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.


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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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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


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.


"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.


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.


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.


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.


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 operations 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."


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Associated Press Writer David B. 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.


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


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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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Wall Street slides as fiscal deal unlikely before 2013

NEW YORK (Reuters) - U.S. stocks tumbled more than 1 percent on Friday after a Republican proposal for averting the "fiscal cliff" failed to pass, diminishing hopes that a deal would be reached soon in Washington.


Trading was volatile as investors reckoned a fiscal agreement between the White House and Republicans before the end of the year was unlikely. Lower volume ahead of the Christmas and New Year holidays exaggerated market swings further, and the CBOE Volatility Index, or VIX, <.vix> was up 6.5 percent.


Late on Thursday, Republican House Speaker John Boehner failed to muster enough votes from his party to pass a tax bill, dubbed "Plan B," to avert the so-called fiscal cliff, $600 billion of tax hikes and spending cuts due to start in January. If U.S. lawmakers don't agree soon on a budget that avoids the cliff, the U.S. economy could tip into recession.


"The failure with Plan B was disappointing, if not terribly surprising, but now there's a real lack of clarity about what will happen and markets hate that," said Mike Hennessy, managing director of investments for Morgan Creek in Chapel Hill, North Carolina.


The lack of support for Plan B, which called for tax increases on those who earn $1 million or more a year, suggested it would be difficult to get Republican support for the more expansive tax increases that President Barack Obama has urged. That, in turn, reduces the possibility of an agreement between the White House and Republicans before the end of the year.


Earlier on Friday, Boehner said congressional leaders and Obama must try to move on and work together.


While Friday's stock market slide reflected investors' anxiety, it wasn't a large enough drop to suggest they believed a deal would be reached too late to avoid damage to the economy, said Mark Lehmann, president of JMP Securities, in San Francisco.


"You could have easily woken up today and seen the market down 300 or 400 points, and everyone would have said, 'That's telling you this is really dire,'" Lehmann said.


"I think if you get into mid-January and (the talks) keep going like this, you get worried, but I don't think we're going to get there."


Banking shares, which outperform in times of economic expansion and have led the market on signs of progress with resolving the fiscal impasse, led declines. Citigroup Inc fell 1.8 percent to $39.44, while Bank of America slid 2.4 percent to $11.24. The KBW Banks index <.bkx> lost 1.4 percent.


The Dow Jones industrial average <.dji> dropped 147.89 points, or 1.11 percent, to 13,163.83. The Standard & Poor's 500 Index <.spx> fell 17.08 points, or 1.18 percent, to 1,426.61. The Nasdaq Composite Index <.ixic> lost 39.90 points, or 1.31 percent, to 3,010.49.


Even with the declines, the S&P 500 is up nearly 1 percent for the week and about 13 percent for the year, though uncertainty over the cliff may prompt many traders to lock in gains as the year draws to a close.


The day's round of data indicated the economy was surprisingly resilient in November; consumer spending rose by the most in three years and a gauge of business investment jumped.


But separate data showed consumer sentiment slumped in December. The S&P Retail Index <.spxrt> fell 1.3 percent.


U.S.-listed shares of Research in Motion sank 19.8 percent to $11.32 after the Canadian company, which makes the BlackBerry, reported its first-ever decline in its subscriber numbers on Thursday. A new fee structure for its high-margin services segment also concerned investors.


Herbalife dropped for an eighth day in a row. Investor Bill Ackman on Thursday ramped up his campaign against the company. Herbalife skidded 17.8 percent to $27.72 and has shed more than 35 percent this week.


(Additional reporting by Ryan Vlastelica; Editing by Bernadette Baum)



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Putin Defends Position on Syria and Chastises U.S. on Libya





MOSCOW — President Vladimir V. Putin on Thursday strongly defended Russia’s implacable opposition to military intervention in Syria and he sharply chastised the United States for its role in toppling Col. Muammar el-Qaddafi of Libya, describing that outcome as a mistake that created chaos and ultimately led to the death of Ambassador J. Christopher Stevens in Benghazi.




Mr. Putin, responding to a question at his annual end-of-year news conference, rejected an assertion that Russia was making a mistake, potentially isolating itself and at risk of losing influence in the Middle East, by opposing intervention in Syria, where the uprising against President Bashar al-Assad is now nearly two years old. Mr. Putin pointed to Libya as his evidence that intervention by the NATO alliance of Western nations had caused more harm than good.


“No matter how they explained their position, the state is falling apart,” he said. “Interethnic, inter-clan and intertribal conflicts continue. Moreover, it went as far as the murder of the United States ambassador.” He added, “I was asked here about mistakes: Isn’t it a mistake? And you want us to constantly repeat these mistakes in other countries?”


Mr. Putin insisted that Russia was not acting in defense of President Assad of Syria, but rather to preserve stability. “We are not concerned with the fate of Assad’s regime,” he said. “Of course, changes are being demanded but it’s something else that concerns – what will happen next?”


His remarks about Syria came as United Nations human rights investigators said in a new report that the Syria crisis had evolved from a battle to oust Mr. Assad into more of a sectarian conflict, pitting entire communities against each other and pulling in fighters from the Middle East and North Africa.


Mr. Putin expressed worry that the Assad government and the Syrian opposition could merely switch places, with the rebels in power but with the fighting unabated.


Later, elaborating on Russia’s position, he said: “We stand for finding a variation of a solution to the problem which would save the region and this country first from collapse and never-ending civil war.”


He continued, “Our position is not for the retention of Assad and his regime in power at any cost but that the people in the beginning would come to an agreement on how they would live in the future, how their safety and participation in ruling the state would be provided for, and then start changing the current state of affairs in accordance with these agreements, and not vice versa.”


Russia, a longtime ally of Syria, has used its veto authority as a permanent member of the United Nations Security Council, both to block more aggressive intervention sought by the United States and many other countries and to defend the sovereignty of the Assad government. But in recent days, the Kremlin has sounded increasingly pessimistic about Mr. Assad’s retention of power, and Russian officials have acknowledged developing contingency plans to evacuate Russia citizens from Syria. Thousands of Syrian men who attended universities in Russia and returned to live in Syria have Russian wives.


While the West has focused closely on any signs that Russia might alter its position on Syria, in the hopes that it might hasten the dislodging of Mr. Assad, it is far from certain that the Kremlin could persuade the Syrian leader to relinquish power.


Russia has been a major Syria arms supplier and trade partner with the Assad government and maintains a small naval refueling installation in the Syrian port of Tartus. But Mr. Putin on Thursday sought to portray the relationship as transactional. “Some special economic relations?” Mr. Putin asked rhetorically. “No. And Assad did not come to Moscow a lot during the period of his presidency. More often he was in Paris and other European capitals than here.”


In Geneva, an interim report on Syria by a panel of the United Nations Human Rights Council said that as the conflict approached the end of its second year, it “has become overtly sectarian in nature.”


The panel, led by Paulo Pinheiro, a veteran human rights investigator from Brazil, said attacks and reprisals had led communities to arm themselves and to be armed by different parties to the conflict. “Entire communities are at risk of being forced out of the country or killed inside the country,” the panel wrote in the report, which covered developments over the past two months.


“Feeling threatened and under attack, ethnic and religious minority groups have increasingly aligned themselves with parties to the conflict, deepening sectarian divides,” the panel said.


The sharpest split is between the ruling minority Alawite sect, a Shiite Muslim offshoot from which President Assad’s most senior political and military associates are drawn, and the country’s Sunni Muslim majority, mostly aligned with the opposition, the panel noted. But it said the conflict had drawn in other minorities, including Armenians, Christians, Druze, Palestinians, Kurds and Turkmens.


Most foreign fighters joining the conflict are Sunni Muslims from neighboring Middle Eastern and North African countries, many of them linked to extremist groups, the panel said, and often operating independently of the opposition Free Syrian Army but coordinating attacks with its forces.


Lebanon’s Shiite group Hezbollah confirmed that its members were fighting for the Assad government, the panel said, and it was investigating reports that Iraqi Shiites had also entered Syria. Iran has also confirmed that members of its Revolutionary Guards Corps are providing the Assad regime with “intellectual and advisory support.”


Making their fourth submission to the Human Rights Council, the panel of four investigators said government forces and supporting militias had attacked Sunni civilians and opposition forces had attacked Alawite and other pro-government communities. It said Kurdish groups had clashed with government and antigovernment forces, Turkmen militias were fighting with antigovernment forces, and Palestinians, increasingly split in their view of the Assad government, were being armed by both pro- and antigovernment forces.


“As the conflict drags on, the parties have become ever more violent and unpredictable, which has led to their conduct increasingly being in breach of international law,” the panel concluded.


David M. Herszenhorn reported from Moscow, and Nick Cumming-Bruce from Geneva. Rick Gladstone contributed reporting from New York.



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Britney Spears: The 3 Most 'Amazing' Things About My Year















12/20/2012 at 01:45 PM EST



It was a very big year for Britney Spears, who's been named one of PEOPLE's 25 Most Intriguing People of 2012.

For starters, Forbes put the pop star at the top of its list of the top-earning female musicians (with $58 million), and her new single with will.i.am, "Scream & Shout," went to No. 1 in 17 countries.

She even took on Simon Cowell, along with the contestants – and any critics – as a judge on The X Factor.

After settling into the Fox reality show – whose two-hour finale airs Thursday night – she developed her own signature sound bite: "Amazing."

Now, Spears, 31, tells PEOPLE the top three things that made her 2012 "amazing."

1. Her career
"It's no secret I'm a shy person," Spears tells PEOPLE. "I feel doing this show over the past year has allowed me to come out of my shell a lot more. Everyone on the show has been amazing and made me feel really comfortable."

2. Her sons Preston, 7 and Jayden, 6
"It's really amazing to see how quickly my boys are growing up," she says. "It seems like yesterday I was reading books to them at night. Now I sit and listen to them read me books!"

3. Her fiancé Jason Trawick, 41
"It amazes me that no matter what situation I'm in," says Spears, "Jason has the ability to always make me feel protected and loved."

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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.


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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 first of a two-part series.


___


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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Wall Street flat amid stalemate in fiscal talks

NEW YORK (Reuters) - U.S. stocks were little changed on Thursday as investors fretted that a deal on the U.S. budget wouldn't come as soon as they had hoped after President Barack Obama threatened to veto a controversial Republican plan.


NYSE Euronext was the star of the day, surging more than 30 percent as the S&P 500's top percentage gainer, after IntercontinentalExchange Inc said it would buy the operator of the New York Stock Exchange for $8.2 billion.


NYSE was up 32.8 percent at $31.95, while ICE shares vacillated between gains and losses. The stock was last down 0.8 percent at $127.22.


The market barely reacted to a round of strong data, including an upward revision of gross domestic product growth and stronger-than-expected home sales, suggesting talks to avert the "fiscal cliff," steep tax hikes and spending cuts due in 2013, remain the primary focus for markets.


Republicans in the U.S. House of Representatives pushed ahead with their own fiscal plan in a move that muddles negotiations with the White House. Obama has vowed to veto the plan.


While investors have hoped for an agreement to come soon between policy makers, this seems unlikely as wrangling continues over the details.


"At least in the posturing it looks as if there are ultimatums put on the table, which tends to box either side in," said Quincy Krosby, market strategist at Prudential Financial in Newark, New Jersey.


Still, the absence of a significant sell-off shows "the market still believes that there will be an announcement of some sort. But as the clock is ticking, the most you're going to get is a stop-gap measure," said Krosby.


The Dow Jones industrial average <.dji> edged down 3.77 points, or 0.03 percent, at 13,248.20. The Standard & Poor's 500 Index <.spx> added 1.12 points, or 0.08 percent, to 1,436.93. The Nasdaq Composite Index <.ixic> slipped 3.58 points, or 0.12 percent, to 3,040.78.


Stocks rallied earlier in the week on signs of progress in the negotiations, led by banking and energy shares, which tend to outperform in times of economic expansion. On signs of complications, however, many have turned to hedging their bets through options and exchange-traded funds.


Herbalife fell 5.3 percent to $35.35 in the wake of news that hedge fund manager Bill Ackman was betting against the company as part of his big end-of-the-year short.


The U.S. economy grew 3.1 percent in the third quarter, faster than previously estimated, while the number of Americans filing new claims for jobless benefits rose more than expected in the latest week.


"It is great to see this kind of growth, but investors know it could all disappear if there's no deal on the cliff," said Todd Schoenberger, managing partner at LandColt Capital in New York. "Macro data may be on the back burner for a while."


Existing home sales jumped 5.9 percent in November, more than expected, and by the fastest monthly place in three years. Housing shares <.hgx> gained 0.4 percent.


But KB Home slid 5.5 percent to $15.75 as the company reported higher homebuilding costs and expenses in the fourth quarter.


(Additional reporting by Ryan Vlastelica; Editing by Bernadette Baum and Nick Zieminski)



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State Department Rebukes Israel Over Settlement Activity





The State Department accused Israel on Tuesday of engaging in a “pattern of provocative action” over the country’s plans to proceed with new settlement construction in the West Bank and East Jerusalem.




Victoria Nuland, a department spokeswoman, said settlement activity only put the goal of peace “further at risk” and urged both Israel and the Palestinians to halt all provocations and take steps to revive long-stalled peace talks.


Her remarks were a rare rebuke of a close ally, but the United States has grown increasingly frustrated with the Israelis, who continue to announce new settlement construction and take other measures seen as retaliation over a recent United Nations vote to upgrade Palestine’s status.


Separately on Tuesday, the British foreign secretary, William Hague, called all Israeli settlements “illegal under international law.”


He warned that the East Jerusalem project “would make a negotiated two-state solution, with Jerusalem as a shared capital, very difficult to achieve.”


The European Union, Israel’s biggest trading partner, has been increasingly vocal in its criticism of new settlements.


A string of European governments summoned their Israeli ambassadors to lodge protests after the Israeli settlement announcements.


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Shooting renews argument over video-game violence






WASHINGTON (AP) — In the days since the massacre at Sandy Hook Elementary School in Newtown, Conn., a shell-shocked nation has looked for reasons. The list of culprits include easy access to guns, a strained mental-health system and the “culture of violence” — the entertainment industry’s embrace of violence in movies, TV shows and, especially, video games.


“The violence in the entertainment culture — particularly, with the extraordinary realism to video games, movies now, et cetera — does cause vulnerable young men to be more violent,” Sen. Joe Lieberman, I-Conn., said.






“There might well be some direct connection between people who have some mental instability and when they go over the edge — they transport themselves, they become part of one of those video games,” said Gov. John Hickenlooper of Colorado, where 12 people were killed in a movie theater shooting in July.


White House adviser David Axelrod tweeted, “But shouldn’t we also quit marketing murder as a game?”


And Donald Trump weighed in, tweeting, “Video game violence & glorification must be stopped — it is creating monsters!”


There have been unconfirmed media reports that 20-year-old Newtown shooter Adam Lanza enjoyed a range of video games, from the bloody “Call of Duty” series to the innocuous “Dance Dance Revolution.” But the same could be said for about 80 percent of Americans in Lanza’s age group, according to the Pew Internet and American Life Project. Law enforcement officials haven’t made any connection between Lanza’s possible motives and his interest in games.


The video game industry has been mostly silent since Friday’s attack, in which 20 children and six adults were killed. The Entertainment Software Association, which represents game publishers in Washington, has yet to respond to politicians’ criticisms. Hal Halpin, president of the nonprofit Entertainment Consumers Association, said, “I’d simply and respectfully point to the lack of evidence to support any causal link.”


It’s unlikely that lawmakers will pursue legislation to regulate the sales of video games; such efforts were rejected again and again in a series of court cases over the last decade. Indeed, the industry seemed to have moved beyond the entire issue last year, when the Supreme Court revoked a California law criminalizing the sale of violent games to minors.


The Supreme Court decision focused on First Amendment concerns; in the majority opinion, Justice Antonin Scalia wrote that games “are as much entitled to the protection of free speech as the best of literature.” Scalia also agreed with the ESA’s argument that researchers haven’t established a link between media violence and real-life violence. “Psychological studies purporting to show a connection between exposure to violent video games and harmful effects on children do not prove that such exposure causes minors to act aggressively,” Scalia wrote.


Still, that doesn’t make games impervious to criticism, or even some soul-searching within the gaming community. At this year’s E3 — the Electronic Entertainment Expo, the industry’s largest U.S. gathering — some attendees were stunned by the intensity of violence on display. A demo for Sony’s “The Last of Us” ended with a villain taking a shotgun blast to the face. A scene from Ubisoft’s “Splinter Cell: Blacklist” showed the hero torturing an enemy. A trailer for Square Enix’s “Hitman: Absolution” showed the protagonist slaughtering a team of lingerie-clad assassins disguised as nuns.


“The ultraviolence has to stop,” designer Warren Spector told the GamesIndustry website after E3. “I do believe that we are fetishizing violence, and now in some cases actually combining it with an adolescent approach to sexuality. I just think it’s in bad taste. Ultimately I think it will cause us trouble.”


“The violence of these games can be off-putting,” Brian Crecente, news editor for the gaming website Polygon, said Monday. “The video-game industry is wrestling with the same issues as movies and TV. There’s this tension between violent games that sell really well and games like ‘Journey,’ a beautiful, artistic creation that was well received by critics but didn’t sell much.”


During November, typically the peak month for pre-holiday game releases, the two best sellers were the military shooters “Call of Duty: Black Ops II,” from Activision, and “Halo 4,” from Microsoft. But even with the dominance of the genre, Crecente said, “There has been a feeling that some of the sameness of war games is grating on people.”


Critic John Peter Grant said, “I’ve also sensed a growing degree of fatigue with ultra-violent games, but not necessarily because of the violence per se.”


The problem, Grant said, “is that violence as a mechanic gets old really fast. Games are amazing possibility spaces! And if the chief way I can interact with them is by destroying and killing? That seems like such a waste of potential.”


There are some hints of a sneaking self-awareness creeping into the gaming community. One gamer — Antwand Pearman, editor of the website GamerFitNation — has called for other players to join in a “Day of Cease-Fire for Online Shooters” this Friday, one week after the massacre.


“We are simply making a statement,” Pearman said, “that we as gamers are not going to sit back and ignore the lives that were lost.”


Gaming News Headlines – Yahoo! News





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It's a Boy for James Marsden




Celebrity Baby Blog





12/19/2012 at 01:30 PM ET



James Marsden Welcomes Son William Luca Christopher Polk/Getty; Courtesy Rose Costa


James Marsden is a father for the third time.


Brazilian model Rose Costa delivered a son, William Luca Costa-Marsden, on Friday, Dec. 14 in Los Angeles, PEOPLE has learned.


The 30 Rock star, who briefly dated Costa after his split from wife Lisa Linde in 2011, picked the name and is being very supportive, a source tells PEOPLE.


Marsden, 39, is already dad to daughter Mary James, 7, and son Jack Holden, 11, with Linde.


A rep for the actor could not be reached for comment.


– Sarah Michaud with reporting by Lesley Messer


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Experts: Kids are resilient in coping with trauma


WASHINGTON (AP) — They might not want to talk about the gunshots or the screams. But their toys might start getting into imaginary shootouts.


Last week's school shooting in Connecticut raises the question: What will be the psychological fallout for the children who survived?


For people of any age, regaining a sense of security after surviving violence can take a long time. They're at risk for lingering anxiety, depression, post-traumatic stress disorder.


But after the grief and fear fades, psychiatrists say most of Newtown's young survivors probably will cope without long-term emotional problems.


"Kids do tend to be highly resilient," said Dr. Matthew Biel, chief of child and adolescent psychiatry at MedStar Georgetown University Hospital.


And one way that younger children try to make sense of trauma is through play. Youngsters may pull out action figures or stuffed animals and re-enact what they witnessed, perhaps multiple times.


"That's the way they gain mastery over a situation that's overwhelming," Biel explained, saying it becomes a concern only if the child is clearly distressed while playing.


Nor is it unusual for children to chase each other playing cops-and-robbers, but now parents might see some also pretending they're dead, added Dr. Melissa Brymer of the UCLA-Duke National Center for Child Traumatic Stress.


Among the challenges will be spotting which children are struggling enough that they may need professional help.


Newtown's tragedy is particularly heart-wrenching because of what such young children grappled with — like the six first-graders who apparently had to run past their teacher's body to escape to safety.


There's little scientific research specifically on PTSD, post-traumatic stress disorder, in children exposed to a burst of violence, and even less to tell if a younger child will have a harder time healing than an older one.


Overall, scientists say studies of natural disasters and wars suggest most children eventually recover from traumatic experiences while a smaller proportion develop long-term disorders such as PTSD. Brymer says in her studies of school shootings, that fraction can range from 10 percent to a quarter of survivors, depending on what they actually experienced. A broader 2007 study found 13 percent of U.S. children exposed to different types of trauma reported some symptoms of PTSD, although less than 1 percent had enough for an official diagnosis.


Violence isn't all that rare in childhood. In many parts of the world — and in inner-city neighborhoods in the U.S., too — children witness it repeatedly. They don't become inured to it, Biel said, and more exposure means a greater chance of lasting psychological harm.


In Newtown, most at risk for longer-term problems are those who saw someone killed, said Dr. Carol North of the University of Texas Southwestern Medical Center, who has researched survivors of mass shootings.


Friday's shootings were mostly in two classrooms of Sandy Hook Elementary School, which has about 450 students through fourth-grade.


But those who weren't as close to the danger may be at extra risk, too, if this wasn't their first trauma or they already had problems such as anxiety disorders that increase their vulnerability, she said.


Right after a traumatic event, it's normal to have nightmares or trouble sleeping, to stick close to loved ones, and to be nervous or moody, Biel said.


To help, parents will have to follow their child's lead. Grilling a child about a traumatic experience isn't good, he stressed. Some children will ask a lot of questions, seeking reassurance, he said. Others will be quiet, thinking about the experience and maybe drawing or writing about it, or acting it out at playtime. Younger children may regress, becoming clingy or having tantrums.


Before second grade, their brains also are at a developmental stage some refer to as magical thinking, when it's difficult to distinguish reality and fantasy. Parents may have to help them understand that a friend who died isn't in pain or lonely but also isn't coming back, Brymer said.


When problem behaviors or signs of distress continue for several weeks, Brymer says it's time for an evaluation by a counselor or pediatrician.


Besides a supportive family, what helps? North advises getting children back into routines, together with their friends, and easing them back into a school setting. Studies of survivors of the Sept. 11 terrorist attacks found "the power of the support of the people who went through it with you is huge," she said.


Children as young as first-graders can benefit from cognitive-behavioral therapy, Georgetown's Biel said. They can calm themselves with breathing techniques. They also can learn to identify and label their feelings — anger, frustration, worry — and how to balance, say, a worried thought with a brave one.


Finally, avoid watching TV coverage of the shooting, as children may think it's happening all over again, Biel added. He found that children who watched the 9/11 clips of planes hitting the World Trade Center thought they were seeing dozens of separate attacks.


___


EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.


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