Restored funding for prescription drug-monitoring program urged

California Atty. Gen. Kamala D. Harris on Thursday called on Gov. Jerry Brown to restore funding to a prescription drug-monitoring program that health experts say is key to combating drug abuse and overdose deaths in the state.

Harris' appeal to restore funding to CURES, as it is known, follows an article in The Times last month that reported that the system, once heralded as an invaluable tool, had been severely undermined by budget cuts and was not being used to its full potential.

The CURES database contains detailed information on prescription narcotics, including the names of patients, the doctors prescribing the drugs and the pharmacies that dispense them. The system was designed to help physicians detect "doctor-shopping" patients who dupe multiple physicians into prescribing drugs such as OxyContin, Vicodin and Xanax.

Harris' request followed Brown's unveiling of a proposed $97.7-billion budget, which projects a surplus — a feat that has been accomplished only one time in the last decade. With California's fiscal condition improving, Harris said it was up to the state to make sure the money was "spent wisely."

"This includes smart investments that benefit Californians, such as restoring funding for the state's prescription drug-monitoring program," she said in a statement.

Brown's office had no comment.

The governor's budget does increase Harris' Department of Justice general fund allocation by 4.5% to $174.3 million, but it does not earmark money for CURES. Harris could seek legislative authority to spend some of her budget on the program.

"We are going to have a discussion on the funding and where the money will come from," said Lynda Gledhill, a spokeswoman for Harris.

CURES is the nation's oldest and largest prescription drug-monitoring program and once served as a model for other states. Today, it has fallen behind similar programs elsewhere. CURES data could be used to monitor physicians whose prescribing puts patients at risk. But it is not.

The U.S. Centers for Disease Control recommends that states use such data to keep tabs on doctors, and at least half a dozen states do so.

As part of spending cuts aimed at maintaining the state's solvency amid a deep recession, Brown gutted the Bureau of Narcotics Enforcement, which ran CURES, in 2011, shortly after Harris succeeded him as attorney general. Harris kept the program alive with about $400,000 in revenue from the Medical Board of California and other licensing boards. But it is down to one employee and has no enforcement capacity.

State officials have estimated it would cost about $2.8 million to make CURES more accessible and easier to use, and $1.6 million more per year to keep it running. However, officials say the program — with little or no additional financial resources — could now be used to identify potentially rogue doctors.

Bob Pack, an Internet entrepreneur, has advocated using CURES more vigorously to track reckless physicians and pharmacies as well as doctor-shopping patients. He became active on the issue after a driver high on painkillers and alcohol struck and killed his two young children in the Bay Area suburb of Danville in 2003.

Pack, who helped design an online portal to give physicians and pharmacists immediate access to CURES, said he was happy to see Harris ask Brown to restore funds for the program.

"But that's only a request," he said. "No one knows if that's really going to happen. Meanwhile, doctors are continuing to over-prescribe and thousands of Californians are dying from prescription drug overdoses. I hope this … has some bite to it."

An aide to Harris said restoring the CURES program is a high priority.

"She's committed to fixing the database and making it as strong as possible," said Travis LeBlanc, special assistant attorney general. "When we have limited resources and in a budget crunch, we need to focus our resources and use it in smart, efficient ways, and [CURES] is one of those," he said.

lisa.girion@latimes.com

scott.glover@latimes.com

Times staff writer Hailey Branson-Potts contributed to this report.

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IHT Rendezvous: Rescuing China's Bears From Bile Farms, One by One

BEIJING — Some had wounded faces and bloodied paws. Some were angry after years of mistreatment.

But six Asiatic black bears now have a chance at a life of dignity after being rescued on Wednesday from a Chinese bile farm by Animals Asia, an animal rights group, and the Chinese government’s State Forestry agency.

The bear rescue will continue for a few days as the animals are settled into their new home at a shelter outside Chengdu, the capital of Sichuan province, which now houses nearly 150 bears, You can follow it on Animals Asia’s Twitter feed with the hashtag #newyearrescue.

Here’s a latest tweet:

Today’s story is a happy one, though it’s part of the bigger, sadder picture of how thousands of bears are “farmed” for their bile here in China, often in excruciatingly painful conditions. Some are caged as cubs, and grow up crooked; physical injury and emotional trauma is the norm.

Rendezvous readers have debated passionately about bear bile farming before. It’s common in China and Vietnam, where it is illegal. While the Chinese government is taking action against some bear farms, it’s not illegal here if farms have licenses for it. About 10,000 bears are believed to be caged for their bile in China and a couple thousand in Vietnam. It’s a lucrative trade, with bile prized by the Chinese traditional medicine industry for a range of cures. As my former colleague, Mark McDonald, summed it up:

“Bear bile is prized in traditional Chinese medicine for its alleged ability to relieve muscle aches, joint pains, fever, migraines and hangovers, as well as being a curative for impotence, gallstones, cirrhosis, even cancer. Synthetic compounds are just as effective for many of these ailments, but many Asians, especially Chinese and Vietnamese men of a certain age, favor fresh bile.”

Your consensus, readers, was that it’s a horrific practice, despite arguments made by the Chinese traditional medicine industry that bile farming is “humane,” as Fang Shuting, the head of the Chinese Association of Traditional Chinese Medicine, said: “The process of extracting bear bile is like turning on a tap: natural, easy and without pain,’’ Mr. Fang said. “After they’re done, the bears can even play happily outside. I don’t think there’s anything out of the ordinary! It might even be a very comfortable process!”

As Mark wrote: “Wildlife biologists vehemently disagree, saying the needle sticks, catheterization and repeated draining of the gall bladder creates infections and leakage, which can lead to peritonitis and septicemia. ‘An excruciating death,’’ said one scientist.”

Revulsion is growing among ordinary Chinese, too. “I don’t believe it at all that extracting bile is as easy and comfortable as Fang said. Why doesn’t he extract the bile from his body in the same way to prove it?” one wrote on Sina Weibo, the microblog site, Mark reported.

But today I want to tell you about a spot of light in the night.

Here’s what a journalist who witnessed a bear arriving at the rescue wrote:

“The Asiatic black bear gave a deep growl and struggled in a rusty cage only just bigger than her giant body, as rescue workers from the Animals Asia bear sanctuary fed her fruit to soothe her shattered nerves, and examined her body for signs of sores or bleeding.” (Full disclosure — this reporter is my husband, Clifford Coonan, the Irish Times China correspondent.)

Jill Robinson, the founder of Animals Asia, was there, organizing and watching.

“What we have here are six highly traumatised bears from an illegal bear bile farm here in Sichuan province,” Clifford quoted her as saying. “One of the bears has bile leakage, and others have the stereotypical head injuries from bashing the bars of their cages. But it’s such a relief to have them here.”

Around the world, on Twitter and through video, people were watching, too.

Here’s a tweet from the actor Peter Egan, of “Downton Abbey” and “A Perfect Spy” fame, and an animal rights supporter.

As a member of Animals Asia wrote in an email to Rendezvous: watching the bears arrive “was exciting and sad in equal measure.” Exciting because it was the start of a new life for six; sad, because they need treatment and help, and because there are so many more out there.

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Three top U.S. wireless carriers to embrace BlackBerry 10

LAS VEGAS (Reuters) – Three of the top U.S. cellphone carriers signaled this week that they would support Research In Motion’s BlackBerry 10 products, the first of which are due to be unveiled Jan 30, offering a hopeful sign for RIM’s comeback effort.

Executives at Verizon Communications , AT&T Inc and T-Mobile USA all said they are looking forward to the devices, which will be crucial for RIM’s chances of regaining lost ground from rivals such as Apple Inc and Samsung Electronics .

“We’re hopeful its going to be a good device,” Lowell McAdam, chief executive of Verizon Communications, majority owner of the biggest U.S. mobile service Verizon Wireless.

“We’ll carry it,” McAdam said in an interview at the Consumer Electronics Show in Las Vegas.

BlackBerry 10 is RIM’s next-generation mobile operating platform and it is preparing to launch new smartphones later this month. Word that major carriers will offer the devices is good news for RIM.

RIM, which once commanded the lead in the smartphone market, has rapidly lost ground to Apple’s iPhone and Samsung’s line of Galaxy products, especially in North American and European markets, as customers abandon its aging BlackBerry devices.

It has been testing the new BlackBerry 10 devices with carriers so they can assess their compatibility with networks.

No. 4 U.S. mobile provider T-Mobile USA, a unit of Deutsche Telekom , also plans to carry the new BlackBerry 10.

“We’re extremely optimistic that it’s going to be a successful product and our business customers are extremely interested in it,” Chief Executive John Legere said.

AT&T has promised to support the BlackBerry 10 platform, according to Chief Marketing Officer David Christopher, but he would not discuss specific devices.

However, AT&T handset executive Jeff Bradley made it clear that the No. 2 U.S. mobile operator would carry the phone.

“It’s logical to expect our current (BlackBerry) customers will have the best BlackBerry devices to choose from in the future,” Bradley said.

(Reporting By Sinead Carew; Editing by Cynthia Osterman)

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Sandra Bullock Honored at People's Choice Awards for New Orleans Support

By Alison Schwartz

01/09/2013 at 10:45 PM EST

Sandra Bullock at the People's Choice Awards

Jason Merritt/Getty

Sandra Bullock took home big honors for her work in the Big Easy Wednesday night.

The People's Choice Awards crowned the Oscar-winning actress the favorite humanitarian for her career-spanning philanthropic efforts, including her dedication to New Orleans's Warren Easton Charter High School

"I'm not at all being modest when I say I'm not doing anything compared to what they do on a daily basis," Bullock, 48, told the crowd gathered at Los Angeles's Nokia Theatre.

Just six months after Hurricane Katrina hit in 2005, the actress showed her support by adopting the school, which sustained $4 million in damages during the storm. She donated hundreds of thousands of dollars for renovations, telling PEOPLE years later that she "felt such a profound need to do something for them."

Her generosity helped the charter school – the first public high school for boys in Louisiana – afford renovations, new band uniforms, athletic equipment and a new health clinic in a city that's close to her heart. After all, she adopted her son, Louis, from New Orleans in 2010 and also has a home in the Garden District.

She pointed to the tireless dedication of the school's students, teachers and tough principal. "I've seen her," she joked. "Yeah, you don't want to go into that office."

Bullock then gave a shout-out to her son, who was sick as home, she said.

"[The students] compete, but they never cut each other down," she added. "And all that happens not because it's easy, but because they do not allow themselves any other option than to succeed."

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Irvine City Council overhauls oversight, spending on Great Park

Capping a raucous eight-hour-plus meeting, the Irvine City Council early Wednesday voted to overhaul the oversight and spending on the beleaguered Orange County Great Park while authorizing an audit of the more than $220 million that so far has been spent on the ambitious project.

A newly elected City Council majority voted 3 to 2 to terminate contracts with two firms that had been paid a combined $1.1 million a year for consulting, lobbying, marketing and public relations. One of those firms — Forde & Mollrich public relations — has been paid $12.4 million since county voters approved the Great Park plan in 2002.

"We need to stop talking about building a Great Park and actually start building a Great Park," council member Jeff Lalloway said.

The council, by the same split vote, also changed the composition of the Great Park's board of directors, shedding four non-elected members and handing control to Irvine's five council members.

The actions mark a significant turning point in the decade-long effort to turn the former El Toro Marine base into a 1,447-acre municipal park with man-made canyons, rivers, forests and gardens that planners hoped would rival New York's Central Park.

The city hoped to finish and maintain the park for years to come with $1.4 billion in state redevelopment funds. But that money vanished last year as part of the cutbacks to deal with California's massive budget deficit.

"We've gone through $220 million, but where has it gone?" council member Christina Shea said of the project's initial funding from developers in exchange for the right to build around the site. "The fact of the matter is the money is almost gone. It can't be business as usual."

The council majority said the changes will bring accountability and efficiencies to a project that critics say has been larded with wasteful spending and no-bid contracts. For all that has been spent, only about 200 acres of the park has been developed and half of that is leased to farmers.

But council members Larry Agran and Beth Krom, who have steered the course of the project since its inception, voted against reconfiguring the Great Park's board of directors and canceling the contracts with the two firms.

Krom has called the move a "witch hunt" against her and Agran. Feuding between liberal and conservative factions on the council has long shaped Irvine politics.

"This is a power play," she said. "There's a new sheriff in town."

The council meeting stretched long into the night, with the final vote coming Wednesday at 1:34 a.m. Tensions were high in the packed chambers with cheering, clapping and heckling coming from the crowd.

At one point council member Lalloway lamented that he "couldn't hear himself think."

During public comments, newly elected Orange County Supervisor Todd Spitzer chastised the council for "fighting like schoolchildren." Earlier this week he said that if the Irvine's new council majority can't make progress on the Great Park, he would seek a ballot initiative to have the county take over.

And Spitzer angrily told Agran that his stewardship of the project had been a failure.

"You know what?" he said. "It's their vision now. You're in the minority."

mike.anton@latimes.com

rhea.mahbubani@latimes.com

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IHT Rendezvous: Macau's Gaming Take: Sign of Chinese Emigration?

BEIJING — Why did gambling boom in Macau in 2012, even as China’s economy slowed? A Hong Kong online magazine that follows the scene closely has a smart take: emigration.

First, the facts. Last year, Macau earned $38 billion from gaming, a 13.5 percent increase from the $33.5 billion in 2011.

“Let’s put some perspective on the record $38 billion in gaming revenues collected by Macau’s casino industry in 2012,” wrote the Las Vegas Review-Journal on Jan. 2.

Macau has long outstripped Las Vegas in terms of revenue, and the 2012 figure “is higher than the $35.64 billion collected by the entire U.S. commercial casino industry in 2011,” the Review-Journal wrote.

“During December, Macau’s 35 casinos collected a single-month record of $3.5 billion in gaming revenues, more than half of what the Strip’s casinos collected in all of 2011,” it wrote.

Pretty astonishing stuff, especially in a year when the growth of the Chinese economy actually fell to a three-year low of 7.4 percent in the third quarter.

Excluding some kind of inverse psychological relationship between growth and gambling, where people might actually enjoy risking their money in a falling economy, the surge in gambling revenue didn’t seem to make sense.

Week in China, a Hong Kong online news magazine, suggests something quite different and fascinating: with so many rich Chinese using the casinos to wash money to finance their emigration to other countries, the gambling take is actually a bellwether of confidence among rich Chinese in their country, the magazine says. In this scenario, the higher the take, the lower the confidence.

As my colleague, Ian Johnson, wrote recently, rich Chinese are emigrating in ever higher numbers

“In 2010, the last year for which complete statistics are available, 508,000 Chinese left for the 34 developed countries that make up the Organization for Economic Cooperation and Development,” Ian wrote. “That is a 45 percent increase over 2000.”

“Individual countries report the trend continuing. In 2011, the United States received 87,000 permanent residents from China, up from 70,000 the year before,” Ian wrote.

Hence the higher spending in Macau, as people move their money from China to overseas, even though the government has forecast something of a recovery and 7.5 percent growth for 2013.

Reasons for emigration vary, but a key one cited by many is that they feel their money isn’t safe in China where the rule of law is weak and where, as one aspiring emigre put it to the immigration lawyer Mikael Charette, “You can be a tiger, but there is always a hunter somewhere,” as I reported in a Letter from China back in 2010.

It all “makes more sense when you realize Macau offers an escape route for ‘smart money’ to leave the country,” Week in China wrote.

“Once this cash reaches the casinos – helped by some financial engineering from the junket operators – it becomes Hong Kong dollars. Much is gambled but plenty also flows into banks offshore,” Week in China wrote.

Junkets?

These are the middlemen who locate wealthy Chinese on the mainland who want to gamble, or, some say, move their money overseas. Aided by a financial commission, they get the money to Macau where the wealthy hit the casinos and, in this scenario, move the rest out in convertible foreign currency.

As Week in China wrote in early 2012: “So if gaming revenues continue to surge this year … it’s a safe bet that corrupt officials and savvy businesspeople are feeling fearful about the future and are getting their money out.”

Surge they did.

Of course, China’s economy is still growing fast and that means quite a lot of people just have more money to play with. But by any standards, Macau’s gambling take in 2012 was extremely high, and came in a year with considerable political uncertainty as China experienced a once-in-a-decade leadership changeover, a major political scandal in the shape of the fall of Bo Xilai, and warnings against corruption by the new leader, Xi Jinping. Sign of a growing economy, or, as Week in China says, a growing loss of confidence?

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The next CIA’s director’s challenges

qWhat John Brennan faces after confirmation

I see no reason why the Senate won’t confirm John Brennan, President Obama‘s chief counter-terrorism adviser, to be the next director of the CIA. There will be pro forma inquiries into his past entanglements with the NSA’s domestic surveillance program and his knowledge and approval of the CIA’s “Greystone” torture protocols, but he will have ready answers for the questions and he will say plenty in private to sooth the concerns of those whose concerns need to be soothed.

Assuming Brennan becomes the DCIA, as he will thenceforth be acronymed, he’ll inherit a powerful spy agency facing a set of tough questions. Actually, every CIA director since the advent of the age of Al Qaeda has more or less dealt with these same issues. The daily demands of the job require tactical thinking and leave little room for attention to the bigger picture.

SEE MORE: Why Django is better than Lincoln

# Is the CIA a paramilitary force? Should it go back to its roots as a source of intelligence and warning?  You see this question phrased as such a lot, but it ignores virtually all of the CIA’s history, except for a period in the 1990s when the “Peace Dividend” and director John Deutch pulled back significantly on the agency’s ambit. The CIA has always been both and will always be both. From the start, the agency has very broadly and probably (in an affront to the original understanding of the National Security Act of 1947) interpreted its mandate to do stuff to further American interests abroad, even and often to the point of violence, as Adam Elkus reminds us today. The question really is one of authorities and chains of command: how are American resources properly allocated? Are the mechanisms of accountability sufficient? Is there really anything better than an ad hoc framework for determining whether combined CIA-military operations are really CIA operations or military operations?

# There is no such thing as secrecy anymore, at least not in the way that the CIA has understood the term. We live in an era of open source everything, which means that the agency’s crown jewels have very short lifespans and that public interest in what the CIA does is bound to increase exponentially. The agency has to figure out a posture on the New Secrecy that satisfies its mission while accepting the Open Source reality. Younger analysts have different expectations of how to gather and collect information and are less satisfied with the complicated and fairly broken traditional secrecy rules.

# Similarly, it is exceedingly difficult for would-be spies to come to the CIA without significant social media trails, and it is very hard for them to work in the world without leaving electromagnetic detritus for everyone to exploit and discover. How can the CIA’s case officers maintain their cover identities? Is the era of fully-fledged cover identities over? Will the CIA continue to rely (and over-rely) on foreign intelligence services for critical human intelligence operations? 

# The same Open Source world that hinders CIA secrecy also provides the agency with far more data than it ever imagined having. The CIA will never face a problem of not having enough intelligence. It will face the problem of having too much and not knowing what it has or how to use it.

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Kangaroo Gets Loose at Melbourne Airport

People Pets

01/08/2013 at 08:00 PM EST

Travelers passing through Australia's Melbourne Airport on Monday may have been greeted by an unexpected baggage handler.

At around 7 a.m., a 3-year-old eastern gray kangaroo was spotted in the airport's parking garage, where it hopped around for almost two hours, giving security officers the slip in the process.

Wildlife officer Manfred Zabinskas was then called in to catch the young animal, who was tranquilized in order to be transported to safety. Analyzing the critter, Zabinskas noted he had been away from his natural habitat for some time, and that the romp through the parking garage had done some damage to his feet. Prior to being re-released into the wild, the kangaroo will be looked at by a veterinarian.

This is the second time a kangaroo has paid a visit to the Melbourne Airport. Last October, another marsupial made its way up to the fifth floor of the parking garage before being spotted.

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Report: Death rates from cancer still inching down

WASHINGTON (AP) — Death rates from cancer are continuing to inch down, researchers reported Monday.

Now the question is how to hold onto those gains, and do even better, even as the population gets older and fatter, both risks for developing cancer.

"There has been clear progress," said Dr. Otis Brawley of the American Cancer Society, which compiled the annual cancer report with government and cancer advocacy groups.

But bad diets, lack of physical activity and obesity together wield "incredible forces against this decline in mortality," Brawley said. He warned that over the next decade, that trio could surpass tobacco as the leading cause of cancer in the U.S.

Overall, deaths from cancer began slowly dropping in the 1990s, and Monday's report shows the trend holding. Among men, cancer death rates dropped by 1.8 percent a year between 2000 and 2009, and by 1.4 percent a year among women. The drops are thanks mostly to gains against some of the leading types — lung, colorectal, breast and prostate cancers — because of treatment advances and better screening.

The news isn't all good. Deaths still are rising for certain cancer types including liver, pancreatic and, among men, melanoma, the most serious kind of skin cancer.

Preventing cancer is better than treating it, but when it comes to new cases of cancer, the picture is more complicated.

Cancer incidence is dropping slightly among men, by just over half a percent a year, said the report published by the Journal of the National Cancer Institute. Prostate, lung and colorectal cancers all saw declines.

But for women, earlier drops have leveled off, the report found. That may be due in part to breast cancer. There were decreases in new breast cancer cases about a decade ago, as many women quit using hormone therapy after menopause. Since then, overall breast cancer incidence has plateaued, and rates have increased among black women.

Another problem area: Oral and anal cancers caused by HPV, the sexually transmitted human papillomavirus, are on the rise among both genders. HPV is better known for causing cervical cancer, and a protective vaccine is available. Government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.

Among children, overall cancer death rates are dropping by 1.8 percent a year, but incidence is continuing to increase by just over half a percent a year. Brawley said it's not clear why.

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Yosemite plan calls for more campsites and parking spaces

Yosemite Valley would have more camp sites and parking spaces — and the number of daily visitors would not be reduced — under a National Park Service plan intended to ease congestion in one of the country's most scenic spots.

The proposal is the agency's third attempt to produce a legally acceptable management plan for the Merced River and the ever popular valley that it flows through. Environmental groups have twice sued the agency, winning court orders that compelled the park service to draw up new blueprints.

The latest effort, a lengthy draft document released Tuesday, navigates a middle course. The agency's preferred alternative would restore 203 acres along the river, change traffic circulation and parking, and eliminate an ice skating rink, commercial horseback riding, hotel swimming pools and raft and bicycle rentals.

But the plan steers clear of the politically sensitive issue of reducing the number of visitors to the valley, which on a busy summer day can be packed with nearly 20,000 people.

Kathleen Morse, chief of planning for Yosemite National Park, said the proposal tries to give the public what it wants. "The feedback they gave us was consistent with what we ended up with in the preferred alternative: We want to be able to come to Yosemite. We want to have our cars. We hate the traffic. We would like you to do something about congestion and we want more camping."

Park planners tried to figure out how best to use the limited land base of the valley, which is 1 mile wide and 7 miles long. They decided some commercial activities could go, including the pools, skating rink and other activities.

A pedestrian underpass would be built to ease traffic on a busy road near Yosemite Lodge. Unofficial roadside parking would be eliminated. A new remote parking lot would be built at El Portal just outside the park and a 100-car dirt lot would be opened for overflow traffic during peak visitor days, increasing parking in the valley by 5%. Both lots would be served by shuttles.

No new construction would be allowed within 150 feet of the Merced River, eroded riverbanks would be repaired and vulnerable areas would be off limits to visitors. Some informal trails in meadows would also be removed. Trails and boardwalks at Bridalveil Fall would be redesigned.

The park service proposes adding 174 camping sites in the valley and replacing some tent cabins in Curry Village with year-round cabins. Some aging, employee housing would be replaced with new buildings.

Representatives of the two small environmental groups that have sued the service over previous management plans said they haven't had time to thoroughly study the lengthy new document.

John Brady, chairman of Mariposans for the Environment and Responsible Government, said that while he was not happy with the park's preferred alternative, the draft was an improvement over previous plans.

"I had a relatively positive reaction to it," Brady said. "I think the park service did a good job."

Greg Adair, director of Friends of Yosemite Valley, was less enthusiastic.

"The plan shouldn't be fundamentally about a tweak here and a nip and tuck there about infrastructure and visitor services," Adair said. "We would like to see them do a plan that makes the connection between the visitor experience and the preservation of the natural environment: That essentially solves the problem of how many people can optimally experience Yosemite at its best."

The draft will be open to 90 days of public comment, after which the park service will issue a final decision.

bettina.boxall@latimes.com

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