LABroadsheet_ 10-28-2014_ A_ 1_ A1_ WEST_ 1_C K Y M TSet: 10-27-2014 22:42 $1.50 DESIGNATED AREAS HIGHER 48 PAGES latimes.com TUESDAY, OCTOBER 28, 2014 © 2014 WST ER data add to alarm on painkillers Treatment for people who overdosed on prescription opioids cost an estimated $1.4 billion in a year. By Lisa Girion and Karen Kaplan Sergei L. Loiko Los Angeles Times A UKRAINIAN SOLDIER patrols inside the Donetsk airport this month. A battle between government forces and separatists since May has wrecked the facility, but the two sides are still fighting over the ruins. COLUMN ONE Enemies inside the gates Ukrainian troops are surrounded but fight on at airport By Sergei L. Loiko reporting from donetsk, ukraine O nly three floors remain in the blackened skeleton of the seven-story, glasswalled airport terminal, opened with a burst of national pride two years ago for the Euro 2012 soccer championship. Ukrainian commandos control two of them: the ground and second floors. The pro-Russia separatists they’re fighting have infiltrated the third floor despite entrances barricaded with debris and booby traps. The separatists have also found a way into the basement, with its system of narrow passageways leading beyond the airport grounds. They are enemies sharing the same building, playing a claustrophobic game of cat and mouse in shadowy rooms and burned-out boarding jetways. Just after midnight on a recent night, a separatist fighter suddenly appeared on a balcony of the third floor and shot a Mukha grenade down at the onetime departure lounge where the Ukrainian troops were trying to sleep on cold concrete floors. The grenade hit a wall and exploded. Shrapnel and debris flew everywhere. Without thinking, a commando nicknamed Batman threw a hand grenade toward the balcony. But it exploded short of its target and sent more shrapnel showering over his comrades. The shouting had barely subsided when a commander announced that government Grad missiles were on the way to hit enemy positions surrounding the terminal. “You know how they do it!” the commander shouted. “They’ll certainly miss. So run for cover.” A few seconds later, the building shook from the explosion right outside, and for a moment it seemed that the structure would finally collapse. But it withstood the blast, and no one was hurt in any of the attacks. After five months of fighting, the battle between government forces and pro-Moscow separatists in east[See Ukraine, A4] Prescription drug overdoses, a dangerous side effect of the nation’s embrace of narcotic painkillers, are a “substantial” burden on hospitals and the economy, according to a new study of emergency room visits. Overdoses involving prescription painkillers have become a leading cause of injury deaths in the U.S. and a closely watched barometer of an evolving healthcare crisis. Little was known, however, about the nature of overdoses treated in the nation’s emergency rooms. A new analysis of 2010 data from hospitals nationwide found that prescription painkillers, known as opioids, were involved in 68% of opioid-related overdoses treated in emergency rooms. Hospital care for those overdose victims cost an estimated $1.4 billion. The estimated 92,200 hospital visits were more than five times the number of deaths involving opioid painkillers that year. Overdoses A nationwide study of opioid overdoses in emergency rooms found that 68% of overdoses were caused by prescription drugs in 2010. Hospitalized 92,209 21,955 21,807 Source: JAMA Internal Medicine Los Angeles Times States’ jumbled Ebola strategies raising worries By Chris Megerian SACRAMENTO — Jerry Brown drew chuckles decades ago when he suggested that California launch its own communications satellite into space. He had a more down-to-earth proposal when he ran for governor in 2010. He wanted to line the state’s highways with shimmering solar panels, an environmentally friendly way to pump clean energy into the power grid. But after he took office, the state transportation agency concluded that the idea wasn’t financially feasible and it was sidelined. There were other goals that didn’t come to fruition, mostly minor items such as his intention to create an academy for training teachers to be principals. But Brown has received praise on more significant vows: to increase local control of government functions, reduce public pension costs, keep a lid on spiraling university tuition and — the central promise of his 2010 campaign — stabilize California’s finances. When he took office in January 2011, the governor faced a $26-billion deficit that was erased with a mix of budget cuts, tax hikes and luck. Brown continued reducing public healthcare and other services, as his Republican predecessor, Arnold Schwarzenegger, had done. Then he persuaded voters to pass a temporary increase in sales taxes and new levies on high earners. Those moves and the economic improvements [See Brown, A11] Released Prescription Heroin Unspecified A look at Brown’s record on campaign pledges “What this study shows us is opioid overdose deaths are just the tip of an iceberg,” said Andrew Kolodny, an addiction doctor who helped found Physicians for Responsible Opioid Prescribing. In a report published online Monday in JAMA Internal Medicine, researchers from Stanford University, the University of Pennsylvania, Brown University and Rush Medical College analyzed data from the Nationwide Emergency Department Sample and adjusted the raw figures to generate national estimates. Researchers found that fewer than 2% of the overdoses treated in emergency rooms were fatal. But in more than half the cases, victims had to be admitted to the hospital. “Further efforts to stem the prescription opioid overdose epidemic are urgently needed,” the researchers concluded. U.S. Atty. Gen. Eric H. Holder Jr. made the same point in a speech to the nation’s police chiefs Monday. He unveiled a Justice Department “tool kit” to guide law enforcement agencies responding to drug overdose calls and encouraged police departments to provide officers with naloxone, a fastacting antidote that can reverse overdoses and prevent [See Drugs, A10] By Tina Susman and Melissa Healy Robert Gauthier Los Angeles Times KOBE BRYANT , 36, whose 2013-14 season lasted only six games, is about to begin his 19th campaign with a Lakers team that again is heavily dependent on his play. It’s still the age of Bryant, but years have added up By Mike Bresnahan Jerry West, whose silhouette is featured in the NBA’s red, white and blue logo, walked away from the Lakers and a renowned basketball career because a groin injury limited his game. At the time he eloquently said, “I’m not willing to sacrifice my standards. Perhaps I expect too much.” The Hall of Famer was a month shy of his 36th birthday and was still averaging a very reasonable 20.3 points a game. Four decades later and another Lakers legend is 36. Also en route to the Hall of Fame, Kobe Bryant is continually reminded of his longevity in the game. He’s logged 54,224 minutes in the regular season and playoffs while also winning five championships over 18 years. There’s also the strain and pain of any of the 37,340 points he’s scored. He’s already shrugged off a torn Achilles’ tendon that ended his 2012-13 season. And a broken bone in his Taylor Swift connects with fans Weather Mostly sunny. L.A. Basin: 81/61. AA8 The country (now pop) star cultivates fan opinion, even inviting groups to “secret” listening sessions in her homes for her new album, “1989.” CALENDAR, D1 knee that ended his 2013-14 campaign after just six games. Bryant, with two seasons left on his contract, is showing no signs of quitting even though the Lakers appear to be going nowhere. Most believe the Lakers will miss the playoffs this season. And though Bryant is one of the oldest players in the league, the Lakers’ fortunes are heavily dependent on his play. Still, the questions that hang in the air as a new season gets underway Tuesday — when the Lakers [See Bryant, A10] NEW YORK — The federal Centers for Disease Control and Prevention issued new guidelines on dealing with travelers from Ebola-stricken regions Monday, but its lack of firm rules left a patchwork of state-bystate strategies that include mandatory quarantines for some travelers. The different rules among states, and the CDC’s recommendation of looser monitoring than what is being carried out in several states, highlight what some public health experts said was the problem with the current system. States not only have the leading role in devising poli- cies to quarantine or isolate people with infectious diseases, they also control the enforcement, said Lawrence Gostin, a public health expert at Georgetown University. “It’s a very ineffective way” to assure Americans’ safety in a public health emergency, he said. “We need to have much more uniformity in funding of local health departments. And we need to make sure procedures are standardized across states and the country. At the moment there’s just far too much variability.” The new guidelines advise states to monitor travelers based on four levels of potential Ebola exposure, from high risk to no risk. They do [See Ebola, A9] Printed with soy inks on partially recycled paper. Don Emmert AFP/Getty Images OUTREACH workers pass out Ebola information in Jeff Kravitz FilmMagic 7 85944 00150 3 New York after a 5-year-old boy in the area showed symptoms. He has tested negative, officials said.
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