Mind-altering ketamine becomes latest pain treatment, despite little research or regulation



Dr. Padma Gulur, a Duke University pain specialist, stands for a portrait on Friday, Oct. 27, 2023, in Durham, N.C. Prescriptions for ketamine have soared in recent years as doctors adopt the mind-altering drug as an alternative pain treatment. Gulur and other specialists see potential for ketamine as a pain therapy, but warn it also carries risks of safety and abuse.

Saline fluid runs through a tube demonstrating how ketamine would be administered to a patient at the Duke Speciality Infusion Center on Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse. 

A lockbox is held to show where ketamine is placed into while administered at the Duke Speciality Infusion Center, Friday, Oct. 27, 2023, in Durham, N.C. Ketamine prescriptions have soared in recent years as an alternative to opioids for pain. But with little research on its effectiveness, some experts worry about the risks of overprescribing another powerful drug that carries risks of safety and abuse.

 (AP Photo/Matt Kelley)

BY MATTHEW PERRONE
 November 6, 2023

WASHINGTON (AP) — As U.S. doctors scale back their use of opioid painkillers, a new option for hard-to-treat pain is taking root: ketamine, the decades-old surgical drug that is now a trendy psychedelic therapy.

Prescriptions for ketamine have soared in recent years, driven by for-profit clinics and telehealth services offering the medication as a treatment for pain, depression, anxiety and other conditions. The generic drug can be purchased cheaply and prescribed by most physicians and some nurses, regardless of their training.

With limited research on its effectiveness against pain, some experts worry the U.S. may be repeating mistakes that gave rise to the opioid crisis: overprescribing a questionable drug that carries significant safety and abuse risks.

“There’s a paucity of options for pain and so there’s a tendency to just grab the next thing that can make a difference,” said Dr. Padma Gulur, a Duke University pain specialist who is studying ketamine’s use. “A medical journal will publish a few papers saying, ‘Oh, look, this is doing good things,’ and then there’s rampant off-label use, without necessarily the science behind it.”

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When Gulur and her colleagues tracked 300 patients receiving ketamine at Duke, more than a third of them reported significant side effects that required professional attention, such as hallucinations, troubling thoughts and visual disturbances.

Ketamine also didn’t result in lower rates of opioid prescribing in the months following treatment, a common goal of therapy, according to Gulur. Her research is under review for medical journal publication.


PSYCHEDELIC EXPERIENCE

Ketamine was approved more than 50 years ago as a powerful anesthetic for patients undergoing surgery. At lower doses, it can produce psychedelic, out-of-body experiences, which made it a popular club drug in the 1990s. With its recent adoption for pain, patients are increasingly encountering those same effects.

Medical equipment used to customize ketamine infusions for patients is seen at the Duke Specialty Infusion Center, Friday, Oct. 27, 2023, in Durham, N.C.

 (AP Photo/Matt Kelley)

Daniel Bass, of Southgate, Kentucky, found the visual disturbances “horrifying.” His doctors prescribed four- to six-hour IV infusions of ketamine for pain related to a rare bone and joint disorder. Seated in a bare hospital room with no stimulation or guidance on the drug’s psychological effects, Bass says he felt “like a lab rat.”

Still, he credits ketamine with reducing his pain during the year that he received twice-a-month infusions.

“No matter how horrific an experience is, if it allows me to be more functional, I will do it,” Bass said.

Ketamine targets a brain chemical messenger called glutamate, which is thought to play a role in both pain and depression. It’s unclear whether the psychedelic experience is part of the drug’s therapeutic effect, though some practitioners consider it essential.

“We want patients to disassociate or feel separate from their pain, depression or anxiety,” said Dr. David Mahjoubi, owner of Ketamine Healing Clinic in Los Angeles. “If they feel like they’re just sitting in the chair the whole time, we actually give them more.”

The Duke Specialty Infusion Center is seen prior to opening for patients, Friday, Oct. 27, 2023, in Durham, N.C. (AP Photo/Matt Kelley)

Mahjoubi’s practice is typical of the burgeoning industry: He offers IV ketamine for alcohol addiction, chronic pain, anxiety and post-traumatic stress disorder. The ketamine doses for those indications are well below those used for surgery, but Mahjoubi favors higher doses for pain than for psychiatric conditions.

Patients pay cash because most insurers don’t cover non-surgical uses of ketamine, none of which are approved by the Food and Drug Administration. Mahjoubi’s background is in anesthesiology, not psychiatry or addiction.

Patients can pay extra for ketamine nasal sprays and tablets to use between infusions. Those formulations are also not FDA approved and are compounded by specialty pharmacies.

Sending ketamine through the mail has become its own profitable business for telehealth services, such as MindBloom, which jumped into the space after regulators relaxed online prescribing rules during COVID-19.

Pain specialists who study ketamine say there’s little evidence for those versions.

“The literature for the nasal and oral formulations is pretty scant,” said Dr. Eric Schwenk of Thomas Jefferson University. “There’s just not a lot of good evidence to guide you.”

Demand for ketamine has sent prescriptions soaring more than 500% since 2017, according to Epic Research, which analyzed the trend using a database of more than 125 million patients. In each year, pain was the No. 1 condition for which ketamine was prescribed, though depression has been rising quickly.

The prescribing boom has led to shortages of manufactured ketamine, driving up sales of compounded versions.

There is more evidence for ketamine’s use against depression than for pain. In 2019, the FDA approved a ketamine-related chemical developed by Johnson & Johnson for severe depression. The drug, Spravato, is subject to strict FDA safety rules on where and how it can be administered by doctors.

Guidelines from pain societies note some evidence for ketamine’s use in complex regional pain, a chronic condition that usually affects the limbs. But the experts found “weak or no evidence” for ketamine in many more conditions, including back pain, migraines, fibromyalgia and cancer pain.

THE ‘WILD WEST’ OF KETAMINE PRESCRIBING

While the science behind ketamine is murky, the business model is clear: Physicians can purchase ketamine for less than $100 a vial and charge $500 to $1,500 per infusion.

The Duke Specialty Infusion Center is seen prior to opening for patients on Friday, Oct. 27, 2023, in Durham, N.C. (AP Photo/Matt Kelley)

The recent boom has been fueled, in part, by venture capital investors. Another set of consulting businesses offer to help doctors set up new clinics.

A blog post from one, Ketamine Startup, lists “Five reasons you should open a ketamine clinic,” including: “You want to be your own boss” and “You want to take control of your money-making ability.”

The clinics are facing increasing competition from telehealth services like MindBloom and Joyous, which connect potential patients with physicians who can prescribe ketamine remotely and send it through the mail.

In May, federal regulators were scheduled to roll back the COVID-era policy that allowed online prescribing of high-risk drugs like ketamine and opioids. But the Drug Enforcement Administration, facing backlash for telehealth companies and physicians, agreed to extend the flexible approach through 2024.

The current landscape is a “wild west,” said Dr. Samuel Wilkinson, a Yale University psychiatrist who prescribes both Spravato and ketamine for depression. U.S. physicians have “quite a bit of latitude” to prescribe drugs for unapproved, or off-label, uses.

“There’s good things about that and not-so-good things about that,” he said.

When used at high doses, ketamine can cause bladder damage, sometimes seen in people who use the drug recreationally. Far less is known about the neurological effects of long-term use. Ketamine was linked to brain abnormalities in rat studies, FDA regulators note.

Last month, the FDA warned doctors and patients against compounded versions of ketamine, including lozenges and pills, saying the agency does not regulate their contents and cannot assure their safety. The warning followed a similar advisory last year about nasal spray versions of ketamine.

But most compounding pharmacies are small operations, overseen by state officials, not the FDA.

In April, Massachusetts’ board of pharmacy flagged the FDA’s warning to local pharmacies, but noted that state officials wouldn’t take any steps to stop “the continued compounding and dispensing of ketamine nasal spray.”

The FDA likewise has little leverage over physicians promoting ketamine, even those making exaggerated or misleading claims.

Drugmakers are subject to strict FDA regulation in how they promote their medicines — with requirements to balance risk and benefit information. Those rules don’t apply to physicians.

Even when the FDA has tried to regulate risky in-office procedures, such as unproven stem cell infusions, the agency has had a mixed track record of prevailing in court.

For now, experts say it’s unlikely regulators will go beyond their recent warnings about off-label ketamine.

“There’s an element of whack-a-mole and it’s essentially beyond their regulatory purview,” said Dr. Caleb Alexander, a drug safety researcher at Johns Hopkins University. “These clinics would represent yet another front that they would be hard pressed to manage and address.”
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Follow Matthew Perrone on Twitter: @AP_FDAwriter
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.


by Taboola Suggested For You

BEWARE CROUCHY PREDATORS

Cheetahs become more nocturnal on hot days. Climate change may trigger fights among predators


In this photo provided by Briana Abrahms, a female cheetah and her cub sit watchfully in front of a herd of zebra in northern Botswana on Aug. 23, 2011. The female wears a GPS collar as part of a study. Cheetahs are usually daytime hunters, but the speedy big cats will shift their activity toward dawn and dusk hours during warmer weather, according to a study published Wednesday, Nov. 8, 2023, in the journal Proceedings of the Royal Society B. Unfortunately for endangered cheetahs, that sets them up for more potential conflicts with mostly nocturnal competing predators like lions and leopards, say the authors of the paper.

 (Briana Abrahms via AP)

In this photo provided by Briana Abrahms, a male cheetah, named Qamar, has a fully belly after making a kill in northern Botswana on July 17, 2015. He wears a GPS collar as part of a study. Cheetahs are usually daytime hunters, but the speedy big cats will shift their activity toward dawn and dusk hours during warmer weather, according to a study published Wednesday, Nov. 8, 2023, in the journal Proceedings of the Royal Society B. Unfortunately for endangered cheetahs, that sets them up for more potential conflicts with mostly nocturnal competing predators like lions and leopards, say the authors of the paper. (Briana Abrahms via AP)

BY CHRISTINA LARSON
 November 8, 2023Share

Cheetahs are usually daytime hunters, but the speedy big cats will shift their activity toward dawn and dusk hours during warmer weather, a new study finds.

Unfortunately for endangered cheetahs, that sets them up for more potential conflicts with mostly nocturnal competing predators such as lions and leopards, say the authors of research published Wednesday in the journal Proceedings of the Royal Society B.

“Changing temperatures can impact the behavior patterns of large carnivore species and also the dynamics among species,” said University of Washington biologist Briana Abrahms, a study co-author.

While cheetahs only eat fresh meat, lions and leopards will sometimes opportunistically scavenge from smaller predators.

“Lions and leopards normally kill prey themselves, but if they come across a cheetah’s kill, they will try to take it,” said Bettina Wachter, a behavioral biologist who leads the Cheetah Research Project at the Leibniz Institute for Zoo and Wildlife Research.

“The cheetahs will not fight the larger cats, they will just leave,” said Wachter, who is based in Namibia and was not involved in the study.

Hunting at different times of the day is one long-evolved strategy to reduce encounters between the multiple predator species that share northern Botswana’s mixed savannah and forest landscape.

But the new study found that on the hottest days, when maximum daily temperatures soared to nearly 45 degrees Celsius (113 degrees Fahrenheit), cheetahs became more nocturnal — increasing their overlapping hunting hours with rival big cats by 16%.

“There’s a greater chance for more unfriendly encounters and less food for the cheetahs,” said co-author Kasim Rafiq, a biologist at the University of Washington and the nonprofit Botswana Predator Conservation Trust.

For the current study, researchers placed GPS tracking collars on 53 large carnivores — including cheetahs, lions, leopards and African wild dogs — and recorded their locations and hours of activity over eight years. They compared this data with maximum daily temperature records.

While seasonal cycles explain most temperature fluctuations in the study window of 2011 to 2018, the scientists say the observed behavior changes offer a peek into the future of a warming world.

In the next phase of research, the scientists plan to use audio-recording devices and accelerometers — “like a Fitbit for big cats,” said Rafiq — to document the frequency of encounters between large carnivores.

In addition to competition with lions and leopards, cheetahs already face severe pressure from habitat fragmentation and conflict with humans.

The fastest land animal, cheetahs are the rarest big cat in Africa, with fewer than 7,000 left in the wild.

“These climate changes could become really critical if we look into the future — it’s predicted to become much warmer in this part of Africa where cheetahs live, in Botswana, Namibia and Zambia,” said Wachter of the Cheetah Research Project.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Mount St. Helens records more than 400 earthquakes since mid-July, but no signs of imminent eruption


Mount St. Helens is seen from the Hummocks Trail, on May 18, 2020, in Washington state. More than 400 earthquakes have been detected beneath Washington’s Mount St. Helens in recent months though there are no signs of an imminent eruption, according to the U.S. Geological Survey. Most of the quakes over a three-month span beginning in mid-July 2023 were less than magnitude 1.0 and too small to be felt at the surface, the agency reported last week. 

(AP Photo/Ted S. Warren, File)

November 8, 2023

VANCOUVER, Wash. (AP) — More than 400 earthquakes have been detected beneath Washington’s Mount St. Helens in recent months, though there are no signs of an imminent eruption, according to the U.S. Geological Survey.

Most of the quakes over a three-month span beginning in mid-July were less than magnitude 1.0 and too small to be felt at the surface, the agency reported last week. Small magnitude earthquakes detected with sensitive equipment signal a volcano is “recharging” as magma flows through chambers and cracks deep underground, Wes Thelen, a volcano seismologist with the agency’s Cascade Volcano Observatory told The Columbian newspaper.

From late August to early September, scientists observed about 40 to 50 earthquakes a week, a number that has fallen to around 30 a week. Since 2008, the volcano has averaged about 11 earthquakes per month.

While swarms of earthquakes occurred in the late 1980s and early 1990s, none directly led to volcanic eruptions.

In 1980, 57 people died when Mount St. Helens erupted, an event that permanently altered the area’s ecosystems. Before that event, only one seismometer was stationed at the volcano, the agency said. Currently, there are at least 20 monitoring stations.

The most recent eruption took place from 2004 to 2008, and allowed scientists to learn more about how the volcano works and to develop new monitoring tools.

UN nuclear chief says nuclear energy must be part of the equation to tackle climate change

BY EDITH M. LEDERER
November 8, 2023Share

UNITED NATIONS (AP) — Nuclear energy must be part of the equation to tackle climate change, the U.N. nuclear chief said Wednesday.

Climate-warming hydrocarbons still supply more than 80% of the world’s energy, even after the trillions of dollars spent in the green transition of the past 20 years, Rafael Grossi, director general of the International Atomic Energy Agency told the U.N. General Assembly.

Over a quarter of the electricity from nuclear power is low-carbon electricity and global carbon dioxide emissions would be considerably higher without nuclear power, Grossi said.

Carbon dioxide is released when fossil fuels such as oil, coal or natural gas are burned for power. In the atmosphere, the gas traps heat and contributes to the warming of the climate.

More than 400 nuclear reactors in over 30 countries are supplying global electricity, and Grossi said more than 50 are under construction and many countries are extending their existing nuclear programs.

But “nuclear power’s share of global electricity production decreased by about half” in the past two decades, he said.

Grossi said interest in nuclear energy is growing because it can not only de-carbonize electricity grids but can also de-carbonize other sectors including to produce sustainable heat for homes and industry as well as drinking water from desalination operations.

And in Africa, where electricity capacity is set to grow fivefold by 2050, and in Latin America, where it is forecast to double, countries are also looking at nuclear power, the IAEA chief said.

“Of the 30 or so countries that are currently either considering or embarking on the introduction of nuclear power, more than half are in the developing world, and most of these are in Africa,” Grossi said.

According to the International Energy Agency, more climate-warming carbon dioxide gas was emitted in 2022 than in any other year in records dating to 1900, a result of air travel rebounding after the COVID-19 pandemic and more cities turning to coal as a low-cost source of power.

Carbon dioxide emissions from energy production grew 0.9% to reach 36.8 gigatons in 2022, the agency reported in March.

Grossi said the growing worldwide interest in nuclear energy has led the IAEA to increase its high nuclear energy projection to 873 gigawatts in 2050.

But he cautioned that “to achieve such growth will require a better investment playing field, one that takes into consideration the full benefits of nuclear.”

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Turkish high court upholds disputed disinformation law. The opposition wanted it annuled

 November 8, 2023

ANKARA, Turkey (AP) — Turkey’s highest court on Wednesday upheld a controversial media law that mandates prison terms for people deemed to be spreading “disinformation,” rejecting the main opposition party’s request for its annulment.

The legislation calls for up to three years in prison for journalists or social media users convicted of spreading information deemed to be “contrary to the truth” concerning domestic and international security, public order or health.

It was approved in parliament a year ago with the votes of legislators from President Recep Tayyip Erdogan’s ruling party and its nationalist allies, heightening concerns over media freedoms and free speech in the country.

The main opposition party had petitioned the Constitutional Court seeking its annulment, arguing that the law would be used to further silence government critics by cracking down on social media and independent reporting.

The court’s justices, however, rejected the request by a majority vote during a meeting on Wednesday, the state-run Anadolu Agency reported. It didn’t elaborate on the ruling.

Around 30 people have been prosecuted under the law since it came into effect last year, the Cumhuriyet newspaper reported.

Last week, authorities arrested investigative journalist Tolga Sardan under the law, accusing him of engaging in disinformation over his report about allegations of corruption within the judiciary.

The journalist, who works for online news website T24, was released days later pending the outcome of a trial, on condition that he reports regularly to authorities. He was also barred from traveling abroad.

Erdogan had long argued for a law to combat disinformation and fake news, saying false news and rising “digital fascism” pose national and global security threats.

Freedom of expression and media freedoms have declined dramatically in Turkey over the years. Reporters Without Borders ranks Turkey 165 out of 180 countries in press freedoms. Currently, 19 journalists or media sector workers are behind bars, according to the Journalists’ Union of Turkey.

Vatican says it’s permissible for transgender Catholics to be baptized

Pope Francis arrives for his weekly general audience in St. Peter’s Square, at the Vatican, Wednesday, Nov. 8, 2023.

 (AP Photo/Alessandra Tarantino)

 Cardinal Víctor Manuel Fernández, Prefect of the Dicastery for the Doctrine of the Faith, poses for a photo, Sept. 30, 2023, in St. Peter’s Square at the Vatican. In the United States, the national conference of Catholic bishops rejects the concept of gender transition. On Wednesday, Nov. 8, the Vatican made public a sharply contrasting statement, saying it’s permissible, under certain circumstances, for trans Catholics to be baptized and serve as godparents. The document was signed Oct. 21 by Pope Francis and Fernández.

 (AP Photo/Riccardo De Luca, File)

 A view of St. Peter’s Basilica at the Vatican, March 11, 2020. In the United States, the national conference of Catholic bishops rejects the concept of gender transition, leaving many transgender Catholics feeling excluded. On Wednesday, Nov. 8, 2023, the Vatican made public a sharply contrasting statement, saying it’s permissible, under certain circumstances, for trans Catholics to be baptized and serve as godparents.

 (AP Photo/Andrew Medichini, File)

BY DAVID CRARY
Updated 5:15 PM MST, November 8, 2023Share


In the United States, the national conference of Catholic bishops rejects the concept of gender transition, leaving many transgender Catholics feeling excluded. On Wednesday, the Vatican made public a sharply contrasting statement, saying it’s permissible, under certain circumstances, for trans Catholics to be baptized and serve as godparents.

“It is a major step for trans inclusion … it is big and good news,” said Francis DeBernardo, executive director of Maryland-based New Ways Ministry, which advocates for greater LGBTQ acceptance in the church.

The document was signed Oct. 21 by Pope Francis and Cardinal Víctor Manuel Fernández, who heads the Vatican’s Dicastery for the Doctrine of the Faith. It was posted Wednesday on that office’s website.

If it did not cause scandal or “disorientation” among other Catholics, a transgender person “may receive baptism under the same conditions as other faithful,” the document said.

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Similarly, the document said trans adults — even if they had undergone gender-transition surgery — could serve as godfathers or godmothers under certain conditions.

DeBernardo said this seemed to be a reversal of a 2015 Vatican decision to bar a trans man in Spain from becoming a godparent.

During his papacy, Pope Francis has frequently expressed an interest in making the Catholic Church more welcoming to LGBTQ people, even though doctrines rejecting same-sex marriage and sexual activity remain firmly in place.

A small but growing number of U.S. parishes have formed LGBTQ support groups and welcome transgender people on their own terms. Yet several Catholic dioceses have issued guidelines targeting trans people with restrictions and refusing to recognize their gender identity.

The Rev. James Martin, a Jesuit priest who has advocated for years for greater LGBTQ inclusion in the church, welcomed the new document.

“In many dioceses and parishes, including in the US, transgender Catholics have been severely restricted from participating in the life of the church, not because of any canon law, but stemming from the decisions of bishops, priests and pastoral associates,” he said via email.

“So the Vatican’s statement is a clear recognition not only of their personhood, but of their place in their own church,” he said. “I hope that it helps the Catholic church treat them less as problems and more as people.”

According to the Vatican, the document was a response to a letter submitted in July by a Brazilian bishop asking about LGBTQ people’s possible participation in baptisms and weddings.

DeBernardo said the document “proves that the Catholic Church can — and does — change its mind about certain practices and policies,” and he suggested that some diocesan anti-trans policies might now have to be rescinded. But he expressed disappointment that the document maintained a ban on same-sex couples serving as godparents.
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Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

Hungary has fired the national museum director over LGBTQ+ content in World Press Photo exhibition

This photo provided by The New York Times shows Al Enriquez, a member of the Golden Gays, is seen in the Home for the Golden Gays, an organisation of elderly gay men in the Philippines who have banded together for social support. On display at the World Press Photo exhibition in Budapest, Hungary in September 2023, this was one of the photos which the government determined was a violation of the law restricting children’s access to content that depicts homosexuality or gender change. On Monday, Nov. 6, 2023, Hungary’s cultural minister fired Laszlo L. Simon, the director of the Hungarian National Museum, accusing him of failing to comply with a contentious law that bans the display of LGBTQ+ content to minors. (Hannah Reyes Morales for The New York Times via AP)Read 

In this photo provided by The New York Times, Al Enriquez, left, a member of the Golden Gays, is seen in the Home for the Golden Gays, an organisation of elderly gay men in the Philippines who have banded together for social support. On display at the World Press Photo exhibition in Budapest, Hungary in September 2023, this was one of the photos which the government determined was a violation of the law restricting children’s access to content that depicts homosexuality or gender change. On Monday, Nov. 6, 2023, Hungary’s cultural minister fired Laszlo L. Simon, the director of the Hungarian National Museum, accusing him of failing to comply with a contentious law that bans the display of LGBTQ+ content to minors. (Hannah Reyes Morales for The New York Times via AP)

In this photo provided by The New York Times, members of the Golden Gays prepare for a show in Manila, Philippines. Home for the Golden Gays, an organisation of elderly gay men in the Philippines who have banded together for social support. On display at the World Press Photo exhibition in Budapest, Hungary in September 2023, this was one of the photos which the government determined was a violation of the law restricting children’s access to content that depicts homosexuality or gender change. On Monday, Nov. 6, 2023, Hungary’s cultural minister fired Laszlo L. Simon, the director of the Hungarian National Museum, accusing him of failing to comply with a contentious law that bans the display of LGBTQ+ content to minors. (Hannah Reyes Morales for The New York Times via AP)

Associated Press photographer Evgeniy Maloletka’s image entitled “Mariupol Maternity Hospital Airstrike”, which was awarded the World Press Photo of the Year by the jury, on display at the opening of the World Press Photo 2023 exhibition at the Hungarian National Museum, in Budapest, Hungary, Thursday, Sept. 21, 2023. Minors under 18 have been barred from visiting this year’s World Press Photo exhibition in Hungary after the government determined that some of its photos violate a contentious law restricting LGBTQ+ content. (Szigetvary Zsolt/MTI via AP)

Jonathan Fointaine’s “The Nomad’s Final Journey”, which was awarded with an honorable mention by the World Press Photo jury, is on display at the opening of the World Press Photo 2023 exhibition at the Hungarian National Museum, in Budapest, Hungary, Thursday, Sept. 21, 2023. Minors under 18 have been barred from visiting this year’s World Press Photo exhibition in Hungary after the government determined that some of its photos violate a contentious law restricting LGBTQ+ content.

 (Szigetvary Zsolt/MTI via AP)




BY JUSTIN SPIKE
November 7, 2023

BUDAPEST, Hungary (AP) — Hungary’s cultural minister on Monday fired the director of the Hungarian National Museum in Budapest, accusing him of failing to comply with a contentious law that bans the display of LGBTQ+ content to minors.

The dismissal of Laszlo L. Simon, who became director of the museum for a five-year term in 2021, came after Hungary’s government determined in late October that five photos on display at the prestigious World Press Photo exhibition violated the law restricting children’s access to content that depicts homosexuality or gender change.

The museum subsequently put a notice on its website and at the entrance to the World Press Photo exhibition — which showcases outstanding photojournalism — that the collection was restricted to visitors over 18.

Writing on his Facebook page on Monday, Simon — a member of Hungary’s ruling Fidesz party and a former secretary of state with the cultural ministry — said that neither he nor the museum had deliberately violated Hungary’s 2021 “child protection” law.

OTHER NEWS

Hungary bans teenagers from visiting World Press Photo exhibition over display of LGBTQ+ images

“I take note of the decision, but I cannot accept it,” Simon wrote. “As a father of four and a grandparent, I firmly reject the idea that our children should be protected from me or from the institution I run.”

The photographs in question document a community of elderly LGBTQ+ people in the Philippines who have shared a home for decades and cared for each other as they age. The photos show some community members dressed in drag and wearing makeup.

Hungary’s government, led by nationalist Prime Minister Viktor Orbán, has restricted the availability of materials that “promote” or depict homosexuality to minors in media, including television, films, advertisements and literature.

While the government insists that the law is designed to insulate children from what it calls sexual propaganda, it has prompted legal action from 15 countries in the European Union, with the bloc’s Commission President Ursula von der Leyen calling it “a disgrace.”

In a statement, the cultural ministry wrote that Simon had been dismissed over failing to comply with the law, and “by engaging in conduct which made it impossible for him to continue his employment.”

Hungary’s cultural ministry did not respond to a request for comment.

JUSTIN SPIKE
Spike is an Associated Press reporter based in Budapest, Hungary.

Minnesota city is believed to be the first in the US to elect a Somali American as mayor


St. Louis Park Mayor-elect Nadia Mohamed speaks to supporters after winning her election Tuesday, Nov. 7, 2023, at the Westwood Hills Nature Center in St. Louis Park, Minn. 

(Aaron Lavinsky/Star Tribune via AP)

St. Louis Park City Council Member Nadia Mohamed, who is a candidate for mayor, votes on Election Day at Wat Promwachirayan in St. Louis Park, Minn. on Tuesday, Nov. 7, 2023.

 (Leila Navidi/Star Tribune via AP)

St. Louis Park Mayor-elect Nadia Mohamed is embraced by a supporter after winning her election Tuesday, Nov. 7, 2023, at the Westwood Hills Nature Center in St. Louis Park, Minn.

 (Aaron Lavinsky/Star Tribune via AP)

 November 8, 2023

ST. LOUIS PARK, Minn. (AP) — A suburban Minnesota city became what is believed to be the first in the U.S. to elect a Somali American mayor when 27-year-old Nadia Mohamed was chosen to lead St. Louis Park.

“This is a milestone. This is not the destination,” Mohamed told supporters after the results came in Tuesday. “As mayor, I want to ensure people see themselves reflected in our policies.”

Mohamed won with 58% of the vote, defeating retired banker Dale A. Anderson, who got 41% of the vote. She had served on the City Council since she was elected at age 23 in 2019.

Deqa Dhalac of South Portland, Maine, was the first Somali American to serve as mayor of an American city, but she was selected by that city’s six-member council in 2021, not elected by the voters.


Minnesota agency had data on iron foundry’s pollution violations but failed to act, report says

Mohamed campaigned in support of investing in community policing and programs to make homeownership more affordable, the Minneapolis Star Tribune reported. Mayor Jake Spano did not seek reelection, and he endorsed Mohamed

Mohamed spoke Tuesday night about her mother’s journey to settle in St. Louis Park, giving her the confidence to enter politics at a young age.

“I have watched a courageous woman handle her business every day,” Mohamed said. “That courage comes easy to me now.”

Liberal and moderate candidates take control of school boards in contentious races across US


This photo provided by Mary Jo Carlson shows balloons attached to yard signs of four school board candidates who defeated Moms for Liberty-backed candidates in the Linn-Mar Community School District, located outside of Cedar Rapids, Iowa, Wednesday, Nov. 8, 2023. Voters across the U.S. largely rebuked conservative candidates on Tuesday, Nov. 7, in school board races across the country.

 (Mary Jo Carlson via AP)

Democrat Susan Gibson, middle, hugs supporters after an announcement that she and fellow Democrats swept the Central Bucks, Pa., school board races on Wednesday, Nov. 8, 2023.

(Jason Nark/The Philadelphia Inquirer via AP)

BY BROOKE SCHULTZ AND GEOFF MULVIHILL
November 8, 2023

HARRISBURG, Pa. (AP) — Voters across the U.S. largely rebuked conservative candidates in local school board elections who want to ban books and restrict classroom conversations on race and gender.

In recent years, down-ballot elections have become proxy votes for polarizing national issues. Liberal and moderate candidates took control in high-profile races Tuesday in conservative Iowa, and the swing states of Pennsylvania and Virginia.

The American Federation of Teachers said that candidates publicly endorsed by conservative groups such as Moms For Liberty and the 1776 Project lost about 80% of their races nationally in elections this week.


“They don’t want to engage in this banning of books or censoring of honest history or undermining who kids are,” Randi Weingarten, the teachers union president told The Associated Press on Wednesday, characterizing the candidates who won as “pro-public school.”

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Conservative groups weren’t totally shut out though. In Pennsylvania’s York County, for instance, the 1776 Project’s political action committee said on social media that 36 of the 37 candidates they endorsed had won. Conservatives took control of the board in Texas’ third-largest district, Cypress-Fairbanks, in the Houston suburbs, and made gains in Minnesota’s largest district, Anoka-Hennepin.

Tina Descovich, a Moms for Liberty founder, said that 40% of the candidates endorsed by the group won in Tuesday’s elections, bringing to 365 the number of its candidates who have won races in the past two years.

“We have to work harder and we have to figure out how to invest in our candidates,” Descovich said, noting that teachers unions — a frequent foe — have decades-old political operations.

School boards, usually nonpartisan, deal with the nitty-gritty of running a key community institution that decides curriculum standards and discipline policies for students, negotiates contracts with teachers unions and sets property tax rates for homeowners.

But they also deal with some of the most divisive issues.

Pennsylvania saw a number of Democratic victories in school boards, particularly in districts that have recently seen GOP-led school boards adopt policies targeting transgender students, as well as reading materials and curriculum on LGBTQ+ history.

Turn PA Blue, a partisan political organization, said Democrats gained control of at least seven school boards and gained ground in a half-dozen others in Pennsylvania.

In the Central Bucks School District north of Philadelphia, Democrats flipped three seats, ousting the incumbent school board president, and retained two others, giving the party majority control. Democrats also wrested control of two other Bucks County boards.

At contentious school board meetings in Central Bucks in the past year, students who spoke out at meetings said they’d hear slurs and hate speech and seen violence at school — a problem they called on the board to address.

Many students felt more isolated after the board barred school staff from using students’ chosen names and pronouns without parental permission. The board also enforced policies of so-called “neutrality,” which prohibited classroom discussions that opponents say targeted LGBTQ+ students.

But strong opinions about these policies are precisely what drove people to the polls, said Bonnie Chang, the chairperson for Turn Bucks Blue.

“I think all of that made people understand that this has to change,” she said.

School board politics have also become contentious in Virginia since 2021, when Republican Gov. Glenn Youngkin successfully campaigned on supporting “ parents’ rights ” in education.

He has criticized local school boards that prohibit schools from telling parents that their child identifies as transgender, and he is trying to roll back accommodations for transgender students.

In Spotsylvania County, in the far outer suburbs of the Washington, D.C. area, all four GOP-endorsed candidates lost to more liberal candidates.

A conservative board in that county was one of the first to enact Youngkin’s reforms, and the superintendent hired by that district pulled 13 books from library shelves, including “Beloved” by Nobel laureate Toni Morrison and “The Perks of Being a Wallflower” by Stephen Chbosky. Two board members went as far as to suggest that the books should be burned. One of those two, Kirk Twigg, lost his reelection race by almost 25 points.

Tamara Quick, a mother of five in Spotsylvania County, said she would leave the county if the current conservative board stayed in place. She was relieved about Tuesday’s results.

“I think it had to do with people really understanding the importance of education,” she said. The current board was not focused on that, Quick said. “They were drunk on power, tilting at windmills, creating monsters that didn’t exist so they could battle them.”

“They were just worried about how many books they could ban,” she continued.

In Loudoun County, another Virginia exurban area where the school board has been beset by controversies for two years, particularly over its policies on transgender students, Democratic-endorsed candidates won or were leading in six of the nine school board races, although two Democratic incumbents lost or were trailing.

Meanwhile in Iowa, three candidates supported by Moms for Liberty were defeated in a district outside Cedar Rapids that has been in the national spotlight for its support of transgender students.

The race was targeted after the school board for Linn-Mar Community School District adopted a policy last year allowing students to request a plan supporting their gender identity that teachers, administrators and other students would follow — but that didn’t require permission from the students’ parents.

Before dropping out of the 2024 presidential race, former Vice President Mike Pence traveled to Cedar Rapids to rally opponents of the policy.

Parents sued over the policy, much of which became unenforceable after Gov. Kim Reynolds signed bills restricting which bathrooms transgender students can use and banning gender-affirming medical care.

“I think that that is a rejection of these policies and beliefs that public schools are bad,” said Brittania Morey, who won reelection to the Linn-Mar board with the support of those who oppose Moms for Liberty-endorsed candidates. “It is a rejection of the belief that there is some sort of hidden agenda of indoctrination. None of that is happening.”
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Mulvihill reported from Cherry Hill, New Jersey. Associated Press writers Trisha Ahmed in Minneapolis; Matthew Barakat in Falls Church, Virginia; John Hanna in Topeka, Kansas; Heather Hollingsworth in Mission, Kansas; and Paul Weber in Austin, Texas, contributed to this article.

BROOKE SCHULTZ
Schultz is a reporter for The Associated Press based in Pennsylvania. She is a Report for America corps member.
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India bars protests that support the Palestinians. Analysts say a pro-Israel shift helps at home

THEY ARE BOTH ISLAMOPHOBES


 India’s Prime Minister Narendra Modi, right gestures and Israeli Prime Minister Benjamin Netanyahu waves to the media as they arrive for a meeting in New Delhi, India, Jan.15, 2018. Modi, a staunch Hindu nationalist, was one of the first global leaders to swiftly express solidarity with Israel and call the Hamas attack “terrorism.” Modi became the first Indian prime minister to visit Israel in 2017. Netanyahu, travelled to New Delhi the following year and called the relationship between New Delhi and Tel Aviv a “marriage made in heaven.” 

BY AIJAZ HUSSAIN AND SHEIKH SAALIQ
November 7, 2023

SRINAGAR, India (AP) — From Western capitals to Muslim states, protest rallies over the Israel-Hamas war have made headlines. But one place known for its vocal pro-Palestinian stance has been conspicuously quiet: Indian-controlled Kashmir.

Indian authorities have barred any solidarity protest in Muslim-majority Kashmir and asked Muslim preachers not to mention the conflict in their sermons, residents and religious leaders told The Associated Press.

The restrictions are part of India’s efforts to curb any form of protest that could turn into demands for ending New Delhi’s rule in the disputed region. They also reflect a shift in India’s foreign policy under populist Prime Minister Narendra Modi away from its long-held support for the Palestinians, analysts say.

India has long walked a tightrope between the warring sides, with historically close ties to both. While India strongly condemned the Oct. 7 attack by the militant group Hamas and expressed solidarity with Israel, it urged that international humanitarian law be upheld in Gaza amid rising civilian deaths.

But in Kashmir, being quiet is painful for many.

“From the Muslim perspective, Palestine is very dear to us, and we essentially have to raise our voice against the oppression there. But we are forced to be silent,” said Mirwaiz Umar Farooq, a key resistance leader and a Muslim cleric. He said he has been put under house arrest each Friday since the start of the war and that Friday prayers have been disallowed at the region’s biggest mosque in Srinagar, the main city in Kashmir.

Anti-India sentiment runs deep in the Himalayan region which is divided between India and Pakistan and claimed by both in its entirety. In 2019, New Delhi removed the region’s semiautonomy, drastically curbing any form of dissent, civil liberties and media freedoms.

Kashmiris have long shown strong solidarity with the Palestinians and often staged large anti-Israel protests during previous fighting in Gaza. Those protests often turned into street clashes, with demands for an end of India’s rule and dozens of casualties.

Modi, a staunch Hindu nationalist, was one of the first global leaders to swiftly express solidarity with Israel and call the Hamas attack “terrorism.” However, on Oct. 12, India’s foreign ministry issued a statement reiterating New Delhi’s position in support of establishing a “sovereign, independent and viable state of Palestine, living within secure and recognized borders, side by side at peace with Israel.”

Two weeks later, India abstained during the United Nations General Assembly vote that called for a humanitarian cease-fire in Gaza, a departure from its usual voting record. New Delhi said the vote did not condemn the Oct. 7 assault by Hamas.

“This is unusual,” said Michael Kugelman, director of the Wilson Center’s South Asia Institute.

India “views Israel’s assault on Gaza as a counterterrorism operation meant to eliminate Hamas and not directly target Palestinian civilians, exactly the way Israel views the conflict,” Kugelman said. He added that from New Delhi’s perspective, “such operations don’t pause for humanitarian truces.”

India’s foreign minister, Subrahmanyam Jaishankar, sought to justify India’s abstention.

“It is not just a government view. If you ask any average Indian, terrorism is an issue which is very close to people’s heart, because very few countries and societies have suffered terrorism as much as we have,” he told a media event in New Delhi on Saturday.

Even though Modi’s government has sent humanitarian assistance for Gaza’s besieged residents, many observers viewed its ideological alignment with Israel as potentially rewarding at a time when the ruling party in New Delhi is preparing for multiple state elections this month and crucial national polls next year.

The government’s shift aligns with widespread support for Israel among India’s Hindu nationalists who form a core vote bank for Modi and his Bharatiya Janata Party. It also resonates with the coverage by Indian TV channels of the war from Israel. The reportage has been seen as largely in line with commentary used by Hindu nationalists on social media to stoke anti-Muslim sentiment that in the past helped the ascendance of Modi’s party.

Praveen Donthi, senior analyst with the International Crisis Group, said the war could have a domestic impact in India, unlike other global conflicts, due to its large Muslim population. India is home to some 200 million Muslims who make up the predominantly Hindu country’s largest minority group.

“India’s foreign policy and domestic politics come together in this issue,” Donthi said. “New Delhi’s pro-Israel shift gives a new reason to the country’s right-wing ecosystem that routinely targets Muslims.”

India’s foreign policy has historically supported the Palestinian cause.

In 1947, India voted against the United Nations resolution to create the state of Israel. It was the first non-Arab country to recognize the Palestinian Liberation Organization as the representative of the Palestinians in the 1970s, and it gave the group full diplomatic status in the 1980s.

After the PLO began a dialogue with Israel, India finally established full diplomatic ties with Israel in 1992.

Those ties widened into a security relationship after 1999, when India fought a limited war with Pakistan over Kashmir and Israel helped New Delhi with arms and ammunition. The relationship has grown steadily over the years, with Israel becoming India’s second largest arms supplier after Russia.

After Modi won his first term in 2014, he became the first Indian prime minister to visit Israel in 2017. Israel’s prime minister, Benjamin Netanyahu, travelled to New Delhi the following year and called the relationship between New Delhi and Tel Aviv a “marriage made in heaven.”

Weeks after Netanyahu’s visit, Modi visited the occupied West Bank city of Ramallah, a first by an Indian prime minister, and held talks with Palestinian President Mahmoud Abbas. “India hopes that Palestine soon becomes a sovereign and independent country in a peaceful atmosphere,” Modi said.

Modi’s critics, however, now draw comparisons between his government and Israel’s, saying it has adopted certain measures, like demolishing homes and properties, as a form of “collective punishment” against minority Muslims.

Even beyond Kashmir, Indian authorities have largely stopped protests expressing solidarity with Palestinians since the war began, claiming the need to maintain communal harmony and law and order.

Some people have been briefly detained by police for taking part in pro-Palestinian protests even in states ruled by opposition parties. The only state where massive pro-Palestinian protests have taken place is southern Kerala, which is ruled by a leftist government.

But in Kashmir, enforced silence is seen not only as violating freedom of expression but also as impinging on religious duty.

Aga Syed Mohammad Hadi, a Kashmiri religious leader, was not able to lead the past three Friday prayers because he was under house arrest on those days. He said he had wanted to stage a protest rally against “the naked aggression of Israel.” Authorities did not comment on such house arrests.

“Police initially allowed us to condemn Israel’s atrocities inside the mosques. But last Friday they said even speaking (about Palestinians) inside the mosques is not allowed,” Hadi said. “They said we can only pray for Palestine — that too in Arabic, not in local Kashmiri language.”

KHASMIR IS INDIA'S GAZA

 Kashmiris pray for Palestinians killed in Israel’s military operations in Gaza, inside a mosque in Budgham, northeast of Srinagar, Indian controlled Kashmir, Oct. 13, 2023. In Indian-controlled Kashmir, known for its vocal pro-Palestinian stance, authorities have barred any solidarity protest and asked Muslim preachers not to mention the conflict in their sermons. Analysts say the new restrictions on speech reflect a shift in India’s foreign policy under the populist Prime Minister Narendra Modi away from its long-held support for the Palestinians. (AP Photo/ Dar Yasin, File)

 Activists of Socialist Unity Center of India (Communist) burn an effigy of U.S. President Joe Biden and Israeli Prime Minister Benjamin Netanyahu during a rally to protest against Israel’s military operations in Gaza and to show solidarity with the Palestinian people, in Kolkata, India, Nov. 1, 2023. Indian authorities have largely stopped protests expressing solidarity with Palestinians since the war began, claiming the need to maintain communal harmony and law and order. Some people have been briefly detained by police for taking part in pro-Palestinian protests even in states ruled by opposition parties. (AP Photo/Bikas Das, File)

-People hold placards in solidarity with Israel in Ahmedabad, India, Oct. 16, 2023. In Indian-controlled Kashmir, known for its vocal pro-Palestinian stance, authorities have barred any solidarity protests. Analysts say the new restrictions on speech reflect a shift in India’s foreign policy under the populist Prime Minister Narendra Modi away from its long-held support for the Palestinians. The government’s shift aligns with widespread support for Israel among India’s Hindu nationalists who form a core vote bank for Modi and his Bharatiya Janata Party. (AP Photo/Ajit Solanki, File)

An elderly Kashmiri shouts slogans against Israel’s military operations in Gaza, inside a mosque in Budgham, northeast of Srinagar, Indian controlled Kashmir, Oct. 13, 2023. In Indian-controlled Kashmir, known for its vocal pro-Palestinian stance, authorities have barred any solidarity protest and asked Muslim preachers not to mention the conflict in their sermons. Analysts say the new restrictions on speech reflect a shift in India’s foreign policy under the populist Prime Minister Narendra Modi away from its long-held support for the Palestinians. (AP Photo/ Dar Yasin, File)

 A student activist resists detention while gathering to protest against Israel’s military operations in Gaza and to support the Palestinian people, in New Delhi, India, Oct. 27, 2023. Indian authorities have largely stopped protests expressing solidarity with Palestinians since the war began, claiming the need to maintain communal harmony and law and order. Some people have been briefly detained by police for taking part in pro-Palestinian protests even in states ruled by opposition parties. (AP Photo/Altaf Qadri, File)

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Find more of AP’s Asia-Pacific coverage at https://apnews.com/hub/asia-pacific

AIJAZ HUSSAIN
Hussain is a correspondent based in Kashmir, India

SHEIKH SAALIQ
Saaliq is a reporter based in New Delhi, India

SEE LA REVUE GAUCHE - Left Comment: Hinduism Is Fascism 

The family of a Palestinian activist jailed for incitement says young woman’s account was hacked


 In this Feb. 13, 2018 file photo, Palestinian activist Ahed Tamimi stands inside the Ofer military prison near Jerusalem. Israeli authorities arrested Tamimi this week for online speech that her family insists wasn’t hers. Israeli authorities say that Tamimi is suspected of incitement to terrorism for an Instagram post under her account. 

(AP Photo/Ariel Schalit, File)

BY JULIA FRANKEL
, November 8, 2023

JERUSALEM (AP) — The family of Palestinian activist Ahed Tamimi insists she didn’t write the words for which she now sits in an Israeli jail.

Israeli authorities burst into the Tamimi home in the occupied West Bank on Monday and arrested the 22-year old for “inciting terrorism” on her Instagram account. But her mother says the account was hacked.

Tamimi gained worldwide fame in 2017 after a video of her slapping an Israeli soldier went viral on social media. She later said the soldiers had shot her cousin in the head just before the video was taken. After being released from prison, she wrote a book and crisscrossed Europe and the Middle East, becoming a sort of superstar in the campaign against Israeli occupation.

Tamimi’s recent arrest has prompted criticism of an Israeli crackdown on Palestinian online speech in the wake of the Hamas cross-border attack Oct. 7. Palestinians have been arrested by Israeli authorities, fired by Israeli employers and expelled from Israeli schools for online speech deemed incendiary, rights groups say.

The Israeli military alleges Tamimi posted a statement reading “we are waiting for you in all the West Bank cities from Hebron to Jenin — we will slaughter you and you will say that what Hitler did to you was a joke, we will drink your blood and eat your skulls, come on, we are waiting for you.”

Nariman Tamimi, Ahed’s mother, said the account had been hacked — a common occurrence for the fiery activist.

Nonetheless, she said soldiers stormed the Tamimi house in the flashpoint village of Nabi Saleh in the occupied West Bank early Monday morning, screaming that they wanted to arrest Ahed.

“She came to me and hugged me, saying, ‘mama, don’t be afraid and don’t worry. I am strong, and you too, be strong. Nothing can shake us,” Nariman recounted.

Soldiers held Nariman in a separate room while others handcuffed her daughter. Through the walls, Nariman says she heard the soldiers beating Ahed before carting her away. The Israeli military declined to say where Tamimi is being held.

A family representative, who declined to be identified because of the delicate legal situation, said an Israeli military court will deliberate on the length of Tamimi’s detention this coming week. Alternatively, Tamimi could be placed under administrative detention, a status that would allow her to be held indefinitely without charge.

Israel’s far right celebrated her arrest. Itamar Ben-Gvir, Israel’s national security minister, praised the soldiers who arrested Tamimi.

In a picture he posted to X, formerly known as Twitter, Tamimi sits handcuffed on a bed, the tight grasp of an armed Israeli soldier hidden by her unruly mane.

“Zero tolerance with terrorists and supporters of terrorism!” Ben-Gvir pledged.

Tamimi’s detention comes as Israel doubles down on Palestinian online expression, rights groups say.

In a report published 20 days after the initial Hamas attack, Palestinian rights group Adalah documented 161 criminal legal proceedings initiated against Palestinians for incitement. Meanwhile, dozens of Palestinian students and employees have faced lower-level disciplinary measures for posts deemed incendiary, it says.

“These measures constitute a severe campaign of repression against Palestinian citizens of Israel and constitute a mass political persecution of them,” the report concluded.

PEN America, an advocacy group that promotes the right to free expression, urged Israeli authorities and Instagram to try to clarify the circumstances of Tamimi’s arrest.

“There are very limited circumstances in which the arrest of an author for their words can be justified,” the statement read. “None of those apply when the writings in question are not the writer’s own.”

Israeli authorities have arrested 2,280 Palestinian detainees in nightly Israeli raids into the West Bank since the start of the war, according to the Palestinian Prisoners Club, an advocacy group.

Israel says the raids root out militancy in the volatile territory. Over 167 Palestinians have been killed in the West Bank in the month since the war’s start.
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Find more of AP’s coverage at https://apnews.com/hub/israel-hamas-war