Medical Malignancy: A Broken System


Centers for Medicare and Medicaid Services (Me...

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Medical
Malignancy

            Sick since childhood, the hospital
and doctor’s office have been my second home. Now –twice removed, the
malignancy lies within my attitude toward the medical system as a whole:
unethical behavior by staff, over-charging Medicare/Medicaid (even outright
fraud), over prescribing narcotics, performing unnecessary tests and visits,
not to mention the all-around bad attitudes –especially within the emergency
departments. Oh, how I long for the days of bedside manners and house calls; a
time when monetary status did not dictate a person’s care and respect (a person
that paid with a chicken got the same care and respect as a person that paid
with gold).

            It is not only the hospitals and
physicians that I am ‘dressing down’; the medical system branches out much
further –so does the culpability. The system in its totality is broken beyond
repair and the fault is a collective one: patients, physicians, pharmacists,
pharmaceutical companies, state and government agencies (Medicare/Medicaid),
nurses, taxpayers, Mental Health services, and the American voters all share in
the guilt. A person does not have to be an expert to see that the medical
system needs a complete over-haul.

            Let’s first discuss the culpability
of the patients: patients have a misconception that physicians are God –or that
they have a cure-all pill that requires no effort on their part for recovery;
moreover, patients tend to feel as if they must hide certain facts, or that
certain facts are not worth mentioning. Additionally, drug addicted patients
have jaded the attitude of the system by abusing the medical system and
emergency rooms –which makes emergency room and primary physicians project an
attitude toward any person in pain –treating all as addicts first and a person
second. The largest part of the patients culpability stems from NOT reporting
abuses by staff and government programs –as well as, committing certain frauds
themselves, which in turn costs everyone more money in one form or another
–driving up health care costs. Patients need to discard the attitude of
entitlement and replace it with an attitude of gratitude.

            Physicians, by default and position
have a higher level of culpability: more and more doctors are over prescribing
narcotics to patients that are at high risk for addiction or relapse –this
practice is presenting problems that reach far beyond the medical system; in
addition, when these over prescribing physicians finally see an issue, instead
of recommending psychotherapy or rehab, the doctor cuts off the patient’s
supply (the CYA syndrome –cover your ass) leaving them to search out other
alternatives (drug dealers). Emergency room doctors should call for a drug
therapist when a known addict comes in looking for a fix, not do expensive
tests then send them back into society with no options or hope for recovery
–the emergency departments become a revolving door for addicts treated in this
manner. In today’s medical world, it seems monetary status dictates the quality
of care and the amount of respect that a patient receives at a facility –it
used to be that the primary reason for becoming a doctor was because the person
wanted to HELP the sick and injured get better (the hero complex), however, now
the primary reason seems to be early retirement and financial gain (the Donald
Trump complex).

            Additionally, physicians have an
obligation to spend more than five minutes with a patient; it is the new ‘norm’
in the medical system to discuss only one issue per visit with five minutes to
do it in –with this practice mainly focused toward Medicare/Medicaid patients.
This practice ends up costing taxpayers more money in the end; while making the
hospitals and doctors more money. I have always joked with my doctors stating,
“Don’t do anything you do not want to pay for –because you are paying for half
this visit, and furthermore –you are only getting half the cost too” (referring
to them being taxpayers). Trust me though –just like any other business, they
will make up the profit somewhere! Physicians (whether intended or not) commit
fraud or know that the system that they are contracted to are committing fraud;
they say nothing –which makes them as unethical as the system they are
contracted through. Finally, doctors need to treat every patient with respect
and honesty –regardless of the insurance group or method of payment used to pay
the bill with; leave the personal problems at home –sick patients do not want
to receive a bad attitude with that high-priced bill –the hospital or office
understaffing, underpaying, complaining co-workers is not something we care to
pay to hear –or for that matter, feel like hearing. Just do the job that you
are paid to do, without the ad-lib attitude and drama.

            Pharmacists have their culpability
as well, although, I have not yet decided to what extent. The only practice
that I really take issue with as far as pharmacists’ culpability is this: many
pharmacists have known that I had an addiction problem in the past (I am sure
to tell all doctors that to protect me from myself) –prescription after early filled
prescription, these professionals said nothing of the over prescribing
practices of my physicians (though they made ‘off the record’ remarks).
Statements made by these pharmacists made it painfully clear that they knew
what was going on with certain doctors –yet they said or did nothing to put an
end to it; this is unethical behavior as well as being part of the problem –not
the solution. This unethical behavior earns pharmacists an F in ethical
behavior and obligation.

            Pharmaceutical companies have a
higher level of culpability than say, the pharmacists and patients –yet not to
the degree that doctors do. These companies give doctors incentives and
kickbacks to push and prescribe their drugs –especially new drugs; advertising
these medications on television, Internet, and magazines –just like a dress or
automobile. Caution should always be used when prescribing any medication
(especially new drugs) –trial and error are for the research process, not the
prescribing process. Pharmaceutical companies should not be allowed to offer
incentives to doctors or advertise medications –especially narcotics.

            State and government agencies have a
different type of culpability –in the end, the economic buck stops with them; state
and government agencies are obligated to protect patients and their rights –as well
as the responsibility of making sure fraud and abuse is not how taxpayer money
is spent. The Medicaid and Medicare dilemma is a major factor in the downfall
of the medical system and its branches of services; Medicaid, which is an
entitlement, is the source of most red tape, high costs, and fraud –causing a
widespread disapproval of the program and its services. These government-subsidized
entitlement programs are close to extinction –almost completely bankrupt; there
are no acceptable excuses for this financial plight –it is a simple case of mismanagement
of funds and authority.

            Nurses (men and women) tend to be
most culpable in the sense of attitude and not reporting abuse and fraud; in
addition too, discussing personal issues with patients and bringing drama into
the workplace via attitude. It was just recently that I paid an unexpected visit
to Helen Keller Emergency Dept. in Alabama; the staff there (except for one
nurse named Glenda) was rude at best –I heard every excuse in the book after
stating my disapproval of the staffs’ attitude and their complaining about the
work conditions at the hospital (except for the rude physician that seemed to
not have the time to complain –just be rude). The result being, I removed
my own IV so that I would not have to deal with one more rude staff member –that
is just how fed up that I was in the few hours spent getting poked and prodded
on, leaving with nothing except an attitude and the taxpayers a bill. I warned
that my recourse would be a prime spot on my blog stating this headline –“Helen
Keller Hospital Blind to Patient Needs”; deeming this ER the worst in the
country thus far! Finally, nurses get so rapped-up in their personal issues
that they make mistakes on notes and administering medications; this is not an
acceptable fallacy by medical staff.

            Taxpayers surprisingly have a
limited liability in this issue as well; taxpayer money supports state and
government programs that spend money with little to no concern, however, they
still give over 1/3 of their income to unthrifty spenders –virtually with no
resistance. Taxpayers must demand that these agencies ‘shape up –or ship out’,
and start holding the states and government accountable for their actions –or lack
thereof. It has gotten to the point where physicians do not want to accept
these insurance options because of the regulations, restrictions, and standards
used for payment of services; moreover, after these agencies decide to cover
medical costs –it takes years for the doctors and hospitals to receive reimbursements
from state and government agencies. American taxpayers have to take a stand
against such behavior and stop these agencies from mishandling taxpayer money,
however, this would take more effort and courage than most people are willing
to muster up. Taxpayers have certain obligations of citizenship that they are
not taking seriously –it is ‘The Peoples’ job to make sure that state and
government agencies do their job, and if they do not –it is ‘The Peoples’
obligation to have them removed and replaced.

            Certainly some taxpayers will
disagree, but they have not seen the unbelievable misuse and abuse of the
entitlement programs that they pay for. I have had many surgeries due to cancer
and other illnesses –seeing the system from the inside with an outsider’s view
is disheartening at best. Medicaid has paid more to prevent tests and
procedures than if done when requested –not to mention the costs of
medications, emergency room visits, therapy, psychologists, and other
entitlement programs that I was ‘farmed’ out to –all to prevent paying for
surgery or preventive care. Additionally, test and x-rays have been
unnecessarily preformed (two of the same x-ray in one day –simply because
one doctor did not care for the other and wanted his own copy). All of these
facts are disturbing indeed; yet they are just the tip of the ice-burg –I would
have to write a complete book to present the horror of the broken medical
system in its totality.

            Mental Health Services’ level of
culpability is lesser in some areas, yet, higher in others. As previously
stated, childhood adversities were no stranger to my sisters and I; needless to
say, I have done my time on the couch (in psychotherapy) –in fact, I could
write a separate book on the faults and culpability of the Mental Health
Services in America. At an early age, I ventured out into the world without
direction, this is when I sought out professional help; what I received instead
was a lot of pills, many appointments, and a plethora of annalistic theories
that kept me baffled for years. It was not until I stopped going to Mental
Health and discontinued psychotherapy drugs that I started to grow and
understand that only I could change my direction my life was headed –and that
getting an education would be essential to my success (I am now in a BS in
Communications). In 1993, a panel of psychologists, professors, and judges
deemed me challenged, with a borderline IQ of 72 –assuring me that I would
never learn enough to tote garbage at McDonald’s; looks as if they were
mistaken – costing taxpayers a lot of money.

            American voters have a minimal level
of culpability: voters are the force behind those on office and position.
Americas must start voting more wisely; ‘The People’ have an obligation to
research the ethical behavior and standards of those running for public office –this
obligation is being neglected. Would any of you hire these people to run a
business that you built from the ground up, if so –if they done their job in
the way Washington D.C are doing now –would you fire them? Of course;
therefore, why would we let them run a Nation ‘The People’ built from the
ground up? The right to vote goes beyond marking a ballot, simply so you have a
“right to complain” (the old theory, if you do not vote you do not have the
right to complain); this theory does not hold water to say the least because,
if you vote the tyranny in –you have no right to complain either. We ‘The
People’ have to shed this half-ass patriotic attitude, and devote ourselves
fully to this country and its electoral process –for if we do not –we will reap
severe consequences.

            In conclusion, America has a broken
medical system that must be addressed firmly; if indeed the issues within these
programs are not addressed, the American public will suffer severe consequences
–especially the old, vulnerable, and weak (not to mention our military vets
that utilize these services). The healthy and rich are making choices that affect
the sick and poor  -this is the main
problem; one cannot possibly know what the sick and poor need –unless they have
been sick and poor themselves. Additionally, I bet if these officials were put
in a position of illness and poverty –the decisions they make afterward may be
different. Finally, nations that act and decide selfishly will fail and fall at
the feet of the sick and meek –history has proven this fact.

        Side Note: Best Hospital in the Country for overall service is St. Charles Medical Center in Bend & Redmond Oregon…

Worst Hospital in the Country  for ER care and attitude is Helen Keller Hospital in Muscle Shoals, Alabama scoring an F for rudeness and inefficiency 

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Benzodiazepines: Silent Killers


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Abstract

            Benzodiazepines are a controlled substance obtained from
a physician for stress, anxiety, muscle spasms, and insomnia. If abused
benzodiazepines can kill or leave lasting effects in the abuser’s brain, as
well as, in the fetus of a pregnant user. In the following article, addiction,
dependency, effects, withdrawals, and conditioning will be discussed in length;
informing the reader of the dangers that come with taking and abusing
benzodiazepines. In addition, the author makes sure to stress to the reader
that there is help, and sobriety is possible.

Benzodiazepines:
Silent Killers

            When we hear the names Elvis Presley, Michael Jackson,
and Anna Nicole Smith, fame, fortune, and notoriety instantly come to mind;
but, they have another stigma to their names, ‘drug overdose’. In August of
1977, it was reported that Elvis died from cardiac arrest; however, later
reports divulged that he died due to constipation induced by narcotics.
“According to Dr. [Nickopoulos], the autopsy revealed that Presley’s colon was
5 to 6 inches in diameter (whereas the normal width is 2 to 3 inches) and
instead of being the standard 4 to 5 feet long, his colon was 8 to 9 feet in
length” (McKay, 2010). One of the main complaints from patients on benzodiazepines
is constipation that is hard to relieve; an embarrassing subject to discuss
with
the
doctor, that if not addressed will cause further illness and possibly death.

Similarly, on June 25 2011, Michael Jackson was rushed
from his luxurious home to UCLA Medical Center in LA from an apparent drug
overdose; he was pronounced dead a short time later from what authorities
called, “acute propofol intoxication” given to help Jackson sleep (Duke, 2010).
CNN first reported Jackson’s death because of cardiac arrest (CNN, 2010),
which, is a common misdiagnosis among overdose cases. Additionally, five months
after Anna Nicole Smith’s son died of a drug overdose, Anna followed; dying in
February of 2007 of an overdose of sleeping medication and eight other prescription
drugs- included in them was the drugs lorazapam and diazepam (Anna Nicole,
2007). Benzodiazepines are not to be mixed with other sedatives or depressants,
the outcome can obviously be deadly.

Benzodiazepines are considered a controlled substance and
can only be obtained legally through a prescription from the doctor. “Benzodiazepines
are a class of drugs primarily classified as anti-anxiety, sedatives, or
hypnotics” (Classification, 2011). There are many names for
benzodiazepines, some of these include:

  • Xanax,
    also known as Alprazolam
  • Librium,
    also called Chlordiazepoxide
  • Klonopin,
    also called Clonazepam
  • Valium,
    also called Diazepam
  • Rohypnol,
    also called Flunitrazepam (Date rare
    drug)
  • Ativan,
    also called Lorazapam
  • Restoril,
    also called Temazepam
    (Classification, 2011)

Although
different in some aspects, these medications are the same in one way, if
misused or abused they will kill. Rohypnol has made headlines for a different
misuse, it has been crowned the king of date rape drugs; leaving the victim
docile and powerless against an offender. For this reason, patrons are advised
not to leave drinks unattended at a bar or restaurant. Additionally, do not ask
a stranger for an ‘aspirin’ or any other drugs at a bar, party, or event; this
can leave you open to unknowingly being drugged, putting your safety and virtue
at risk.

Dependency
and Addiction:

            Addiction is a noun, defined by the American Heritage
Dictionary as, “to devote or surrender (oneself) to something habitually or
obsessively” (Why Can’t I Stop, 2011). People can become addicted to most
anything; gambling, food, drugs, tobacco, and alcohol just to name a few. According
to studies, there are several factors that create an addiction, as well as,
different levels of abuse. “Dr. Arthur Horvath, Ph.D., at the Center for
Cognitive Therapy in California [suggests] there are four primary phases in a
negative addiction”:

  • Experimentation (urges arise out of
    curiosity)”
  • Expected Enjoyment (urges arise out of
    fond memories of past enjoyment)”
  • Doing it to Cope (urges arise primarily
    in response to stress)”
  • Doing it to Survive (urges are
    frequent)” (Why Can’t I Stop, 2011)

These patterns may vary according to how
long the addiction has been present in the person’s life. Additionally, there
are many other things that influence the severity of the addiction, and age of
onset. Studies have shown repeatedly that family history plays a significant
role in a person’s risk for addictive behavior, in addition too, peer-pressure,
stress, low self-worth, and environment. In other words, if a person’s father
or mother was an addict, friends encourage it and the addiction is easily
accessible, and a person feels as if their life is worthless, the risk of
addiction goes up significantly. In addition, getting help for addiction is
complicated since most addicts are in denial of the addiction (Why Can’t I
Stop, 2011).

The first thing that family and friends need to know is
that, an addict cannot be helped until they accept their addiction as a problem
not a solution. There are several ways to detect that a person is an addict;
the person stops doing things that normally brings them pleasure, their only
interest is in the substance or activity, aggressive behavior, lying, and
disassociation from social activities. Additionally, addicts will make choices
and display behaviors normally out of character for them. “The crucial factor
is that addiction has profound effects on people in the immediate social
network or family” (Holtzman, 2000). Family and friends suffer greatly for the
addictions of the one’s they love, often feeling helpless in their efforts.

Conditioning
and Learning:

Social Learning Theory:

There are three great paradigms of learning and
conditioning; these are classical conditioning, operant conditioning, and what
will be discussed first, social learning; for the purpose of this discussion,
only social learning and operant conditioning will be referred. “[The] Social
learning theory focuses on the learning that occurs within a social concept…it
considers that people learn from one another, including such concepts as
observational learning, imitation, and modeling” (Social Learning, 2011). In
other words, we learn from observing others behavior; however, this does not
always mean a change will occur. The social learning theory also exerts that
“cognition plays a role in learning”, learning through “observation”, and that,
“learning can occur without a change in behavior” (Social Learning, 2011).
Maybe this is why we tend to be ‘people watchers’; we learn while laughing.

The more modern theory of social learning suggests that,
“reinforcement and punishment have direct and indirect effects on learning”,
also that, “reinforcement and punishment influence the extent to which an
individual exhibits a behavior that has been learned”, and finally, “the
expectation of reinforcement influences cognitive processes that promote
learning” (Social Learning, 2011). In a sense we learn from observing others
successes and failures. Does this mean if someone does something wrong and pays
horrible consequences, that we will not make the same mistake because we have learned
from their behavior; no, the reason being that, there is always another person
who will reinforce that bad behavior, still leaving us to make our own choice.
We choose from whom we want to learn from, or model.

On that note, most addicts’ report getting high for the
first time with someone else, a friend, family member, or mate. One former
addict states, “the first joint I smoked or pill that I took came from my
mother…forty some years later, I am still an addict, fighting for sobriety”
(Anonymous, personal correspondence, 2011). Whether a person does drugs with
someone they know, or someone they just met, this behavior is socially learned;
for instance, now day’s teenagers are having pill parties, cleaning out their
parent’s medicine cabinet, putting the pills in a bowl and everyone takes a
handful. Despite the fact that research proves (not to mention the overdoses),
that drugs, especially benzodiazepines, are dangerous and addictive more
Americans are dying from abusing these medications.

Many Americans have been arrested and imprisoned due to
benzodiazepines, and as discussed in the first couple of paragraphs, many
people have also died. Moreover, still people use, abuse, and sell drugs; this
proves not that the social learning theory is wrong, but, just the opposite, we
learn from others behavior- good or bad. Although, we learn from others
behavior, we have the ability to decide what behaviors we will mimic and the
ones we will not.  Many factors determine
how competent a person is to make decisions; some people do not have the
capacity to make good choices.

Operant
Conditioning:

            Reinforcement roughly means, forced strengthening; “A
reinforce is anything that strengthens the desired response” (Operant
Conditioning, 2011). Skinner suggests that there are three kinds of responses
or operant that follows actions, these being:

  • Neutral Operant: responses from the
    environment that neither increase nor decrease the probability of a behavior
    being repeated”.
  • “[Reinforcement]: Responses
    from the environment that increase the probability of a behavior being
    repeated. [Reinforcement] can be either positive or negative”.
  • “Punishers: Response
    from the environment that decrease the likelihood of a behavior being repeated.
    Punishment weakens behavior” (B.F Skinner, 2011).

If a person thinks logically, it is
easy to see how this process works; by using positive reinforcement, we
strengthen the desired behavior. If, for example, a child comes home from
school raving about a straight A’s on a report card, the parent would give
praise and a reward to the child, if the parent wants that behavior to
continue. Additionally, if the parent does not give positive reinforcement, the
child will most likely start failing school, hoping that will get them
attention. Then what happens is the parent will have to punish the child for
wrongful behavior. Relearning adults however, is a bit more complicated.

Take drug addicts for example, if a person that abuses
drugs tells their friends and family they have quit using, and the friends and
family are excited about the news and offer their help, it is likely that the
addict will succeed in sobriety. However, if the same scenario occurs and the
friends and family take an attitude of, “we have heard that before” not
offering help, then it is likely the addict will not be successful in sobriety.
What happens then is, the addict is arrested; or eventually overdosing, or, the
addict will continue with that behavior until positive reinforcement comes
along in some form.

If the addict ends up in jail, the system will use the
same theory in correcting the behavior of the addicted offender. Prisons and jails
have good rehabilitation programs for addicts of all kinds; the belief is that
if counseling and positive reinforcement, combined with punishment, and absent
of negative reinforcements applied properly reduces the addicts’ chance at
relapse. Despite the efforts of family, friends, jail, and prison officials,
some addicts never change; there are just as many negative reinforcements as
positive, both incarcerated and loved ones. These negative reinforcements are
present from cradle to grave, and only the strong and determined will stay on
the path of sobriety.

Short
Term and Long Term Effects of Benzodiazepines:

            Some of the effects of benzodiazepines are obvious,
drowsiness, constipation, nausea, with alcohol increasing their effect;
addiction, although, long lasting, can occur with short-term use. We will
concentrate on the long-term effects of benzodiazepines, and withdrawal
symptoms for this discussion. Primarily, addiction and dependency are the most
common long-term effects of benzodiazepines; abusers’ lose jobs, friends,
money, self-respect, and sometimes their freedom and children. All of these
things can be replaced are regained in most situations, however, some effects
of benzodiazepines cannot be undone.

The one important effect of benzodiazepines, these
medications, especially if taken in high doses, can build up in the fatty
tissues in the body; making long-term use more dangerous than assumed. “The
symptoms of over-sedation may not appear for a few days…some include”:

  • “Impaired thinking, memory, and
    judgment
  • Disorientation
  • Confusion
  • Slurred speech
  • Muscle weakness, lack of
    coordination
    (CESAR, 2011)

Still, these symptoms
can be corrected, whereas, brain damage cannot. In the late 1970s, David Knott
(a doctor at the University of Tennessee) stated, “I am very convinced that
Valium, Librium, and other drugs of that class cause damage to the brain…I have
seen damage to the cerebral cortex that I believe is due to the use of these
drugs…”(Lane, 2010). Permanent brain damage is a stiff penalty for relaxation
or entertainment.

If pregnant, benzodiazepines do not just affect the
mother; babies born to addicts are usually addicted as well. “Benzodiazepines
generally carry FDA ratings of “X-contraindicated in pregnancy” or “D-positive
evidence of risk…there have been case reports of anatomical birth defects (BJC,
2011). This classification in effect means that taking benzodiazepines while
pregnant will cause birth defects. The mother runs a risk through the entire
pregnancy; “the first and second trimesters are commonly sensitive for
teratogenic effects…the last trimester is particularly sensitive for brain effects-
apoptotic degeneration of neurons- with life-long impact” (BJC, 2011). What is
shocking is that even given the proven effect, mothers’ still will take drugs
during pregnancy.

As non-addicts, we can make judgments about why people,
pregnant or not, take benzodiazepines; but there are always underlying issue
when someone turns to drugs for comfort. Things such as, low self-esteem,
stress, insomnia, pressure from work, troubles in a relationship, as well as an
array of other discomforts; one particular reason is withdrawals. Withdrawals
are excruciating at best. “Professor Lader declared, in a 1999 interview on BBC
Radio 4, “It is more difficult to withdrawal people from benzodiazepines than
it is from heroin” (Lane, 2010). Lader’s statement is enough to scare anyone
from taking that first step toward sobriety, moreover, the first 5 days into
detox will burn it into the psyche.

Many addicts reported relapsing several times before
finally getting sober. As stated, withdrawals are devastating, and the symptoms
can start with just a slight change of the dosage. It starts with skin
crawling, shaking, the trots, sweating, with added symptoms by the minute. There
are however, some things that can be done to ease the intensity of the
symptoms. Two particular ways to ease the symptoms of withdrawal would be
tapper off the medication slowly, or take a Benadryl every 4 to 6 hours to ease
the discomfort; although, speaking with the doctor is the best advice. Make
sure to drink plenty of water, sweating during the detoxification period can
cause dehydration; furthermore, it will help clear out the system.

Whatever the method used to get through withdrawals, make
sure there is other support available to give “positive reinforcement”; it can
be easy to relapse when alone. Many programs exist to prevent a person from
relapsing. If a person was not able to find a mental health facility, ask the
doctor for a referral to a specialist. The very first risk to eliminate is the
‘party friends’ and the “negative reinforcements”; many times addicts’ quit
taking drugs, but, still hang out with the same crowd they partied with.  When a person does not rid themselves of the
negative reinforcements that enabled the addiction in the first place, the
person’s sobriety is destined to fail.

In conclusion, benzodiazepines are an addictive substance
that can cause death if abused. Additionally, benzodiazepines can leave
life-long effects in the user’s brain, as well as, in the fetus of a pregnant
user. These medications should only be taken under strict observation from a
physician in extreme cases only. If a person does become dependent or addicted
to benzodiazepines, there are programs and positive reinforcers’ to assist in
recovery and relapse. An addict must rid themselves of all negative reinforcers
to succeed at sobriety and change. Finally, it does not matter if a person’s
conditioning is wrongfully learned, with the correct support, a will for
change, and positive reinforcement addiction can be overcome.

References

Anna Nicole. (2007,
March 26). Anna Nicole Smith’s death due to accidental overdose. Fox

News. http://www.foxnews.com/story/0%2C2933%2C611160%2C00.htm

B.F. Skinner. (2011,
May 7). Skinner- Operant conditioning and reinforcement. Simply

Psychology. http:// www.simplypsychology.org/operant-conditioning.html

BJC. (2011, May 9). Benzodiazepines.
BJC behavioral health. BJC Health Care.

http://www.bjcbehavioralhealth.org/behavioralhealth+print.aspx?=1891&template=/behav

CESAR. (2011, May 6).
Benzodiazepines: Profile. Center for substance abuse research.

http://www.cesar.umd.edu/cesar/drugs/benzos.asp>

Classification. (2011,
January 19). Benzodiazepines drug information: Classification. Redwood

Toxicology Laboratory.

http://www.redwoodtoxicology.com/resourses/drug_info/benzodiazepines.html>

CNN. (2010, June 25). Michael
Jackson dead at 50 after cardiac arrest. CNN Entertainment.

http://articles.cnn.com/entertainment/michael.jacks

Duke, Alan. (2010,
February 9). Corner releases new details about Jackson’s death. CNN

Justice. http://articles.cnn/2010-02-09/justice/michael.jackson.auto

Holtzman, Elizabeth. (2000,
August 19). Addictive behaviors, compulsions, and habits: A

Spectrum of need intensity. http://www.umass.edu/fsap/articles/addictive.html

Lane, Christopher.
(2010 November 18). Brain damage from benzodiazepines: The

Troubling facts, risks, and history of
minor tranquilizers. Psychology Today.

http://www.psychologytoday.com/print/50664?page=2

McKay, Hollie. (2010,
May 5). Exclusive: Elvis Presley’s doctor claims he died of an

Embarrassing case of constipation. Fox
News.

http://www.foxnews.com/entertainment/2010/05/05/exclusive-el

Operant Conditioning.
(2011, May 8). Operant conditioning (B.F. Skinner). Psychology.com.

http://tip.psychology.org/skinner.html

Social Learning. (2011,
May 7). Social learning theory. University of Texas.

http://teachnet.edb.utexas.edu/~lynda_abbott/Social.html

Why Can’t I Stop?
(2011, May 10). Why can’t I stop? Dealing with addictive behavior.

http://mtnviewhospital.com/PDF%@)Files/Addictive%20Behavior.pdf