Ex-cop at center of manhunt called 'depraved,' 'cowardly'

The fired LAPD officer suspected of terrorizing Southern California in a bloody rampage opened fire on two Riverside police officers with a rifle in a "cowardly ambush" early Thursday morning, Riverside police Chief Sergio Diaz told reporters at a morning news conference.

A 34-year-old officer who was an 11-year veteran of the department was killed in the attack. He was training a 27-year-old officer, who was shot in the upper body but survived, Diaz said. Their names were not released.

Diaz, a former Los Angeles Police Department deputy chief, said he believed the attack was random, coming less than 20 minutes after the suspect -- identified as Christopher Jordan Dorner -- had opened fire on two LAPD officers in Corona near the Magnolia Street exit ramp on Interstate 15.

PHOTOS: The Manhunt

Those officers were among 41 special details dispatched to protect LAPD officers whom Dorner, in an online manifesto, allegedly threatened to hunt down in revenge for being dismissed from the force.

"My opinion of the suspect is unprintable,'' Diaz said. "The manifesto I think speaks for itself as evidence enough of a depraved and abandoned mind and heart.''

The suspect allegedly opened fire as the Riverside officers were stopped at red light at the intersection of Magnolia Avenue and Arlington Boulevard around 1:35 p.m. Bullets pierced the patrol car's windshield, hitting both officers in the chest, Diaz said.

Law enforcement officers from agencies around the Inland Empire descended on Riverside after the shooting to assist with the manhunt. Officers tooting rifles and shotguns stood vigil outside the Riverside police station, which has been placed on "high alert.''

Diaz described the situation as surreal.

"We're hoping to wake up and find this is a bad dream,'' he said

Corona police Chief Michael Abel said the suspect opened fire on two LAPD officers after they were flagged down by a resident who recognized Dorner's Nissan Titan pickup truck. After a short pursuit, Dorner shot at the officers with a rifle, grazing one on the head. The LAPD officers returned fire but their patrol car was disabled and they could not continue the pursuit.

The LAPD officer who was shot was hospitalized and a full recovery is expected, said LAPD Dep. Chief Jose Perez. He was not identified.

Diaz's news conference, held in a Riverside police station near the Tyler Mall, was flooded with television news crews and other media.

Diaz said the department decided to delay releasing the names of the slain and wounded officers because of fears that Dorner, in his quest to hunt down police officers and their relatives, may target their families.

With the city on edge, Diaz urged parents to continue sending their children to school -- which he said was the safest place for them -- and for local businesses to stay open. There's no evidence that Dorner remained in Riverside, or that that he was targeting anyone in the city, Diaz said.

Diaz said he did not know the suspect while he was with the LAPD, and did not have any role in the grievance proceeding that led to Dorner's dismissal in 2009.

"We're going to find him. You can't have this many people looking for you and not be found,'' Diaz said.

Some schools in the area were closed.

A note posted on the Notre Dame Catholic High School website said the school was closed because of the shooting. The school is not far from the scene of the attack.

Meanwhile, a spokeswoman with the Riverside Unified School District said officials were trying to reassure parents that the district's campuses were safe and that they were working closely with authorities.

"Of course, we are being vigilant, even more extra than we normally do," said district spokeswoman Jacquie Paul.

Despite the outreach some parents have chosen to keep their children at home, she said.

PHOTOS: The Manhunt

The district oversees about 42,000 students from kindergarten through high school. She said students would be excused if their parents decided to keep them home. 

"We're very understanding of parents who are nervous, because we understand where they are coming from."

Assistant Supt. David Hansen of the Corona Norco Unified School District said some parents in his district had also kept their students home.

Hansen said all schools were operating normally. He said a automatic phone message was sent to parents telling them that officials were aware if the shootings, and to ensure them they were working closely with police.

"There's anxiety all around because this has been on the news," Hansen said.

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Afghan boys from nominated film to walk red carpet

KABUL, Afghanistan (AP) — Fawad Mohammadi has spent half his life peddling maps and dictionaries to foreigners on a street of trinket shops in Kabul. Now the 14-year-old Afghan boy with bright green eyes is getting ready for a trip down the red carpet at the Oscars.

It will also be his first time out of the country and his first time on a plane.

Mohammadi was plucked from the dingy streets of the Afghan capital to be one of the main stars of "Buzkashi Boys," a coming-of-age movie filmed entirely in a war zone and nominated in the Best Live Action Short Film category.

The movie is about two penniless young boys — a street urchin and a blacksmith's son — who are best friends and dream of becoming professional players of buzkashi, a particularly rough and dangerous game that somewhat resembles polo: Horseback riders wrangle to get a headless goat carcass into a circular goal at one end of the field.

It's also part of an American director's effort to help revive a film industry devastated by decades of civil war and by the Taliban, an Islamic fundamentalist movement that banned entertainment and burned films and theaters during its five years in power.

Sam French, a Philadelphia native who has lived in Afghanistan for about five years, said his 28-minute movie was initially conceived as a way of training local film industry workers — the first installment in his nonprofit Afghan Film Project.

"We never dreamed of having the film come this far and get an Oscar nomination," French, 36, said in a telephone interview from Los Angeles, where he is preparing for the Feb. 24 Academy Awards and raising money to fly the two young co-stars in for the ceremony.

The two boys playing the main characters — Mohammadi and Jawanmard Paiz — can barely contain their excitement about going to the Oscars.

"It will be a great honor for me and for Afghanistan to meet the world's most famous actors," said Mohammadi, whose real-life dream is to become a pilot. He's also hoping to go see the cockpit during the flight.

The farthest Mohammadi has ever traveled was to the northern Afghan city of Mazar-i-Sharif when he was younger.

Mohammadi's father died a few years ago, leaving him with his mother, five brothers and a sister. He started selling chewing gum when he was about 7 years old and soon expanded his trade to maps and dictionaries.

He learned to speak English hustling foreigners on Chicken Street, the main tourist area in Kabul with shops selling multicolor rugs, lapis bowls and other crafts and souvenirs, and gained a reputation for being polite, helpful and trustworthy. He was even able to enroll in a private school, thanks to the generosity of some other foreigners unrelated to the film project.

In the movie Mohammadi plays the blacksmith's son, Rafi, whose father wants him to follow in his footsteps.

"His life was so much harder than mine," Mohammadi said. "The blacksmith made him go out on the streets. I came myself here (to Chicken Street). My family didn't make me come. I wanted to make money to feed myself and to feed my family. He didn't have a home. They lived in the blacksmith shop."

Ironically it's not Mohammadi but Paiz, the youngest son of a well-known Afghan actor, who plays the homeless boy Ahmad.

Paiz, also 14, already was an experienced actor: He's appeared in films since the age of 5 and has gone to the Cannes Film Festival.

Paiz and Mohammadi had a lot to learn from each other and became friends. He gave Mohammadi tips for acting and handling himself in live interviews, while Fawad taught him about life outside his sheltered surroundings.

"When I saw Fawad was such a good actor even though he was a street boy and he was so brave in acting, I was very surprised and I said to myself, 'Everybody can achieve what they desire to do,'" Paiz said during an interview this week, shivering in the snow-covered courtyard of the Afghan Film Institute while a local TV series was being filmed nearby.

French, who co-wrote the script and produced "Buzkashi Boys" with Martin Roe of the Los Angeles-based production company Dirty Robber, launched a fundraising drive that's raised almost $10,000 so far to help bring the boys to Los Angeles for the ceremony. Any extra money will be placed in a fund to provide for Mohammadi's education and help his family. The boys will travel with an escort and will stay with the extended Afghan family of one of the film's producers, French said.

French said he's aware of the pitfalls in working with child actors from developing countries.

The makers of "Slumdog Millionaire," the rags-to-riches blockbuster about three poor Indian children, have struggled to make a better life for the young stars, and four boys who acted in "The Kite Runner" had to leave Afghanistan out of concern they could be ostracized or subject to violence because of a rape scene in the movie.

French said he and others involved in the "Buzkashi Boys" took pains to involve the community and made sure to avoid any scenes that could be offensive.

"We're not filmmakers who just do a film and leave. We remain there and present," he said. "We had lots and lots of tea with lots and lots of people."

The Academy of Motion Picture Arts and Sciences says there have been three documentary features nominees filmed at least in part in Afghanistan since 2007 — all about the U.S. military. The Kite Runner, which was nominated for original score in 2007, was set in Afghanistan but not filmed there.

Afghanistan had a burgeoning film industry starting in the early 20th century, but it suffered from fighting during the civil war and the Taliban campaign to stamp out entertainment. Actors and film industry workers like Paiz's father and the actor who plays the blacksmith, Wali Talash, fled the country. They returned only after the 2001 U.S.-led assault that ousted the Islamic movement and its al-Qaida allies.

Talash, 56, said he hopes the "Buzkashi Boys" will show the world the rich culture of Afghanistan, which too few in the world know beyond reports of roadside bombs and suicide attacks.

"I hope if this movie wins that it will be an earthquake that will shake the industry and help Afghan filmmakers get back on their feet," he said.

Mohammadi, meanwhile, says he knows the money and fame he earned from the movie can carry him only so far. He still sells maps, though not so often as before, because he has school.

"For my work I used to know a lot of foreigners and I still do, but before they used to know me as a map seller. Now they know me as an actor," he said, waving a plastic-covered map as weary Afghans walked by on the muddy street. "Most of them take pictures with me and sometimes they buy maps from me even if they don't need any just because they spotted me in the movie."

___

Associated Press writer Steve Loeper in Los Angeles contributed to this report.

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Online:

Fundraising site — https://rally.org/buzkashiboys

Film website — http://www.buzkashiboys.com/

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Well: The 'Monday Morning' Medical Screaming Match

I did not think I would ever see another “morbidity and mortality” conference in which senior doctors publicly attacked their younger colleagues for making medical errors. These types of heated meetings were commonplace when I was a medical student but have largely been abandoned.

Yet here they were again on “Monday Mornings,” a new medical drama on the TNT network, based on a novel by Dr. Sanjay Gupta, CNN’s chief medical correspondent and one of the executive producers of the show. Such screaming matches may make for good television, but it is useful to review why new strategies have emerged for dealing with medical mistakes.

So-called M&M conferences emerged in the early 20th century as a way for physicians to review cases that had either surprising outcomes or had somehow gone wrong. Although the format varied among institutions and departments, surgery M&Ms were especially known for their confrontations, as more experienced surgeons often browbeat younger doctors into admitting their errors and promising to never make them again.

Such conferences were generally closed door — that is, attended only by physicians. Errors were a private matter not to be shared with other hospital staff, let alone patients and families.

But in the late 1970s, a sociology graduate student named Charles L. Bosk gained access to the surgery department at the University of Chicago. His resultant 1979 book, “Forgive and Remember,” was one of the earliest public discussions of how the medical profession addressed its mistakes.

Dr. Bosk developed a helpful terminology. Technical and judgment errors by surgeons could be forgiven, but only if they were remembered and subsequently prevented by those who committed them. Normative errors, which called into question the moral character of the culprit, were unacceptable and potentially jeopardized careers.

Although Dr. Bosk’s book was more observational than proscriptive, his depiction of M&M conferences was disturbing. I remember attending a urology M&M as a medical student in which several senior physicians berated a very well-meaning and competent intern for a perceived mistake. The intern seemed to take it very well, but my fellow students and I were shaken by the event, asking how such hostility could be conducive to learning.

There were lots of angry accusations in the surgical M&Ms in the pilot episode of “Monday Mornings.” In one case, a senior doctor excoriated a colleague who had given Tylenol to a woman with hip pain who turned out to have cancer. “You allowed metastatic cancer to run amok for four months!” he screamed.

If this was what Dr. Bosk would have called a judgment error, the next case raised moral issues. A neurosurgeon had operated on a boy’s brain tumor without doing a complete family history, which would have revealed a disorder of blood clotting. The boy bled to death on the operating table. “The boy died,” announced the head surgeon, “because of a doctor’s arrogance.”

In one respect, it is good to see that the doctors in charge were so concerned. But as the study of medical errors expanded in the 1990s, researchers found that the likelihood of being blamed led physicians to conceal their errors. Meanwhile, although doctors who attended such conferences might indeed not make the exact same mistakes that had been discussed, it was far from clear that M&Ms were the best way to address the larger problem of medical errors, which, according to a 1999 study, killed close to 100,000 Americans annually.

Eventually, experts recommended a “systems approach” to medical errors, similar to what had been developed by the airline industry. The idea was to look at the root causes of errors and to devise systems to prevent them. Was there a way, for example, to ensure that the woman with the hip problem would return to medical care when the Tylenol did not help? Or could operations not be allowed to occur until a complete family history was in the chart? Increasingly, hospitals have put in systems, such as preoperative checklists and computer warnings, that successfully prevent medical errors.

Another key component of the systems approach is to reduce the emphasis on blame. Even the best doctors make mistakes. Impugning them publicly — or even privately — can make them clam up. But if errors are seen as resulting from inadequate systems, physicians and other health professionals should be more willing to speak up.

Of course, the systems approach is not perfect. Studies continue to show that physicians conceal their mistakes. And elaborate systems for preventing errors can at times interfere with getting things done in the hospital.

Finally, it is important not to entirely remove the issue of responsibility. Sad to say, there still are physicians who are careless and others who are arrogant. Even if today’s M&M conferences rarely involve screaming, supervising physicians need to let such colleagues know that these types of behaviors are unacceptable.

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Barron H. Lerner, M.D., professor of medicine at New York University Langone Medical Center, is the author, most recently, of “One for the Road: Drunk Driving Since 1900.”

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Hedge fund manager Bill Ackman steps up campaign against Herbalife

Hedge fund manager Bill Ackman is stepping up his attack against Herbalife Ltd., releasing a 40-page list of questions about how the Los Angeles nutrition company does business.

Ackman, whose Pershing Square fund has a $1-billion short against Herbalife’s stock, has been campaigning against the company for nearly two months. He contends Herbalife is a pyramid scheme in which the vast majority of its independent distributors make little or no money while a scant few get rich by collecting commissions from people they recruit into the business.

On Thursday, Ackman released a list of more than 270 questions for Herbalife executives. The questions – posted on Ackman’s anti-Herbalife website – focused on many aspects of the company's business, from the serving size of its meal-replacement shake mix to whether it is complying with a 1986 injunction obtained by the California attorney general  that prohibits the company from paying commissions for recruiting.

“Herbalife executives have repeatedly committed to having a fact-based conversation and total transparency about Herbalife’s business,” Ackman said in the beginning of his open letter to the company. “Pershing Square would welcome responses to the following questions.”

Herbalife released a statement that did not address any of Ackman’s questions specifically.  

“Herbalife is a financially strong and successful global nutrition company, having created meaningful value for shareholders, significant opportunities for distributors and positively impacted the lives and health of consumers since our founding in 1980,” Herbalife said in a statement. “Pershing Square's latest tome is motivated by a reckless $1-billion short bet.” 

Herbalife has denied Ackman’s previous allegations, contending that all of the commissions it pays are based directly on sales.

A California attorney general's spokeswoman declined to say whether the office was investigating Herbalife. Earlier this week, the Federal Trade Commission disclosed that it has received more than 100 complaints about Herbalife in recent years. That agency also declined to say whether it was investigating.

A significant portion of Ackman’s questions focused on commissions distributors receive when people they have recruited into the business purchase Herbalife products.

For instance, Ackman asked, because Herbalife does not track retail sales, only sales to its independent sales force, how is it possible to award sales-based commissions?

Other questions targeted a $15-million bonus paid to a scientist who has promoted Herbalife products and marketing that implies Herbalife distributors can become millionaires by selling its vitamins, powders and drinks, when about 90% of them make little or no money.

Herbalife shares gained about 0.4% on Thursday.

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Boy Scouts postpone decision on admitting gays

A decision on whether the Boy Scouts of America will keep its policy that excludes gay members and leaders will not be voted on until the organization's annual meeting in May.

By Michael Muskal and Molly Hennessy-Fiske

February 6, 2013, 9:18 a.m.

IRVING, Texas -- The Boy Scouts of America decided Wednesday to put off a decision on whether to lift a national ban of gay members and leaders, saying the issue of sexual orientation was too complex and needed more time for study.

The decision to wait came after the organization recently announced that it would consider changing its policies and might allow local chapters to decide whether to admit gays as Scouts and leaders.

“After careful consideration and extensive dialog within the Scouting family, along with comments from those outside the organization, the volunteer officers of the Boy Scouts of America's National Executive Board concluded that due to the complexity of this issue, the organization needs time for a more deliberate review of its membership policy,” Deron Smith, the BSA director of public relations, said in a statement.

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“To that end, the executive board directed its committees to further engage representatives of Scouting’s membership and listen to their perspectives and concerns. This will assist the officers’ work on a resolution on membership standards,” he stated.

The approximately 1,400 voting members of the national council will take action on the resolution at the national meeting in May in Grapevine, Texas, he said.

It was the Scouts that put the issue back on the agenda for the current executive board meeting, held in its headquarters in Irving. But the move also came amid declining membership, questions by corporate sponsors and public pressure from activists who oppose the current national ban.

“Today the Boy Scouts of America have chosen to remain irrelevant by delaying the vote,” said James Dale, who was expelled from the Scouts in 1990 for being openly gay. “For over 23 years, since I was expelled from the Scouts, I have held out hope that the Boy Scouts would end their discriminatory policy. With each passing day the Scouts will continue to lose members, sponsors and funding. No parent or child should associate with an organization that sends a toxic message telling children they are immoral if they are gay.”

GLAAD, the nation's lesbian, gay, bisexual and transgender advocacy group, condemned the decision to wait.

“An organization that serves youth and chooses to intentionally hurt dedicated young people and hard-working parents not only flies in the face of American principles, but the principles of being a Boy Scout,” GLAAD President Herndon Graddick stated.

“The Boy Scouts of America is choosing to ignore the cries of millions, including religious institutions, current Scouting families, and corporate sponsors, but these cries will not be silenced. We're living in a culture where hurting young gay people because of who they are is unpopular and discriminatory. They had the chance to end the pain this ban has caused to young people and parents; they chose to extend the pain.”

Those seeking to keep the ban were also vocal. A majority of the Boy Scout organizations are sponsored by local churches, many of which have religious objections to homosexuals.

About 100 people gathered outside Boy Scouts headquarters in suburban Dallas carrying signs that said “Save our boys from homosexual acts;” “God votes no gays” and “Don't invite sin into the camp.”

Texas Values, a conservative group that organized a prayer vigil this week in support of keeping gays out of the Scouts, said the Scouts organization was right to delay a decision.

“It's a temporary victory,” Jonathan Saenz said of Wednesday's vote. “Good for them -- they're obviously listening. We are encouraged and we're glad they're going to delay the decision. When you deal with such fundamental principles, it's not something you want to tinker with overnight.”

Robert Davis, 48, of Benbrook, Texas, wore his Longhorn Council Scouting uniform and brought his two sons to the protest Wednesday.

“I think it's a good sign,” he said of the organization’s vote. “The Boy Scouts of America is one of the last moral high grounds in this country. I hate to see it die.”

Among politicians, both President Obama and Texas Gov. Rick Perry have been part of the debate.

“My attitude is that gays and lesbians should have access and opportunity the same way everybody else does in every institution and walk of life,” said Obama, who as U.S. president is the honorary president of BSA, in a Sunday interview with CBS.

Perry, the author of the book “On My Honor: Why the American Values of the Boy Scouts Are Worth Fighting For,” said in a speech Saturday that “to have popular culture impact 100 years of their standards is inappropriate.”

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In Vegas, Abrams gives few hints about 'Star Wars'

LAS VEGAS (AP) — A newly announced "Star Wars" sequel was on everyone's mind when J.J. Abrams took the stage Wednesday at a Las Vegas video game conference, but he made only a sideways mention of the film he has been hired to direct.

The reference was a throw-away joke from his last franchise reboot.

The director played a scene from his 2009 "Star Trek" film to illustrate the importance of embroidering films with subtle details, and freeze-framed on a shot of a familiar "Star Wars" robot peeking from space junk.

"So they're looking at all the debris that's out there, and curiously, it's R2D2," he said, drawing a roar of laughter.

Gabe Newell, president of video game developer Valve, shared a stage with Abrams at the Design, Innovate, Communicate, Entertain Summit at the Hard Rock Hotel & Casino.

"So now I have to go back through your movies looking at all the debris to figure out what movie you're going to direct next?" Newell asked.

Abrams has given die-hard fans few clues about his vision for the seventh live-action "Star Wars" film. He was announced as its director in January.

The Sin City appearance left fans of The Force hungering for more insight.

"I'd love to know who they'll focus on, what character, how far in the future it will be set, things like that," said Sadierose Schwartzmiller, 19, a comic-book creator who won her ticket to the event in an art contest.

Abrams has made a name for himself as a trusted steward of beloved fantasy universes, directing well-received additions to the "Star Trek" and "Mission: Impossible" franchises.

"Star Wars" creator George Lucas opened the door to the latest round of spin-offs when he sold his Lucasfilm empire to The Walt Disney Co. for $4.05 billion last fall. The company is planning three sequels and two peripheral movies focusing on characters.

"Episode VII" is tentatively scheduled for release in the summer of 2015.

Last month, Abrams told a group of reporters that he wanted to make sure the sequel was "something that touches people."

On Wednesday, he did give his audience of nerds and gamers one revelation when he announced his intention to collaborate with Newell — the man behind the hit games "Portal," "Half-Life" and "Counter-Strike."

"There's an idea that we had for a game that we'd like to develop," he said.

Fans wanted more information on that, too.

"If they would reveal even the genre," said Kellen Smalley, 32, a gamer. "If they would bring what J.J. does with stories to the 'Star Wars' games, it would be very fun."

Abrams' development company, Bad Robot Interactive, has released apps related to his movies. Newell said his company would like to work with Abrams on a movie adaptation of "Portal" or "Half-Life."

___

Hannah Dreier can be reached at http://twitter.com/hannahdreier

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Personal Health: Effective Addiction Treatment

Countless people addicted to drugs, alcohol or both have managed to get clean and stay clean with the help of organizations like Alcoholics Anonymous or the thousands of residential and outpatient clinics devoted to treating addiction.

But if you have failed one or more times to achieve lasting sobriety after rehab, perhaps after spending tens of thousands of dollars, you’re not alone. And chances are, it’s not your fault.

Of the 23.5 million teenagers and adults addicted to alcohol or drugs, only about 1 in 10 gets treatment, which too often fails to keep them drug-free. Many of these programs fail to use proven methods to deal with the factors that underlie addiction and set off relapse.

According to recent examinations of treatment programs, most are rooted in outdated methods rather than newer approaches shown in scientific studies to be more effective in helping people achieve and maintain addiction-free lives. People typically do more research when shopping for a new car than when seeking treatment for addiction.

A groundbreaking report published last year by the National Center on Addiction and Substance Abuse at Columbia University concluded that “the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care.” The report added, “Only a small fraction of individuals receive interventions or treatment consistent with scientific knowledge about what works.”

The Columbia report found that most addiction treatment providers are not medical professionals and are not equipped with the knowledge, skills or credentials needed to provide the full range of evidence-based services, including medication and psychosocial therapy. The authors suggested that such insufficient care could be considered “a form of medical malpractice.”

The failings of many treatment programs — and the comprehensive therapies that have been scientifically validated but remain vastly underused — are described in an eye-opening new book, “Inside Rehab,” by Anne M. Fletcher, a science writer whose previous books include the highly acclaimed “Sober for Good.”

“There are exceptions, but of the many thousands of treatment programs out there, most use exactly the same kind of treatment you would have received in 1950, not modern scientific approaches,” A. Thomas McLellan, co-founder of the Treatment Research Institute in Philadelphia, told Ms. Fletcher.

Ms. Fletcher’s book, replete with the experiences of treated addicts, offers myriad suggestions to help patients find addiction treatments with the highest probability of success.

Often, Ms. Fletcher found, low-cost, publicly funded clinics have better-qualified therapists and better outcomes than the high-end residential centers typically used by celebrities like Britney Spears and Lindsay Lohan. Indeed, their revolving-door experiences with treatment helped prompt Ms. Fletcher’s exhaustive exploration in the first place.

In an interview, Ms. Fletcher said she wanted to inform consumers “about science-based practices that should form the basis of addiction treatment” and explode some of the myths surrounding it.

One such myth is the belief that most addicts need to go to a rehab center.

“The truth is that most people recover (1) completely on their own, (2) by attending self-help groups, and/or (3) by seeing a counselor or therapist individually,” she wrote.

Contrary to the 30-day stint typical of inpatient rehab, “people with serious substance abuse disorders commonly require care for months or even years,” she wrote. “The short-term fix mentality partially explains why so many people go back to their old habits.”

Dr. Mark Willenbring, a former director of treatment and recovery research at the National Institute for Alcohol Abuse and Alcoholism, said in an interview, “You don’t treat a chronic illness for four weeks and then send the patient to a support group. People with a chronic form of addiction need multimodal treatment that is individualized and offered continuously or intermittently for as long as they need it.”

Dr. Willenbring now practices in St. Paul, where he is creating a clinic called Alltyr “to serve as a model to demonstrate what comprehensive 21st century treatment should look like.”

“While some people are helped by one intensive round of treatment, the majority of addicts continue to need services,” Dr. Willenbring said. He cited the case of a 43-year-old woman “who has been in and out of rehab 42 times” because she never got the full range of medical and support services she needed.

Dr. Willenbring is especially distressed about patients who are treated for opioid addiction, then relapse in part because they are not given maintenance therapy with the drug Suboxone.

“We have some pretty good drugs to help people with addiction problems, but doctors don’t know how to use them,” he said. “The 12-step community doesn’t want to use relapse-prevention medication because they view it as a crutch.”

Before committing to a treatment program, Ms. Fletcher urges prospective clients or their families to do their homework. The first step, she said, is to get an independent assessment of the need for treatment, as well as the kind of treatment needed, by an expert who is not affiliated with the program you are considering.

Check on the credentials of the program’s personnel, who should have “at least a master’s degree,” Ms. Fletcher said. If the therapist is a physician, he or she should be certified by the American Board of Addiction Medicine.

Does the facility’s approach to treatment fit with your beliefs and values? If a 12-step program like A.A. is not right for you, don’t choose it just because it’s the best known approach.

Meet with the therapist who will treat you and ask what your treatment plan will be. “It should be more than movies, lectures or three-hour classes three times a week,” Ms. Fletcher said. “You should be treated by a licensed addiction counselor who will see you one-on-one. Treatment should be individualized. One size does not fit all.”

Find out if you will receive therapy for any underlying condition, like depression, or a social problem that could sabotage recovery. The National Institute on Drug Abuse states in its Principles of Drug Addiction Treatment, “To be effective, treatment must address the individual’s drug abuse and any associated medical, psychological, social, vocational, and legal problems.”

Look for programs using research-validated techniques, like cognitive behavioral therapy, which helps addicts recognize what prompts them to use drugs or alcohol, and learn to redirect their thoughts and reactions away from the abused substance.

Other validated treatment methods include Community Reinforcement and Family Training, or Craft, an approach developed by Robert J. Meyers and described in his book, “Get Your Loved One Sober,” with co-author Brenda L. Wolfe. It helps addicts adopt a lifestyle more rewarding than one filled with drugs and alcohol.

This is the first of two articles on addiction treatment.

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Postal Service plan to end Saturday delivery likely to affect business

The financially struggling U.S. Postal Service said it will stop delivering mail on Saturdays but continue to disburse packages six days a week.

By W.J. Hennigan

February 6, 2013, 1:22 p.m.

The U.S. Postal Service's announcement that it plans to stop delivering most mail on Saturdays is likely to have an effect on the business world.

The Postal Service said it made the announcement Wednesday -- about six months in advance of implementing a five-day mail delivery schedule on Aug. 5 -- to give residential and business customers time to plan and adjust.

Hallmark Card Inc., the Kansas City-based greeting card company, said it anticipated problems with the decision. 

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"Hallmark continues to believe a reduction in service will not induce customer loyalty and will negatively impact small towns and small businesses that depend on timely, affordable, reliable mail delivery," the company said. "This move should only be considered once all other cost-saving options are fully explored and acted upon."

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Online retailer Amazon.com said it was not worried about the announcement's effect on its business.

"We use multiple carriers in all of our geographies to ensure we are delivering products to customers on time," said Scott Stanzel, a company spokesman.

Netflix Inc., the Los Gatos, Calif.-based DVD-by-mail company, would not comment on the announcement, but has said in the past that it needs to have a healthy postal service.

The Postal Service's announcement came with proviso: Six-day-a-week delivery of packages will continue, allowing the agency to stay competitive with other carriers, said Postmaster General Patrick R. Donahoe.

The Postal Service said there has been recent strong growth in package delivery -- a 14% increase since 2010. It projects continued strong growth in that service through the coming decade as an increasing number of big retailers join online companies such as Amazon in selling their wares online.

"Our customers see strong value in the national delivery platform we provide and maintaining a six-day delivery schedule for packages is an important part of that platform," Donahoe said. "As consumers increasingly use and rely on delivery services -- especially due to the rise of e-commerce -- we can play an increasingly vital role as a delivery provider of choice, and as a driver of growth opportunities for America's businesses."

Wall Street first-glance reaction was a bit of good news for other delivery services: United Parcel Service Inc.'s shares were up 2 cents, or .02%, to $80.82. FedEx Corp.'s shares were up 69 cents, or .7%, to $105.76.

In a statement, FedEx spokesman Jess Bunn said: "While it is too early to say precisely what the eventual impact to FedEx would be from the U.S. Postal Service's proposed Saturday delivery changes, it appears the effect would be minimal. FedEx has an outstanding business relationship with the USPS, both as a customer and a supplier, and looks forward to its continuation."

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Obama urges short-term solution to prevent steep budget cuts

WASHINGTON – President Obama on Tuesday called on Congress to come up with short-term spending cuts and revenue increases that would stave off more drastic cuts set to take effect in March.

In a brief appearance in the White House briefing room, Obama asked lawmakers to come up with a quick fix that would postpone the automatic cuts and their "devastating" effects on the economy.

The economy is in recovery, Obama said, but that won’t continue if there are “self-inflicted wounds” caused by elected officials. 

The economy shouldn’t be at risk “just because folks in Washington couldn’t come together to eliminate a few special-interest tax loopholes or government programs that we agreed need some reform,” he said.

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The president said he still wants to deal with deficits over the longer term, but that he doesn’t want to see workers laid off and critical programs lapse while Congress works its way to a more broad-based budget solution.

When the automatic cuts were first devised in 2011, the $1.2-trillion in so-called sequester cuts were intentionally designed to be severe. Lawmakers on all sides believed they would force Congress to come up with a better alternative for deficit reduction.

But the deadline is drawing close and the sides are nowhere near a permanent solution. Democrats want to exchange the pending across-the-board cuts for tax revenue generated in part by ending tax breaks for oil and gas companies.

Republicans, meanwhile, see the looming sequester as one of their best chances to exact steep spending cuts. They want to steer away from reductions at the Pentagon and toward Medicare, food stamps and other domestic programs.

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Sen. Mitch McConnell of Kentucky, the Republican minority leader, calls the Democrats' ideas “gimmicks.” House Speaker John A. Boehner (R-Ohio) argues that the public doesn’t support the idea of raising taxes in place of cutting spending.

“The president’s sequester should be replaced with spending cuts and reforms that will start us on the path to balancing the budget in 10 years,” Boehner said.

Speaking to reporters, Obama said he believes “modest reforms” in social insurance programs would eventually have to be paired with tax reform.

For the moment, he said, it appears a full budget “may not be finished” before the automatic cuts kick in. Congress can’t let that happen, he said.

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“If Congress can’t act immediately on a bigger package,” he said, “they should at least pass a smaller package of spending cuts and tax reforms that would delay the economically damaging effects of the sequester for a few more months.”

After that, he said, the two sides can work together to replace cuts with a “smarter solution.”

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christi.parsons@latimes.com

lisa.mascaro@latimes.com

Twitter: @cparsons and @lisamascaroindc

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Brown's attorney calls DA's report scurrilous

LOS ANGELES (AP) — Chris Brown's attorney says a motion seeking to revoke the singer's probation is shameful and he intends to seek sanctions against prosecutors because it is defamatory.

Mark Geragos says the Los Angeles district attorney's office has ignored sworn statements by police in Virginia that Brown's community service was supervised. He says he intends to seek sanctions against the prosecutor's office at a hearing Wednesday.

Geragos called the motion "shameful and a disgrace."

Prosecutors filed a motion Tuesday claiming that there's no credible evidence that the R&B singer performed six months of community labor in Virginia as ordered by a court after he pleaded guilty to assaulting Rihanna in 2009.

Geragos says the motion essentially calls everyone in the Richmond Police Department a liar, and that should not be allowed.

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