Egyptians vote on Islamist-inspired constitution


CAIRO (Reuters) - Early indications suggested Egyptians approved an Islamist-drafted constitution in Saturday's second-round referendum despite opposition criticism of the measure as divisive.


As counting began, an official from the Muslim Brotherhood's political party, which backs President Mohamed Mursi, said a sample of a few hundred thousand votes had "yes" in the lead.


An official from the opposition National Salvation Front said their early exit polls showed the constitution passing.


Last week's first round returned 57 percent in favor of the constitution, according to unofficial data. The vote was split over two days as many judges refused to supervise the ballot.


The referendum committee may not declare official results for the two rounds until Monday, after hearing appeals.


Islamist backers of Mursi say the constitution is vital to move to democracy, nearly two years after an Arab Spring revolt overthrew authoritarian ruler Hosni Mubarak. It will provide stability for a weak economy, they say.


But the opposition accuses Mursi of pushing through a text that favors Islamists and ignores the rights of Christians, who make up about 10 percent of the population, as well as women.


"I'm voting 'no' because Egypt can't be ruled by one faction," said Karim Nahas, 35, a stockbroker, heading to a polling station in Giza, in greater Cairo.


At another polling station, some voters said they were more interested in ending Egypt's long period of political instability than in the Islamist aspects of the charter.


"We have to extend our hands to Mursi to help fix the country," said Hisham Kamal, an accountant.


VICE PRESIDENT ANNOUNCES RESIGNATION


Hours before polls closed, Vice President Mahmoud Mekky announced his resignation. He said he wanted to quit last month but stayed on to help Mursi tackle a crisis that blew up when the Islamist leader assumed wide powers.


Mekky, a prominent judge who said he was uncomfortable in politics, disclosed earlier he had not been informed of Mursi's power grab. The timing of his resignation appeared linked to the lack of a vice-presidential post under the draft constitution.


Rights groups reported alleged law violations during voting. They said some polling stations opened late, that Islamists illegally campaigned at some of them, and complained of voter registration irregularities, including listing of a dead person.


The new basic law sets a limit of two four-year presidential terms. It says sharia law principles remain the main source of legislation but adds an article to explain this further. It also says Islamic authorities will be consulted on sharia - a source of concern to Christians and other non-Muslims.


If the constitution passes, there will be parliamentary elections in about two months.


After the first round of voting, the opposition said alleged abuses meant the first stage of the referendum should be re-run.


But the committee overseeing the two-stage vote said its investigations showed no major irregularities in voting on December 15, which covered about half of Egypt's 51 million voters. About 25 million were eligible to vote in the second round.


MORE UNREST


If the charter is approved, the opposition says it is a recipe for trouble since it will not have received sufficiently broad backing and that it will not have been a fair vote.


"I see more unrest," said Ahmed Said, head of the liberal Free Egyptians Party and a member of the National Salvation Front, an opposition coalition formed after Mursi expanded his powers on November 22 and then pushed the constitution to a vote.


Protesters accused the president of acting like a pharaoh, and he was forced to issue a second decree two weeks ago that amended a provision putting his decisions above legal challenge.


Said cited "serious violations" on the first day of voting, and said anger against Mursi was growing. "People are not going to accept the way they are dealing with the situation."


At least eight people were killed in protests outside the presidential palace in Cairo this month. Islamists and rivals hurled stones at each other on Friday in Alexandria, the second-biggest city. Two buses were torched.


Late on Saturday, Mursi announced the names of 90 new members he had appointed to the upper house of parliament, state media reported, and a presidential official said the list was mainly liberals and other non-Islamists.


Mursi's main opponents from liberal, socialist and other parties said they had refused to take any seats.


Two-thirds of the 270-member upper house were elected in a vote early this year, with one third appointed by the president. Mursi, elected in June, had not named them till now. Mursi's Islamist party and its allies dominate the assembly. (Additional reporting by Tamim Elyan and Shaimaa Fayed; Writing by Edmund Blair and Giles Elgood; Editing by Mark Trevelyan and Jason Webb)



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CIA chief decries torture in Osama bin Laden hunt movie






WASHINGTON: Acting CIA director Michael Morell said that "Zero Dark Thirty," the Hollywood take on the hunt for Osama bin Laden, exaggerates the importance of information obtained by harsh interrogations.

The movie by Academy Award-winning director Kathryn Bigelow tells the story of the decade-long search after September 11, 2001 that climaxed in last year's dramatic and deadly raid in May on the Al-Qaeda terror leader's hideout in Abbottabad, Pakistan.

The film shows US personnel using harsh interrogation techniques like water-boarding -- a method widely seen as torture -- to force captives to speak. The information obtained was crucial, according to the movie, in piecing together the trail that eventually led to bin Laden.

Not so, Morell said in a message to Central Intelligence Agency employees released to AFP on Saturday.

The movie "creates the strong impression that the enhanced interrogation techniques that were part of our former detention and interrogation program were the key to finding bin Laden. That impression is false."

Morell's message, sent to the employees on Friday, states that "multiple streams of intelligence" led CIA analysts to conclude that bin Laden was hiding in Abbottabad.

He acknowledged that "some" of the information "came from detainees subjected to enhanced techniques. But there were many other sources as well."

The controversial techniques were banned in 2009 by President Barack Obama.

Morell said that "whether enhanced interrogation techniques were the only timely and effective way to obtain information from those detainees, as the film suggests, is a matter of debate that cannot and never will be definitively resolved."

Morell is widely believed to be a top candidate for the job of CIA director after the resignation of David Petreaus, America's most celebrated military leader in a generation. Petreaus stepped down in November after admitting to an extra-marital affair with his biographer.

Morell's message, first reported by The New York Times, echoes a statement decrying the "Zero Dark Thirty" interrogation scenes signed by three senators, including Republican John McCain, himself a prisoner of war and torture victim during the Vietnam War.

In a letter to the head of Sony Pictures, McCain -- the 2008 Republican presidential candidate -- and Democratic senators Diane Feinstein and Carl Levin wrote that the movie "clearly implies that the CIA's coercive interrogation techniques were effective" in obtaining information that would lead to bin Laden.

"We have reviewed CIA records and know that this is incorrect," the senators wrote. "We believe that you have an obligation to state that the role of torture in the hunt for (Bin Laden) is not based on the facts, but rather part of the film's fictional narrative."

However two CIA officials active when suspects were tortured disputed those assertions.

Jose Rodriguez, who oversaw the CIA's counterterrorism operations when "harsh interrogation" methods were in use, wrote in the Washington Post in April that the path leading to bin Laden "started in a CIA black site ... and stemmed from information obtained from hardened terrorists who agreed to tell us some (but not all) of what they knew after undergoing harsh but legal interrogation methods."

And former CIA director Michael Hayden wrote in a Wall Street Journal in June 2011 that a "crucial component" of information that eventually led to bin Laden came from three CIA prisoners, "all of whom had been subjected to some form of enhanced interrogation."

Hayden claimed that he learned the information when, in 2007, he was first briefed about pursuing bin Laden through his courier network.

But interim CIA director Morell emphasized the film, a likely Oscar contender, "takes significant artistic licence, while portraying itself as being historically accurate."

"What I want you to know is that Zero Dark Thirty is a dramatization, not a realistic portrayal of the facts.

"CIA interacted with the filmmakers through our Office of Public Affairs but, as is true with any entertainment project with which we interact, we do not control the final product."

- AFP/jc



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Virbhadra Singh to be Himachal CM

SHIMLA: Congress Party's old warhorse Virbhadra Singh will be the next chief minister of Himachal Pradesh. This will be his sixth term as the head of the hill state. After a meeting of Himachal Pradesh Congress Legislature Party (CLP) here on Saturday, Virbhadra's name was cleared by party president Sonia Gandhi.

At the CLP meet, the MLAs had sent a one-line resolution asking Sonia Gandhi to decide on who would be the chief minister. Congress general secretary Janardhan Dwivedi said here that the Congress leadership on Saturday evening decided on Virbhadra to head the government in the state.

Earlier, hundreds of Congress supporters had gathered at Himachal Pradesh Vidhan Sabha complex to witness the election of CLP leader despite tight security.

Party observer Sheila Dikshit arrived late and the CLP meeting began after 6.40pm, when she reached there along with Birender Singh and Janardhan Dwivedi. Out of the 34 MLAs present, 22 backed Virbhadra, while one of the contenders for the CM's post, Kaul Singh Thakur, claimed the support of 18 MLAs.

While most of the MLAs had reached the venue much in advance, Virbhadra Singh arrived at 6:08pm with his supporters raising slogans like "Raja nahin faqir hai ... Himachal ki taqdir hai". Senior Congress leaders Vidya Stokes and Asha Kumari were present at the meeting. On Friday, Virbhadra had met Stokes at her residence.

The Congress had defeated the BJP in the assembly polls, winning 36 out of 68 seats on Thursday. BJP got 26 while six seats went to independents.

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


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


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


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


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


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


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


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


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


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


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


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


—Previous violent or aggressive behavior


—Being a victim of physical or sexual abuse


—Guns in the home


—Use of drugs or alcohol


—Brain damage from a head injury


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


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


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


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


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


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


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


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


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


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


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


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Online:


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


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


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Urban Advocates Say New Gun Control Talk Overdue













For years, voices have cried in the urban wilderness: We need to talk about gun control.



Yet the guns blazed on.



It took a small-town slaughter for gun control to become a political priority. Now, decades' worth of big-city arguments against easy access to guns are finally being heard, because an unstable young man invaded an elementary school in Newtown, Conn., with a military-style assault rifle and 30-bullet magazines. Twenty young children and six adults were slain.



President Barack Obama called the tragedy a "wake-up call." Vice President Joe Biden met Thursday with Obama's cabinet and law-enforcement officers from around the country to launch a task force on reducing gun violence. Lawmakers who have long resisted gun control are saying something must be done.



Such action is energizing those who have sought to reduce urban gun violence. Donations are up in some places; other leaders have been working overtime due to this unprecedented moment.



The moment also is causing some to reflect on the sudden change of heart. Why now? Why weren't we moved to act by the killing of so many other children, albeit one by one, in urban areas?



Certainly, Newtown is a special case, 6- and 7-year-olds riddled with bullets inside the sanctuary of a classroom. Even in a nation rife with violence, where there have been three other mass slayings since July and millions enjoy virtual killing via video games, the nature of this tragedy is shocking.










Critics Slam NRA for Proposing Armed School Guards Watch Video









Gun Violence Victims, Survivors Share Thoughts After Newtown Massacre Watch Video






But still: "There's a lot of talk now about we have to protect our children. We have to protect all of our children, not just the ones living in the suburbs," said Tammerlin Drummond, a columnist for the Oakland Tribune.



In her column Monday, Drummond wrote about 7-year-old Heaven Sutton of Chicago, who was standing next to her mother selling candy when she was killed in the crossfire of a gang shootout. Also in Chicago, which has been plagued by a recent spike in gun violence: 6-year-old Aaliyah Shell was caught in a drive-by while standing on her front porch; and 13-year-old Tyquan Tyler was killed when a someone in a car shot into a group of youths outside a party.



Wrote Drummond: "It has taken the murders of 20 babies and six adults in an upper-middle class neighborhood in Connecticut to achieve what thousands of gun fatalities in urban communities all over this country could not."



So again: What took so long? The answers are complicated by many factors: resignation to urban violence, even among some of those who live there; the assumption that cities are dangerous and small towns safe; the idea that some urban victims place themselves in harm's way.



In March, the Children's Defense Fund issued a report titled "Protect Children, Not Guns 2012." It analyzed the latest federal data and counted 299 children under age 10 killed by guns in 2008 and 2009. That figure included 173 preschool-age children.



Black children and teens accounted for 45 percent of all child and teen gun deaths, even though they were only 15 percent of the child/teen population.



"Every child's life is sacred and it is long past time that we protect it," said CDF president Marian Wright Edelman in the report.



It got almost no press coverage — until nine months later, when Newtown happened.



Tim Stevens, founder and chairman of the Black Political Empowerment Project in Pittsburgh, has been focusing on urban gun violence since 2007, when he said Pennsylvania was declared the worst state for black-on-black violence.





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Italy PM Monti resigns, elections likely in February


ROME (Reuters) - Italian Prime Minister Mario Monti tendered his resignation to the president on Friday after 13 months in office, opening the way to a highly uncertain national election in February.


The former European commissioner, appointed to lead an unelected government to save Italy from financial crisis a year ago, has kept his own political plans a closely guarded secret but he has faced growing pressure to seek a second term.


President Giorgio Napolitano is expected to dissolve parliament in the next few days and has already indicated that the most likely date for the election is February 24.


In an unexpected move, Napolitano said he would hold consultations with political leaders from all the main parties on Saturday to discuss the next steps. In the meantime Monti will continue in a caretaker capacity.


European leaders including German Chancellor Angela Merkel and European Commission President Jose Manuel Barroso have called for Monti's economic reform agenda to continue but Italy's two main parties have said he should stay out of the race.


Monti, who handed in his resignation during a brief meeting at the presidential palace shortly after parliament approved his government's 2013 budget, will hold a news conference on Sunday at which he is expected clarify his intentions.


Ordinary Italians are weary of repeated tax hikes and spending cuts and opinion polls offer little evidence that they are ready to give Monti a second term. A survey this week showed 61 percent saying he should not stand.


Whether he runs or not, his legacy will loom over an election which will be fought out over the painful measures he has introduced to try to rein in Italy's huge public debt and revive its stagnant economy.


His resignation came a couple of months before the end of his term, after his technocrat government lost the support of Silvio Berlusconi's centre-right People of Freedom (PDL) party in parliament earlier this month.


Speculation is swirling over Monti's next moves. These could include outlining policy recommendations, endorsing a centrist alliance committed to his reform agenda or even standing as a candidate in the election himself.


The centre-left Democratic Party (PD) has held a strong lead in the polls for months but a centrist alliance led by Monti could gain enough support in the Senate to force the PD to seek a coalition deal which could help shape the economic agenda.


BERLUSCONI IN WINGS


Senior figures from the alliance, including both the UDC party, which is close to the Roman Catholic Church, and a new group founded by Ferrari sports car chairman Luca di Montezemolo, have been hoping to gain Monti's backing.


He has not said clearly whether he intends to run, but he has dropped heavy hints he will continue to push a reform agenda that has the backing of both Italy's business community and its European partners.


The PD has promised to stick to the deficit reduction targets Monti has agreed with the European Union and says it will maintain the broad course he has set while putting more emphasis on reviving growth.


Berlusconi's return to the political arena has added to the already considerable uncertainty about the centre-right's intentions and increased the likelihood of a messy and potentially bitter election campaign.


The billionaire media tycoon has fluctuated between attacking the government's "Germano-centric" austerity policies and promising to stand aside if Monti agrees to lead the centre right, but now appears to have settled on an anti-Monti line.


He has pledged to cut taxes and scrap a hated housing tax which Monti imposed. He has also sounded a stridently anti-German line which has at times echoed the tone of the populist 5-Star Movement headed by maverick comic Beppe Grillo.


The PD and the PDL, both of which supported Monti's technocrat government in parliament, have made it clear they would not be happy if he ran against them and there have been foretastes of the kind of attacks he can expect.


Former centre-left prime minister Massimo D'Alema said in an interview last week that it would be "morally questionable" for Monti to run against the PD, which backed all of his reforms and which has pledged to maintain his pledges to European partners.


Berlusconi who has mounted an intensive media campaign in the past few days, echoed that criticism this week, saying Monti risked losing the credibility he has won over the past year and becoming a "little political figure".


(Additional reporting by Gavin Jones, Massimiliano Di Giorgio and Paolo Biondi; Writing by Gavin Jones and James Mackenzie; Editing by Michael Roddy)



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Football: Late-show Juventus go 10 points clear






ROME: Juventus needed two goals in stoppage time to seal a come-from-behind 3-1 win at Cagliari on Friday and move 10 points clear at the top of Serie A.

Cagliari, just a point above the relegation zone, went ahead after 16 minutes through a Mauricio Pinilla penalty awarded after Arturo Vidal had chopped down Marco Sau in the box.

In a contentious game, Cagliari played the last 30 minutes a man short after the sending off of Davide Astori, who had already been booked, for a foul on Sebastian Giovinco.

Alessandro Matri, playing against his old club, levelled for Juventus 10 minutes later and added another in the second minute of injury time.

Mirko Vucinic put away the third in the fifth minute of time added on.

"I have waited for this moment for a long time. My morale had gone down because I wasn't scoring but I always believed in myself," said Matri, who hadn't found the back of the net since September 29.

Inter Milan can close the gap on Juve back to seven points if they beat Genoa on Saturday.

- AFP/jc



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Supreme Court orders to jail convicts on bail ignored for 4 years

NEW DELHI: Here is why people are increasingly getting frustrated by the absence of deterrent effect of law on criminals — the authorities ignored for four years a Supreme Court order directing immediate arrest of convicts, who were on bail, in a murder case to serve out the 10-year imprisonment sentence.

In a startling case, the Supreme Court in May 2008 dismissed the appeal of one Sambu Rai, who was accused in a murder case, and restored the trial court's August 4, 1989 order convicting him and seven other accused under Section 304 (culpable homicide not amounting to murder) to 10 years imprisonment.

Since September 11, 1989, that is for nearly 23 years, all the accused have been on bail since the Patna high court entertained their appeal. The HC decided the appeal on November 10, 2000. The Supreme Court took another eight years to dismiss their appeals and restore the trial court order.

Though the Supreme Court set aside the HC's lenient order and restored the stringent punishment recorded by the trial court 19 years ago, it had little effect on the convicts. A week after the June 17, 2008 judgment of the apex court, the registry sent out a letter to authorities concerned in Bihar directing that "this order be punctually observed and carried into execution by all concerned".

The Supreme Court's warning went unheeded, which allowed the convicts to roam free for four more years when they should have been serving out their 10-year sentence. The SC order was finally complied with on May 9, 2012, when the Motihari trial court issued arrest warrants against the eight convicts.

Three convicts — Sambu Rai, Jhulan Rai and Dila Rai — were arrested the same day the warrants were issued by the additional district judge. Another convict Bali Rai was arrested on May 24. Three others — Manak Rai, Ram Ikbal Rai and Gorakh Rai — had died by the time arrest warrants were issued and the last convict Parshuram Rai was physically handicapped and bed ridden.

This is not an isolated incident of criminals roaming free despite conviction. Another common feature of our criminal justice system is convicts remaining on bail during pendency of appeals, which remain pending for a long time as the appellate court's order summoning trial court records do not get complied with for years.

From Motihari alone, there are seven such instances where appeals have not been taken up for hearing for years, in one case for more than 20 years, as the trial court records have not reached the appellate court.

In the appeal filed by Muktar Mian against state of Bihar, the appellate court admitted his plea and requisitioned the trial court records to commence hearing on the appeal. After more than 20 years on November 21 this year, the appellate court said, "Appellant takes no step. Lower court records not received. Put up on February 21, 2013. Appellant and officer concerned to comply with the previous order."

Of the six other cases, one appeal is pending since August 1995, two each from 2004 and 2006 and another from 2010. In all these cases, the accused in all probability continue to enjoy freedom on bail and may continue to do so in the face of judicial lethargy.

In the Baithani Tola massacre, too, a similar trend is visible. The Supreme Court in July this year admitted the Bihar government's appeal challenging the Patna High Court order acquitting all the accused convicted of massacre of dalits in 1996. But the SC's order seeking trial court records is yet to be complied with.

An Ara trial court in 2010 had convicted 23 and sentenced three to death while awarding life sentence to the other 20 for the massacre of 21 landless poor, most of whom were women and children. But on April 16 this year, the HC overturned their conviction and acquitted the accused.

On July 16 this year, the SC did not accept Bihar government's plea for issuance of bailable warrants against the accused for taking them into custody during pendency of the appeal.

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AP IMPACT: Big Pharma cashes in on HGH abuse


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


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


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


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


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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."


___


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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Critics Slam NRA's Call for Armed School Guards













Gun control advocates slammed the National Rifle Association today for its proposal to create a force of armed security guards at schools across the country as a response to the Connecticut school shooting.


"It is beyond belief that following the Newtown tragedy, the National Rifle Association's leaders want to fill our communities with guns and arm more Americans," Sen. Frank Lautenberg, D-N.J., said.


Criticism mounted after the NRA addressed for the first time last week's school shooting in Newtown, Conn., in which Adam Lanza, 20, used a semiautomatic weapon to open fire on students and teachers at Sandy Hook Elementary School, killing 26 at the school.


NRA spokesman Wayne LaPierre this morning dismissed the notion that the pro-gun group of about 4 million members would support any kind of gun-control laws, instead saying that "the only thing that can stop a bad guy with a gun is a good guy with a gun."


Rep. Chris Murphy, D-Conn., who represents the district encompassing Newtown, reacted angrily to the comments after attending the funeral of another victim from last Friday's massacre.


"Walking out of another funeral and was handed the NRA transcript. The most revolting, tone deaf statement I've ever seen," @ChrisMurphyCT tweeted.


LaPierre argued that the answer to gun violence in schools is an armed security force that can protect students, made up of trained volunteers stationed at every school across the country.


"It's not just our duty to protect [our children], it's our right to protect them," LaPierre said at a news conference. "The NRA knows there are millions of qualified active and reserved police, active and reserve military, security professionals, rescue personnel, an extraordinary corps of qualified trained citizens to join with local school officials and police in devising a protection plan for every single school."


He was interrupted twice by protestors who stood in front of LaPierre's podium holding signs and shouting that the NRA "has blood on its hands" and that the NRA is "killing our kids."


The protestors were eventually escorted out of the room.


Lautenberg, who has introduced legislation that would ban large-capacity ammunition magazines, called the NRA "irresponsible."


"The NRA points the finger of blame everywhere and anywhere it can, but they cannot escape the devastating effects of their reckless comments and irresponsible lobbying tactics," Lautenberg said.


Mark Kelly, a former NASA astronaut and husband of former congresswoman Gabrielle Giffords, who was shot in Arizona, said, "The NRA could have chosen to be a voice for the vast majority of its own members who want common sense, reasonable safeguards on deadly firearms, but instead it chose to defend extreme pro-gun positions that aren't even popular among the law-abiding gun owners it represents."






Chip Somodevilla/Getty Images











National Rifle Association Calls for Armed Security at Schools Watch Video









President Obama Launches Gun-Violence Task Force Watch Video









President Obama on Gun Control: Ready to Act? Watch Video





The Violence Policy Center, a gun-control advocacy organization, said the NRA's idea of arming security guards at schools would not stop school violence.


"The NRA plan, which cynically allows for the continued sale of the assault weapons and high-capacity ammunition magazines marketed by its gun industry corporate donors, has already been tried, and it did not work," the group said in a statement released today.


It pointed to the mass shooting at Columbine High School in 1999, in which two armed police officers were at the school when Eric Harris and Dylan Klebold opened fire. The officers exchanged gunfire with the killers, but were unable to stop them from their rampage.


House Minority Leader Nancy Pelosi conceded that the issue is "complicated, but she said the NRA's call for an escalation "is not a positive force" in the renewed gun-control debate.


"For the NRA and others to sort of shield themselves by saying it's the mentally ill or something, and therefore we have to have more armed cops in the schools or more guns in the school -- what are they -- are they going to have [a gun] on the teacher's desk?" Pelosi wondered.


"'Wait a minute, man with a gun; I have it locked up someplace. Wait until I go get it.' I mean, this ... just doesn't make sense; we've got to reduce violence."


LaPierre had dismissed the notion that banning so-called assault weapons or enacting gun-control laws would stop school violence. He instead cast blame for gun violence in schools on violent entertainment, including video games, and the media.


"How many more copycats are waiting in the wings for their moment of fame from a national media machine that rewards them with a wall of attention they crave while provoking others to make their mark?" he asked.


LaPierre announced that former U.S. congressman Asa Hutchinson of Arkansas would lead the NRA's effort to advocate for school security forces. Hutchinson specified that the NRA, with about 4 million members, is calling for volunteers to act as the armed guards, rather than requiring funding from local or federal authorities.


"Whether they're retired police, retired military or rescue personnel, I think there are people in every community in this country who would be happy to serve if only someone asked them and gave them the training and certifications to do so," Hutchinson said.


NRA leaders have held off on interviews this week after refusing to appear on Sunday morning public affairs shows. They said they would grant interviews beginning next week to discuss their position.


NRA News anchor Ginny Simone said Thursday that in the wake of the Sandy Hook shooting, membership surged "with an average of 8,000 new members a day."


New York City Mayor Michael Bloomberg has said the NRA is partially to blame for the tragedy.


"We're not trying to take away your right to advance the interests of gun owners, hunters, people who want to protect themselves," Bloomberg told "Nightline" anchor Cynthia McFadden in an interview Thursday. "But that's not an absolute right to encourage behavior which causes things like Connecticut. In fact, Connecticut is because of some of their actions."


The guns used in the attack were legally purchased and owned by the shooter's mother, Nancy Lanza, whom Adam Lanza shot to death before his assault on the school.


In the aftermath of the shooting, many, including Bloomberg, have called for stricter regulations on the type of weapons used in this and other instances of mass gun violence this year.


Sen. Dianne Feinstein, D-Calif., has said she intends to introduce a bill banning assault weapons on the first day of next year's Congress -- a step the president said he supports.






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