The Lede Blog: Bahrain Welcomes European Delegation, Not Delegates' Calls to Free Dissidents

Last Updated, Saturday, 10:34 a.m. As The Lede reported on Wednesday, a delegation from the European Parliament visited Bahrain this week to discuss human rights, just as the kingdom jailed a rights advocate for documenting a protest on Twitter.

Bahrain’s state news media presented the visit as evidence that the kingdom is committed to human rights. One report showed the delegates meeting with the head of an official human rights organization established by royal decree, another their briefing by the royal who oversees the police force “on human rights reforms that have been implemented within the interior ministry.”

What the country’s official news agency did not report, however, is that the head of the delegation, Inese Vaidere of Latvia, called for the release of all “prisoners of conscience” currently being detained for their role in the protest movement.

Ms. Vaidere’s call was joined by at least two other members of the European Parliament who made the trip, Richard Howitt of Britain and Ana Gomes of Portugal. At the end of their visit, those members issued a joint statement calling on the government to immediately release up to 800 “political prisoners” and begin direct talks with the opposition.

Like the New York Times Op-Ed columnist Nicholas Kristof, who was denied entry to Bahrain last week after reporting on human-rights abuses on previous trips, Ms. Gomes was stopped at the airport in April, the last time she attempted to visit the kingdom to meet with rights activists.

Throughout their three-day visit, Ms. Gomes and Mr. Howitt posted a stream of updates on their Twitter feeds as the delegation met with Bahraini officials and detained opposition members. They both reported questioning the treatment of human rights activists like Said Yousif al-Muhafda, who was jailed on Monday for tweeting about a protest.

Mr. Howitt and Ms. Gomes also described meetings with detained rights activists. They included Nabeel Rajab, the president of the Bahrain Center for Human Rights — who was jailed for inciting antigovernment protests in speeches and Twitter updates — and the same rights group’s founder, Abdulhadi al-Khawaja — who was sentenced to life in prison by a military court last year for his role in the 2011 protests. Claims that the men are confined in luxurious surroundings are untrue, the parliamentarians reported.

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Douglas wins AP female athlete of the year honors


When Gabby Douglas allowed herself to dream of being the Olympic champion, she imagined having a nice little dinner with family and friends to celebrate. Maybe she'd make an appearance here and there.


"I didn't think it was going to be crazy," Douglas said, laughing. "I love it. But I realized my perspective was going to have to change."


Just a bit.


The teenager has become a worldwide star since winning the Olympic all-around title in London, the first African-American gymnast to claim gymnastics' biggest prize. And now she has earned another honor. Douglas was selected The Associated Press' female athlete of the year, edging out swimmer Missy Franklin in a vote by U.S. editors and news directors that was announced Friday.


"I didn't realize how much of an impact I made," said Douglas, who turns 17 on Dec. 31. "My mom and everyone said, 'You really won't know the full impact until you're 30 or 40 years old.' But it's starting to sink in."


In a year filled with standout performances by female athletes, those of the pint-sized gymnast shined brightest. Douglas received 48 of 157 votes, seven more than Franklin, who won four gold medals and a bronze in London. Serena Williams, who won Wimbledon and the U.S. Open two years after her career was nearly derailed by a series of health problems, was third (24).


Britney Griner, who led Baylor to a 40-0 record and the NCAA title, and skier Lindsey Vonn each got 18 votes. Sprinter Allyson Felix, who won three gold medals in London, and Carli Lloyd, who scored both U.S. goals in the Americans' 2-1 victory over Japan in the gold-medal game, also received votes.


"One of the few years the women's (Athlete of the Year) choices are more compelling than the men's," said Julie Jag, sports editor of the Santa Cruz Sentinel.


Douglas is the fourth gymnast to win one of the AP's annual awards, which began in 1931, and first since Mary Lou Retton in 1984. She also finished 15th in voting for the AP sports story of the year.


Douglas wasn't even in the conversation for the Olympic title at the beginning of the year. That all changed in March when she upstaged reigning world champion and teammate Jordyn Wieber at the American Cup in New York, showing off a new vault, an ungraded uneven bars routine and a dazzling personality that would be a hit on Broadway and Madison Avenue.


She finished a close second to Wieber at the U.S. championships, then beat her two weeks later at the Olympic trials. With each competition, her confidence grew. So did that smile.


By the time the Americans got to London, Douglas had emerged as the most consistent gymnast on what was arguably the best team the U.S. has ever had.


She posted the team's highest score on all but one event in qualifying. She was the only gymnast to compete in all four events during team finals, when the Americans beat the Russians in a rout for their second Olympic title, and first since 1996. Two nights later, Douglas claimed the grandest prize of all, joining Retton, Carly Patterson and Nastia Liukin as what Bela Karolyi likes to call the "Queen of Gymnastics."


But while plenty of other athletes won gold medals in London, none captivated the public quite like Gabby.


Fans ask for hugs in addition to photographs and autographs, and people have left restaurants and cars upon spotting her. She made Barbara Walters' list of "10 Most Fascinating People," and Forbes recently named her one of its "30 Under 30." She has deals with Nike, Kellogg Co. and AT&T, and agent Sheryl Shade said Douglas has drawn interest from companies that don't traditionally partner with Olympians or athletes.


"She touched so many people of all generations, all diversities," Shade said. "It's her smile, it's her youth, it's her excitement for life. ... She transcends sport."


Douglas' story is both heartwarming and inspiring, its message applicable those young or old, male or female, active or couch potato. She was just 14 when she convinced her mother to let her leave their Virginia Beach, Va., home and move to West Des Moines, Iowa, to train with Liang Chow, Shawn Johnson's coach. Though her host parents, Travis and Missy Parton, treated Douglas as if she was their fifth daughter, Douglas was so homesick she considered quitting gymnastics.


She's also been open about her family's financial struggles, hoping she can be a role model for lower income children.


"I want people to think, 'Gabby can do it, I can do it,'" Douglas said. "Set that bar. If you're going through struggles or injuries, don't let it stop you from what you want to accomplish."


The grace she showed under pressure — both on and off the floor — added to her appeal. When some fans criticized the way she wore her hair during the Olympics, Douglas simply laughed it off.


"They can say whatever they want. We all have a voice," she said. "I'm not going to focus on it. I'm not really going to focus on the negative."


Besides, she's having far too much fun.


Her autobiography, "Grace, Gold and Glory," is No. 4 on the New York Times' young adult list. She, Wieber and Fierce Five teammates Aly Raisman and McKayla Maroney recently wrapped up a 40-city gymnastics tour. She met President Barack Obama last month with the rest of the Fierce Five, and left the White House with a souvenir.


"We got a sugar cookie that they were making for the holidays," Douglas said. "I took a picture of it."


Though her busy schedule hasn't left time to train, Douglas insists she still intends to compete through the Rio de Janeiro Olympics in 2016.


No female Olympic champion has gone on to compete at the next Summer Games since Nadia Comaneci. But Douglas is still a relative newcomer to the elite scene — she'd done all of four international events before the Olympics — and Chow has said she hasn't come close to reaching her full potential. She keeps up with Chow through email and text messages, and plans to return to Iowa after her schedule clears up in the spring.


Of course, plenty of other athletes have said similar things and never made it back to the gym. But Douglas is determined, and she gets giddy just talking about getting a new floor routine.


"I think there's even higher bars to set," she said.


Because while being an Olympic champion may have changed her life, it hasn't changed her.


"I may be meeting cool celebrities and I'm getting amazing opportunities," she said. "But I'm still the same Gabby."


___


AP Projects Editor Brooke Lansdale contributed to this report.


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The Neediest Cases: The Daughter of a Sick Woman Falls Prey to a Craigslist Scam





Sitting side by side on their living room sofa, Patricia Morales and her daughter, Katherine, could be any mother-daughter duo. Both have dark hair, dark eyes and welcoming, infectious smiles.







Librado Romero/The New York Times

Patricia Morales, 62, at home in the Bronx. Her treatment for ailments like rheumatoid arthritis and hepatitis C led to depression.






2012-13 Campaign


Previously recorded:

$3,375,394



Recorded Wednesday:

182,251



*Total:

$3,557,645



Last year to date:

$3,320,812




*Includes $709,856 contributed to the Hurricane Sandy relief efforts.

The Neediest CasesFor the past 100 years, The New York Times Neediest Cases Fund has provided direct assistance to children, families and the elderly in New York. To celebrate the 101st campaign, an article will appear daily through Jan. 25. Each profile will illustrate the difference that even a modest amount of money can make in easing the struggles of the poor.


Last year donors contributed $7,003,854, which was distributed to those in need through seven New York charities.







The Youngest Donors


If your child or family is using creative techniques to raise money for this year’s campaign, we want to hear from you. Drop us a line on Facebook or talk to us on Twitter.





But the ties that bind them go beyond their genes, beyond the bodies they were born with.


“It’s called a neck ring. It’s a silver curved barbell, one inch,” Katherine, 20, said as she swept aside her shoulder-length black hair to show the piercing in the back of her neck, a show of solidarity with her mother. She had it done when she was 16. “I wanted to know what it felt like for my mom.”


Her mother then turned around and outlined with her finger two lengthy scars that run down her back.


“I’ve had a lot of physical problems,” Ms. Morales, 62, said. Shaking her head at her daughter’s piercing, she added, “I’ve had rods put in my upper and lower spine, but I could never do that.”


The rods were surgically planted to treat herniated discs, the result of having a cruel combination of osteoporosis, hepatitis C, fibromyalgia and rheumatoid arthritis. Ms. Morales contracted hepatitis C from a blood transfusion she received in 1972 after the birth of her only son, she said.


“I didn’t even know about it until 10 years ago,” she said. “My liver blood count was a little high.”


Since the diagnosis, Ms. Morales, a former schoolteacher, has ridden the arduous highs and lows common to patients with hepatitis C. Her treatments for the disease, which debilitates the liver over time, have included pills and injections that can cause depression. Ms. Morales, a single parent, found an unforgiving salve in alcohol.


“I was depressed; I was totally drunk,” she said. “I didn’t want to live anymore.”


Then, about a year ago, she reached a turning point when visiting her hepatitis C specialist.


“I was 210 pounds,” she said. “The doctor said: ‘You have to stop drinking. You have to lose weight.’ ”


To help combat the depression, her doctor referred her to Jewish Association Serving the Aging, a beneficiary agency of UJA-Federation of New York, one of the organizations supported by The New York Times Neediest Cases Fund. She began weekly counseling sessions with a social worker and started taking an antidepressant medication. The federation drew about $600 from the fund in May so that Ms. Morales could buy a mattress.


“I had a horrible bed,” she said. “I felt like I was sleeping on rocks, and with rods in my back, I was waking up every hour.”


After several months of therapy and starting a diet, Ms. Morales was on her way to losing 60 pounds. Today, she weighs 148.


Light was starting to show itself again when the family took an unexpected financial hit this summer. While taking time off from attending Hostos Community College, Katherine Morales looked for work on Craigslist.


“I saw my mom, and I realized I needed to get a job,” Katherine said shyly. “This guy asked me to be his personal assistant, and he asked me to wire money.”


Offering $400 a week, the man requested help transferring almost $2,000 from what he said was his wife’s account. He transferred the money to Katherine’s account, asking her to wire it to a bank account in Malaysia.


Shortly after she wired the money, the bank froze the account, which Katherine and her mother shared. It was then that Katherine realized she had been the victim of a scam. The money transferred into her account turned out to have been stolen, and she was responsible for repaying it.


Katherine went to detectives immediately with more than 20 pages of evidentiary e-mails, but found that she was unable to file a complaint.


“They told me it wasn’t enough,” she said. “These things happen all the time.”


They lost almost $2,000.


Ms. Morales lives on a fixed income. She receives just over $700 a month from Social Security and $200 month in food stamps. The rent for the apartment she shares with her daughter in the Throgs Neck neighborhood of the Bronx is $230, and Ms. Morales has a monthly combined phone and cable bill of $140. Ms. Morales has a son, but he is unable to help the family.


Falling behind on her bills, Ms. Morales turned once again to JASA for help paying a combined phone and cable bill of nearly $200, a grant the agency drew from the Neediest Cases Fund.


“It was terrible, because my intention was to help my mom,” said Katherine, who has since found a part-time job at a vitamin shop.


Ms. Morales has been feeling much better, but she is nervous about an appointment with her hepatitis C specialist in January.


“I’m taking things one day at a time, but I’m looking forward to someone taking care of me,” she said. “I want to live a little bit longer, but not that long.”


“Why are you putting a time limit on it?” Katherine said, jokingly. “Seventy’s the new 20!” she added, nudging her mother in the side. “Remember, the doctor said you wouldn’t live past your late 50s, but you did.”


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Monti Resigns in Italy, but May Seek to Regain Office





ROME — Prime Minister Mario Monti resigned on Friday evening following Parliament’s confidence vote on the 2013 budget, but he is still expected to play a major role in early elections, possibly as a candidate, analysts said.




At a news conference scheduled for Sunday, Mr. Monti is expected to present a political agenda — pro-Europe and pro-fiscal rigor — and call on all parties to endorse it, aides said Friday. Mr. Monti, an economist who has helped restore Italy’s international credibility but has suffered politically for championing a series of tax increases and budget cuts, has steadfastly refused to say whether he will run for prime minister or present an agenda that he hopes parties will endorse. Whether he does run or not, however, he has already radically shifted Italy’s political landscape.


With Italy facing economic uncertainty and sluggish growth, Mr. Monti has emerged as a centrist force in a field previously divided between the center-left Democratic Party of Pier Luigi Bersani, which opinion polls place first, and former Prime Minister Silvio Berlusconi, who has risen in polls since taking to the airwaves with a populist message critical of Mr. Monti’s tax increases.


“He’s de facto a candidate. He is the head politician of this coalition,” said Stefano Folli, a columnist for the business daily Il Sole 24 Ore, referring to a centrist grouping that has been courting Mr. Monti.


On Friday evening, Mr. Monti handed in his resignation to President Giorgio Napolitano, who in a tough speech to lawmakers last week lamented the “brusque” end of the government and Parliament’s failure to carry out significant structural changes in Italy’s encrusted economy.


Mr. Napolitano is soon expected to dissolve Parliament, opening a hard-fought campaign amid rising unemployment, taxes and populism. Mr. Monti will stay on as caretaker prime minister until a new government is formed. In that time, he is expected to retain the power to pass emergency legislation.


“He’s already a senator for life, so he doesn’t have to become a candidate in the technical way,” Mr. Folli added.


After losing the support of Mr. Berlusconi’s People of Liberty party this month, Mr. Monti said that he would step down after the budget was passed. On Friday, lawmakers voted 373 in favor and 67 against with 15 abstentions in a confidence vote over the budget, which stipulates spending cuts of $4.8 billion through 2015.


Mr. Monti could run as a candidate or endorse a centrist alliance that includes a veteran political party, the Union of Christian Democrats, and Toward the Third Republic, a fledgling civic movement led by the chairman of Ferrari, Luca Cordero di Montezemolo. If Mr. Monti lends his name to the centrists, he is expected to draw moderates from Mr. Berlusconi’s party. Mr. Monti also has the implicit support of the Catholic Church, which is crucial to the survival of any Italian government.


After weeks of wavering, Mr. Monti seems to have decided to stay involved in Italian politics after other European leaders, concerned about the prospect of an increasingly populist Mr. Berlusconi, urged him to stay in the picture.


Last week, members of the European People’s Party, a group of center-right parties across Europe, asked the unelected Mr. Monti to attend a summit in Brussels, which Mr. Berlusconi attended as the head of Italy’s largest center-right party. “I can say that there was massive support from E.P.P. members that Monti should remain at the helm of Italy,” said Kostas Sasmatzoglou, the group’s spokesman.


“It was Europe pushing him to continue,” Mr. Folli, the columnist, said. “Germany already has Hollande,” he said, referring to France’s Socialist prime minister, François Hollande. “It doesn’t want another country to go to the left, to go back on fiscal rigor.”


He added: “It can have Bersani, but Bersani ‘corrected’ and supported by Monti.”


Indeed, if he lends them his support, Mr. Monti and the centrist groupings are not expected to get more than 15 percent of the vote. Mr. Bersani’s Democratic Party is expected to place first, but without enough votes to govern in both houses even if it allies with the smaller Left Ecology and Freedom party. It remains to be seen if the center will take votes away from Mr. Berlusconi or Mr. Bersani.


On Thursday, Mr. Monti was widely perceived to have begun his campaign with a politically calculated speech at a Fiat automotive plant in southern Italy. With Fiat’s chairman, Sergio Marchionne, by his side, he said that Italy needed to stay the course on structural changes. The speech effectively challenged Mr. Bersani, a moderate who will most likely have to tack further left.


Mr. Monti came to power in November 2011, replacing Mr. Berlusconi amid global financial panic. He helped burnish Italy’s image abroad, but effectively raised taxes, worsening Italy’s recession. Although populists have depicted Mr. Monti and his government as a puppet of Europe and the banks, many Italians support him as a needed change from politics as usual.


“I prefer Monti to Berlusconi or any other politician, even if he left us in our underwear,” said Annalisa di Piero, 50, a costume designer and stylist, referring to the tax increases that have left Italians with less in their pockets in the holiday shopping season. “I just paid my property tax, but I still prefer him to these other clowns.”


Gaia Pianigiani contributed reporting.



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Putin Evasive on Banning Adoptions by Americans


James Hill for The New York Times


Journalists attended a news conference held by President Vladimir V. Putin of Russia in Moscow on Thursday.







MOSCOW — He seemed to wince a bit as he sauntered on stage — a twinge no doubt from a lingering back injury — but as he took his seat before scores of cameras in a hall packed with more than 1,000 journalists on Thursday, President Vladimir V. Putin was clearly in his element: under the bright lights, jaunty and confident, arriving to theme music befitting an action hero.




But this virtuoso performance was nearly upstaged by an issue that emerged only in the last few days: a proposed ban on adoptions of Russian children by American citizens, as part of a measure retaliating against the United States for a new law that will punish Russian citizens accused of violating human rights. Mr. Putin was pressed repeatedly for his view — eight times in all — and each time he skirted the question.


When it first came up, he gave an exaggerated shrug, palms turned upward, as if to say, “Bring it on.” By the last one, he was snapping back, short of patience, visibly annoyed.


Over and over, Mr. Putin said he needed time to read the text of the legislation before making a decision. But the text of the ban is just two simple sentences, and it was clear that Mr. Putin was buying time to contemplate what would be the most potent, anti-American action yet in his new term. This year, there have already been several setbacks in bilateral relations, including his ousting of the United States Agency for International Development.


“The talk here is not about the ban on adoption to all foreigners. The talk is about Americans who want to adopt children,” he said, adding, “I am simply not ready to answer you now.”


In other respects, this was the cocksure Mr. Putin of 10 years ago. As his mostly adoring audience settled in, Mr. Putin, who has seemed subdued at times since beginning a third term as president in May, appeared eager to joust. And he did — for four and a half hours — on virtually any subject: crop subsidies for sugar beet farmers and housing for miners, political relations with Georgia, economic ties with China, fishing restrictions in the Volga River delta.


After months of aggressive steps to squash political dissent and curtail what he views as undue political influence by outsiders, he seemed to relish every chance to take jabs at the United States, especially over its policies in the Middle East and on human rights.


He fielded dozens of questions, on topics like a continuing national debate over adopting daylight saving time, taxes, pensions and Russia’s position on the war in Syria. After each reply, journalists clamored for a chance to ask a question, waving signs and flags, scarves, even a red balloon to get noticed.


At one point, discussing the French actor Gérard Depardieu’s decision to renounce his French citizenship, Mr. Putin warmly invited him to live in Russia. “If Gérard really wants to have a residency permit for Russia or a Russian passport,” Mr. Putin said, “we can consider this issue resolved.”


Throughout the day, Mr. Putin basked in the fawning adulation of journalists visiting the capital from virtually every provincial corner of Russia. Near the end of the news conference, he paused to write a personal note extending birthday wishes to a reporter’s daughter.


But in a series of unusually sharp challenges, he was repeatedly forced back to the issue of the proposed adoption ban and pressed to say if he would support it.


Mr. Putin repeatedly criticized the new American law — the Magnitsky Act — as a provocation, and said Russia had no choice but to retaliate. “This is very bad and it poisons our relations,” he said.


Mr. Putin said the United States was failing to live up to an agreement ratified earlier this year, by not allowing Russian officials to get involved in abuse cases involving adopted Russian children, even as observers. And he lashed out at one reporter who challenged him.


“This is unacceptable,” he said. “Do you find it normal? Do you like it? Are you a sadomasochist?” At other times, Mr. Putin acknowledged that most adoptive parents from America are “kind and decent people.”


At several points, he said legal experts would have to review the proposed ban to see if it could be enacted given the agreement with the United States on adoptions. He also repeatedly rejected assertions that the ban would most hurt Russian orphans because he said it would apply only to the United States.


According to the Russian government, there were 956 Russian children adopted by families from the United States in 2011 — the most of any country. Italy was next with 798 followed by Spain with 685.


Mr. Putin did not cite those statistics, but he began his news conference rattling off an array of others to illustrate Russia’s recent successes. Economic output is growing stronger than in the United States or Europe, he said. Unemployment is lower. Average salaries are up. Reserve funds are flush. The birthrate is climbing.


One reporter asked him about the jailed former billionaire, Mikhail B. Khodorkovsky, whose imprisonment has been condemned as politically motivated. A court on Thursday reduced Mr. Khodorkovsky’s sentence so he may be released two years early, in 2014. Mr. Putin said the issue should not be politicized. Then, archly, he noted that at some point Mr. Khodorkovsky would be free. “May God give him health,” he said.


Ellen Barry and Andrew Roth contributed reporting.



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Investors shed shares of Blackberry maker






NEW YORK (AP) — Shares of Blackberry maker Research in Motion slumped more than 16 percent Friday with future revenue coming into question and a declining number of subscribers.


RIM’s stock jumped initially Thursday when the Canadian company released better-than-expected third-quarter results and a stronger cash position.






Shares reversed course during a conference call later, when executives said that the company won’t generate as much revenue from telecommunications carriers once it releases the new BlackBerry 10.


RIM’s stock had been on a three-month rally in which the stock more than doubled from levels not previously seen since 2003.


“Despite a solid quarter, the stock is trading down due to the introduction of a lower enterprise service tier and fears that RIM will not receive monthly services revenues for consumer BB10 subscribers,” said Jefferies analyst Peter Misek. He thinks RIM has offered carriers a lower-priced option in exchange for a bigger purchase commitment for the new device. He kept his “Hold” rating.


Sterne Agee analyst Shaw Wu kept maintained a “Neutral” rating on the stock, but lowered his earnings estimates, saying he continued to be concerned about RIM’s ability to compete with Apple and Google.


Shares of Research in Motion Ltd. fell $ 2.29 to $ 11.83 in morning trading.


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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.


___


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.


___


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. In other cases, the drug was used "for an unknown indication," meaning that the reason for treatment wasn't clear.


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. And nearly half the increase came in one year: 2007.


"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.


The AP approached every U.S.-authorized manufacturer to ask what efforts they make to market responsibly and prevent abuse. Only one HGH supplier, Novo Nordisk, agreed to an interview.


"We're doing our level best to make sure that the right patients are getting the right medicine at the right time," said company spokesman Ken Inchausti.


He said the company is aware of the abuse issue. He said if patients apply for assistance from the company's patient-support hub, prescriptions will be flagged for review if they are missing the most rigorous test or an endocrinologist's signature. He said the company won't sell HGH directly to doctors accused of bad practices and does not deal with anti-aging clinics.


Representatives of other FDA-approved HGH makers insist they do not encourage use by bodybuilders or athletes or wealthy baby boomers trying to recapture their youth. But some said they are largely powerless to control who uses their medications or why.


"Lilly cannot restrict the actions of distributors, pharmacies or doctors," Eli Lilly spokeswoman Kelley Murphy said in a written statement.


That argument doesn't fly for critics like Dr. Peter Rost, a retired Pfizer executive who filed a whistleblower lawsuit over the HGH marketing practices of Pharmacia, which later merged with Pfizer. He said drug companies are simply looking the other way and betting that their profits will eclipse the cost of any fines.


They view it as "good business," he said.


___


PEDDLED ON INTERNET


Type "human growth hormone" into any Internet search engine, and it will spit back countless websites with overblown promises of smoother skin, better sex, weight loss and even renewed body organs.


Any doctor who actually prescribes the drug for those purposes is taking a legal risk.


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.


Such marketing claims are routinely made at hormone clinics like Palm Beach Life Extension, whose owners are among 13 people now awaiting trial on federal charges in Florida in a steroids and HGH distribution case brought last year.


"Grow YOUNG with Us!" screamed a banner on the company's now-defunct website, which advertised that HGH can reduce body fat, improve vision, strengthen the immune system, aid kidney function, lower blood pressure and enhance memory and mood.


The clinic arranged to have its clients' prescriptions filled at Treasure Coast Pharmacy, in Jensen Beach, Fla.


In 2009, the FBI recorded a phone call between the pharmacy's owner, Peter Del Toro, and a doctor in Elkton, Md., who was cooperating with agents after being implicated in a related steroid-distribution case.


Their talk, documented in a court filing, illustrates how things often work in the networks of pharmacies and clinics that drive HGH sales.


Patients submitted a medical history form by mail and took a blood test. But in most instances, the indictment said, the evaluation was a sham: One doctor was charged with giving a clinic a pad of blank, signed prescriptions to save him the chore of signing off on each diagnosis. He got $50 for every drug order bearing his name, the indictment said.


Dr. Rodney Baltazar, the Maryland physician cooperating with the FBI, sometimes consulted briefly with patients via webcam. But he made it clear in the call that those evaluations were perfunctory at best.


Baltazar was a gynecologist, not an endocrinologist. He said he knew "a little bit" about HGH and testosterone, which are often prescribed in tandem, but he relied largely on clinic salespeople to set doses.


The pharmacist coached the doctor: Keep detailed medical charts documenting that patients are taking the drug for at least some kind of health problem, just in case the U.S. Drug Enforcement Administration ever came calling.


"Because somebody questions you, you want to be able to say, 'Here, look at his chart. You know, he's got fatigue. He's got, you know, a decreased sex drive. He's got increased body fat. He has some -- some slight depression, probably.' Whatever his signs and symptoms are."


None of these conditions is a legal reason to prescribe HGH. But the pharmacist said that most investigators will be satisfied and move on "because there's guys that are just selling stuff basically like a boiler room."


Del Toro was arrested along with 12 other people in September 2011 on charges that they distributed steroids and human growth hormone to people who had no legitimate medical need. He is awaiting trial. His lawyer declined to comment. Baltazar was sentenced to six months in prison for involvement in steroid distribution schemes.


At the height of the crackdown in 2007, the federal government went after Pfizer in a case involving anti-aging clinics. The company paid $34.7 million in fines to settle the case — 11 percent of the company's annual revenue from the drug.


___


TROUBLED HISTORY


Blockbuster U.S. sales of HGH represent the latest frustration in 25 years of government efforts to control abuse of the growth drug made infamous by sports scandals.


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.


For years, cheaper supplies from unauthorized foreign factories, particularly in China, fed the market via direct and Internet sales that sidestepped the medical establishment.


Though such shipments were banned under other law, the imports initially attracted little attention because they were usually labeled as raw pharmaceutical ingredients, which compounding pharmacies are allowed to bring into the country.


That flow began to be curtailed in 2006, when U.S. drug authorities stepped up efforts to block shipments at the border.


A handful of pharmacies across the country were hit with criminal charges over their handling of HGH. Federal prosecutors charged China's biggest HGH maker, GeneScience Pharmaceutical, with illegally distributing its Jintropin brand in the U.S. The company's CEO pleaded guilty in 2010.


With illicit supplies crimped, many pharmacies stopped selling unauthorized HGH. But tens of thousands of adult abusers began buying pricey U.S.-approved HGH that remained available in abundant supply, the AP found in its analysis of sales data.


Thus, pushed by a powerful demand, sales of U.S.-approved brands have swelled far beyond expected levels for a drug approved in just a handful of rare conditions.


Dr. Robert Marcus, a retired hormone specialist who left HGH manufacturer Eli Lilly and Co. in 2008, said that company was bent on stopping foreign counterfeits, not on cutting off abusers. "That's where their major level of frustration was — pharmaceutical fraud — rather than focusing on people who were using growth hormone illegitimately," he said.


Dr. Jim Meehan, of Tulsa, Okla., who has used HGH to treat aging problems and sports injuries, said the federal clampdown "never seemed to affect my patients and their ability to get Omnitrope, Tev-Tropin" and other government-approved brands.


The big drug companies have applauded the foreign crackdown and urged the government to do even more to combat sales of fake or fraudulently labeled HGH. In 2004, Bruce Kuhlik, speaking for the Pharmaceutical Research and Manufacturers of America, told a federal task force that unauthorized drug importation "is inherently unsafe" and industry representatives used Chinese HGH imports as their poster child.


In 2007, as the HGH embargo gained momentum, authorized makers picked up 41 percent more HGH orders, raising their annual total from 245,000 to 345,000, according to the analysis of the IMS Health data. Similarly, most of the drug's sales boom happened in the first two years of the crackdown, with 46 percent inflation-adjusted growth in yearly sales to $1.1 billion.


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.


Despite higher prices, the business has expanded in recent years largely on the strength of sales to healthy adults who can afford to indulge their hope of retaining youthful vigor.


___


GROWING OLD


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 clinics 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."


Some scientific studies of HGH have found modest benefits: some muscle and bone building, as well as limited fat loss, but nothing like the claims of the anti-aging industry. And some of the value credited to HGH may instead come from testosterone, which is routinely provided with HGH by anti-aging doctors and sports suppliers.


Endocrinologists say it's natural for the body to produce less growth hormone as people age beyond their early 20s, because they aren't growing anymore. Only a tiny number of adults with extraordinarily low HGH levels — perhaps several thousand of them — are believed to suffer real deficiencies that can properly be treated with the hormone.


Still, anti-aging doctors routinely diagnose otherwise healthy middle-aged people with an HGH deficiency, simply because their levels are lower than in young adults. "Basically anyone going through midlife," can benefit from the drug, declared one prescriber, Dr. Howard Elkin, of Whittier, Calif., who has himself competed as a bodybuilder.


Dr. Kenneth Knott, of Marietta, Ga., said HGH helps his older patients feel "more vibrant" and look "more alive."


Like many anti-aging doctors, he diagnoses patients by testing for a blood component called insulin growth factor, which is indirectly tied to HGH. Endocrinologists use a more authoritative test that stimulates the pituitary gland to make HGH itself. Nearly all insurers insist on this stimulation testing, and that's why clinic patients almost always pay for HGH out of their own pockets.


Bob Vitols, a 50-year-old lab assistant at a veterinary medicine company in Lincoln, Neb., is a rare exception. His unusually generous health plan isn't allowed to challenge a doctor's prescription.


Four years ago, Vitols began feeling run down. So he Googled his symptoms on the Internet, decided he had a hormone deficiency, and sought out a clinic.


One doctor put him on testosterone replacement therapy. A second clinic added HGH after diagnosing him with osteopenia, a mild bone thinning common in aging adults. It is not, however, a condition that can properly be treated with HGH.


Despite the diagnosis, the treatments — which can cost $10,000 per year — have been covered by his health insurance, he said. He takes Genotropin, the HGH made by Pfizer. His prescriptions are filled via mail order by CVS Caremark Corp., one of the largest dispensers of prescription drugs in the U.S.


Vitols said the drug changed his life: his mood is better, and he isn't burning out every day at 2 p.m. "I feel like I could walk outside and just walk through a fence — and come out fine on the other side," he said.


His experiences with the drug haven't all been positive, though. Vitols said he initially developed elevated liver enzymes and went to a specialist, who told him to stop taking hormones immediately.


Instead, Vitols said, he adjusted his dosage, and the problem disappeared.


He also dumped the specialist:


"I could tell he was against hormones right at the start," Vitols said.


___


Associated Press Writer David 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.


___


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


___


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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Boehner Tax Plan in House Is Pulled, Lacking Votes


Brendan Hoffman for The New York Times


Speaker John A. Boehner of Ohio leaving a meeting Thursday with fellow House Republicans on talks over the “fiscal cliff.”







WASHINGTON — Speaker John A. Boehner’s effort to pass fallback legislation to avert a fiscal crisis in less than two weeks collapsed Thursday night in an embarrassing defeat after conservative Republicans refused to support legislation that would allow taxes to rise on the most affluent households in the country.




House Republican leaders abruptly canceled a vote on the bill after they failed to rally enough votes for passage in an emergency meeting about 8 p.m. Within minutes, dejected Republicans filed out of the basement meeting room and declared there would be no votes to avert the “fiscal cliff” until after Christmas. With his “Plan B” all but dead, the speaker was left with the choice to find a new Republican way forward or to try to get a broad deficit reduction deal with President Obama that could win passage with Republican and Democratic votes.


What he could not do was blame Democrats for failing to take up legislation he could not even get through his own membership in the House.


“The House did not take up the tax measure today because it did not have sufficient support from our members to pass,” Mr. Boehner said in a statement that said responsibility for a solution now fell to the White House and Senator Harry Reid, Democrat of Nevada, the majority leader. “Now it is up to the president to work with Senator Reid on legislation to avert the fiscal cliff.”


The stunning turn of events in the House left the status of negotiations to head off a combination of automatic tax increases and significant federal spending cuts in disarray with little time before the start of the new year.


At the White House, the press secretary, Jay Carney, said the defeat should press Mr. Boehner back into talks with Mr. Obama.


“The president will work with Congress to get this done, and we are hopeful that we will be able to find a bipartisan solution quickly that protects the middle class and our economy,” he said.


The refusal of a band of House Republicans to allow income tax rates to rise on incomes over $1 million came after Mr. Obama scored a decisive re-election victory campaigning for higher taxes on incomes over $250,000. Since the November election, the president’s approval ratings have risen, and opinion polls have shown a strong majority not only favoring his tax position, but saying they will blame Republicans for a failure to reach a deficit deal.


With a series of votes on Thursday, the speaker, who faces election for his post in the new Congress next month, had hoped to assemble a Republican path away from the cliff. With a show of Republican unity, he also sought to strengthen his own hand in negotiations with Mr. Obama. The House did narrowly pass legislation to cancel automatic, across-the-board military cuts set to begin next month, and shift them to domestic programs.


But the main component of “Plan B,” a bill to extend expiring Bush-era tax cuts for everyone with incomes under $1 million, could not win enough Republican support to overcome united Democratic opposition. Democrats questioned Mr. Boehner’s ability to deliver any agreement.


“I think this demonstrates that Speaker Boehner has a real challenge,” said Representative Steny H. Hoyer of Maryland, the No. 2 House Democrat. “He hasn’t been able to cut any deal, make any agreement that’s balanced. Even if it’s his own compromise.”


Representative Rick Larsen of Washington accused Republicans of shirking their responsibility by leaving the capital. “The Republicans just picked up their toys and went home,” he said.


Futures contracts on indexes of United States stock listings and shares in Asia fell sharply after Mr. Boehner conceded that his bill lacked the votes to pass.


The point of the Boehner effort was to secure passage of a Republican plan, then demand that the president and the Senate to take up that measure and pass it, putting off the major fights until early next year when Republicans would conceivably have more leverage because of the need to increase the federal debt limit. It would also allow Republicans to claim it was Democrats who had caused taxes to rise after the first of the year had no agreement been reached.


That strategy lay in tatters after the Republican implosion.“Some people don’t know how to take yea for an answer,” said Representative Charlie Dent of Pennsylvania, a Republican who supported the measure and was open about his disappointment with his colleagues.


Opponents said they were not about to bend their uncompromising principles on taxes just because Mr. Boehner asked.


“The speaker should be meeting with us to get our views on things rather than just presenting his,” said Representative Justin Amash of Michigan, who recently lost a committee post for routinely crossing the leadership.


Jeremy W. Peters contributed reporting.



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French Court Refuses to Dismiss Strauss-Kahn Sex Investigation





PARIS — A French appeals court on Wednesday rejected a demand from Dominique Strauss-Kahn to dismiss an investigation of him in connection with a ring that recruited prostitutes for sex parties from Paris to Washington.




His appeal was an effort to end the last of the legal problems that forced him to resign as head managing director of the International Monetary Fund and ruined his ambition to seek the French presidency. Mr. Strauss-Kahn, 63, and his lawyers vowed to challenge the ruling from the court of appeal of Douai in northern France, which announced the decision without an explanation.


In the case, nine people in the northern city of Lille are under investigation for procurement of prostitutes, and in some cases, fraud. Mr. Strauss-Kahn has insisted that he was unaware that prostitutes were involved in the parties.


“This is not a victory for rights,” Frédérique Baulieu, a lawyer for Mr. Strauss-Kahn, said outside the courthouse in Douai. Mr. Strauss-Kahn’s lawyers had questioned the impartiality of judges, citing the leak of transcripts of his testimony when he was questioned by investigators and offered an explanation for his libertine lifestyle.


In October, the prosecutor’s office in Lille dropped sexual assault charges against Mr. Strauss-Kahn after an “escort girl” withdrew her complaint about an incident that took place in Washington in December 2010, saying it was simply sex play.


Mr. Strauss-Kahn and his lawyers in the United States negotiated a confidential settlement earlier this month with Nafissatou Diallo, the hotel housekeeper who in 2011 accused him of sexual assault in a New York hotel room, charges that were dropped by the prosecutor because of doubts about Ms. Diallo’s credibility.


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Facebook predicted to overtake Google in mobile display ad revenue this year






Shares of Facebook (FB) have begun to rebound since the company’s disastrous initial public offering this past May. After opening at $ 38 per share the company’s stock plummeted into the mid-20s over the summer months and eventually fell to a low of $ 17.55 in early September. Since then, however, Facebook shares have begun to bounce back after the company posted better-than-expected results in the third quarter. While Facebook stock is still down more than 25% on the year, it is rising steadily as analysts and investors become increasingly bullish about the company’s future as a leading advertising platform.


[More from BGR: BlackBerry 10 browser smokes iOS 6 and Windows Phone 8 in comparison test [video]]






According to a new report from eMarketer, Facebook is predicted to surpass Google (GOOG) in mobile display advertising in 2012. Google is expected to generate $ 339 million in mobile ad revenue this year, a significant increase from previous estimates of between $ 45 and $ 100 million. The research firm notes that Facebook is expected to capture an 18.4% share of the mobile display ad market in the U.S. this year, compared to Google’s 17% share, which is down from 23% in 2011.


[More from BGR: New iMac early adopters upset that they can’t run Boot Camp]


“Major ad publishers are strengthening their offerings much faster than previously expected,” said Clark Fredricksen, vice president of communications at eMarketer. “I don’t think anybody thought after the second quarter that Google and Facebook would be in position that they are now in the mobile ad marketplace.”


The company’s mobile ad revenue is expected to more than triple by 2014 when it will reach an estimated $ 1.2 billion. The firm predicts that Facebook and Google will continue to battle for the No.1 spot in the mobile ad market over the next few years. Facebook is expected to increase its lead to 25.2% in 2013, compared to Google’s 19.6% share. Google is estimated to bounce back in 2014, however, with a market leading 23.1% share, ahead of Facebook’s 22.7% share.


Despite the impressive numbers, eMarketer notes that mobile still represents a small slice of the total advertising market. In 2012, only 2.4% of total ad spending in the U.S. is expected to go towards mobile ads, but the market is expected to reach an 11% share by 2016 when it surpasses both radio and print spending.


This article was originally published by BGR


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AP IMPACT: Steroids loom in major-college football


WASHINGTON (AP) — With steroids easy to buy, testing weak and punishments inconsistent, college football players are packing on significant weight — 30 pounds or more in a single year, sometimes — without drawing much attention from their schools or the NCAA in a sport that earns tens of billions of dollars for teams.


Rules vary so widely that, on any given game day, a team with a strict no-steroid policy can face a team whose players have repeatedly tested positive.


An investigation by The Associated Press — based on dozens of interviews with players, testers, dealers and experts and an analysis of weight records for more than 61,000 players — revealed that while those running the multibillion-dollar sport believe the problem is under control, that is hardly the case.


The sport's near-zero rate of positive steroids tests isn't an accurate gauge among college athletes. Random tests provide weak deterrence and, by design, fail to catch every player using steroids. Colleges also are reluctant to spend money on expensive steroid testing when cheaper ones for drugs like marijuana allow them to say they're doing everything they can to keep drugs out of football.


"It's nothing like what's going on in reality," said Don Catlin, an anti-doping pioneer who spent years conducting the NCAA's laboratory tests at UCLA. He became so frustrated with the college system that it drove him in part to leave the testing industry to focus on anti-doping research.


Catlin said the collegiate system, in which players often are notified days before a test and many schools don't even test for steroids, is designed to not catch dopers. That artificially reduces the numbers of positive tests and keeps schools safe from embarrassing drug scandals.


While other major sports have been beset by revelations of steroid use, college football has operated with barely a whiff of scandal. Between 1996 and 2010 — the era of Barry Bonds, Mark McGwire, Marion Jones and Lance Armstrong — the failure rate for NCAA steroid tests fell even closer to zero from an already low rate of less than 1 percent.


The AP's investigation, drawing upon more than a decade of official rosters from all 120 Football Bowl Subdivision teams, found thousands of players quickly putting on significant weight, even more than their fellow players. The information compiled by the AP included players who appeared for multiple years on the same teams, making it the most comprehensive data available.


For decades, scientific studies have shown that anabolic steroid use leads to an increase in body weight. Weight gain alone doesn't prove steroid use, but very rapid weight gain is one factor that would be deemed suspicious, said Kathy Turpin, senior director of sport drug testing for the National Center for Drug Free Sport, which conducts tests for the NCAA and more than 300 schools.


Yet the NCAA has never studied weight gain or considered it in regard to its steroid testing policies, said Mary Wilfert, the NCAA's associate director of health and safety. She would not speculate on the cause of such rapid weight gain.


The NCAA attributes the decline in positive tests to its year-round drug testing program, combined with anti-drug education and testing conducted by schools.


"The effort has been increasing, and we believe it has driven down use," Wilfert said.


Big gains, data show


The AP's analysis found that, regardless of school, conference and won-loss record, many players gained weight at exceptional rates compared with their fellow athletes and while accounting for their heights. The documented weight gains could not be explained by the amount of money schools spent on weight rooms, trainers and other football expenses.


Adding more than 20 or 25 pounds of lean muscle in a year is nearly impossible through diet and exercise alone, said Dan Benardot, director of the Laboratory for Elite Athlete Performance at Georgia State University.


The AP's analysis corrected for the fact that players in different positions have different body types, so speedy wide receivers weren't compared to bulkier offensive tackles. It could not assess each player's physical makeup, such as how much weight gain was muscle versus fat, one indicator of steroid use. In the most extreme case in the AP analysis, the probability that a player put on so much weight compared with other players was so rare that the odds statistically were roughly the same as an NFL quarterback throwing 12 passing touchdowns or an NFL running back rushing for 600 yards in one game.


In nearly all the rarest cases of weight gain in the AP study, players were offensive or defensive linemen, hulking giants who tower above 6-foot-3 and weigh 300 pounds or more. Four of those players interviewed by the AP said that they never used steroids and gained weight through dramatic increases in eating, up to six meals a day. Two said they were aware of other players using steroids.


"I just ate. I ate 5-6 times a day," said Clint Oldenburg, who played for Colorado State starting in 2002 and for five years in the NFL. Oldenburg's weight increased over four years from 212 to 290, including a one-year gain of 53 pounds, which he attributed to diet and two hours of weight lifting daily. "It wasn't as difficult as you think. I just ate anything."


Oldenburg told the AP he was surprised at the scope of steroid use in college football, even in Colorado State's locker room. "College performance enhancers were more prevalent than I thought," he said. "There were a lot of guys even on my team that were using." He declined to identify any of them.


The AP found more than 4,700 players — or about 7 percent of all players — who gained more than 20 pounds overall in a single year. It was common for the athletes to gain 10, 15 and up to 20 pounds in their first year under a rigorous regimen of weightlifting and diet. Others gained 25, 35 and 40 pounds in a season. In roughly 100 cases, players packed on as much 80 pounds in a single year.


In at least 11 instances, players that AP identified as packing on significant weight in college went on to fail NFL drug tests. But pro football's confidentiality rules make it impossible to know for certain which drugs were used and how many others failed tests that never became public.


What is bubbling under the surface in college football, which helps elite athletes gain unusual amounts of weight? Without access to detailed information about each player's body composition, drug testing and workout regimen, which schools do not release, it's impossible to say with certainty what's behind the trend. But Catlin has little doubt: It is steroids.


"It's not brain surgery to figure out what's going on," he said. "To me, it's very clear."


Football's most infamous steroid user was Lyle Alzado, who became a star NFL defensive end in the 1970s and '80s before he admitted to juicing his entire career. He started in college, where the 190-pound freshman gained 40 pounds in one year. It was a 21 percent jump in body mass, a tremendous gain that far exceeded what researchers have seen in controlled, short-term studies of steroid use by athletes. Alzado died of brain cancer in 1992.


The AP found more than 130 big-time college football players who showed comparable one-year gains in the past decade. Students posted such extraordinary weight gains across the country, in every conference, in nearly every school. Many of them eclipsed Alzado and gained 25, 35, even 40 percent of their body mass.


Even though testers consider rapid weight gain suspicious, in practice it doesn't result in testing. Ben Lamaak, who arrived at Iowa State in 2006, said he weighed 225 pounds in high school and 262 pounds in the summer of his freshman year on the Cyclones football team. A year later, official rosters showed the former basketball player from Cedar Rapids weighed 306, a gain of 81 pounds since high school. He graduated as a 320-pound offensive lineman and said he did it all naturally.


"I was just a young kid at that time, and I was still growing into my body," he said. "It really wasn't that hard for me to gain the weight. I had fun doing it. I love to eat. It wasn't a problem."


In addition to random drug testing, Iowa State is one of many schools that have "reasonable suspicion" testing. That means players can be tested when their behavior or physical symptoms suggest drug use.


Despite gaining 81 pounds in a year, Lamaak said he was never singled out for testing.


The associate athletics director for athletic training at Iowa State, Mark Coberley, said coaches and trainers use body composition, strength data and other factors to spot suspected cheaters. Lamaak, he said, was not suspicious because he gained a lot of "non-lean" weight.


"There are a lot of things that go into trying to identify whether guys are using performance-enhancing drugs," Coberley said. "If anybody had the answer, they'd be spotting people that do it. We keep our radar up and watch for things that are suspicious and try to protect the kids from making stupid decisions."


There's no evidence that Lamaak's weight gain was anything but natural. Gaining fat is much easier than gaining muscle. But colleges don't routinely release information on how much of the weight their players gain is muscle, as opposed to fat. Without knowing more, said Benardot, the expert at Georgia State, it's impossible to say whether large athletes were putting on suspicious amounts of muscle or simply obese, which is defined as a body mass index greater than 30.


Looking solely at the most significant weight gainers also ignores players like Bryan Maneafaiga.


In the summer of 2004, Maneafaiga was an undersized 180-pound running back trying to make the University of Hawaii football team. Twice — once in pre-season and once in the fall — he failed school drug tests, showing up positive for marijuana use. What surprised him was that the same tests turned up negative for steroids.


He'd started injecting stanozolol, a steroid, in the summer to help bulk up to a roster weight of 200 pounds. Once on the team, where he saw only limited playing time, he'd occasionally inject the milky liquid into his buttocks the day before games.


"Food and good training will only get you so far," he told the AP recently.


Maneafaiga's coach, June Jones, meanwhile, said none of his players had tested positive for doping since he took over the team in 1999. He also said publicly that steroids had been eliminated in college football: "I would say 100 percent," he told The Honolulu Advertiser in 2006.


Jones said it was news to him that one of his players had used steroids. Jones, who now coaches at Southern Methodist University, said many of his former players put on bulk working hard in the weight room. For instance, adding 70 pounds over a three- to four-year period isn't unusual, he said.


Jones said a big jump in muscle year-over-year — say 40 pounds — would be a "red light that something is not right."


Jones, a former NFL head coach, said he is unaware of any steroid use at SMU and believes the NCAA is doing a good job testing players. "I just think because the way the NCAA regulates it now that it's very hard to get around those tests," he said.


The cost of testing


While the use of drugs in professional sports is a question of fairness, use among college athletes is also important as a public policy issue. That's because most top-tier football teams are from public schools that benefit from millions of dollars each year in taxpayer subsidies. Their athletes are essentially wards of the state. Coaches and trainers — the ones who tell players how to behave, how to exercise and what to eat — are government employees.


Then there are the health risks, which include heart and liver problems and cancer.


On paper, college football has a strong drug policy. The NCAA conducts random, unannounced drug testing and the penalties for failure are severe. Players lose an entire year of eligibility after a first positive test. A second offense means permanent ineligibility from sports.


In practice, though, the NCAA's roughly 11,000 annual tests amount to just a fraction of all athletes in Division I and II schools. Exactly how many tests are conducted each year on football players is unclear because the NCAA hasn't published its data for two years. And when it did, it periodically changed the formats, making it impossible to compare one year of football to the next.


Even when players are tested by the NCAA, people involved in the process say it's easy enough to anticipate the test and develop a doping routine that results in a clean test by the time it occurs. NCAA rules say players can be notified up to two days in advance of a test, which Catlin says is plenty of time to beat a test if players have designed the right doping regimen. By comparison, Olympic athletes are given no notice.


"Everybody knows when testing is coming. They all know. And they know how to beat the test," Catlin said, adding, "Only the really dumb ones are getting caught."


Players are far more likely to be tested for drugs by their schools than by the NCAA. But while many schools have policies that give them the right to test for steroids, they often opt not to. Schools are much more focused on street drugs like cocaine and marijuana. Depending on how many tests a school orders, each steroid test can cost $100 to $200, while a simple test for street drugs might cost as little as $25.


When schools call and ask about drug testing, the first question is usually, "How much will it cost," Turpin said.


Most schools that use Drug Free Sport do not test for anabolic steroids, Turpin said. Some are worried about the cost. Others don't think they have a problem. And others believe that since the NCAA tests for steroids their money is best spent testing for street drugs, she said.


Wilfert, the NCAA official, said the possibility of steroid testing is still a deterrent, even at schools where it isn't conducted.


"Even though perhaps those institutional programs are not including steroids in all their tests, they could, and they do from time to time," she said. "So, it is a kind of deterrence."


For Catlin, one of the most frustrating things about running the UCLA testing lab was getting urine samples from schools around the country and only being asked to test for cocaine, marijuana and the like.


"Schools are very good at saying, 'Man, we're really strong on drug testing,'" he said. "And that's all they really want to be able to say and to do and to promote."


That helps explain how two school drug tests could miss Maneafaiga's steroid use. It's also possible that the random test came at an ideal time in Maneafaiga's steroid cycle.


Enforcement varies


The top steroid investigator at the U.S. Drug Enforcement Administration, Joe Rannazzisi, said he doesn't understand why schools don't invest in the same kind of testing, with the same penalties, as the NFL. The NFL has a thorough testing program for most drugs, though the league has yet to resolve a long-simmering feud with its players union about how to test for human growth hormone.


"Is it expensive? Of course, but college football makes a lot of money," he said. "Invest in the integrity of your program."


For a school to test all 85 scholarship football players for steroids twice a season would cost up to $34,000, Catlin said, plus the cost of collecting and handling the urine samples. That's about 0.2 percent of the average big-time school football budget of about $14 million. Testing all athletes in all sports would make the school's costs higher.


When schools ask Drug Free Sport for advice on their drug policies, Turpin said she recommends an immediate suspension after the first positive drug test. Otherwise, she said, "student athletes will roll the dice."


But drug use is a bigger deal at some schools than others.


At Notre Dame and Alabama, the teams that will soon compete for the national championship, players don't automatically miss games for testing positive for steroids. At Alabama, coaches have wide discretion. Notre Dame's student-athlete handbook says a player who fails a test can return to the field once the steroids are out of his system.


"If you're a strength-and-conditioning coach, if you see your kids making gains that seem a little out of line, are you going to say, 'I'm going to investigate further? I want to catch someone?'" said Anthony Roberts, an author of a book on steroids who says he has helped college football players design steroid regimens to beat drug tests.


There are schools with tough policies. The University of North Carolina kicks players off the team after a single positive test for steroids. Auburn's student-athlete handbook calls for a half-season suspension for any athlete caught using performance-enhancing drugs.


Wilfert said it's not up to the NCAA to determine whether that's fair.


"Obviously if it was our testing program, we believe that everybody should be under the same protocol and the same sanction," she said.


Fans typically have no idea that such discrepancies exist and players are left to suspect who might be cheating.


"You see a lot of guys and you know they're possibly on something because they just don't gain weight but get stronger real fast," said Orrin Thompson, a former defensive lineman at Duke. "You know they could be doing something but you really don't know for sure."


Thompson gained 85 pounds between 2001 and 2004, according to Duke rosters and Thompson himself. He said he did not use steroids and was subjected to several tests while at Duke, a school where a single positive steroid test results in a yearlong suspension.


Meanwhile at UCLA, home of the laboratory that for years set the standard for cutting-edge steroid testing, athletes can fail three drug tests before being suspended. At Bowling Green, testing is voluntary.


At the University of Maryland, students must get counseling after testing positive, but school officials are prohibited from disciplining first-time steroid users. Athletic department spokesman Matt Taylor denied that was the case and sent the AP a copy of the policy. But the policy Taylor sent included this provision: "The athletic department/coaching staff may not discipline a student-athlete for a first drug offense."


By comparison, in Kentucky and Maryland, racehorses face tougher testing and sanctions than football players at Louisville or the University of Maryland.


"If you're trying to keep a level playing field, that seems nonsensical," said Rannazzisi at the DEA. He said he was surprised to learn that what gets a free pass at one school gets players immediately suspended at another. "What message does that send? It's OK to cheat once or twice?"


Only about half the student athletes in a 2009 NCAA survey said they believed school testing deterred drug use.


As an association of colleges and universities, the NCAA could not unilaterally force schools to institute uniform testing policies and sanctions, Wilfert said.


"We can't tell them what to do, but if went through a membership process where they determined that this is what should be done, then it could happen," she said.


'Everybody around me was doing it'


Steroids are a controlled substance under federal law, but players who use them need not worry too much about prosecution. The DEA focuses on criminal operations, not individual users. When players are caught with steroids, it's often as part of a traffic stop or a local police investigation.


Jared Foster, 24, a quarterback recruited to play at the University of Mississippi, was kicked off the team in 2008 after local authorities arrested him for giving a man nandrolone, an anabolic steroid, according to court documents. Foster pleaded guilty and served jail time.


He told the AP that he doped in high school to impress college recruiters. He said he put on enough lean muscle to go from 185 pounds to 210 in about two months.


"Everybody around me was doing it," he said.


Steroids are not hard to find. A simple Internet search turns up countless online sources for performance-enhancing drugs, mostly from overseas companies.


College athletes freely post messages on steroid websites, seeking advice to beat tests and design the right schedule of administering steroids.


And steroids are still a mainstay in private, local gyms. Before the DEA shut down Alabama-based Applied Pharmacy Services as a major nationwide steroid supplier, sales records obtained by the AP show steroid shipments to bodybuilders, trainers and gym owners around the country.


Because users are rarely prosecuted, the demand is left in place after the distributor is gone.


When Joshua Hodnik was making and wholesaling illegal steroids, he had found a good retail salesman in a college quarterback named Vinnie Miroth. Miroth was playing at Saginaw Valley State, a Division II school in central Michigan, and was buying enough steroids for 25 people each month, Hodnik said.


"That's why I hired him," Hodnik said. "He bought large amounts and knew how to move it."


Miroth, who pleaded no contest in 2007 and admitted selling steroids, helped authorities build their case against Hodnik, according to court records. Now playing football in France, Miroth declined repeated AP requests for an interview.


Hodnik was released from prison this year and says he is out of the steroid business for good. He said there's no doubt that steroid use is widespread in college football.


"These guys don't start using performance-enhancing drugs when they hit the professional level," the Oklahoma City man said. "Obviously it starts well before that. And you can go back to some of the professional players who tested positive and compare their numbers to college and there is virtually no change."


Maneafaiga, the former Hawaii running back, said his steroids came from Mexico. A friend in California, who was a coach at a junior college, sent them through the mail. But Maneafaiga believes the consequences were nagging injuries. He found religion, quit the drugs and became the team's chaplain.


"God gave you everything you need," he said. "It gets in your mind. It will make you grow unnaturally. Eventually, you'll break down. It happened to me every time."


At the DEA, Rannazzisi said he has met with and conducted training for investigators and top officials in every professional sport. He's talked to Major League Baseball about the patterns his agents are seeing. He's discussed warning signs with the NFL.


He said he's offered similar training to the NCAA but never heard back. Wilfert said the NCAA staff has discussed it and hasn't decided what to do.


"We have very little communication with the NCAA or individual schools," Rannazzisi said. "They've got my card. What they've done with it? I don't know."


___


Associated Press writers Ryan Foley in Cedar Rapids, Iowa; David Brandt in Jackson, Miss.; David Skretta in Lawrence, Kan.; Don Thompson in Sacramento, Calif.;and Alexa Olesen in Shanghai, China; and researchers Susan James in New York and Monika Mathur in Washington contributed to this report.


___


Contact the Washington investigative team at DCinvestigations (at) ap.org.


Whether for athletics or age, Americans from teenagers to baby boomers are trying to get an edge by illegally using anabolic steroids and human growth hormone, despite well-documented risks. This is the first of a two-part series.


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