Personal Health: Getting the Right Addiction Treatment

“Treatment is not a prerequisite to surviving addiction.” This bold statement opens the treatment chapter in a helpful new book, “Now What? An Insider’s Guide to Addiction and Recovery,” by William Cope Moyers, a man who nonetheless needed “four intense treatment experiences over five years” before he broke free of alcohol and drugs.

As the son of Judith and Bill Moyers, successful parents who watched helplessly during a 15-year pursuit of oblivion through alcohol and drugs, William Moyers said his near-fatal battle with addiction demonstrates that this “illness of the mind, body and spirit” has no respect for status or opportunity.

“My parents raised me to become anything I wanted, but when it came to this chronic incurable illness, I couldn’t get on top of it by myself,” he said in an interview.

He finally emerged from his drug-induced nadir when he gave up “trying to do it my way” and instead listened to professional therapists and assumed responsibility for his behavior. For the last “18 years and four months, one day at a time,” he said, he has lived drug-free.

“Treatment is not the end, it’s the beginning,” he said. “My problem was not drinking or drugs. My problem was learning how to live life without drinking or drugs.”

Mr. Moyers acknowledges that treatment is not a magic bullet. Even after a monthlong stay at a highly reputable treatment center like Hazelden in Center City, Minn., where Mr. Moyers is a vice president of public affairs and community relations, the probability of remaining sober and clean a year later is only about 55 percent.

“Be wary of any program that claims a 100 percent success rate,” Mr. Moyers warned. “There is no such thing.”

“Treatment works to make recovery possible. But recovery is also possible without treatment,” Mr. Moyers said. “There’s no one-size-fits-all approach. What I needed and what worked for me isn’t necessarily what you or your loved one require.”

As with many smokers who must make multiple attempts to quit before finally overcoming an addiction to nicotine, people hooked on alcohol or drugs often must try and try again.

Nor does treatment have as good a chance at succeeding if it is forced upon a person who is not ready to recover. “Treatment does work, but only if the person wants it to,” Mr. Moyers said.

Routes to Success

For those who need a structured program, Mr. Moyers described what to consider to maximize the chances of overcoming addiction to alcohol or drugs.

Most important is to get a thorough assessment before deciding where to go for help. Do you or your loved one meet the criteria for substance dependence? Are there “co-occurring mental illnesses, traumatic or physical disabilities, socioeconomic influences, cultural issues, or family dynamics” that may be complicating the addiction and that can sabotage treatment success?

While most reputable treatment centers do a full assessment before admitting someone, it is important to know if the center or clinic provides the services of professionals who can address any underlying issues revealed by the assessment. For example, if needed, is a psychiatrist or other medical doctor available who could provide therapy and prescribe medication?

Is there a social worker on staff to address challenging family, occupational or other living problems? If a recovering addict goes home to the same problems that precipitated the dependence on alcohol or drugs, the chances of remaining sober or drug-free are greatly reduced.

Is there a program for family members who can participate with the addict in learning the essentials of recovery and how to prepare for the return home once treatment ends?

Finally, does the program offer aftercare and follow-up services? Addiction is now recognized to be a chronic illness that lurks indefinitely within an addict in recovery. As with other chronic ailments, like diabetes or hypertension, lasting control requires hard work and diligence. One slip need not result in a return to abuse, and a good program will help addicts who have completed treatment cope effectively with future challenges to their recovery.

How Families Can Help

“Addiction is a family illness,” Mr. Moyers wrote. Families suffer when someone they love descends into the purgatory of addiction. But contrary to the belief that families should cut off contact with addicts and allow them to reach “rock-bottom” before they can begin recovery, Mr. Moyers said that the bottom is sometimes death.

“It is a dangerous, though popular, misconception that a sick addict can only quit using and start to get well when he ‘hits bottom,’ that is, reaches a point at which he is desperate enough to willingly accept help,” Mr. Moyers wrote.

Rather, he urged families to remain engaged, to keep open the lines of communication and regularly remind the addict of their love and willingness to help if and when help is wanted. But, he added, families must also set firm boundaries — no money, no car, nothing that can be quickly converted into the substance of abuse.

Whether or not the addict ever gets well, Mr. Moyers said, “families have to take care of themselves. They can’t let the addict walk over their lives.”

Sometimes families or friends of an addict decide to do an intervention, confronting the addict with what they see happening and urging the person to seek help, often providing possible therapeutic contacts.

“An intervention can be the key that interrupts the process and enables the addict to recognize the extent of their illness and the need to take responsibility for their behavior,”Mr. Moyers said.

But for an intervention to work, Mr. Moyers said, “the sick person should not be belittled or demeaned.” He also cautioned families to “avoid threats.” He noted that the mind of “the desperate, fearful addict” is subsumed by drugs and alcohol that strip it of logic, empathy and understanding. It “can’t process your threat any better than it can a tearful, emotional plea.”

Resource Network

Mr. Moyer’s book lists nearly two dozen sources of help for addicts and their families. Among them:

Alcoholics Anonymous World Services www.aa.org;

Narcotics Anonymous World Services www.na.org;

Substance Abuse and Mental Health Services Administration treatment finder www.samhsa.gov/treatment/;

Al-Anon Family Groups www.Al-anon.alateen.org;

Nar-Anon Family Groups www.nar-anon.org;

Co-Dependents Anonymous World Fellowship www.coda.org.

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This is the second of two articles on addiction treatment. The first can be found here.

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DealBook: Goldman Names Gregg Lemkau as New Co-Head of M.&A.

Goldman Sachs named Gregg R. Lemkau as a new co-head of global mergers and acquisitions on Monday, according to an internal memorandum reviewed by DealBook.

Mr. Lemkau, who has been based in London since 2008, will hold that title along with Gene T. Sykes, who has served as the sole co-head since the departure of Yoel Zaoui in April.

“Gregg will work closely together with Gene, as well as with Michael Carr, head of Americas M.&A., to lead this important client franchise, which is core to our investment banking business,” Goldman’s three heads of investment banking, Richard J. Gnodde, David Solomon and John S. Weinberg, wrote in the memo.

Mr. Lemkau is currently the head of mergers for Europe, the Middle East, Africa and Asia Pacific, and was previously a global co-head of the technology, media and telecommunications group. He was previously the chief operating officer of the firm’s investment bank and co-head of its health care banking group.

He also comes from a banking family of sorts. His brother Curt, known as Chip, is a wealth management executive at Goldman, according to Financial Industry Regulatory Authority records. And a sister, Kristin, is a senior media relations executive at JPMorgan Chase.

He will be succeeded as the head of mergers for Europe by Gilberto Pozzi, who currently is a co-head of Goldman’s global consumer retail group. Mr. Pozzi will in turn be succeeded by F.X. de Mallmann.

Here is the memo for Mr. Lemkau:

We are pleased to announce that Gregg Lemkau will become co-head of Global Mergers & Acquisitions alongside Gene Sykes. Gregg will work closely together with Gene, as well as with Michael Carr, head of Americas M.&A., to lead this important client franchise which is core to our investment banking business.

Gregg has been head of Mergers & Acquisitions for EMEA and Asia Pacific since 2011. Prior to this, he was global co-head of the Technology, Media and Telecom Group and served as chief operating officer for the Investment Banking Division. Gregg serves as co-chair of the Firmwide Commitments Committee and is a member of the Partnership Committee and the Investment Banking Division Operating Committee. He joined Goldman Sachs as an analyst in the Mergers & Acquisitions Department in 1992 and was named managing director in 2001 and partner in 2002.

Please join us in congratulating Gregg and wishing him continued success in his new role.

Richard J. Gnodde
David Solomon
John S. Weinberg

And here is the one for Mr. Pozzi:

We are pleased to announce that Gilberto Pozzi will become head of EMEA Mergers & Acquisitions. In his new role, Gilberto will strive to further deepen the dialogue with our clients on their M.&A. strategic objectives, continue to enhance our execution standards and share best practices across industry and country teams. Gilberto will retain responsibilities for many of his clients in the consumer and retail sector while sourcing and executing M.&A. transactions across various countries and industry groups in EMEA.

Gilberto has been co-head of the Global Consumer Retail Group since 2010. Previously, he was head of the Consumer Retail Group for EMEA. Gilberto joined Goldman Sachs as an associate in London in 1995 and was named managing director in 2003 and partner in 2008.

Please join us in congratulating Gilberto and wishing him continued success in his new role.

Richard J. Gnodde
David Solomon
John S. Weinberg

And here is the one for Mr. de Mallmann:

We are pleased to announce that F.X. de Mallmann will become co-head of the Global Consumer Retail Group alongside Kathy Elsesser. In addition to his new role, F.X. will continue to be responsible for Investment Banking Services (I.B.S.) in EMEA.

F.X. has been head of I.B.S. in EMEA since January 2012. Prior to this, he was head of the Financing Group in EMEA from 2008 to 2011. Before that, F.X. served as chief operating officer for the Investment Banking Division. From 2002 to 2007, he served as head of Investment Banking for Switzerland. F.X. joined Goldman Sachs as an analyst in London in 1993 and was named managing director in 2003 and partner in 2004.

Please join us in congratulating F.X. and wishing him continued success in his new role.

Richard J. Gnodde
David Solomon
John S. Weinberg

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IHT Rendezvous: A Different Kind of Labyrinth in the London Underground

LONDON — The artist Mark Wallinger has a few strings to his bow: he spent 10 days in a bear suit in 2004 in the Neue Nationalgalerie in Berlin; he won the Turner Prize in 2007; he enjoyed a few days of media admiration/derision in 2009 when he proposed a 50-meter white horse as a public art project in Ebbsfleet in Kent.

On Thursday, Mr. Wallinger presented his newest work: a commission from the London Underground, for which he has created 270 individual panels — one for every Tube station — showing a labyrinth design in black on white square enamel panels. A small red cross marks a point of entry, and each panel is individually numbered, according to the order used by the winner of the Tube Challenge, an eccentric affair in which people compete to pass through every Tube stop on the network in the shortest possible time. (The current record is 16 hours, 29 minutes and 59 seconds.)

The Underground has long had a tradition of commissioning art. Its headquarters in St. James’s Park boasts reliefs by Henry Moore and Jacob Epstein among others, and its Art on the Underground program has shown admirable eclecticism in its choice of artists for commissioned posters, map brochures and in-station work. Mr. Wallinger’s Labyrinth project is part of Art on the Underground’s celebration, this year, of the Tube’s 150th anniversary.

“Something like 4 million people every day have an opportunity to encounter the art works,” said Tamsin Dillon, the head of Art on the Underground, in a statement marking the official opening of the project.

On the basis of visits, on Friday morning, to 4 of the 10 Tube stations at which the panels were displayed, and the remaining 260 stations will get theirs over the next few months, it seems clear that opportunity is one thing, actual encounters are another.

At Baker Street station (No. 58), my first stop, a friendly Tube employee went to find out where the panel was located and came to look at it with me. It was next to the Marylebone Road exit, near a few public phones. In and out streamed the passengers; no one except the two of us seemed to notice the new artwork. “Nice,” he said cautiously.

Similar indifference pertained at Oxford Circus (no. 60), Victoria (no. 103) and Green Park (no. 232), where a man stood consulting his cell phone right next to the panel without noticing it was there.

While this may be a bit discouraging for Mr. Wallinger and Ms. Dillon, there was something rather nice about seeking out the unobtrusively placed artworks, and a slightly Harry Potter-ish aspect to being the only person who could apparently see them as the rest of the world wandered by. Looking for the panels may not be the journey that Mr. Wallinger had in mind (unlike a maze, the labyrinth allows a straightforward passage between entrance and exit, and presumably symbolizes each passenger’s trajectory), but it’s a pleasant diversion in the hurly-burly of commuting. I see a Labyrinth Challenge coming up.

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Paternos issue report, challenge Freeh's findings

STATE COLLEGE, Pa. (AP) — A report commissioned by Joe Paterno's family says the late coach did nothing wrong in his handling of the Jerry Sandusky child sex abuse scandal and portrays the late Hall of Fame coach as the victim of a "rush to injustice" created by former FBI director Louis Freeh's investigation of the case for Penn State.

The family's critique, released Sunday, argues that the findings of the Freeh report published last July were unsupported by the facts.

Former U.S. Attorney General Dick Thornburgh, one of the experts assembled by the family's lawyer to review Freeh's report last year to Penn State, called the document was fundamentally flawed and incomplete.

Freeh's report reached "inaccurate and unfounded findings related to Mr. Paterno and its numerous process-oriented deficiencies was a rush to injustice and calls into question" the investigation's credibility, Thornburgh was quoted as saying.

In a statement released Sunday through a spokesman, Freeh defended his work.

"I stand by our conclusion that four of the most powerful people at Penn State failed to protect against a child sexual predator harming children for over a decade," he said.

Paterno's family released what it billed as an exhaustive response to Freeh's work, based on independent analyses, on the website paterno.com.

"We conclude that the observations as to Joe Paterno in the Freeh report are unfounded, and have done a disservice not only to Joe Paterno and the university community," the family's report said, "but also to the victims of Jerry Sandusky and the critical mission of educating the public on the dangers of child sexual victimization."

Freeh's findings also implicated former administrators in university president Graham Spanier, athletic director Tim Curley and retired vice president Gary Schultz. Less than two weeks after the Freeh report was released in July, the NCAA acted with uncharacteristic speed in levying massive sanctions against the football program for the scandal.

"Taking into account the available witness statements and evidence, it is more reasonable to conclude that, in order to avoid the consequences of bad publicity, the most powerful leaders at Penn State University — Messrs. Spanier, Schultz, Paterno and Curley — repeatedly concealed critical facts relating to Sandusky's child abuse" from authorities, trustees and the university community, Freeh wrote in releasing the report.

The former administrators have vehemently denied the allegations. So, too, has Paterno's family, though it reserved more extensive comment until its own report was complete.

The counter-offensive began in earnest this weekend. The family's findings said that Paterno:

— Never asked or told anyone not to investigate an allegation made against Sandusky 12 years ago, Saturday, Feb. 9, 2001.

— Never asked or told former administrators not to report the 2001 allegation.

— And never asked or told anyone not to discuss or hide information reported by graduate assistant Mike McQueary about the 2001 allegation.

"Paterno reported the information to his superior(s) pursuant to his understanding of university protocol and relied upon them to investigate and report as appropriate," the family's analysis said.

Paterno's widow, Sue, broke her silence Friday in a letter to hundreds of former players informing them of the report's impending release. "The Freeh report failed and if it is not challenged and corrected, nothing worthwhile will have come from these tragic events," she wrote.

"I had expected to find Louis Freeh had done his usual thorough and professional job," Thornburgh said in a video posted on paterno.com. "I found the report to be inaccurate in some respects, speculative and unsupported to the record compiled ... in short, fundamentally flawed as to the determinations made to the role — if any — Mr. Paterno played in any of this."

Freeh, in his report, said his team conducted 430 interviews and analyzed over 3.5 million emails and documents. The former federal judge said evidence showed Paterno was involved in an "active agreement to conceal" and his report cited email exchanges, which referenced Paterno, between administrators about allegations against Sandusky in 1998 and 2001.

According to Thornburgh's findings, Freeh's report relied on about 30 documents, including three notes authored by Paterno, and 17 emails. Four emails referenced Paterno — none sent by the octogenarian coach who notoriously shunned modern electronic technology.

Sandusky, 69, was sentenced to at least 30 years in prison in October after being convicted last summer of 45 criminal counts. Prosecutors said assaults occurred off and on campus, including the football building.

His arrest in November 2011 triggered the turmoil that led to Paterno's firing days later. Under pressure, Spanier left as president the same day. Curley was placed on administrative leave, while Schultz retired.

Spanier, Curley and Schultz are awaiting trial on obstruction and conspiracy, among other charges. They have maintained their innocence.

Critics have said that Freeh's team didn't speak with key figures including Curley, Schultz and Paterno, who died in January 2012 at age 85. The authors of the emails referenced in Freeh's report, which included Curley and Schultz, were not interviewed by Freeh, the family's analysis said.

Spanier spoke to Freeh six days before the report was released July 12.

"They missed so many key people. They didn't interview most of the key players, with the exception of President Spanier, who at the last minute we brought in and interviewed at a time when frankly the report ... was pretty well all prepared," Thornburgh said on the video.

Freeh said he respected the family's right to conduct a campaign to "shape the legacy of Joe Paterno," but called the critique self-serving. Paterno's attorney was contacted for an interview with the coach, he said, and Paterno spoke with a reporter and biographer before his death but not Freeh's team.

Curley and Schultz also declined numerous requests for interviews, Freeh said. They have been facing criminal charges since November 2011.

Freeh on Sunday cited grand jury testimony by Paterno in 2011 in which Paterno said a graduate assistant relayed to him the 2001 allegation against Sandusky of a "sexual nature" with a child.

He referred to a key point in the July report in which he said Spanier, Schultz and Curley drew up a plan that called for reporting Sandusky to the state Department of Public Welfare in 2001. But Curley later said in an email that he changed his mind "after giving it more thought and talking it over with Joe," according to Freeh's findings.

Said Freeh on Sunday: "These men exhibited a striking lack of empathy for Sandusky's victims by failing to inquire as to their safety and well-being, especially by not even attempting to determine the identity of the child" in the 2001 allegation.

The Paterno family report said Freeh chose not to "present alternative, more plausible, conclusions" about Paterno's actions. Their attorney, Wick Sollers, responded Sunday that Freeh didn't take the time to read the family's critique, or address accusations of procedural shortcomings.

"A failure to consider the facts carefully is exactly the problem our expert analysis highlights," Sollers said. "Everyone, including Mr. Freeh, should take the time to study this report."

Sue Paterno had directed Sollers, to review Freeh's report and her husband's actions. Sollers brought in Thornburgh, as well as former FBI profiler and special agent Jim Clemente, described as a child molestation and behavioral expert.

Also brought in was Dr. Fred Berlin, a psychologist from Johns Hopkins Hospital and School of Medicine whose profile lists him as the founder of the Johns Hopkins Sexual Disorders Clinic.

The analysis included interviews, including of Paterno before his death, as well as a review of documents and testimony and "information from our access to the lawyers for other Penn State administrators."

The Paterno family's analysis said Freeh's report turned into a platform for scapegoating Paterno rather than seizing on an opportunity to educate about identifying child sex abuse victims, and ignored "decades of expert research and behavioral analysis regarding the appropriate way to understand and investigate a child victimization case."

It said expert analysis showed Sandusky "fooled qualified child welfare professionals and law enforcement, as well as laymen inexperienced and untrained in child sexual victimization like Joe Paterno." The coach respected Sandusky as an assistant, but knew little about Sandusky's personal life, the analysis said, though Freeh's report "missed that they disliked each other personally, had very little in common outside work, and did not interact much if at all socially."

Penn State removed a bronze statue of Paterno outside Beaver Stadium on July 22. The next day, the NCAA in levying sanctions said Freeh's report revealed "an unprecedented failure of institutional integrity leading to a culture in which a football program was held in higher esteem."

The NCAA improperly relied on that report and never identified a rules infraction "based on Sandusky's crimes, much less an infraction by Penn State that implicated the NCAA's jurisdiction and core mission of ensuring competitive balance," the Paterno family report said.

A four-year bowl ban and steep scholarship cuts were included among the sanctions, while 111 wins between 1998 and 2011 under Paterno were vacated. It meant Paterno no longer holds the record for most wins by a major college coach.

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Family report: http://paterno.com/

Freeh comment: http://www.freehgroup.com/news/29

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For Families Struggling with Mental Illness, Carolyn Wolf Is a Guide in the Darkness

When a life starts to unravel, where do you turn for help?

Melissa Klump began to slip in the eighth grade. She couldn’t focus in class, and in a moment of despair she swallowed 60 ibuprofen tablets. She was smart, pretty and ill: depression, attention deficit disorder, obsessive-compulsive disorder, either bipolar disorder or borderline personality disorder.

In her 20s, after a more serious suicide attempt, her parents sent her to a residential psychiatric treatment center, and from there to another. It was the treatment of last resort. When she was discharged from the second center last August after slapping another resident, her mother, Elisa Klump, was beside herself.

“I was banging my head against the wall,” the mother said. “What do I do next?” She frantically called support groups, therapy programs, suicide prevention lines, anybody, running down a list of names in a directory of mental health resources. “Finally,” she said, “somebody told me, ‘The person you need to talk to is Carolyn Wolf.’ ”

That call, she said, changed her life and her daughter’s. “Carolyn has given me hope,” she said. “I didn’t know there were people like her out there.”

Carolyn Reinach Wolf is not a psychiatrist or a mental health professional, but a lawyer who has carved out what she says is a unique niche, working with families like the Klumps.

One in 17 American adults suffers from a severe mental illness, and the systems into which they are plunged — hospitals, insurance companies, courts, social services — can be fragmented and overwhelming for families to manage. The recent shootings in Newtown, Conn., and Aurora, Colo., have brought attention to the need for intervention to prevent such extreme acts of violence, which are rare. But for the great majority of families watching their loved ones suffer, and often suffering themselves, the struggle can be boundless, with little guidance along the way.

“If you Google ‘mental health lawyer,’ ” said Ms. Wolf, a partner with Abrams & Fensterman, “I’m kinda the only game in town.”

On a recent afternoon, she described in her Midtown office the range of her practice.

“We have been known to pull people out of crack dens,” she said. “I have chased people around hotels all over the city with the N.Y.P.D. and my team to get them to a hospital. I had a case years ago where the person was on his way back from Europe, and the family was very concerned that he was symptomatic. I had security people meet him at J.F.K.”

Many lawyers work with mentally ill people or their families, but Ron Honberg, the national director of policy and legal affairs for the National Alliance on Mental Illness, said he did not know of another lawyer who did what Ms. Wolf does: providing families with a team of psychiatrists, social workers, case managers, life coaches, security guards and others, and then coordinating their services. It can be a lifeline — for people who can afford it, Mr. Honberg said. “Otherwise, families have to do this on their own,” he said. “It’s a 24-hour, 7-day-a-week job, and for some families it never ends.”

Many of Ms. Wolf’s clients declined to be interviewed for this article, but the few who spoke offered an unusual window on the arcane twists and turns of the mental health care system, even for families with money. Their stories illustrate how fraught and sometimes blind such a journey can be.

One rainy morning last month, Lance Sheena, 29, sat with his mother in the spacious family room of her Long Island home. Mr. Sheena was puffy-eyed and sporadically inattentive; the previous night, at the group home where he has been living since late last summer, another resident had been screaming incoherently and was taken away by the police. His mother, Susan Sheena, eased delicately into the family story.

“I don’t talk to a lot of people because they don’t get it,” Ms. Sheena said. “They mean well, but they don’t get it unless they’ve been through a similar experience. And anytime something comes up, like the shooting in Newtown, right away it goes to the mentally ill. And you think, maybe we shouldn’t be so public about this, because people are going to be afraid of us and Lance. It’s a big concern.”

Her son cut her off. “Are you comparing me to the guy that shot those people?”

“No, I’m saying that anytime there’s a shooting, like in Aurora, that’s when these things come out in the news.”

“Did you really just compare me to that guy?”

“No, I didn’t compare you.”

“Then what did you say?”

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Boeing 787 Completes Test Flight

A Boeing 787 test plane flew for more than two hours on Saturday to gather information about the problems with the batteries that led to a worldwide grounding of the new jets more than three weeks ago.

The flight was the first since the Federal Aviation Administration gave Boeing permission on Thursday to conduct in-flight tests. Federal investigators and the company are trying to determine what caused one of the new lithium-ion batteries to catch fire and how to fix the problems.

The plane took off from Boeing Field in Seattle heading mostly east and then looped around to the south before flying back past the airport to the west. It covered about 900 miles and landed at 2:51 p.m. Pacific time.

Marc R. Birtel, a Boeing spokesman, said the flight was conducted to monitor the performance of the plane’s batteries. He said the crew, which included 13 pilots and test personnel, said the flight was uneventful.

He said special equipment let the crew check status messages involving the batteries and their chargers, as well as data about battery temperature and voltage.

FlightAware, an aviation data provider, said the jet reached 36,000 feet. Its speed ranged from 435 to 626 miles per hour.

All 50 of the 787s delivered so far were grounded after a battery on one of the jets caught fire at a Boston airport on Jan. 7 and another made an emergency landing in Japan with smoke coming from the battery.

The new 787s are the most technically advanced commercial airplanes, and Boeing has a lot riding on their success. Half of the planes’ structural parts are made of lightweight carbon composites to save fuel.

Boeing also decided to switch from conventional nickel cadmium batteries to the lighter lithium-ion ones. But they are more volatile, and federal investigators said Thursday that Boeing had underestimated the risks.

The F.A.A. has set strict operating conditions on the test flights. The flights are expected to resume early this week, Mr. Birtel said.

Battery experts have said it could take weeks for Boeing to fix the problems.

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Dutch Put Electric Cars to the Test

AMSTERDAM — When Patrick Langevoort’s company issued him an electric vehicle two years ago, the first months were filled with misadventure: he found himself far from Amsterdam, with only a 25 percent charge remaining, unable to find the charging point listed on a map. Though the car was supposed to travel 100 miles on a full battery, he discovered that cold weather and fast driving decreased that range.

But electric vehicles have improved, the network of charging stations in the Netherlands has expanded and drivers like Mr. Langevoort are getting used to the particularities of electric driving. “I used to be a real petrol head,” said Mr. Langevoort, who works for a company that manages electricity networks. “Now, I’ve sold my petrol car.”

Although a number of European countries and a few American states are aggressively promoting the use of electric vehicles to reduce planet-warming emissions and pollution, the Netherlands provides perhaps the ultimate feasibility test. If electric vehicles catch on anywhere, it should be here: a small country — about 100 miles east to west — with gas prices of about $8.50 a gallon and a long tradition of environmental activism.

To encourage electric driving, the country is developing a rapidly expanding national grid of charging stations in cities and along highways; and Amsterdam offers owners of electric vehicles free street parking and charging. With hefty tax breaks, promotional leases and cheaper operating costs, the vehicles offer driving costs no more than those of conventional cars, some analysts say.

The number of plug-in electric vehicles in the Netherlands soared eightfold to about 7,500 last year, and charging posts dot the sidewalks. “In a few countries you’re starting to see a number of E.V.’s on the road, especially in capital cities; they’re very visible,” said Peder Jensen, a transportation expert at the European Environment Agency.

And yet, experiments with the cars in the Netherlands and Denmark also underscore the challenges facing this new technology. Sales have been lower than politicians and automakers hoped, representing under 1 percent of new vehicles, even here. “It seems that the industry has not convinced consumers that they can do this,” Mr. Jensen said. “If they fail over the next few years, I think investors will pull out, and that will be a problem.”

Last year 120,000 plug-in electric vehicles were sold globally, according to a recent report by Pike Research, an industry analyst group, which predicts 40 percent annual growth between now and 2020. In 2012, 52,000 were sold in the United States, which now has 12,000 charging stations, according to the automotive consulting firm J. D. Power; but they are dispersed over a large area. Those statistics include pure electric cars and plug-in hybrids, which can run on gas or propane once the battery loses power.

Though many analysts had assigned electric vehicles to the second-car niche, a 2012 survey of Dutch drivers of the cars by the consulting firm Accenture found that most of them ended up being used as a family’s primary vehicle.

Drivers learned to figure out how far they could drive on a charge, overcoming what has been dubbed “range anxiety.” They started off cautiously driving straight from home to the office, knowing they could charge at one or both sites. Over time, they expanded their driving repertoire, learning where to find charging points in garages and along highways — a smartphone app contains them all — much as people learn the locations of convenient A.T.M.’s. That task was made easier by the growing number of chain stores and restaurants offering parking spots with charging outlets, so that customers can refuel while they dine or shop.

Still, a layer of complexity limits acceptance. “There’s still some planning; it’s a bit like a puzzle,” said Maarten Noom, an Accenture consultant who drives an electric vehicle. “It’s not the same ease of mind as with a gas car.”

Mr. Noom, for example, charges at his office and overnight at home, but he switches to a gasoline car when his appointments are scattered around the Netherlands, since he sometimes drives hundreds of miles in a day. Charging at home uses low voltage and takes four to eight hours. New high-voltage rapid charging stations give an 80 percent charge in 20 to 30 minutes, but they are costly to install and still rare.

Mr. Langevoort, the electricity company manager, says he now leaves for work later because his Opel Ampera’s charge goes further as the day warms.

Some electric car leasing programs here provide free or discounted gas vehicles for those who want to take a weeklong driving vacation around Europe.

Many experts say the lack of a uniform business model in the fledgling market is also a hindrance. Contracts for charging are sometimes purchased along with the car and tied to a particular charging network, much as cellphones are linked to a certain carrier. What is more, the penetration of the various networks varies depending on the region, and technology is not always interchangeable.

In Europe, the charging network run by New Motion delivers electricity from pumplike devices. One rival, Better Place, offers swap stations where drivers get a fresh battery in addition to charging points. In the United States, SAE International, an organization of scientists and vehicle engineers, recently adopted a standard charging plug nationwide so that most electric vehicles can use any charging station. But some companies, like Tesla Motors, operate closed networks of high-performance “superchargers.”

“That type of uncertainty is also unsettling to customers,” said Mike Omotoso, a senior manager of forecasting at LMC Automotive, a market research firm. “There’s a Wild West feel, with a lot of companies jumping in. But ultimately there will be a shakeout and consolidation.”

In many European countries there is a good financial case for driving electric. In Denmark, taxes on new luxury cars can be 200 percent of the sticker price, whereas electric vehicles come tax-free. In the Netherlands, gas costs about five times as much as the electricity needed for a similar journey.

While there are some tax breaks for electric vehicle purchases in the United States, the Obama administration has relied more on exhortation to make electric vehicles “as affordable and convenient as gasoline-powered cars in the next 10 years.” Last month, the Energy Department announced its Workplace Charging Challenge, in which Google, Verizon, Eli Lilly, Nissan and other companies pledged to put charging infrastructure in at least one major office.

Mr. Jensen, of the European Environment Agency, said that a big infusion of money could be needed to improve infrastructure in those countries seeking to increase the use of electric vehicles.

When he looked into buying an electric car, the charging system would not fit in his garage, Mr. Jensen said, and few are willing to drive around Europe with a trunk full of adapters. “I think the companies who will win are not necessarily the ones that have the best technology, but the ones that form the best alliances,” he said. “It you have a mobile phone — and even more a car — the most important thing is that you can use it wherever you go.”

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Northeast storm disrupts travel for sports teams

Several professional and college sports teams were forced to rearrange their travel plans as a massive storm swept through the Northeast, dumping a few feet of snow in some areas.

The NBA's New York Knicks were stuck in Minnesota after playing the Timberwolves on Friday night, hoping to try to fly home sometime Saturday. The San Antonio Spurs were also staying overnight in Detroit after seeing their 11-game winning streak fall to the Pistons, awaiting word on when they might be able to fly to New York for their game Sunday night at Brooklyn.

"We can't get there tonight — we know that," Spurs coach Gregg Popovich said. "So we're going to stay here tonight and try to get there (Saturday). Hopefully, we will be able to get there, but at this point, we don't know."

Airlines canceled more than 5,300 flights through Saturday, and New York City's three major airports and Boston's Logan Airport closed.

The Brooklyn Nets planned to take a train home instead of flying from Washington D.C. after losing to the Wizards on Friday night.

Knicks coach Mike Woodson said before a 100-94 victory that his team initially planned to fly home after the game, but the flight had already been postponed. New York is scheduled to play the Los Angeles Clippers at Madison Square Garden on Sunday.

The NHL's Boston Bruins pushed back the start of Saturday's game against the Tampa Bay Lightning by six hours because of the blizzard. The game originally slated for 1 p.m. was rescheduled for 7 p.m., but Boston was expected to be one of the cities hit hardest by the storm.

The storm had dumped more than 2 feet of snow on New England by early Saturday and knocked out power to 650,000 customers. The National Weather Service said up to 3 feet of snow is expected in Boston, threatening the city's 2003 record of 27.6 inches.

The Bruins and Lightning each already had road games scheduled for Sunday night.

The New Jersey Devils were still scheduled to host the Pittsburgh Penguins at 1 p.m., while the New York Islanders were slated to play at home against the Buffalo Sabres at 7 p.m.

Two Ivy League men's college basketball games that were scheduled for Saturday night were moved back to Sunday because of treacherous travel conditions.

Dartmouth will play at Cornell at noon on Sunday in Ithaca, N.Y., and Harvard will visit Columbia at 2 p.m. Sunday in New York. Dartmouth played at Columbia on Friday night, and Harvard played at Cornell. Two other Ivy League games were still scheduled to be played Saturday night, with Yale visiting Princeton and Brown playing at Pennsylvania.

Aqueduct also called off Saturday's card because of the storm. The track and Belmont Park were expected to remain open for wagering on out-of-town races, with racing scheduled to resume Sunday.

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In Nigeria, Polio Vaccine Workers Are Killed by Gunmen

At least nine polio immunization workers were shot to death in northern Nigeria on Friday by gunmen who attacked two clinics, officials said.

The killings, with eerie echoes of attacks that killed nine female polio workers in Pakistan in December, represented another serious setback for the global effort to eradicate polio.

Most of the victims were women and were shot in the back of the head, local reports said.

A four-day vaccination drive had just ended in Kano State, where the killings took place, and the vaccinators were in a “mop-up” phase, looking for children who had been missed, said Sarah Crowe, a spokeswoman for the United Nations Children’s Fund, one of the agencies running the eradication campaign.

Dr. Mohammad Ali Pate, Nigeria’s minister of state for health, said in a telephone interview that it was not entirely clear whether the gunmen were specifically targeting polio workers or just attacking the health centers where vaccinators happened to be gathering early in the morning. “Health workers are soft targets,” he said.

No one immediately took responsibility, but suspicion fell on Boko Haram, a militant Islamist group that has attacked police stations, government offices and even a religious leader’s convoy.

Polio, which once paralyzed millions of children, is now down to fewer than 1,000 known cases around the world, and is endemic in only three countries: Nigeria, Pakistan and Afghanistan.

Since September — when a new polio operations center was opened in the capital and Nigeria’s president, Goodluck Jonathan, appointed a special adviser for polio — the country had been improving, said Dr. Bruce Aylward, chief of polio eradication for the World Health Organization. There have been no new cases since Dec. 3.

While vaccinators have not previously been killed in the country, there is a long history of Nigerian Muslims shunning the vaccine.

Ten years ago, immunization was suspended for 11 months as local governors waited for local scientists to investigate rumors that it caused AIDS or was a Western plot to sterilize Muslim girls. That hiatus let cases spread across Africa. The Nigerian strain of the virus even reached Saudi Arabia when a Nigerian child living in hills outside Mecca was paralyzed.

Heidi Larson, an anthropologist at the London School of Hygiene and Tropical Medicine who tracks vaccine issues, said the newest killings “are kind of mimicking what’s going on in Pakistan, and I feel it’s very much prompted by that.”

In a roundabout way, the C.I.A. has been blamed for the Pakistan killings. In its effort to track Osama bin Laden, the agency paid a Pakistani doctor to seek entry to Bin Laden’s compound on the pretext of vaccinating the children — presumably to get DNA samples as evidence that it was the right family. That enraged some Taliban factions in Pakistan, which outlawed vaccination in their areas and threatened vaccinators.

Nigerian police officials said the first shootings were of eight workers early in the morning at a clinic in the Tarauni neighborhood of Kano, the state capital; two or three died. A survivor said the two gunmen then set fire to a curtain, locked the doors and left.

“We summoned our courage and broke the door because we realized they wanted to burn us alive,” the survivor said from her bed at Aminu Kano Teaching Hospital.

About an hour later, six men on three-wheeled motorcycles stormed a clinic in the Haye neighborhood, a few miles away. They killed seven women waiting to collect vaccine.

Ten years ago, Dr. Larson said, she joined a door-to-door vaccination drive in northern Nigeria as a Unicef communications officer, “and even then we were trying to calm rumors that the C.I.A. was involved,” she said. The Iraq and Afghanistan wars had convinced poor Muslims in many countries that Americans hated them, and some believed the American-made vaccine was a plot by Western drug companies and intelligence agencies.

Since the vaccine ruse in Pakistan, she said, “Frankly, now, I can’t go to them and say, ‘The C.I.A. isn’t involved.’ ”

Dr. Pate said the attack would not stop the newly reinvigorated eradication drive, adding, “This isn’t going to deter us from getting everyone vaccinated to save the lives of our children.”

Aminu Abubakar contributed reported from Kano, Nigeria.

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U.S. Use of Mexican Battery Recyclers Is Faulted

United States companies are sending spent lead batteries to recycling plants in Mexico that do not meet American environmental standards, according to an environmental agency created under the North American Free Trade Agreement, putting Mexican communities at risk.

In a blistering report submitted this week, the agency, the Commission for Environmental Cooperation, notes that the United States does not fully follow procedures common among developed nations that treat international battery shipments as hazardous waste. It faults environmental agencies on both sides of the border for lapses in regulation and enforcement. Cross-border trade in lead batteries increased by up to 525 percent from 2004 to 2011, the report said.

The report, which has been circulating in draft form, has been forwarded to the governments of the United States, Canada and Mexico, which have 60 days to object to its publication. An estimated 20 percent of lead acid batteries from the United States now go to Mexico for recycling, according to trade statistics.

“There needs to be better coordination between government agencies and better cross-border tracking,” said Evan Lloyd, who was the agency’s executive director until late last year and oversaw the yearlong study.

The report highlighted a number of shortcomings: Customs data on the number of batteries crossing the border did not mesh with counts by the United States Environmental Protection Agency. Though the E.P.A. requires notice of batteries leaving the United States, there was no effort to make sure that they had arrived at qualified recyclers in Mexico. The data that battery companies sent to the E.P.A. about exports consisted of “piles of paper,” Mr. Lloyd said, and it was never amassed into an electronic database that would be “useful to regulators.”

Almost all lead acid batteries used in the United States are recycled to extract the lead for reuse because lead is a dangerous pollutant and because it is a valuable commodity. Lead batteries are used in vehicles, cellphone towers and wind turbines.

Since 2008, new United States limits on lead pollution have made domestic recycling complicated and costly. That has helped propel the recycling trade to Mexico, both legally and illegally, environmental groups say, because that country has less stringent limits for lead pollution, and far less vigorous enforcement.

“There’s a pretty consistent pattern suggesting that exports are the direct result of U.S. emissions standards,” said Perry Gottesfeld, executive director of Occupational Knowledge International, which has led the campaign against lead poisoning internationally. Mr. Gottesfeld noted that a Mexican plant owned by a major American recycler, Johnson Controls Inc., puts out more than 30 times as much lead emissions as its newest plant in the United States.

“What Mexico needs to do is to get its recycling up to U.S. standards, and the U.S. needs to do a much better job of tracking batteries overseas,” he said. In an e-mail, Johnson Controls, based in Milwaukee, said it was “modernizing and reinvesting” in the Mexican facility, acquired in 2005, “to reduce its environmental footprint.”

The report was initiated in response to a report by Occupational Knowledge International and Fronteras Comunes, a Mexican environmental group, as well as to an investigative article in The New York Times, Mr. Lloyd said. Soil collected by The Times in a school playground near a recycling plant outside Mexico City was found to have lead levels five times those allowed in the United States.

Lead poisoning causes high blood pressure, kidney damage and abdominal pain in adults, and serious developmental delays and behavioral problems in young children. When batteries are broken for recycling, the lead is released as dust and, during melting, as lead-laced emissions.

In the United States, recyclers operate in highly mechanized, tightly sealed plants, with smokestack scrubbers and extensive monitors to detect lead release. Plants in Mexico vary greatly in safety standards, and in some, the recycling process is little more than men with hammers smashing batteries and melting down their contents in furnaces.

In recent months, there have been new efforts to curb the flow of batteries south of the border, though many battery makers have fought that. In response to a draft of the report released late last year, Battery Council International, an industry group, said it opposed “the creation of additional burdensome certification programs.”

Last year, the United States General Services Administration, which is responsible for federal vehicles, asked ASTM International, an independent standards agency, to explore a voluntary standard for battery recycling.

But that effort came to naught after the proposal was voted down at an open meeting attended by representatives from industry, government and environmental groups in December. Of the 103 people at the meeting, 49 worked for Johnson Controls.

This article has been revised to reflect the following correction:

Correction: February 9, 2013

An earlier version of this article misstated part of the name of an American recycler cited by Perry Gottesfeld, executive director of Occupational Knowledge International, as the owner of a Mexican plant that puts out more than 30 times as much lead emissions as the company’s newest plant in the United States. The American recycling company is Johnson Controls Inc., not Johnson Controls International.

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