Thousands flock to annual MP 'bhoot mela' to get exorcised

BETUL: It's a mela with a spirited presence. In Malajpur, a village in Betul district some 300 km from Bhopal, an annual fair is devoted to the exorcising of ghosts. Thousands throng here from Madhya Pradesh, Maharashtra, Rajasthan and even Andhra Pradesh for the month-long 'bhoot pret ka mela' that will make their lives easier.

While exorcism is an old practice in some of India's villages, holding a fair for it is rare. The mela is held in a temple on the first day of Paush Poornima and continues till Basant Panchami. Bhikhari lal Yadav, a priest there explains, "Exorcism here is a centuries-old practice. We hold a samadhi of Guru Deoji sant and every evening, after the prayer, we treat those under the spell of ghosts and evil spirits." Guru Deoji, incidentally, was a Rajput with supernatural powers who was born around 1700 AD. His powers included turning sand to sugar, clay to jaggery and restoring eyesight to the blind. His reputation grew when, during droughts, he made the granaries overflow. After his death, a samadhi was made and for the last two-and-a-half centuries, exorcism has been going on here.

It is mainly women who come here to get rid of evil spirits. Psychiatrists say this is because their mental problems are often ignored by their families till it gets worse and they seem 'possessed'. The treatment is free here and devotees offer jaggery if their wishes are fulfilled. This year, more than 1,000 women were exorcised.

The exorcism starts late in the evening after 'aarti' has been performed. While normal people do a 'parikrama' of the temple anti-clockwise, the 'possessed' walk clockwise. Crowds chant, "Guru Maharaj ki jai" and families bring their ill members one-by-one. Amidst the chanting of mantras and sprinkling of holy water, the women become hysterical and flay about wildly before collapsing. Earlier, the priests would wield brooms during the rituals but that's a practice of the past.

Sunita, a Class IX student from Rampur village in Chhindwara district, is one of those believed to have benefited from this ritual. A relative of hers says, " One day, she suddenly fell unconscious and we were convinced she was possessed by an evil spirit. After a session of exorcism, she has started behaving normally."

Families of others too say their wards have got better. However, Rahul Sharma, a clinical psychologist from Gandhi Medical College, Bhopal, says the psyche of those assembled at Malajpur can be termed as a "hysterical" and says that conventional treatments such as psychotherapy, sociotherapy and medicines can also cure this problem.

Such blind practices are being combated, says S R Azad, general secretary of MP Vigyan Sabha. "We often do awareness camps and communicate to the villagers through science. The government should discourage this kind of superstition where poor villagers are exploited."

That's easier said than done.

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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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Sony bills coming PS4 console as future of gaming

NEW YORK: Sony unveiled a new-generation PlayStation 4 (PS4) system on Wednesday and laid out its vision for the "future of gaming" in a world rich with mobile gadgets and play streamed from the Internet cloud.

At a press event in New York, computer entertainment unit chief Andrew House said PS4 "represents a significant shift from thinking of PlayStation as a box or console to thinking of the PlayStation 4 as a leading place for play."

PS4 was designed to get to know players, ideally to the point of being able to predict which games people will buy and have them pre-loaded and ready to go.

It also allows live streaming of gameplay in real-time, letting friends virtually peer over one another's shoulders and even letting game makers to act as "directors" guiding players along.

Sony has also given a "green light" to building "the most powerful network for gaming in the world", according to David Perry, chief of Gaikai cloud gaming company purchased last year by Sony.

Gaikai specialises in letting people play video games streamed from the Internet "cloud" instead of buying titles on disks popped into consoles or computers.

"By combining PlayStation 4, PlayStation Network and social platforms, our vision is to create the first social network with meaning dedicated to games," Perry said during the event.

A button on the PS4 controller will let players instantly stream in-game action to friends in real time, and even allow someone to transfer control to more capable allies when stuck, according to Perry.

He expressed a vision of letting people access and play video games old or new on the Internet using PS4, smartphones, tablets or PS Vita handheld devices.

"We are exploring opportunity enabled by cloud technology with a long-term vision of making PlayStation technology available on any device," Perry said.

"This would fundamentally change the concept of game longevity, making any game new or old available to get up and running on any device, anywhere."

Sony needs to adapt to changing lifestyles while not alienating video game lovers devoted to its hardware.

Low-cost or free games on smartphones or tablet computers are increasing the pressure on video game companies to deliver experiences worth players' time and money.

With the press event still in progress, Sony had yet to indicate availability or pricing for the PS4. New-generation consoles are typically priced in the $400 to $500 range, and blockbuster game titles hit the market at $60 each.

-AFP/gn

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Jallianwala Bagh massacre: David Cameron's apology that wasn't?

NEW DELHI: David Cameron's statement on the 1919 Jallianwala Bagh massacre, marking it as a "deeply shameful event" in British history but stopping short of a full apology, has not impressed historians.

Mushirul Hasan, directorgeneral of the National Archives, says, "The present generation is not necessarily responsible for mistakes of the past. By apologizing for what General Dyer did, Cameron has set a bad precedent. Now others will demand apologies for past acts of belligerence. There'll be no end to this. The past should be interpreted in that context, not outside it. Such an apology, which obviously has other motives, is not necessarily a good thing."

Writer William Dalrymple agrees for different reasons. "It's meaningless to apologize for what you have no control over. It makes sense if the Congress apologized for 1984, Modi for Gujarat, Blair for Iraq. It was actually a good move for Cameron not to apologize fully — that would've seemed very cynical when you've arrived with a trade delegation. But what Cameron can do is teach the British more about the empire. My children at school have learnt about Tudor England, the Nazis, wars in Europe, but nothing in comparison about the empire. The British are simply unaware of the empire's good — like the Indian civil service's integrity — or its bad, like the terrifying killings of 1858 in north India, compared to which Jallianwala Bagh was a sideshow. The British don't know enough about a period which was much longer and more radically important in its global effects than Nazi Germany."

Current efforts to revamp history-teaching aren't good enough, Dalrymple feels. "I believe Cameron's interested in getting Niall Ferguson on this. Niall's a thorough historian and a very clever and amusing gadfly — but he's also the most pro-empire voice in academia. We need more neutral efforts to educate the British, so they can squarely face the bad parts of this period."

Historian Dilip Simeon feels the British are not the only ones who should confront an unjust past. "The fact that it took nearly 100 years for a British PM to apologize is a commentary in itself," Simeon says. "But we're in no position to look down on the Brits. Countless Indians have been killed in communal riots but no one's ever passed a resolution of regret in Parliament. I take a dim view of British sentiments now but I also ask — how long will it take us?"

Jallianwala Bagh massacre: A timeline

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Agency checks water after body found in hotel tank

LOS ANGELES (AP) — British tourist Michael Baugh and his wife said water had only dribbled out of the taps at the downtown Cecil Hotel for days.

On Tuesday, after showering, brushing their teeth and drinking some of the tap water, they headed down to the lobby and found out why.

The body of a Canadian woman had been discovered at the bottom of one of four cisterns on the roof of the historic hotel near Skid Row. The tanks provide water for hotel taps and would have been used by guests for washing and drinking.

"The moment we found out, we felt a bit sick to the stomach, quite literally, especially having drank the water, we're not well mentally," Michael Baugh, 27, said.

Los Angeles County Department of Public Health officials issued a do-not-drink order Tuesday while its lab analyzes the water, said Terrance Powell, a director coordinating the department's response. The disclosure contradicts a previous police statement that the water had been deemed safe. Results of the testing were expected by Thursday.

Powell said the water was also used for cooking in the hotel; a coffee shop in the hotel would remain closed and has been instructed to sanitize its food equipment before reopening.

"Our biggest concern is going to be fecal contamination because of the body in the water," Powell said. He said the likelihood of contamination is "minimal" given the large amount of water the body was found in, but the department is being extra cautious.

Powell said the hotel hired a water treatment specialist after the department required it to do so to disinfect its plumbing lines.

A call to the hotel was not returned.

The remains of Elisa Lam, 21, were found by a maintenance worker at the 600-room hotel that charges $65 a night after guests complained about the low water pressure.

Police detectives were working to determine if her death was the result of foul play or an accident.

LAPD Sgt. Rudy Lopez called it suspicious and said a coroner's investigation will determine Lam's cause of death.

Before she died, hotel surveillance footage showed Lam inside an elevator pushing buttons and sticking her head out the doors, looking in both directions. She was later found in the water tank.

Lam, of Vancouver, British Columbia, traveled alone to Los Angeles on Jan. 26 and was last seen five days later by workers at the hotel.

Lopez said the hotel has four cisterns on its roof that are each about 10 feet tall, 4.5 feet wide and hold at least 1,000 gallons of water pumped up from city pipes.

Lam's body was found Tuesday morning at the bottom of one cistern that was about three-quarters full of water, Lopez said.

The opening at the top of the cistern is too small to accommodate firefighters and equipment, so they had to cut a hole in the storage tank to recover Lam's body.

The cisterns are on a platform at least 10 feet above the roof.

To get to the tanks, someone would have to go to the top floor then take a staircase with a locked door and emergency alarm preventing roof access.

Another ladder would have to be taken to the platform and a person would have to climb the side of the tank.

Lopez said there are no security cameras on the roof.

Lam intended to travel to Santa Cruz, about 350 miles north of Los Angeles. Officials said she tended to use public transportation and had been in touch with her family daily until she disappeared.

The Cecil Hotel was built in the 1920s and refurbished several years ago. The hotel is on Main Street in a part of downtown where efforts at gentrification often conflicts with homelessness and crime. It had once been the occasional home of infamous serial killers such as Richard Ramirez, known as the Night Stalker, and Austrian prison author Jack Unterweger, who was convicted of murdering nine prostitutes in Europe and the U.S., the Los Angeles Times reported.

By noon Wednesday, the Cecil Hotel had relocated 27 rooms used by guests to another hotel, but 11 rooms remained filled, Powell said. Those who chose to remain in the hotel were required to sign a waiver in which they acknowledged being informed of the health risks and were being provided bottled water, Powell said.

Baugh and his wife, who were on their first trip to the U.S., had planned to go to SeaWorld on Wednesday. Instead, they were trying to find a new hotel. Their tour agency placed them in another downtown hotel with a less than sterling reputation, from what they heard.

"We're just going from one dodgy place to another," Baugh said, resigned, "but at least there's water."

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Tami Abdollah can be reached at http://www.twitter.com/latams. Shaya Tayefe Mohajer contributed to this report.

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Arias Says Violent Sex Preceded Killing

Jodi Arias and her ex-boyfriend, Travis Alexander,, had increasingly violent sex in which he tied her to his bed, twisted her arm, bent her over a desk for anal sex, and made sex videos with her in the hours leading up to the stabbing and shooting frenzy that left Alexander dead.

It was a day in which Arias, 32, inched closer to telling the court how the killing of Alexander took place, but after several hours of increasingly emotional testimony the court was adjourned until Wednesday.

In her sixth day on the stand, Arias tearfully described the sex-filled hours that led to Alexander's death on June 4, 2008. She is charged with murder for killing her former boyfriend, but claims she was forced to kill him self-defense. She could face the death penalty if convicted.

"He tied me up, (on) the bed. It's not my favorite but it's not unbearable," Arias told the court.

She said he used a kitchen knife in the bathroom to cut the rope to the proper length, but she didn't remember whether he left the knife in the bathroom or brought it back to the nightstand in the bedroom.

"There are a lot gaps that day... a lot of things I don't remember that day," she said.

Arias and Alexander then took graphic sexual photos of one another and made a sex video, both of which Arias said were Alexander's ideas. Arias has girlish braids in the pictures.

But the mood of the afternoon turned, she said, when Alexander became angry over a scratched computer disk of photos she gave him. He threw the CD and Arias said she became "apprehensive" of his rising temper.

"I know he's getting angry because Napoleon [Alexander's dog] got up and left the room and he always leaves the room when he gets mad." she testified.

"I don't know that I was consciously thinking (of violence) but I was more tense. I stood up, went to walk over to him, to rub his back and make sure he was okay," she said. "But he grabbed me on the upper arms, spun me around and grabbed my right arm and twisted it behind my back, and bent me over the desk, and pressed up against me."

Charlie Leight/Pool/The Arizona Republic/AP Photo

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"I was scared he was going to throw me or something, kick me," she continued. "He pressed his groin up against my butt, did a few thrusts and then started pulling my pants down."

The pair then had anal sex, which Arias said pacified Alexander.

"I was very relieved. I felt like we had avoided catastrophe. It could have led to another fight," she said.

Instead of a fight, Alexander, who was 27 and a devout Mormon, and Arias decide to go upstairs and take more nude photos of one another. Arias said she hoped the photos would satisfy Alexander over his frustration with the scratched CD.

Evidence introduced earlier in the trial show that Alexander was killed while Arias was photographing Alexander in the shower.

Catching Up on the Trial? Check Out ABC News' Jodi Arias Trial Coverage

Timeline of the Jodi Arias Trial

Earlier, Arias explained that she wasn't planning to visit Alexander during her roadtrip from her home in California, but was convinced by him to spontaneously take a detour to his house for sex and to hang out.

"The very last time I called Travis it was kind of like, I don't know how to describe it, he had been very sweet and was guilting me and making me feel bad that I was taking this big trip without going to see him," Arias said this afternoon.

"When I called him last time it was just like all right, I'm going," she said. "(Sex) was our thing at that time. I wasn't going to go there, stay the night and not do that."

Arias' attorney, Kirk Nurmi, asked her repeatedly on the stand if Arias brought a gun or knife with her on the roadtrip and to Alexander's house. She said that she did not.

She also denied a series of allegations made by the prosecution that she dyed her hair, rented an inconspicuous car, borrowed gas cans, turned off her cell phone, and switched money around her bank accounts as she left for Alexander's house because she was planning to murder him when she got there.

Arias said that her hair remained the same color, auburn-brown, throughout May and June, that she rented a car because her own car was not stable enough for highway travel, that she requested a white car instead of a red one because police pull red ones over more often, and that she transferred money to a business banking account for a tax write-off to classify it as a business trip.

The testimony about the road trip and Arias' planning could be key to the jury as they decide whether the killing was pre-meditated, as the prosecution claims. Arias could face the death penalty if convicted of murder with aggravating factors such as pre-meditation.

Arias said that she "didn't sleep at all last night" before testifying about the dramatic incident today. Her comment was stricken from the record.

Arias also described a barrage of threatening text messages sent by Alexander in which he told her he would exact "revenge" on her soon and called her a "sociopath."

She told the court that Alexander's temper would make her "cower."

The messages show a growing discord between the pair in April 2008, less than two months before Arias killed Alexander.

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Syria "Scud-type" missile said to kill 20 in Aleppo

AMMAN (Reuters) - A Syrian missile killed at least 20 people in a rebel-held district of Aleppo on Tuesday, opposition activists said, as the army turns to longer-range weapons after losing bases in the country's second-largest city.

The use of what opposition activists said was a large missile of the same type as Russian-made Scuds against an Aleppo residential district came after rebels overran army bases over the past two months from which troops had fired artillery.

As the uprising against President Bashar al-Assad, now a civil war, nears its two-year mark, rebels also landed three mortar bombs in the rarely-used presidential palace compound in the capital Damascus, opposition activists said on Tuesday.

The United Nations estimates 70,000 people have been killed in the conflict between largely Sunni Muslim rebels and Assad's supporters among his minority Alawite sect. An international diplomatic deadlock has prevented intervention, as the war worsens sectarian tensions throughout the Middle East.

A Russian official said on Tuesday that Moscow, which is a long-time ally of Damascus, would not immediately back U.N. investigators' calls for some Syrian leaders to face the International Criminal Court for war crimes.

Moscow has blocked three U.N. Security Council resolutions that would have increased pressure on Assad.

Casualties are not only being caused directly by fighting, but also by disruption to infrastructure and Syria's economy.

An estimated 2,500 people in a rebel-held area of northeastern Deir al-Zor province have been infected with typhoid, which causes diarrhea and can be fatal, due to drinking contaminated water from the Euphrates River, the World Health Organization (WHO) said on Tuesday.

"There is not enough fuel or electricity to run the pumps so people drink water from the Euphrates which is contaminated, probably with sewage," the WHO representative in Syria, Elisabeth Hoff, told Reuters by telephone.

The WHO had no confirmed reports of deaths so far.

BURIED UNDER RUBBLE

In northern Aleppo, opposition activists said 25 people were missing under rubble of three buildings hit by a several-meter-long missile. They said remains of the weapon showed it to be a Scud-type missile of the type government forces increasingly use in Aleppo and in Deir a-Zor.

NATO said in December Assad's forces fired Scud-type missiles. It did not specify where they landed but said their deployment was an act of desperation.

Bodies were being gradually dug up, Mohammad Nour, an activist, said by phone from Aleppo.

"Some, including children, have died in hospitals," he said.

Video footage showed dozens of people scouring for victims and inspecting damage. A body was pulled from under collapsed concrete. At a nearby hospital, a baby said to have been dug out from wreckage was shown dying in the hands of doctors.

Reuters could not independently verify the reports.

Opposition activists also reported fighting near the town of Nabak on the Damascus-Homs highway, another route vital for supplying forces in the capital loyal to Assad, whose family has ruled Syria since the 1960s.

Rebels moved anti-aircraft guns into the eastern Damascus district of Jobar, adjacent to the city centre, as they seek to secure recent gains, an activist said.

"The rebels moved truck-mounted anti-aircraft guns to Jobar and are now firing at warplanes rocketing the district," said Damascus activist Moaz al-Shami.

Russian Deputy Foreign Minister Gennady Gatilov told a news conference a U.N. war crimes report, which accuses military leaders and rebels of terrorizing civilians, was "not the path we should follow ... at this stage it would be untimely and unconstructive."

Syria is not party to the Rome Statute that established the ICC and the only way the court can investigate the situation is if it receives a referral from the Security Council, where Moscow is a permanent member.

(Writing by Oliver Holmes; Editing by Jason Webb)

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Retinal implants clear new hurdle

PARIS: German-designed implants aimed at restoring vision to patients blinded by retinal disease have succeeded in the second phase of trials, researchers reported on Wednesday.

The device was tested for up to nine months among nine people with retinitis pigmentosa, an inherited disease in which light receptors on the back of the eyeball degenerate and eventually cease to function.

"Of the nine patients observed in the study, three patients were able to read letters spontaneously," Retina Implant AG, a nine-year-old technology startup company that invented the device, said in a press release.

"During observation in and outside the laboratory, patients also reported the ability to recognise faces, distinguish objects such as telephones and read signs on doors."

The study appears in Proceedings of the Royal Society B, a journal published by Britain's de-facto academy of sciences.

The device consists of a tiny light-sensitive chip measuring 3mm by 3mm (0.11 x 0.11 inches), which sends electrical signals down the optic nerve to the brain, providing a "diamond-shaped" black-and-white image with a field of 15 degrees.

Attached to the retina, the implant is powered via a thin cable which connects to a small coil fitted under a fold of skin behind the ear.

The coil is charged when a handheld battery unit is brought up close to it -- the same principle of wireless charging that is used, for instance, in electrical toothbrushes -- and thus means it can be used outdoors.

The battery unit also has two knobs, enabling the user to adjust the brightness and contrast of the image.

The patients received the implant in one eye, the one with the worst visual function.

One of the nine had to drop out of the experiment after the optic nerve was damaged during the implant operation, and another experienced a buildup in eyeball pressure which was successfully treated with drugs.

New drugs and revolutionary medical devices typically undergo a three-phase process of trials on human volunteers.

The number of patients and the scope of the test gradually widens, in a bid to ensure that the innovation is both safe and effective.

The first trial of the implant, published in 2010, used a cable, rather than wireless technology, to power the device.

There are several other entrants in the field for retinal implants, reflecting big advances in electronic miniaturisation and microsurgery in the past decade.

None claims to be a cure but rather an aid to distinguish between light and darkness and ascertain the shape of objects.

"Although the restoration of vision described here is limited, blind persons with no alternative therapy options regard this type of artificial vision as an improvement in everyday life," the German doctors said.

Last week the US firm Second Sight Medical Products gained US regulatory approval in addition to the green light from Europe for its Argus II retinal prosthesis.

There is also a 24-electrode device made by Bionic Vision Australia, which has so far been tested on one patient.

-AFP/gn

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US supports India's constructive role in Afghanistan

WASHINGTON: Asserting that the United States and India share a vision of a secure, peaceful, democratic and prosperous Afghanistan, the Obama administration has said it strongly supports the constructive role being played by New Delhi in the war-torn country's ongoing development.

During the just concluded trilateral dialogue involving India and Afghanistan in New Delhi on Tuesday, the US expressed particular appreciation for the former's leading role in developing regional trade and investment.

"The US side expressed particular appreciation for India's leading role in helping to advance opportunities for regional trade and investment - and noted our shared interest in advancing the New Silk Road vision of connectivity between South and Central Asia - with Afghanistan at its core," a State Department spokesperson said on the conclusion of the trilateral dialogue in New Delhi.

Officials from the three countries, the spokesperson said, held in-depth consultations on issues ranging from political and security spheres to trade, commerce and investment.

"The United States and India share a vision of a secure, peaceful, democratic and prosperous Afghanistan. We strongly support the constructive role that India plays in Afghanistan's ongoing development," he said.

The US delegation was led by the assistant secretary of state for South and Central Asia, Robert Blake. The US delegation also included the deputy special representative for Afghanistan and Pakistan, Dan Feldman, for the trilateral dialogue.

This meeting follows the inaugural trilateral consultations held at the Afghan Mission in New York City on September 25, 2012.

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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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