India Ink: Classes Warfare

NEW DELHI — It was a widely awaited verdict: Tens of thousands of parents seeking admission for their children to nursery schools in New Delhi were hoping for some remedy against a system that rewards inherited privilege and access to political power. But the High Court of Delhi upheld the status quo on Tuesday.

Most parents have little or no choice over which school their children will attend.

Two years ago the India blog for The Wall Street Journal ran a piece entitled “Delhi’s Nursery Schools Still Tougher to Crack Than Harvard?” The catchy headline was only partly true: New Delhi’s top private nursery schools are perhaps as competitive as an Ivy League college, but that’s not saying much about the means required to get in.

I should know: I spent the last month filling in application forms to 10 private schools for my three-year-old son, and he wasn’t admitted to any.

The Indian public school system is too dysfunctional to be a serious choice for most middle-class parents. As a result, the total number of applicants to the top 20 private nursery schools in New Delhi is well over 50,000 for about 1,500 slots. (This is my rough estimate.) Most parents have little or no choice over which school their children will attend. Rather, the question is which school, if any, will admit their children.

A few years ago, worried about the growing pressure to which children no more than four years of age were being subjected, the city government forbade entrance exams and interviews for nursery schools, as well as the screening of parents’ educational background. Before then, New Delhi schools openly sought out candidates whose parents were affluent, spoke English fluently and mattered in the city’s power hierarchy. A privileged class kept replicating itself.

In theory, the new norms suggested a more egalitarian process: They prescribed a point system, and a lottery would be drawn among candidates who were tied. In practice, this favored the old elite. A school could attribute points to a child who lived nearby, whose siblings were pupils or whose parents were alumni. The residency requirement benefited the rich because the best schools are in affluent parts of the city, and the legacy criteria only served those already entrenched in the system.

Some schools also went out of their way to bypass the law by creating subjective criteria for assigning points to applicants. One top school I sent an application to has a special category for the “Promotion of Indian heritage/Exceptional achievement/Significant inspirational work for the nation/Any other, please specify.” I have asked them to clarify what this means.

The new norms also created two sets of restricted seats. All schools were required to set aside 25 percent of seats for students from poor families, which in New Delhi are defined as having annual incomes of less than $2,500. Perhaps to compensate for the attending monetary loss — poorer students pay reduced fees — the city government also allowed schools to allot 20 percent of the total seats under a management quota free of any regulation.

While I have had no direct access to any school official who decides on such quotas, anecdotal evidence I’ve gleaned from other parents suggests that some schools are trading admission for donations of $40,000 or more — unless, of course, applicants are backed by ministers or powerful bureaucrats. Even schools that are less sought-after are asking between $2,000 and $3,000 just to register students who have been admitted. No receipts are being issued.

The Indian middle class, especially in a city like New Delhi, is a substantial and growing presence. But very few of its members have the means or the connections to secure seats in good schools for their children.

The new admissions system is only a pretense at nondiscrimination. As much as the old, it ensures that rich or well-connected Indians will continue to corner most seats in the country’s top schools.


Hartosh Singh Bal is political editor of Open Magazine and co-author of “A Certain Ambiguity.’’

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American Idol: Sudden-Death Round Begins for Men















02/21/2013 at 11:00 PM EST







From left: Randy Jackson, Mariah Carey, Ryan Seacrest, Nicki Minaj and Keith Urban


George Holz/FOX


On Wednesday, 10 women sang for five spots on American Idol's live shows. On Thursday, it was the remaining guys' turn.

The judges have their own euphemisms when they don't like a performance – it's usually easy to read between the lines: If they compliment a singer on his shoes, he won't advance. On Thursday, Nicki Minaj actually told a contestant, "Kudos to you for being really freshly, nicely groomed." They might as well have had a stagehand pull him offstage with an oversized vaudeville hook.

After several weeks of good behavior by the judges, Thursday's episode showed a spark of life when Nicki – who was wearing her very best Jan Brady wig – began rolling her eyes whenever Randy Jackson spoke. At one point, Ryan Seacrest even tried to get them to kiss and make up. There was talk about lipstick, and Mariah Carey did her best to look at anything other than the awkward air kiss that followed.

But the theatrics did not eclipsed some solid singers – and a few performances that just weren't good enough for the competition.

The Good: Curtis Finch Jr. wowed judges with his version of Luther Vandross's "Superstar." It was oversung. But there was no denying Finch's vocal talent. Charlie Askew's rendition of Elton John's "Rocketman" was interesting and well-suited to his voice. And Devin Velez pleased the crowd when he infused Spanish lyrics into Beyoncé's "Listen." The three of them advanced easily.

The Okay: Elijah Liu chose Bruno Mars's "Talking to the Moon," a song that felt current and new. Paul Jolley sang Keith Urban's "Tonight I'm Gonna Cry." Generally, it's a risky move to sing a song made popular by one of the judges, but Jolley's performance was pleasant, if a little shaky. Both advanced, although the judges were split on their assessment of Jolley.

The Others: Johnny Keiser, Kevin Harris, Chris Watson and Jimmy Smith sang unspectacular versions of various songs that everyone knows. Each of them had a decent voice, but none of their performances were all that unique, and none of them advanced. On the other side of the spectrum, J'DA performed an over-the-top rendition of Adele's "Rumor Has It." It wasn't enough for him to advance, but his performance – at one point he collapsed on the floor but continued singing – was by far the most memorable of the night.

There are ten contestants – five men and five women – who have made it to the next round. Next week, the remaining 20 contestants will complete for the remaining 10 spots – and all will hope the judges don't compliment what they're wearing.

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APNewsBreak: Govs to hear Oregon health care plan


SALEM, Ore. (AP) — Oregon Gov. John Kitzhaber will brief other state leaders this weekend on his plan to lower Medicaid costs, touting an overhaul that President Barack Obama highlighted in his State of the Union address for its potential to lower the deficit even as health care expenses climb.


The Oregon Democrat leaves for Washington, D.C., on Friday to pitch his plan that changes the way doctors and hospitals are paid and improves health care coordination for low income residents so that treatable medical problems don't grow in severity or expense.


Kitzhaber says his goal is to win over a handful of other governors from each party.


"I think the politics have been dialed down a couple of notches, and now people are willing to sit down and talk about how we can solve the problem" of rising health care costs, Kitzhaber told The Associated Press in a recent interview.


Kitzhaber introduced the plan in 2011 in the face of a severe state budget deficit, and he's been talking for two years about expanding the initiative beyond his state. Now, it seems he's found people ready to listen.


Hospital executives from Alabama visited Oregon last month to learn about the effort. And the U.S. Department of Health and Human Services announced Thursday that it's giving Oregon a $45 million grant to help spread the changes beyond the Medicaid population and share information with other states, making it one of only six states to earn a State Innovation Model grant.


Kitzhaber will address his counterparts at a meeting of the National Governors Association. His talk isn't scheduled on the official agenda, but a spokeswoman confirmed that Kitzhaber is expected to present.


"The governors love what they call stealing from one another — taking the good ideas and the successes of their colleagues and trying to figure out how to apply that in their home state," said Matt Salo, director of the National Association of Medicaid Directors.


There's been "huge interest" among other states in Oregon's health overhaul, Salo said, not because the concepts are brand new, but because the state managed to avoid pitfalls that often block health system changes.


Kitzhaber persuaded state lawmakers to redesign the system of delivering and paying for health care under Medicaid, creating incentives for providers to coordinate patient care and prevent avoidable emergency room visits. He has long complained that the current financial incentives encourage volume over quality, driving costs up without making people healthier.


Obama, in his State of the Union address this month, suggested that changes such as Oregon's could be part of a long-term strategy to lower the federal debt by reigning in the growing cost of federally funded health care.


"We'll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn't be based on the number of tests ordered or days spent in the hospital — they should be based on the quality of care that our seniors receive," Obama said.


The Obama administration has invested in the program, putting up $1.9 billion to keep Oregon's Medicaid program afloat over the next five years while providers make the transition to new business models and incorporate new staff and technology.


In exchange, though, the state has agreed to lower per-capita health care cost inflation by 2 percentage points without affecting quality.


The Medicaid system is unique in each state, and Kitzhaber isn't suggesting that other states should adopt Oregon's specific approach, said Mike Bonetto, Kitzhaber's health care policy adviser. Rather, he wants governors to buy into the broad concept that the delivery system and payment models need to change.


That's not a new theory. But Oregon has shown that under the right circumstances massive changes to deeply entrenched business models can gain wide support.


What Oregon can't yet show is proof the idea is working — that it's lowering costs without squeezing on the quality or availability of care. The state is just finishing compiling baseline data that will be used as a basis of comparison.


One factor driving the Obama administration's interest in Oregon's success is the president's health care overhaul. Under the Affordable Care Act, millions more Americans will join the Medicaid rolls after Jan. 1, and the health care system will have to be able to absorb the influx of patients in a logistically and financially sustainable way.


The federal government will pay 100 percent of the costs for those additional patients in the first three years before scaling back to 90 percent in 2020 and beyond.


"There are a lot of governors who are facing the same challenges we're facing in Oregon," Kitzhaber said. "They recognize that the cost of health care is something they're going to have to get their arms around."


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Jobs, factory, inflation data favor easy Fed policy


WASHINGTON (Reuters) - A raft of U.S. economic data on Thursday from claims for jobless aid to factory activity and consumer prices pointed to a still tepid recovery and supported the argument for the Federal Reserve to maintain its monetary stimulus.


The Fed is currently buying $85 billion in bonds per month and has said it would keep up purchases until the labor market outlook improves substantially, although officials are increasingly divided over the wisdom of that course.


"The economy is in a holding pattern. It's not going to strengthen sufficiently to justify an end of the current program," said Millan Mulraine, senior economist at TD Securities in New York.


Initial claims for state unemployment benefits increased 20,000 last week to a seasonally adjusted 362,000, unwinding the bulk of the prior week's decline, the Labor Department said.


A second report from the department showed consumer prices were flat for a second straight month in January as gasoline prices fell and the cost of food held steady.


In the 12 months through January, consumer prices rose 1.6 percent, the smallest gain since July. That suggested there was little inflation pressure to worry the Fed.


Concerns over tepid job growth prompted the U.S. central bank last year to embark on its open-ended bond buying program.


However, minutes of the Fed's January 29-30 policy meeting published on Wednesday showed some policymakers feel the central bank may have to slow or stop the asset purchases before it sees an acceleration in job growth because of concerns over the financial risks of the program.


Those diverging views were evident on Thursday, with two Fed officials signaling support for scaling back the program, while another outlined the case for maintaining bond purchases until well into the second half of the year.


MANUFACTURING SLOWING


News on the manufacturing sector, which has supported the economy's recovery from the 2007-09 recession, was downbeat.


The Philadelphia Fed's business activity index dropped to minus 12.5 in February, the lowest level since June. The index, which measures factory activity in the mid-Atlantic region, had fallen to minus 5.8 in January.


A reading below zero indicates contraction in the region's manufacturing sector. The survey covers factories in eastern Pennsylvania, southern New Jersey and Delaware.


Another report from financial data firm Markit that tries to gauge overall national factory activity showed manufacturing growth slowed in February but remained near a nine-month peak.


"We believe manufacturing activity will continue to expand early in 2013," said Daniel Silver, an economist at JPMorgan in New York.


The claims and factory reports, as well as weak data from Europe weighed on U.S. stocks. The Standard & Poor's 500 index recorded its worst two-day loss since November.


Prices for U.S. government debt rose and the dollar touched a 5-1/2-month high against a basket of currencies.


Growth in the U.S. economy braked sharply in the fourth quarter, but it expanded at a 2.2 percent clip for the full year. Output is being hampered by lackluster demand as employment struggles to gain traction.


Job growth has been far less than the at least 250,000 per month over a sustained period that economists say is needed to significantly reduce the ranks of unemployed. The unemployment rate rose 0.1 percentage point to 7.9 percent in January.


Last week's claims data covered the survey period for the government's closely watched monthly tally of nonfarm jobs. Claims were up 27,000 between the January and February survey periods.


However, the increase probably does not suggest any material change in the pace of job growth given that claims have been very volatile since January because of difficulties smoothing the data for seasonal fluctuations.


Despite the weak factory and jobs data, there is reason for optimism about the economy. The housing market recovery is gaining momentum.


A report from the National Association of Realtors showed existing home sales rose 0.4 percent last month, pushing the supply of homes on the market to a 13-year low. The median home price rose 12.3 percent from a year earlier.


Rising home values should help to support consumer spending.


Although consumer prices excluding food and energy rose 0.3 percent - the largest gain since May 2011 - most of that reflected outsized increases in apparel and education costs.


"January is a tough month because you get a lot of price hikes at the start of the new year and the seasonals have a hard time sort of adjusting," said Omair Sharif, an economist at RBS in Stamford, Connecticut.


"I don't expect the core CPI to maintain that pace of increase in the near term."


(Additional reporting by Jason Lange in Washington and Steven C Johnson in New York; Editing by Andrea Ricci and James Dalgleish)



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Police Detective in Pistorius Case Faces Attempted Murder Charges





PRETORIA, South Africa — In a remarkable twist in the case of Oscar Pistorius, the double amputee track star accused of murdering his girlfriend, the South African police said on Thursday that the officer leading the investigation against the athlete is himself facing attempted murder charges.







Stephane De Sakutin/Agence France-Presse — Getty Images

Police detective Hilton Botha arrived at court for the bail hearing of Oscar Pistorius on Wednesday.







The disclosure deepened questions surrounding the detective, Hilton Botha, who, under cross-examination at a bail hearing on Wednesday, was forced to concede that he could not rule out Mr. Pistorius’s own version of events based on the existing evidence.


While the prosecution has accused Mr. Pistorius, 26, of the premeditated murder of his girlfriend Reeva Steenkamp, 29, a week ago, the track star himself said he opened fire thinking there was an intruder in his home in a gated community and had no intention of killing her.


In a development that seemed as bewildering as it was sensational on Thursday, Police Brig. Neville Malila said that Mr. Botha is himself set to appear in court in May facing attempted murder charges relating to an incident in Oct. 2011, when Mr. Botha and two other police officers were accused of firing at a minivan carrying seven people.


The case had initially been dropped but was reinstated on Wednesday at the insistence of the state prosecutor, even as Mr. Botha was appearing as the lead police witness in the prosecution’s attempt to prevent Mr. Pistorius from securing bail.


“Botha and two other policemen allegedly tried to stop a mini bus taxi with seven people. They fired shots," Brigadier Malila told Reuters.


“We were informed yesterday that the charges will be reinstated," he said. “At this stage there are no plans to take him off the Pistorius case.”


Mr. Pistorius returned to court on Thursday for further arguments about whether he should be granted bail in a case that has riveted South Africa and fascinated a wider audience, reflecting Mr. Pistorius’s status as one of the world’s most renowned athletes, whose distinctive carbon-fiber running blades have given him the nickname Blade Runner.


On Wednesday, what was supposed to be a simple bail hearing took on the proportions of a full-blown trial, with sharp questions from the presiding magistrate, Desmond Nair, and a withering cross-examination that left Detective Botha grasping for answers that did not contradict his earlier testimony.


Initially, Detective Botha explained how preliminary ballistic evidence supported the prosecution’s assertion that Mr. Pistorius had been wearing prosthetic legs when he shot at a bathroom door early on Feb. 14. Ms. Steenkamp, a model and law school graduate, was hiding behind it at the time.


Mr. Pistorius said in an affidavit read to the court on Tuesday that he had hobbled over from his bed on his stumps and had felt extremely vulnerable to a possible intruder as a result.


But when questioned by Barry Roux, Mr. Pistorius’s lawyer, Detective Botha was forced to acknowledge sloppy police work, and he eventually conceded that he could not rule out Mr. Pistorius’s version of events based on the existing evidence. Mr. Roux accused the prosecution of selectively taking “every piece of evidence” and trying “to extract the most possibly negative connotation and present it to the court.”


Lydia Polgreen reported from Pretoria, South Africa, and Alan Cowell from London.



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American Idol: Women Face Sudden-Death Round






American Idol










02/20/2013 at 11:00 PM EST







Mariah Carey


Mario Anzuoni/Reuters/Landov


American Idol threw yet another new twist at its 40 remaining contestants: a sudden-death round.

"One song, one chance, no mercy," Ryan Seacrest said as the first group of 10 female contestants gathered in Las Vegas to try to finally sing their way – in front of a boisterous studio audience – through to the "America votes" phase of the competition.

Five women moved on, five went home.

Kentucky high school junior Jenny Beth Willis, whose rendition of a Trisha Yearwood song earned mixed reviews from the judges, was the first up. Although Keith Urban appreciated her "effortless confidence," Nicki Minaj said her performance lacked excitement (a comment that elicited the first audience boos of the season). Final result: It was the end of the road for Willis.

Tenna Torres, 28, – who attended Mariah Carey's camp for kids as a youngster – took the stage next and impressed the judges with her take on the Natasha Bedingfield's "Soulmate." But she lost style points with Minaj, who didn't like one particular aspect of her look. "Lose the hair," said Minaj, who felt the contestant's coif aged her. Final result: She made it through to the Top 20.

The three most powerful performances of the night all made it to the next round: Nashville's Kree Harrison, who despite taking a decidedly plain-Jane approach to styling, wowed the judges with her version of Patty Griffin's "Up to the Mountain." "You sang the hell out of that song," said Carey.

Angela Miller, 18, of Massachusetts, belted out Jessie J's hit "Nobody's Perfect." But she pretty much was.

And Amber Holcomb, an assistant teacher from Texas, closed the show with a rousing (and well received) rendition of "My Funny Valentine."

For the final spot of the night, it came down to Anchorage, Alaska, resident Adriana Latonio, 17, who tackled Aretha Franklin's "Ain't No Way," and Shubha Vedula, a Michigan high school senior who sang Lady Gaga's "Born This Way."

Although the judges saw potential in both contestants, they ultimately picked Lantonio's powerhouse vocals in a final emotional moment.

Thursday will bring out the guys. The first round of 10 will take the stage to try to make the top 20 – but once again, five will go home.

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Doc groups issue list of overused tests, therapies


WASHINGTON (AP) — Don't be afraid to question your doctor and ask, "Do I really need that?"


That's the advice from leading medical groups who came up dozens of tests and treatments that physicians too often prescribe when they shouldn't.


No worrisome stroke signs? Then don't screen a healthy person for a clogged neck artery, the family physicians say. It could lead to risky surgery for a blockage too small to matter.


Don't routinely try heartburn medicine for infants with reflux, the pediatric hospitalists say. It hasn't been proven to work in babies, and could cause side effects.


Don't try feeding tubes in people with advanced dementia, say the hospice providers. Helping them eat is a better option.


These are examples of potentially needless care that not only can waste money and time, but sometimes can harm, says the warning being issued Thursday from medical specialty groups that represent more than 350,000 doctors.


Too many people "think that more is better, that more treatment, more testing somehow results in better health care," said Dr. Glen Stream, former president of the American Academy of Family Physicians, which contributed to the list. "That really is not true."


The recommendations are part of a coalition called Choosing Wisely, formed by the American Board of Internal Medicine Foundation. Participating medical societies were asked to identify five tests or treatments that are commonly overused in their specialty. The list is aimed at doctors and includes references to published studies. Consumers Reports and other consumer groups are publicizing the information in more patient-friendly terms.


Last year, the coalition listed 45 overused tests and treatments. It included some of the best known examples, such as too much imaging for back pain and repeating colonoscopies too frequently.


This year's list adds 90 more overused kinds of care. Some are the result of doctors' habits, hard to overcome despite new evidence, Stream said. Others come about because patients demand care they think they need.


Some other examples:


—Don't use opioid painkillers for migraines except as a last resort, say the neurologists. There are better, more migraine-specific drugs available without the addictive risk of narcotics. Plus, frequent use of opioids actually can worsen migraines, a concept known as rebound headache.


—Just because a pregnant woman misses her due date, don't race to induce labor if mom and baby are doing fine, say the obstetricians. Inducing before the cervix is ready often fails, leading to an unneeded C-section. "Just being due by the calendar doesn't mean your body says you're due," Stream notes.


—Don't automatically give a child a CT scan after a minor head injury, say the pediatricians. About half of children who go to the ER with head injuries get this radiation-heavy scan, and clinical observation first could help some who don't really need a CT avoid it.


—And don't leave an implanted heart-zapping defibrillator turned on when a patient is near death, say the hospice providers. This technology clearly saves lives by guarding against an irregular heartbeat. But if someone is dying of something else, or is in the terminal stages of heart disease, it can issue repeated painful shocks, to no avail. Yet fewer than 10 percent of hospices have formal policies on when to switch off the implants.


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India Ink: Irene Genovese, the Traveler from Italy

Why do millions of people, from entire Indian villages to urbane middle managers to foreign tourists, brave the crowds at the Kumbh Mela? During this year’s 55-day pilgrimage, to Allahabad, Uttar Pradesh, an estimated 100 million Hindus and others are expected to take a holy dip in the Ganges River to wash away their sins. India Ink interviewed some of them.

Irene Genovese, 55, a traveler from Tuscany, Italy,  was one among them. This is what she had to say.

Why did you come to the Kumbh Mela this year? Is it your first time?

Yes, it is my first time. I love the experience so far. My partner has been teaching yoga in Italy for about 40 years now, so he wanted to come down here and meet the sadhus who practice yoga regularly.

How have you found it so far?

I am overwhelmed by the number of people there are here! We knew there would be crowds, but didn’t expect this. These are unbelievable numbers. We have also liked the interactions with the sadhus. We live in the Hare Krishna tent so get to interact a lot more with the devotees.

Describe your journey to the Kumbh. Did you travel alone? How long did it take?

We took a stopover in Delhi before coming here. Our Kumbh trip is for only four days. Now we are wondering how we would get back to Delhi. They say there are no last-minute reservations on trains.

Do you consider yourself a religious person?

Yes, I am religious. But my partner is more religious than I. And I respect that.

Do you follow Indian politics? Who do you think is going to win the 2014 election?

I don’t follow Indian politics. I don’t follow politics at all.

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What's Next for Mindy McCready's Two Young Boys?















02/19/2013 at 07:00 PM EST



Mindy McCready's apparent suicide on Sunday has left her two young sons in custodial limbo.

The boys – Zander, 6, and Zayne, 10 months – had been in state custody since Feb. 7, when McCready called police to ask for help in making her father and stepmother leave her home. When police arrived, McCready appeared to be intoxicated, according to a Department of Human Services report.

In a subsequent petition, the singer's father, Tim McCready, asked the court to order her to undergo mental health and substance abuse evaluation and treatment, alleging that his daughter, who had recently lost her boyfriend, "hasn't had a bath in a week ... screams about everything ... [is] very verbally abusive to Zander."

After a judge granted the petition, the children were quickly removed and placed into foster care. Although McCready was released from treatment, the boys remained in state custody.

At the time, Zander's father, Billy McKnight, requested custody of his son. "My son needs me," he told PEOPLE on Feb. 8. "I'm married, working and successful. I'm on the right track and proud of it. I've been sober for years. I just want my son."

But McCready's mother and stepfather, Gayle and Michael Inge, also want custody of the children – and authorities seem to agree.

In a proposed order sent to Circuit Judge Lee Harrod, the Department of Human Services proposed that the Inges might be a better fit for the children, claiming that they have "a substantial relationship." The Inges had custody of Zander for much the past few years, during McCready’s rehab and jail stints.

With McCready's death, the judge will have to determine what is in the children's best interest. A custody hearing has been scheduled for April 5.

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Drug overdose deaths up for 11th consecutive year


CHICAGO (AP) — Drug overdose deaths rose for the 11th straight year, federal data show, and most of them were accidents involving addictive painkillers despite growing attention to risks from these medicines.


"The big picture is that this is a big problem that has gotten much worse quickly," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which gathered and analyzed the data.


In 2010, the CDC reported, there were 38,329 drug overdose deaths nationwide. Medicines, mostly prescription drugs, were involved in nearly 60 percent of overdose deaths that year, overshadowing deaths from illicit narcotics.


The report appears in Tuesday's Journal of the American Medical Association.


It details which drugs were at play in most of the fatalities. As in previous recent years, opioid drugs — which include OxyContin and Vicodin — were the biggest problem, contributing to 3 out of 4 medication overdose deaths.


Frieden said many doctors and patients don't realize how addictive these drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs.


They're useful for cancer, "but if you've got terrible back pain or terrible migraines," using these addictive drugs can be dangerous, he said.


Medication-related deaths accounted for 22,134 of the drug overdose deaths in 2010.


Anti-anxiety drugs including Valium were among common causes of medication-related deaths, involved in almost 30 percent of them. Among the medication-related deaths, 17 percent were suicides.


The report's data came from death certificates, which aren't always clear on whether a death was a suicide or a tragic attempt at getting high. But it does seem like most serious painkiller overdoses were accidental, said Dr. Rich Zane, chair of emergency medicine at the University of Colorado School of Medicine.


The study's findings are no surprise, he added. "The results are consistent with what we experience" in ERs, he said, adding that the statistics no doubt have gotten worse since 2010.


Some experts believe these deaths will level off. "Right now, there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin," said Don Des Jarlais, director of the chemical dependency institute at New York City's Beth Israel Medical Center.


"But at some point, people using these drugs are going to become more aware of the dangers," he said.


Frieden said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" — doctor offices and pharmacies that over-prescribe addictive medicines.


Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be subjected to the same restrictions as other narcotic drugs like oxycodone and morphine. Meanwhile, more and more hospitals have been establishing tougher restrictions on painkiller prescriptions and refills.


One example: The University of Colorado Hospital in Aurora is considering a rule that would ban emergency doctors from prescribing more medicine for patients who say they lost their pain meds, Zane said.


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Stobbe reported from Atlanta.


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Online:


JAMA: http://www.jama.ama-assn.org


CDC: http://www.cdc.gov


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


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