Experts: Weiner's behavior similar to addicts' (AP)

GARDEN CITY, N.Y. � So what's wrong with Anthony Weiner?

The New York congressman says he is seeking professional treatment "to focus on becoming a better husband and healthier person" following a sexting scandal that threatens to drive him from office.

Weiner hasn't specified what type of care he is getting, or where. If he has opted for an inpatient treatment facility, experts say there are just a handful of places where he could be, including a Mississippi clinic where Tiger Woods reportedly sought help for his litany of marital indiscretions. Or perhaps he is getting outpatient advice on sexual addiction.

Experts witnessing the demise of the rising politician's reputation, if not his career, are among those opining from afar. Some say Weiner's actions � making electronic sexual contact with strangers � mimic the characteristics of drug addicts, alcoholics or problem gamblers.

"He's exhibiting behavior of an addict. The secrecy, the risk taking, the denial," said Robert Weiss, founder of the Sexual Recovery Institute in Los Angeles.

"I am sure he understood on some level what he was doing," Weiss said. "When someone like that is not in a state of arousal, they can have a more intellectual, nuanced view of things. But that gets lost in the euphoria. And he begins not thinking clearly."

Weiss, a nationally recognized expert who has appeared on the Oprah Winfrey and Larry King programs, said Weiner probably can't explain his actions because they are on some level inexplicable even to him.

"I have a lot of empathy for him. He really doesn't understand why," Weiss said. "He can't figure out why he made these choices."

Kimberly Young, clinical director of the Center for Online Addiction in Bradford, Pa., said that in many ways, Weiner's online behavior was "very commonplace." Plenty of men and women secretly live out their fantasies on the Internet, sometimes in compulsive fashion.

The treatment for online compulsion, she said is usually twofold. Patients have to first modify their online behavior; that might mean not using the computer during certain hours, or at certain locations, or only communicating with certain types of people online. Next, they must examine what mental health issues might be causing the behavior.

"Is he depressed, is he anxious and stressed out?" she said. "First you need to deal with the behavior, then deal with the reasons why that happened ... It will probably take more than a 28-day rehab program. ... The treatment has to fit the person."

Timothy Lee, a licensed clinical social worker who runs New York Pathways, which treats sexual addiction on an outpatient basis, said Weiner's proclivity for sending photos of himself to strangers likely has escalated over time.

"He didn't wake up and just start sending pictures," Lee said. "I assume this is some type of voyeuristic exhibitionism type behavior. But it does show how delusional one must be to engage in this behavior. To think that the person on the other end is going to get off on it?"

Behavior like Weiner has confessed to, Lee said, usually starts with an innocent joke or flirtation, perhaps with an acquaintance or co-worker, but can quickly escalate.

"The greater the risk, the more excited they get. It's sort of like the high gamblers get," Lee said. "The greater the risk in getting caught, the bigger the high. I would look at his abusing his sexuality like someone else might abuse a drug," Lee said.

Weiner's weekend announcement that he is seeking treatment was short on specifics; he did not explicitly say that he has entered a rehab facility. A statement said only that he requested "a short leave of absence from the House of Representatives so that he can get evaluated and map out a course of treatment to make himself well."

Lee said if the congressman has gone for inpatient treatment, he would likely have to be in a program for 30 days or more, although some facilities offer help in less time. He said Pine Grove Behavioral Health and Addiction Services in Hattiesburg, Miss., where Woods reportedly went, has a 45-day program. The Meadows in Wickenburg, Ariz., has about a 30-day program, The Keystone in Chester, Pa., offers a 14-day program, other experts said.

Calls or e-mails to clinic officials seeking comment were not returned; most boast of offering confidentiality to patients.

As far as Weiner's prospects after treatment?

"People love a comeback story," said Lee. "From a PR perspective, going into rehab is the best thing he can do. Obviously he is also dealing with the humiliation he has brought upon his wife. It's just a sad case."

Dr. Jeffrey T. Parsons, a sex addiction expert and psychology professor at Hunter College in New York City, noted sexual addiction is officially recognized as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders. The next edition is due out in 2013 and there has been talk about including a passage on the topic, describing it clinically as a hypersexual disorder, he said.

Taking an alternate view from some his colleagues, Parsons questions whether Weiner indeed is a sex addict in need of treatment.

"I'm not so sure. He certainly has a media relations nightmare and saying he needs treatment sounds a lot better than the alternatives," Parsons said. "It's a lot harder to bash someone who says he is seeking treatment and help."

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Associated Press writer David B. Caruso contributed to this report.

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Vermont capital residents OK wood-heating system (AP)

MONTPELIER, Vt. � Vermont's capital city is going ahead with a plan to expand state government's wood-fired heating system into city schools and government buildings.

Montpelier voters approved the plan Tuesday, saying yes to a $2.75 million bond issue to help finance a $20 million biomass project that would hook up City Hall, the police and fire stations and two schools to the wood chip-burning system that's been heating the Statehouse and other state buildings for more than 20 years.

The vote was 963 in favor, 609 against.

So-called biomass heating plants � some public, some private � already exist in St. Paul, Minn., Seattle, and Concord, N.H., while a handful of other municipalities are exploring the idea, including at least five in Vermont.

The technology has gained favor with the rise of oil prices and concerns about climate change. Supporters say burning wood, wood chips or other plant matter would reduce costs, air pollution and reliance on foreign oil.

Critics, meanwhile, note that some studies � including one last year by the Manomet Center for Conservation Sciences in Massachusetts � have found that wood-burning power plants emit more greenhouse gases than coal.

"It's one more thing that's helpful with our big problem, which is that we're running out of liquid sources of petroleum and it's controlled by people in foreign countries that don't particularly like us, and it's expensive," said William Schlesinger, president of the Cary Institute of Ecosystem Studies. "The idea of trying this, seeing if it works, recognizing that it won't be the only solution to the problem, is a great idea."

In February, the Millbrook, N.Y.,-based nonprofit issued a report concluding that forest biomass could replace up to 25 percent of the liquid fossil fuel now used for industrial and commercial heating in the Northeast.

But it warned that fuel could be a problem, with forest biomass resources limited in some regions and vulnerable to a sudden rush that would degrade forests.

In Vermont, it would seem like a natural. Long, cold winters, vast expanses of forests and a deep-seated environmental ethic were among the factors that persuaded Montpelier voters to give it a chance.

"I think it's important for the city to try to get off of using heating oil," said Shawn White, 43, who voted yes Tuesday. "I like the idea of using wood chips and saving the city money."

Most of the financing wouldn't fall only to city taxpayers. The expansion of the state's system would be paid for with an $8 million grant from the U.S. Department of Energy, $7 million from the state, $1 million from the Vermont Clean Energy Fund and money from the city bond issue approved Tuesday.

The money would go to replacing the state's World War II-era boiler plant, which was retrofitted in the 1980s to burn wood chips.

Eventually, downtown businesses could be offered the opportunity to hook up to it, according to city officials.

Still, there are concerns � about how it would work, whether it would cost taxpayers more and whether the money might be better spent on more immediate problems, like pothole pocked roads. Opponents erected lawn signs reading "Heat Bond No! Fix Our Streets," tapping into residents' fiscal worries.

"We don't have the money," said Marie Hamel, 75, who voted no. "I'm not sure Montpelier's handled the money we let them have that well. And this is for downtown. Us up in the hills, all we will have to do is pay. And pay and pay and pay."

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New rules to cut confusion on sunscreen claims (AP)

WASHINGTON � Help is on the way if you're confused by the maze of sun protection numbers and other claims on sunscreens.

Starting next summer, you can start looking for SPF 15 bottles and tubes with the label "broad spectrum" and feel confident they're lowering your risk of skin cancer.

Under new rules published Tuesday, sunscreens will have to filter out the most dangerous type of radiation to claim they protect against skin cancer and premature aging. "Broad spectrum" is the new buzzword from the Food and Drug Administration to describe a product that does an acceptable job blocking both ultraviolet B rays and ultraviolet A rays.

If a sunscreen doesn't protect against both, or the sun protection factor is below 15, then it has to carry a warning: "This product has been shown only to help prevent sunburn, not skin cancer or early skin aging."

The guidelines, which spent more than 30 years in bureaucratic limbo, are designed to help consumers like Paul Woodburn, who says he's not sure of the difference between UVA and UVB rays and that he judges sunscreen by one factor alone.

"The SPF number is what counts for me," the 55-year-old Indianapolis resident said as he sat next to a public pool. "Beyond the SPF, I don't think anybody really watches."

The new regulations require that sunscreens be tested for the ability to block the more dangerous UVA rays, which can penetrate glass and pose the greatest risk of skin cancer and wrinkles. FDA currently requires testing only for protection against UVB rays, which primarily cause sunburn but can also cause cancer and other damage. That's what the familiar SPF measure is based on.

"For the first time, the FDA has clearly defined the testing required to make a broad-spectrum protection claim in a sunscreen," said Dr. Ronald L. Moy, president of The American Academy of Dermatology Association.

Under the new rules FDA will:

� Prohibit sunscreen marketing claims like "waterproof" and "sweatproof," which the agency said "are exaggerations of performance." Water-resistance claims will be allowed, but companies must explain how much time consumers can expect to get the same benefit while swimming or sweating.

� Cap the highest SPF value at 50, unless companies can provide results of further testing that support a higher number.

� Require that manufacturers phase out a four-star system currently used by some companies to rate UVA protection.

In reviewing more than 3,000 comments submitted to the agency, the FDA decided the star system was too confusing. Instead, protection against UVA should be proportional to protection against UVB, which is already measured using SPF.

SPF measures the amount of sun exposure needed to cause sunburn on UV-protected skin versus unprotected skin. The level of exposure varies by geography, time of day and skin complexion.

There is a popular misconception that SPF relates to time of solar exposure. Many consumers believe that if they normally get sunburn in one hour, then an SPF 15 sunscreen allows them to stay in the sun for 15 hours without burning. This isn't true because SPF is not directly related to length of sun exposure.

The U.S. market for sunscreens has been growing steadily because of worries about cancer and an aging population. It now totals about $900 million annually, according to research firm IBISWorld.

The new rules were decades in the making.

FDA announced its intent to draft sunscreen rules in 1978 and published them in 1999. The agency then delayed finalizing the regulations until it could address concerns from both industry and consumers.

Some consumer advocates complained the agency's final guidelines did not go far enough.

"FDA's rule will allow most products on the U.S. market to use the label `broad spectrum sunscreen,' even though some will not offer enough protection to assure Americans they can stay in the sun without suffering skin damage from invisible UVA radiation," said David Andrews, senior scientist with the Environmental Working Group.

The FDA is still working on updated guidelines for spray-on products, which use different formulations from other sun-protection solutions.

Many companies have already adopted some of the language. For example, all Coppertone products from Merck & Co.'s Schering-Plough unit and Neutrogena Sunblock from Johnson & Johnson boast "broad spectrum UVA and UVB protection."

Most dermatologists recommend a broad spectrum, water-resistant sunscreen of SPF 30 or higher every two hours while outside.

Last year an estimated 68,130 people in the U.S. were diagnosed with melanoma � the most dangerous form of skin cancer � and an estimated 8,700 died, according to the National Cancer Institute. Nearly $2 billion is spent treating the disease each year.

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AP Business Writer Tom Murphy contributed to this report from Indianapolis.

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On the Net:

http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/ucm258468.htm

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FDA wants more sunscreen protections (AP)

WASHINGTON � Federal regulators will require sunscreen manufacturers to test their products' effectiveness against sun rays that pose the greatest risk of skin cancer. Under new rules published Tuesday, they also will have to follow stricter guidelines when describing how well their products block ultraviolet B rays.

The Food and Drug Administration announced new regulations Tuesday designed to enhance effectiveness of sunscreens and make them easier to use.

Sunscreens that don't protect against both ultraviolet A and B rays and have a sun protection factor, or SPF, below 15 will have to carry warning label: "This product has been shown only to help prevent sunburn, not skin cancer or early skin aging."

Currently, the FDA only requires testing for ultraviolet B rays that cause sunburn. That's what the familiar SPF measure is based on.

But the new regulations require testing for the more dangerous ultraviolet A rays, which can penetrate glass and are most commonly linked to wrinkles and skin cancer.

FDA will also prohibit sunscreen marketing claims like "waterproof" and "sweatproof," which the agency said "are exaggerations of performance."

Products that protect against UVA and UVB will be labeled "broad spectrum." In an effort to clear up the confusing mix of numbers, acronyms and symbols on sunscreen labels, the FDA says manufacturers must phase out a four-star system currently used by some companies to rate UVA protection.

The FDA rules will also standardize the older SPF protection rankings for UVB rays. Only sunscreens with an SPF of 15 or higher can claim to lower the risk of cancer. The FDA also proposed capping the highest SPF value at 50, unless companies can provide results of further testing that support a higher number. Some products on the market claim to offer SPF protection of a 100 or higher.

The SPF figure indicates the amount of sun exposure needed to cause sunburn on sunscreen-protected skin compared with unprotected skin. For example, an SPF rating of 30 means it would take the person 30 times longer to burn wearing sunscreen than with exposed skin.

FDA announced its intent to draft sunscreen rules in 1978 and published them in 1999. The agency then put the plan on indefinite hold until it could address issues concerning both UVA and UVB protection.

The delay in FDA regulations means many companies have already adopted the some of the language. For example, all Coppertone products from Merck & Co.'s Schering-Plough unit and Neutrogena Sunblock from Johnson & Johnson already boast "broad spectrum UVA and UVB protection."

Most dermatologists recommend a broad spectrum, water-resistant sunscreen of SPF 30 or higher every two hours while outside.

Last year an estimated 68,130 people in the U.S. were diagnosed with melanoma � the most dangerous form of skin cancer � and an estimated 8,700 died, according to the National Cancer Institute. Nearly $2 billion is spent treating the disease each year.

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Author Terry Pratchett defends right-to-die film (AP)

LONDON � Writer Terry Pratchett said Tuesday that watching a man being helped to die had reaffirmed his support for assisted suicide, while anti-euthanasia groups criticized the televised death as propaganda.

The suicide, filmed for a BBC documentary, has reopened debate on Britain's decades-old law against helping another person end their life.

Pratchett watched Peter Smedley, a 71-year-old British businessman with motor neuron disease, take a lethal dose of barbiturates at a Swiss suicide clinic.

Best-selling fantasy author Pratchett was diagnosed with early onset Alzheimer's disease in 2007 and is a vocal supporter of the right to die.

He said he was moved by Smedley's death at a clinic run by the Dignitas group, broadcast Monday on BBC television.

"He said to me 'Have a good life.' And then he shook (my PA) Rob's hand and said 'Have a good life, I know I have,'" 63-year-old Pratchett told the broadcaster.

"The incongruity of the situation overtakes you. A man has died, that's a bad thing, but he wanted to die, that's a good thing."

Pratchett said he was ashamed that British people had "to drag themselves to Switzerland, at considerable cost, in order to get the services that they were hoping for."

Anti-euthanasia campaigners criticized the decision to show Smedley's death. The former Bishop of Rochester, Michael Nazir-Ali, called the program "propaganda on one side."

"I think an opportunity had been bypassed of having a balanced program � the thousands of people who use the hospice movement and who have a good and peaceful death, there was very little about them," Nazir-Ali told BBC radio.

The BBC denied bias, saying it was "giving people the chance to make their own minds up on the issue."

Assisted suicide is illegal and carries a maximum 14-year sentence in England and Wales, but few people have been prosecuted in recent years for helping friends or relatives die abroad.

After a series of legal test cases, the chief prosecutor last year drew up guidelines to clarify when criminal charges would be more or less likely.

Mitigating factors include a motive of compassion, evidence the victim had made a voluntary and informed decision to end their lives and evidence a suspect tried to talk the victim out of suicide.

In Switzerland, "passive assisted suicide" � giving another person the means to kill themselves � is legal provided the helper isn't a medical doctor and doesn't personally benefit from a patient's death.

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John Heilprin in Geneva contributed to this report.

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Doc's arthritis struggle shows illness' severity (AP)

WASHINGTON � Dr. Sue Zieman can almost set her watch by her disease: Twice a day, she gets a fever and the already arthritic joints in her arms and hands, legs and feet abruptly, painfully swell even more. During the evening flare, even the tendons in her feet puff up, rope-like worms just under her skin.

The rest of the day, her joints are so stiff that the once robust Maryland physician frequently uses a scooter to get around. Just shaking hands hurts the 47-year-old.

Inflammatory arthritis is disabling Zieman but exactly what kind and what caused it to attack suddenly is a mystery. Nor do her fellow doctors know what treatment to suggest next. She's tried all of today's arthritis medications with little relief.

Say arthritis, and people tend to shrug it off as a rite of passage of aging. The reality is much more complicated. Arthritis encompasses 100 different conditions and affects about 46 million people in the U.S.

Osteoarthritis � where cartilage gradually erodes with the wear-and-tear of aging � is by far the most common type.

But inflammatory types � such as rheumatoid arthritis, psoriatic arthritis, lupus � occur when something makes the immune system run amok and attack the body's own tissues, eating away cartilage and eventually harming bone. It can strike at far younger ages.

Zieman's saga highlights not just how much doctors still have to learn about arthritis, but how devastating a severe case can be.

"It totally stripped my identity," says Zieman, whose illness cost her career as a cardiologist and her love of sailing. "I just don't think people realize how debilitated you can be, and young."

She uses humor to help cope, nicknaming her scooter Bella and joking that "I know I'm going to turn into a pumpkin each night" when that 7 p.m. flare sends her to bed.

Infections sometimes trigger inflammatory arthritis, and that's what probably happened with Zieman. She'd just returned from a business trip to India in December 2008 when she came down with a fever, fatigue and pain in her shoulder and knee. Antibiotics didn't help.

A month later, Zieman became short of breath and both legs swelled. An emergency hospital admission prompted a battery of tests for infections, even super-rare ones she might have encountered abroad. Again, nothing. Maybe it was cancer? Nope.

Then the joints in her wrists and hands began swelling. Soon she couldn't lift a glass. Swelling and pain moved to her ankles and toes.

Her joints had the classic look of rheumatoid arthritis, a disease that affects 1.3 million Americans and that can begin with a low fever and fatigue.

But it wasn't a slam-dunk diagnosis. Blood tests check for specific markers of the disease, such as a substance called rheumatoid factor, and Zieman's results were negative, something that occurs occasionally.

More important, a variety of drugs hit the market in the last 15 years that can rein in the disease and target some of the immune cells doing the damage.

But drug after drug failed, and the illness was spreading to her elbows, knees, hips, even her jaw.

Within a few months, she was on leave from her cardiology job. She couldn't walk up the stairs at home and moved to a one-floor apartment that's walking � or scootering � distance from her new job in aging research at the disability-friendly National Institutes of Health.

She even had episodes of an irregular heartbeat, as inflammation struck part of the heart.

Then six months ago, she started having those bizarre twice-a-day flare-ups. When she joined some friends for a vacation in France recently, the flares just switched time zones.

That's not typical rheumatoid arthritis, leaving in question Zieman's diagnosis and what to do next.

While Zieman's case is extreme, it's not unusual for inflammatory arthritis to become debilitating so quickly, especially in young or middle-aged women, says Dr. Assil Saleh, a Washington rheumatologist and internist who, along with doctors at Johns Hopkins University and the NIH, treats Zieman.

When an infection is the suspected trigger, patients desperately want to know which bug even though it's usually long gone by the time joints swell, leaving rogue immune cells in its wake.

"Now we're left with a forest fire, and we try to extinguish it," Saleh explains. Most cases of inflammatory arthritis "are not curable but they are treatable in this day and age."

Zieman gets modest relief from very high doses of the steroid prednisone, along with injections of the drug Kineret that targets an inflammation-causing protein named interleukin-1.

She's still hopeful scientists will point her to better treatment as she enters an NIH study. Researchers will videotape her evening flare-ups and try to measure what role that interleukin-1 is playing.

And while she wants to know what's fueling her disease � "I'm as geeky as most cardiologists" � her bigger frustration is how few services help arthritis patients with daily functioning: "I need to know how to open the fridge."

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EDITOR'S NOTE � Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

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