whose guns were used to kill first-graders. And others think Nancy Lanza was an innocent victim, one who should be counted and included at memorials.


Newtown and environs weathered a fourth day of funerals Thursday as mourners laid to rest Catherine Hubbard, Benjamin Wheeler, Jesse Lewis and Allison Wyatt, all 6 years old; and Grace McDonnell, 7. On Friday, five funerals or memorials were planned.


U.S. Attorney General Eric Holder was one of the people to visit Newtown on Thursday, stopping by a firehouse.


Biden, who is overseeing the administration's response to last week's shooting, said he and Obama are "absolutely committed" to curbing gun violence in the United States.


"Even if we can only save one life, we have to take action," he said.


Gun-control measures have faced fierce resistance in Congress for years, but that may be changing because of the events in Connecticut, which shocked the nation.


After the shooting, Obama signaled for the first time that he's willing to spend significant political capital on the issue. Some prominent gun-rights advocates on Capitol Hill — Democrats and Republicans alike — have expressed willingness to consider new measures.


Investigators have said that Nancy Lanza, a gun enthusiast, visited shooting ranges several times and that her son also visited an area range.


Authorities say Adam Lanza shot his mother at their home and then took her car and some of her guns to the school, where he broke in and opened fire. A Connecticut official said Nancy Lanza was shot four times in the head with a .22-caliber rifle.


Adam Lanza was wearing all black, with an olive-drab utility vest, during the school attack. Investigators have found no letters or diaries that could explain the rampage.


Friends and acquaintances have described him as intelligent, but odd and quiet.


Friends said he would stare down at the floor and not speak when she brought him into a local pizzeria. They knew that he'd switched schools more than once and that she'd tried home schooling him. But while she occasionally expressed concern about his future during evenings at the bar, she never complained.


"I heard her as a parent. I always said that I wouldn't want to be in her shoes. But I thought, 'Wow. She holds it well,'" said Jon Tambascio, son of the pizzeria operator.


___


Contributing to this report were Associated Press writers Michael Melia, John Christoffersen and David Klepper in Newtown; Jim Fitzgerald in Katonah, N.Y.; and Frederic J. Frommer in Washington.


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Afghan president welcomes British pullout timeline


KABUL, Afghanistan (AP) — The Afghan president on Thursday welcomed the withdrawal of nearly half of the British troops stationed in Afghanistan next year, saying his forces were ready to take up the country's defense.


A statement from Hamid Karzai's office said the partial pull-out was an "appropriate" move as NATO forces transfer responsibility for the war against the Taliban to the Afghan military.


British Prime Minister David Cameron announced Wednesday that about 3,800 British troops would be withdrawn by the end of 2013, with some 5,000 staying into 2014. The majority of NATO forces, including those of the United States, are set to leave by the end of 2014.


"The Afghan security forces are ready to implement the defense and security of the country. It is an appropriate act in the transition of security to Afghan forces," Karzai's statement said.


Cameron told lawmakers in London that the decision reflects confidence in the Afghan military. It also reflects mounting political pressure and periodic public protests in Britain for the end of its military role in Afghanistan, where it sent the second largest NATO force after the United States and sustained the second highest number of casualties.


Afghanistan's army and police have grown substantially with the help of international allies and now number 350,000. But desertion rates, illiteracy and tensions among ethnic groups within the ranks remain high and analysts say the Afghan military still lacks the know-how to mount major, multi-unit operations. Attacks by insurgents still occur daily.


In the latest incidence of violence, a powerful roadside bomb killed five civilians and two police officers Thursday in the western province of Nimroz, governor Mohammad Sarwar Subat told The Associated Press. The blast, he said, occurred near a police checkpoint as a vehicle carrying the civilians headed for a session in the provincial capital, Zaranuj. The governor said the bomb was set by "enemies of the state," used by officials to describe the Taliban or groups allied to it.


NATO officials regularly praise operations as "Afghan-led," even when Afghan forces play a minimal role, making it difficult to determine their full capability to take over. Also, a surge in insider attacks by Afghan soldiers and police against their own colleagues and international allies has raised further questions about their readiness.


U.S. Defense Secretary Leon Panetta, who visited the country last week, said U.S. commanders in Afghanistan believe NATO has "turned the tide" after 11 years of war. But skepticism remains over whether the Afghan military can hold back a still powerful and resilient insurgency after 2014.


The U.S. has some 66,000 troops in the country with the number to be pulled out next year and the size of a residual force past 2014 currently under review in Washington.


Cameron said some British troops would stay on after 2014 to return equipment and deal with logistics.


"We've said very clearly: no one in a combat role, nothing like the number of troops there are now," Cameron said. "We've promised the Afghans that we will provide this officer training academy that they've specifically asked for. We are prepared to look at other issues above and beyond that, but that is the starting baseline."


The withdrawal of British troops from Afghanistan will start next April, according to Defense Secretary Philip Hammond.


Cameron said Britain would continue to support Afghanistan by contributing about 70 million pounds (US $114,000) a year to help pay for Afghan security forces. Another 70 million pounds a year are spread through other aid programs.


Since 2001, 438 British personnel have died in Afghanistan.


Last month, France ended its combat operations in the country, pulling hundreds of troops from a base in a volatile region northeast of Kabul and fulfilling promises to end its combat role ahead of other NATO allies. France has lost 88 troops in Afghanistan since late 2001.


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Facebook predicted to overtake Google in mobile display ad revenue this year






Shares of Facebook (FB) have begun to rebound since the company’s disastrous initial public offering this past May. After opening at $ 38 per share the company’s stock plummeted into the mid-20s over the summer months and eventually fell to a low of $ 17.55 in early September. Since then, however, Facebook shares have begun to bounce back after the company posted better-than-expected results in the third quarter. While Facebook stock is still down more than 25% on the year, it is rising steadily as analysts and investors become increasingly bullish about the company’s future as a leading advertising platform.


[More from BGR: BlackBerry 10 browser smokes iOS 6 and Windows Phone 8 in comparison test [video]]






According to a new report from eMarketer, Facebook is predicted to surpass Google (GOOG) in mobile display advertising in 2012. Google is expected to generate $ 339 million in mobile ad revenue this year, a significant increase from previous estimates of between $ 45 and $ 100 million. The research firm notes that Facebook is expected to capture an 18.4% share of the mobile display ad market in the U.S. this year, compared to Google’s 17% share, which is down from 23% in 2011.


[More from BGR: New iMac early adopters upset that they can’t run Boot Camp]


“Major ad publishers are strengthening their offerings much faster than previously expected,” said Clark Fredricksen, vice president of communications at eMarketer. “I don’t think anybody thought after the second quarter that Google and Facebook would be in position that they are now in the mobile ad marketplace.”


The company’s mobile ad revenue is expected to more than triple by 2014 when it will reach an estimated $ 1.2 billion. The firm predicts that Facebook and Google will continue to battle for the No.1 spot in the mobile ad market over the next few years. Facebook is expected to increase its lead to 25.2% in 2013, compared to Google’s 19.6% share. Google is estimated to bounce back in 2014, however, with a market leading 23.1% share, ahead of Facebook’s 22.7% share.


Despite the impressive numbers, eMarketer notes that mobile still represents a small slice of the total advertising market. In 2012, only 2.4% of total ad spending in the U.S. is expected to go towards mobile ads, but the market is expected to reach an 11% share by 2016 when it surpasses both radio and print spending.


This article was originally published by BGR


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Study: Solo stars at higher death risk than bands


LONDON (AP) — Rock 'n' roll will never die — but it's a hazardous occupation.


A new study confirms that rock and pop musicians die prematurely more often than the general population, and an early death is twice as likely for solo musicians as for members of bands.


Researchers from Liverpool John Moores University studied 1,489 rock and pop stars who became famous between 1956 and 2009 and found they suffered "higher levels of mortality than demographically matched individuals in the general population."


American stars are more likely to die prematurely than British ones.


Lead researcher Mark Bellis speculates that could be because bands provide peer support at stressful times.


The research was published Thursday in online journal BMJ Open.


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AP IMPACT: Steroids loom in major-college football


WASHINGTON (AP) — With steroids easy to buy, testing weak and punishments inconsistent, college football players are packing on significant weight — 30 pounds or more in a single year, sometimes — without drawing much attention from their schools or the NCAA in a sport that earns tens of billions of dollars for teams.


Rules vary so widely that, on any given game day, a team with a strict no-steroid policy can face a team whose players have repeatedly tested positive.


An investigation by The Associated Press — based on dozens of interviews with players, testers, dealers and experts and an analysis of weight records for more than 61,000 players — revealed that while those running the multibillion-dollar sport believe the problem is under control, that is hardly the case.


The sport's near-zero rate of positive steroids tests isn't an accurate gauge among college athletes. Random tests provide weak deterrence and, by design, fail to catch every player using steroids. Colleges also are reluctant to spend money on expensive steroid testing when cheaper ones for drugs like marijuana allow them to say they're doing everything they can to keep drugs out of football.


"It's nothing like what's going on in reality," said Don Catlin, an anti-doping pioneer who spent years conducting the NCAA's laboratory tests at UCLA. He became so frustrated with the college system that it drove him in part to leave the testing industry to focus on anti-doping research.


Catlin said the collegiate system, in which players often are notified days before a test and many schools don't even test for steroids, is designed to not catch dopers. That artificially reduces the numbers of positive tests and keeps schools safe from embarrassing drug scandals.


While other major sports have been beset by revelations of steroid use, college football has operated with barely a whiff of scandal. Between 1996 and 2010 — the era of Barry Bonds, Mark McGwire, Marion Jones and Lance Armstrong — the failure rate for NCAA steroid tests fell even closer to zero from an already low rate of less than 1 percent.


The AP's investigation, drawing upon more than a decade of official rosters from all 120 Football Bowl Subdivision teams, found thousands of players quickly putting on significant weight, even more than their fellow players. The information compiled by the AP included players who appeared for multiple years on the same teams, making it the most comprehensive data available.


For decades, scientific studies have shown that anabolic steroid use leads to an increase in body weight. Weight gain alone doesn't prove steroid use, but very rapid weight gain is one factor that would be deemed suspicious, said Kathy Turpin, senior director of sport drug testing for the National Center for Drug Free Sport, which conducts tests for the NCAA and more than 300 schools.


Yet the NCAA has never studied weight gain or considered it in regard to its steroid testing policies, said Mary Wilfert, the NCAA's associate director of health and safety. She would not speculate on the cause of such rapid weight gain.


The NCAA attributes the decline in positive tests to its year-round drug testing program, combined with anti-drug education and testing conducted by schools.


"The effort has been increasing, and we believe it has driven down use," Wilfert said.


Big gains, data show


The AP's analysis found that, regardless of school, conference and won-loss record, many players gained weight at exceptional rates compared with their fellow athletes and while accounting for their heights. The documented weight gains could not be explained by the amount of money schools spent on weight rooms, trainers and other football expenses.


Adding more than 20 or 25 pounds of lean muscle in a year is nearly impossible through diet and exercise alone, said Dan Benardot, director of the Laboratory for Elite Athlete Performance at Georgia State University.


The AP's analysis corrected for the fact that players in different positions have different body types, so speedy wide receivers weren't compared to bulkier offensive tackles. It could not assess each player's physical makeup, such as how much weight gain was muscle versus fat, one indicator of steroid use. In the most extreme case in the AP analysis, the probability that a player put on so much weight compared with other players was so rare that the odds statistically were roughly the same as an NFL quarterback throwing 12 passing touchdowns or an NFL running back rushing for 600 yards in one game.


In nearly all the rarest cases of weight gain in the AP study, players were offensive or defensive linemen, hulking giants who tower above 6-foot-3 and weigh 300 pounds or more. Four of those players interviewed by the AP said that they never used steroids and gained weight through dramatic increases in eating, up to six meals a day. Two said they were aware of other players using steroids.


"I just ate. I ate 5-6 times a day," said Clint Oldenburg, who played for Colorado State starting in 2002 and for five years in the NFL. Oldenburg's weight increased over four years from 212 to 290, including a one-year gain of 53 pounds, which he attributed to diet and two hours of weight lifting daily. "It wasn't as difficult as you think. I just ate anything."


Oldenburg told the AP he was surprised at the scope of steroid use in college football, even in Colorado State's locker room. "College performance enhancers were more prevalent than I thought," he said. "There were a lot of guys even on my team that were using." He declined to identify any of them.


The AP found more than 4,700 players — or about 7 percent of all players — who gained more than 20 pounds overall in a single year. It was common for the athletes to gain 10, 15 and up to 20 pounds in their first year under a rigorous regimen of weightlifting and diet. Others gained 25, 35 and 40 pounds in a season. In roughly 100 cases, players packed on as much 80 pounds in a single year.


In at least 11 instances, players that AP identified as packing on significant weight in college went on to fail NFL drug tests. But pro football's confidentiality rules make it impossible to know for certain which drugs were used and how many others failed tests that never became public.


What is bubbling under the surface in college football, which helps elite athletes gain unusual amounts of weight? Without access to detailed information about each player's body composition, drug testing and workout regimen, which schools do not release, it's impossible to say with certainty what's behind the trend. But Catlin has little doubt: It is steroids.


"It's not brain surgery to figure out what's going on," he said. "To me, it's very clear."


Football's most infamous steroid user was Lyle Alzado, who became a star NFL defensive end in the 1970s and '80s before he admitted to juicing his entire career. He started in college, where the 190-pound freshman gained 40 pounds in one year. It was a 21 percent jump in body mass, a tremendous gain that far exceeded what researchers have seen in controlled, short-term studies of steroid use by athletes. Alzado died of brain cancer in 1992.


The AP found more than 130 big-time college football players who showed comparable one-year gains in the past decade. Students posted such extraordinary weight gains across the country, in every conference, in nearly every school. Many of them eclipsed Alzado and gained 25, 35, even 40 percent of their body mass.


Even though testers consider rapid weight gain suspicious, in practice it doesn't result in testing. Ben Lamaak, who arrived at Iowa State in 2006, said he weighed 225 pounds in high school and 262 pounds in the summer of his freshman year on the Cyclones football team. A year later, official rosters showed the former basketball player from Cedar Rapids weighed 306, a gain of 81 pounds since high school. He graduated as a 320-pound offensive lineman and said he did it all naturally.


"I was just a young kid at that time, and I was still growing into my body," he said. "It really wasn't that hard for me to gain the weight. I had fun doing it. I love to eat. It wasn't a problem."


In addition to random drug testing, Iowa State is one of many schools that have "reasonable suspicion" testing. That means players can be tested when their behavior or physical symptoms suggest drug use.


Despite gaining 81 pounds in a year, Lamaak said he was never singled out for testing.


The associate athletics director for athletic training at Iowa State, Mark Coberley, said coaches and trainers use body composition, strength data and other factors to spot suspected cheaters. Lamaak, he said, was not suspicious because he gained a lot of "non-lean" weight.


"There are a lot of things that go into trying to identify whether guys are using performance-enhancing drugs," Coberley said. "If anybody had the answer, they'd be spotting people that do it. We keep our radar up and watch for things that are suspicious and try to protect the kids from making stupid decisions."


There's no evidence that Lamaak's weight gain was anything but natural. Gaining fat is much easier than gaining muscle. But colleges don't routinely release information on how much of the weight their players gain is muscle, as opposed to fat. Without knowing more, said Benardot, the expert at Georgia State, it's impossible to say whether large athletes were putting on suspicious amounts of muscle or simply obese, which is defined as a body mass index greater than 30.


Looking solely at the most significant weight gainers also ignores players like Bryan Maneafaiga.


In the summer of 2004, Maneafaiga was an undersized 180-pound running back trying to make the University of Hawaii football team. Twice — once in pre-season and once in the fall — he failed school drug tests, showing up positive for marijuana use. What surprised him was that the same tests turned up negative for steroids.


He'd started injecting stanozolol, a steroid, in the summer to help bulk up to a roster weight of 200 pounds. Once on the team, where he saw only limited playing time, he'd occasionally inject the milky liquid into his buttocks the day before games.


"Food and good training will only get you so far," he told the AP recently.


Maneafaiga's coach, June Jones, meanwhile, said none of his players had tested positive for doping since he took over the team in 1999. He also said publicly that steroids had been eliminated in college football: "I would say 100 percent," he told The Honolulu Advertiser in 2006.


Jones said it was news to him that one of his players had used steroids. Jones, who now coaches at Southern Methodist University, said many of his former players put on bulk working hard in the weight room. For instance, adding 70 pounds over a three- to four-year period isn't unusual, he said.


Jones said a big jump in muscle year-over-year — say 40 pounds — would be a "red light that something is not right."


Jones, a former NFL head coach, said he is unaware of any steroid use at SMU and believes the NCAA is doing a good job testing players. "I just think because the way the NCAA regulates it now that it's very hard to get around those tests," he said.


The cost of testing


While the use of drugs in professional sports is a question of fairness, use among college athletes is also important as a public policy issue. That's because most top-tier football teams are from public schools that benefit from millions of dollars each year in taxpayer subsidies. Their athletes are essentially wards of the state. Coaches and trainers — the ones who tell players how to behave, how to exercise and what to eat — are government employees.


Then there are the health risks, which include heart and liver problems and cancer.


On paper, college football has a strong drug policy. The NCAA conducts random, unannounced drug testing and the penalties for failure are severe. Players lose an entire year of eligibility after a first positive test. A second offense means permanent ineligibility from sports.


In practice, though, the NCAA's roughly 11,000 annual tests amount to just a fraction of all athletes in Division I and II schools. Exactly how many tests are conducted each year on football players is unclear because the NCAA hasn't published its data for two years. And when it did, it periodically changed the formats, making it impossible to compare one year of football to the next.


Even when players are tested by the NCAA, people involved in the process say it's easy enough to anticipate the test and develop a doping routine that results in a clean test by the time it occurs. NCAA rules say players can be notified up to two days in advance of a test, which Catlin says is plenty of time to beat a test if players have designed the right doping regimen. By comparison, Olympic athletes are given no notice.


"Everybody knows when testing is coming. They all know. And they know how to beat the test," Catlin said, adding, "Only the really dumb ones are getting caught."


Players are far more likely to be tested for drugs by their schools than by the NCAA. But while many schools have policies that give them the right to test for steroids, they often opt not to. Schools are much more focused on street drugs like cocaine and marijuana. Depending on how many tests a school orders, each steroid test can cost $100 to $200, while a simple test for street drugs might cost as little as $25.


When schools call and ask about drug testing, the first question is usually, "How much will it cost," Turpin said.


Most schools that use Drug Free Sport do not test for anabolic steroids, Turpin said. Some are worried about the cost. Others don't think they have a problem. And others believe that since the NCAA tests for steroids their money is best spent testing for street drugs, she said.


Wilfert, the NCAA official, said the possibility of steroid testing is still a deterrent, even at schools where it isn't conducted.


"Even though perhaps those institutional programs are not including steroids in all their tests, they could, and they do from time to time," she said. "So, it is a kind of deterrence."


For Catlin, one of the most frustrating things about running the UCLA testing lab was getting urine samples from schools around the country and only being asked to test for cocaine, marijuana and the like.


"Schools are very good at saying, 'Man, we're really strong on drug testing,'" he said. "And that's all they really want to be able to say and to do and to promote."


That helps explain how two school drug tests could miss Maneafaiga's steroid use. It's also possible that the random test came at an ideal time in Maneafaiga's steroid cycle.


Enforcement varies


The top steroid investigator at the U.S. Drug Enforcement Administration, Joe Rannazzisi, said he doesn't understand why schools don't invest in the same kind of testing, with the same penalties, as the NFL. The NFL has a thorough testing program for most drugs, though the league has yet to resolve a long-simmering feud with its players union about how to test for human growth hormone.


"Is it expensive? Of course, but college football makes a lot of money," he said. "Invest in the integrity of your program."


For a school to test all 85 scholarship football players for steroids twice a season would cost up to $34,000, Catlin said, plus the cost of collecting and handling the urine samples. That's about 0.2 percent of the average big-time school football budget of about $14 million. Testing all athletes in all sports would make the school's costs higher.


When schools ask Drug Free Sport for advice on their drug policies, Turpin said she recommends an immediate suspension after the first positive drug test. Otherwise, she said, "student athletes will roll the dice."


But drug use is a bigger deal at some schools than others.


At Notre Dame and Alabama, the teams that will soon compete for the national championship, players don't automatically miss games for testing positive for steroids. At Alabama, coaches have wide discretion. Notre Dame's student-athlete handbook says a player who fails a test can return to the field once the steroids are out of his system.


"If you're a strength-and-conditioning coach, if you see your kids making gains that seem a little out of line, are you going to say, 'I'm going to investigate further? I want to catch someone?'" said Anthony Roberts, an author of a book on steroids who says he has helped college football players design steroid regimens to beat drug tests.


There are schools with tough policies. The University of North Carolina kicks players off the team after a single positive test for steroids. Auburn's student-athlete handbook calls for a half-season suspension for any athlete caught using performance-enhancing drugs.


Wilfert said it's not up to the NCAA to determine whether that's fair.


"Obviously if it was our testing program, we believe that everybody should be under the same protocol and the same sanction," she said.


Fans typically have no idea that such discrepancies exist and players are left to suspect who might be cheating.


"You see a lot of guys and you know they're possibly on something because they just don't gain weight but get stronger real fast," said Orrin Thompson, a former defensive lineman at Duke. "You know they could be doing something but you really don't know for sure."


Thompson gained 85 pounds between 2001 and 2004, according to Duke rosters and Thompson himself. He said he did not use steroids and was subjected to several tests while at Duke, a school where a single positive steroid test results in a yearlong suspension.


Meanwhile at UCLA, home of the laboratory that for years set the standard for cutting-edge steroid testing, athletes can fail three drug tests before being suspended. At Bowling Green, testing is voluntary.


At the University of Maryland, students must get counseling after testing positive, but school officials are prohibited from disciplining first-time steroid users. Athletic department spokesman Matt Taylor denied that was the case and sent the AP a copy of the policy. But the policy Taylor sent included this provision: "The athletic department/coaching staff may not discipline a student-athlete for a first drug offense."


By comparison, in Kentucky and Maryland, racehorses face tougher testing and sanctions than football players at Louisville or the University of Maryland.


"If you're trying to keep a level playing field, that seems nonsensical," said Rannazzisi at the DEA. He said he was surprised to learn that what gets a free pass at one school gets players immediately suspended at another. "What message does that send? It's OK to cheat once or twice?"


Only about half the student athletes in a 2009 NCAA survey said they believed school testing deterred drug use.


As an association of colleges and universities, the NCAA could not unilaterally force schools to institute uniform testing policies and sanctions, Wilfert said.


"We can't tell them what to do, but if went through a membership process where they determined that this is what should be done, then it could happen," she said.


'Everybody around me was doing it'


Steroids are a controlled substance under federal law, but players who use them need not worry too much about prosecution. The DEA focuses on criminal operations, not individual users. When players are caught with steroids, it's often as part of a traffic stop or a local police investigation.


Jared Foster, 24, a quarterback recruited to play at the University of Mississippi, was kicked off the team in 2008 after local authorities arrested him for giving a man nandrolone, an anabolic steroid, according to court documents. Foster pleaded guilty and served jail time.


He told the AP that he doped in high school to impress college recruiters. He said he put on enough lean muscle to go from 185 pounds to 210 in about two months.


"Everybody around me was doing it," he said.


Steroids are not hard to find. A simple Internet search turns up countless online sources for performance-enhancing drugs, mostly from overseas companies.


College athletes freely post messages on steroid websites, seeking advice to beat tests and design the right schedule of administering steroids.


And steroids are still a mainstay in private, local gyms. Before the DEA shut down Alabama-based Applied Pharmacy Services as a major nationwide steroid supplier, sales records obtained by the AP show steroid shipments to bodybuilders, trainers and gym owners around the country.


Because users are rarely prosecuted, the demand is left in place after the distributor is gone.


When Joshua Hodnik was making and wholesaling illegal steroids, he had found a good retail salesman in a college quarterback named Vinnie Miroth. Miroth was playing at Saginaw Valley State, a Division II school in central Michigan, and was buying enough steroids for 25 people each month, Hodnik said.


"That's why I hired him," Hodnik said. "He bought large amounts and knew how to move it."


Miroth, who pleaded no contest in 2007 and admitted selling steroids, helped authorities build their case against Hodnik, according to court records. Now playing football in France, Miroth declined repeated AP requests for an interview.


Hodnik was released from prison this year and says he is out of the steroid business for good. He said there's no doubt that steroid use is widespread in college football.


"These guys don't start using performance-enhancing drugs when they hit the professional level," the Oklahoma City man said. "Obviously it starts well before that. And you can go back to some of the professional players who tested positive and compare their numbers to college and there is virtually no change."


Maneafaiga, the former Hawaii running back, said his steroids came from Mexico. A friend in California, who was a coach at a junior college, sent them through the mail. But Maneafaiga believes the consequences were nagging injuries. He found religion, quit the drugs and became the team's chaplain.


"God gave you everything you need," he said. "It gets in your mind. It will make you grow unnaturally. Eventually, you'll break down. It happened to me every time."


At the DEA, Rannazzisi said he has met with and conducted training for investigators and top officials in every professional sport. He's talked to Major League Baseball about the patterns his agents are seeing. He's discussed warning signs with the NFL.


He said he's offered similar training to the NCAA but never heard back. Wilfert said the NCAA staff has discussed it and hasn't decided what to do.


"We have very little communication with the NCAA or individual schools," Rannazzisi said. "They've got my card. What they've done with it? I don't know."


___


Associated Press writers Ryan Foley in Cedar Rapids, Iowa; David Brandt in Jackson, Miss.; David Skretta in Lawrence, Kan.; Don Thompson in Sacramento, Calif.;and Alexa Olesen in Shanghai, China; and researchers Susan James in New York and Monika Mathur in Washington contributed to this report.


___


Contact the Washington investigative team at DCinvestigations (at) ap.org.


Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the first of a two-part series.


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Manhunt intensifies for two escaped bank robbers in Chicago



The manhunt for two bank robbers who escaped from a downtown Chicago
prison this week intensified overnight, with police chasing multiple
leads as new footage shows the men getting into a taxi minutes after
their brazen escape.



Investigators say surveillance cameras captured Joseph "Jose" Banks, 37, and Kenneth Conley, 38,
getting into a taxi minutes after their early Tuesday escape. They entered the taxi at the intersection of Michigan Avenue and Congress Street, just blocks away from the jail.



The FBI considers them "armed and dangerous."



The men then showed up five hours later at the home of Sandy Conley, Kenneth Conley's mother, in the Chicago suburb of Tinley Park, Ill.



"He was in the house for two minutes," Sandy Conley said. "I can't tell you if he was armed. I made him get out."



Thomas Trautmann of the Chicago FBI said the clock is ticking on finding the men.



"[As] each hour goes by, our chances get longer and longer," he said. "However, we do have several viable leads that we are running down."



He did not specify the information.



Banks and Conley were last seen Monday at 10 p.m. during a prison head count at the Metropolitan Correctional Center in downtown Chicago's Loop district. The two borrowed a move from the film "Escape From Alcatraz" by stuffing their beds with clothes in the shape of bodies.



They men then broke the window of their cell at the federal prison, shimmying out a hole only inches wide, and scaled down the side of the building 17 stories, all the while holding onto a rope of sheets and towels taken from the prison. The rope was strong enough to support the two, one weighing 165 pounds the other 185 pounds.



At 7 a.m. the next morning, as employees arrived at work, they noticed the sheets left dangling from the building and at jailers discovered that Conley and Banks were missing.



While the men have had plenty of time to leave the area, there's no indication that they have, ABC 7 TV's public-safety expert Jody Weis said.



"There's a likelihood that they're going to stay here," Weis, a former Chicago police superintendent, said. "They'll have people they can trust. They can have people they can work with. There are going to be people that might be able to hide them out."



Banks, nicknamed "the second-hand bandit" because of the used clothing disguises he wore in several robberies, was convicted of armed robbery last week. His parting words to his judge, Rebecca Pallmeyer, were, "I'll be seeking retribution as well as damages ... you'll hear from me."



Conley had been in jail for several years.



Pallmeyer and others who presided over the men's cases have reportedly been offered protection.



"If they're willing to go down a sheet 17 floors, they're willing to take a chance," Weis said. "And I think you can draw your own conclusion as to what that might mean."



The FBI and U.S. Marshals are offering a combined reward of $60,000 to find the inmates and bring them back into custody.

Also Read

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Dictator father looms over SKorea's new president


SEOUL, South Korea (AP) — When Park Geun-hye last lived in the presidential Blue House more than 30 years ago, she was a young, stand-in first lady, serving after the assassination of her mother and before the killing of her dictator father.


After defeating Moon Jae-in in elections Wednesday, she will return to her childhood home as the first female president of a country where women continue to face widespread sexism, huge income gaps with men doing the same work and few opportunities to rise to the top in business, politics and other fields.


Her presidency will shatter the bias that women are less capable of thriving in male-oriented South Korean politics, said Lim Woo-youn, a researcher at the Chungcheongnam-do Women's Policy Development Institute in central South Korea.


Her biggest challenge after she takes office in February, however, may be the still-fresh divisions that linger from the 18 years that her father, President Park Chung-hee, ruled South Korea.


Many, including the older conservative voters who form her political base, see Park Chung-hee as a hero, the man whose strong hand guided the country from the devastation of the Korean War to an economic force that lifted millions from crushing poverty. His critics remember the brutal way he dealt with opponents to his unchecked rule, the claims of torture, execution and vote rigging.


"There's still a sentiment that rejects Park Geun-hye" because of her father's brutality, said Lee Cheol-hee, a political analyst and head of Dumon Political Strategy Institute, a think tank. Park must appear sincere when she tries to "heal the past" as president, Lee said. She needs to convince people that she's sympathetic to the pain caused by her father's rule.


Park, a legislator since 1998, laid out a fairly moderate platform in her campaign to replace unpopular President Lee Myung-bak, a member of her conservative party.


The 60-year-old has vowed to reach out to North Korea and ease the current government's hard line, fight widespread government corruption, strengthen social welfare, help small companies, close growing gaps between rich and poor, ease heavy household debt and curb the power of big corporations so powerful they threaten to eclipse national laws.


But despite her history-making win and her efforts to forge her own path, many see in her only the embodiment of her father, who grabbed power in a 1961 coup and ruled with ruthless efficiency until his spy chief shot him dead at a 1979 drinking party.


Critics have long seized on what they see as Park's queen-like aura in an attempt to link her with her father. Park herself points to the embodiment of female imperial rule, Elizabeth I of England, as her role model.


"We have known Park Geun-hye as an imperial candidate, and no one can argue with her decisions," said Yoon Yeo-joon, a key member of the camp of her liberal opponent, Moon Jae-in.


Much of Park's public persona has been built on her close association with her father's rule. She has created an image as a selfless daughter of Korea, never married, who served first her father as his first lady and then the people as a female lawmaker in South Korea's tough political world.


Her website describes a young Park losing sleep in the Blue House and praying for rain during a devastating drought. Even her choice of college major — electronic engineering, which the website describes as "rare for women" — is put down to self-sacrifice, an effort to help the country increase exports by concentrating on developing electronic industries.


Her "dreams of living a normal life" were crushed on Aug. 15, 1974, she says, when a Korean resident of Japan, claiming orders from North Korean leader Kim Il Sung, shot and killed her mother in a botched assassination attempt against her father. At 22, she rushed home from Paris, where she was studying, and for the next five years stood by her father's side as acting first lady.


Violence came again in 1979 when her father was murdered. Park was said to have thought first of Korea: "Is the frontline well?" were her first words when learning of the shooting, according to her website, recognition that instability in Seoul could mean trouble on the Koreas' tense border.


She was a major figure in conservative politics in 2006 when a convicted criminal slashed her face as she was shaking hands with voters, opening up a gash that needed 60 stitches during surgery.


Park lost narrowly in the 2007 presidential primaries to Lee.


Her father was a staunch anti-communist, but Park has shown a willingness to work with North Korea. She met privately with former leader Kim Jong Il during a visit to Pyongyang in 2002 and has vowed to ease Lee's hard-line policy to Pyongyang.


That might be difficult, however, with a belligerent Pyongyang fresh off the surprising success of a rocket launch that the South, the United States and others say was a cover for testing long-range missile technology. North Korea's state media has repeatedly said that her presidential ambitions are an attempt to bring back her father's dictatorship.


___


Associated Press writers Sam Kim and Youkyung Lee contributed to this report. Follow Klug on Twitter: (at)APklug.


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