what to do if you miss your dose of methadone

Most people know what a methadone clinic is, cheers to widespread representation in movies and TV. However, if you enquire the boilerplate person how one of these clinics actually operates or what it's meant to do, yous're likely to get a blank stare. Methadone clinics are a chip of a mystery for people who haven't been to i, and that tin can exist nervus-wracking when you lot or someone you care most is considering this grade of habit handling.

You've got a lot of important questions about methadone treatment, and this guide will requite you lot the understanding you lot need to choose the right program with confidence.

What Is Methadone?

Methadone is a long-acting analgesic in the opioid family unit. It is chemically related to opium but is completely synthetic. A group of High german scientists kickoff made methadone in the 1930s. Initially, they were searching for a painkiller that did not accept the extremely addictive properties of morphine. The two scientists, Max Bockmhl and Gustav Ehrhart, synthesized a substance they called polamidon. During World War II, a shortage of painkillers pressed a different team of scientists to outset synthesizing the substance, and they changed the proper name to methadone.

Methadone came to the Us in 1947, as a pain reliever useful in treating multiple conditions. Over fourth dimension, information technology became clear that methadone was useful in treating addictions to narcotics. With a surge in heroin habit in the 1960s, researchers were scrambling to discover a substance that would go rid of or at least reduce cravings for drugs as well equally symptoms of withdrawal. Methadone was the ideal candidate.

Methadone reduces the painful symptoms of withdrawal and helps suppress cravings for drugs for 24 to 36 hours, all without providing any feelings of euphoria. This medication makes recovery more achievable and is by and large taken for at least a year. This blazon of treatment is called methadone maintenance.

In 1971, the federal regime formalized the recognition of methadone as an effective recovery assistant by developing regulations governing its use in treating addiction to heroin. Those regulations stayed essentially the same until 2001, when they were modified so doctors and sure other wellness care professionals could provide methadone to patients more consistently. Today, methadone maintenance treatment is considered the golden standard for opioid addiction treatment.

How Does Methadone Work?

Methadone is an opioid agonist that works past attaching to the brain's opioid receptors. It'south a constructed opioid that activates opioid receptors slower than other opioids do, easing withdrawal symptoms without creating a euphoric feeling in people with an opioid use disorder. It also alters how the brain and nervous system react to pain, reducing the pain that people feel during opioid withdrawal. Methadone also blocks the effects of other opioids, discouraging people from using opioids to experience "high."

What Is a Methadone Clinic Used For?

A methadone clinic is a facility where people seeking opioid addiction treatment can get to receive medication that will help them brainstorm their journey to addiction recovery. Methadone clinics are more accurately called substance use disorder services clinics (SUDS) since they are too equipped to dispense naltrexone and Suboxone®. Nonetheless, since methadone is the primary medication dispensed, the ii terms have get synonymous to most people.

All methadone clinic programs must exist certified by the Substance Abuse and Mental Wellness Services Assistants (SAMHSA) and registered with the Drug Enforcement Agency (DEA). Equally of 2018, at that place were about 1,500 methadone clinics in the U.S., most of which were concentrated in New York, New Jersey, Maryland and California.

There are ii types of methadone clinics — public and private. Public clinics are less expensive, but limited regime funding means people commonly end up on a waiting list. With an upshot equally serious as addiction, having to look days or weeks to begin handling greatly lessens the chances of a person actually returning, and increases the likelihood that they won't become the aid they need.

Private clinics are undoubtedly more expensive, simply the benefits are also articulate. In that location is oftentimes no waiting list at a private dispensary, and if there is ane, information technology will exist brusk. The intendance provided at private clinics is too markedly meliorate since staff and medical professionals are far less probable to be overworked.

What Are the Requirements for a Methadone Clinic?

To gain the certification necessary to dispense methadone and other treatments, clinics must meet specific federal requirements. All clinics take to offering a minimum range of services, including:

• Initial examination: Every patient must receive a complete physical past a physician or a health care professional under a program doctor'southward supervision. Clinics must provide total documentation.
• Services for pregnancy: Clinics must accept policies and procedures in identify to address the unique needs of meaning patients. The dispensary must be able to provide prenatal care or be able to refer the patient to an appropriate service.
• Assessments: Patients accepted for a treatment program must receive an initial assessment including a treatment plan, also as subsequent periodic assessments throughout treatment.
• Counseling: Patients must receive adequate substance use counseling from a professional qualified to assess social and psychological backgrounds, contribute to the handling plan and monitor the progress of patients.
• Drug testing: Clinics must bear at least eight random drug tests per twelvemonth, per patient. If the patient is in a short-term detox treatment, they must receive an initial drug exam. Long-term detoxification requires an initial drug examination too as randomized monthly tests.

These are the bare minimum of services a methadone clinic must provide. The best clinics go above and beyond these requirements past offering multiple types of counseling and holistic services.

How Do Methadone Clinics Piece of work?

Individuals struggling with an opioid habit can walk into a methadone dispensary and request to exist treated. Once the clinic has established the private'southward eligibility through various initial screening exams and interviews, patients tin receive methadone on-site. Some programs allow patients to take their medication home for cocky-assistants once they have earned the privilege.

The medication is dispensed by an appropriate practitioner who is licensed past the state or federal government to give out opioids. Pharmacists, nurse practitioners and registered nurses can also manipulate methadone and other opioid treatment medications if a licensed practitioner supervises them.

When someone enters a methadone treatment program, they receive a daily dose of methadone and must participate in counseling of some kind. Methadone treatment at a dispensary is oftentimes a long-term commitment.

Who Is Eligible for Methadone Handling?

Methadone maintenance treatment is only an pick for people who see specific requirements. To meet state and federal requirements for this form of treatment, a person must exist physically fond to opioids at the time handling is requested. They must too take struggled with the habit for at least a year before requesting the treatment.

Yous tin prove your opiate addiction has lasted at to the lowest degree a year with a dr.'s letter or records of any by treatment you have received. If you cannot go that, you tin can accept a family member draw up a notarized certification of your opioid utilise. A history of being arrested for opioid use or possession tin can also qualify yous, equally can a confirmation from a parole or probation officer. You tin fifty-fifty enquire a member of the clergy to give you a notarized letter if you're out of other options or that's easier than asking a family member.

There are exceptions to the one-year rule. If yous are pregnant, have been released from prison inside the last six months, or have participated in a methadone treatment programme in the past, you lot don't need to prove i year of addiction.

For the most part, methadone clinics don't serve individuals under the historic period of 18. Because methadone is an opioid, its effects may be more significant on brains that haven't matured yet, and other treatments are preferred when possible. However, minors tin become eligible for methadone if they can provide two things:

• Documentation of two detoxification or handling attempts inside the past 12 months
• Written consent of a parent or guardian

Methadone maintenance treatment is generally reserved for people with a severe or long-term addiction, for whom other types of treatment have non been completely effective.

Common Reasons Why People Use Methadone Clinics

Methadone clinics are condign available to more and more than people across the country due to the opioid crisis. From 2014 to 2018, 254 new clinics were established. The people attention these programs are struggling with addictions to the post-obit mutual opioids.

i. Codeine

Many people are surprised to detect that codeine, the active ingredient in some cough syrups, can be dangerous. When ingested, codeine is broken down in the liver, where it reverts to morphine. At that place's a good reason why cough medicine is locked upwardly backside the counter — the sleepy feelings of pleasure that an excessive mensurate provides can lead to unexpected addiction.

The about common form of codeine use is mixing coughing syrup with Sprite to make what'southward known equally "lean." This concoction, which tin can also comprise alcohol, is a staple of rap culture. Artist Mac Miller, who died of a drug overdose in 2018, was open about his struggle with codeine.

2. Oxymorphone

Oxymorphone is a schedule II opioid analgesic. The original drug was approved for medical utilise in 1959 merely only came in injectable and suppository forms. In 2006, the Food and Drug Administration (FDA) approved immediate-release and extended-release tablets to be taken orally. The merchandise name for these tablets is Opana, and the release of the tablet format coincided with a jump in addiction rates. From 2010 to 2011, the number of emergency department visits triggered by oxymorphone use skyrocketed from 4,599 to 12,122.

iii. Hydrocodone and Oxycodone

These closely-related medications accept been in the top 10 drugs involved in overdose deaths from 2011 to 2016, and continue to be some of the about mutual sources of addiction. Because physicians prescribe these drugs, many people don't fully empathize their addictive potential.

iv. Morphine

Morphine addiction is not terribly common because information technology'due south not readily available in pill format, and is heavily safeguarded in medical settings. For the most part, morphine is delivered via an intravenous drip. Because it is easier for medical professionals to obtain, doctors and nurses are the nearly likely to develop a morphine addiction. Like other opioids, misuse of morphine tin can rapidly screw out of command.

five. Heroin

Heroin is one of the almost strong and deadly opioid drugs in the world, as well as 1 of the virtually addictive. Notably, 86% of heroin users in urban areas report that they outset used prescription opioids earlier moving on to heroin. Abusing it leads to concrete deterioration and serious health issues in a matter of weeks. Withdrawals from heroin are extremely severe, making it even more challenging to quit successfully.

Benefits of Methadone Clinics

What does a methadone dispensary do for recovery? No matter the specific drug, methadone maintenance handling is highly constructive in combating addiction. One of the main reasons people choose methadone is its cost-effectiveness and convenience equally compared to residential handling. With methadone maintenance, you lot just pay for the medication and services, not for accommodations.

Maybe the biggest benefit of methadone clinics is the time efficiency. Rather than putting life on pause for weeks or months to receive treatment at a residential center, patients receiving methadone can continue to live their lives with minimal intermission. Every bit long as you can schedule time for counseling and go once a twenty-four hour period, every solar day, to receive your medication, yous can successfully participate in a methadone maintenance program.

Taking what yous're learning in your counseling sessions and applying it to life every bit you become helps you acquire more than finer. It as well gives you and your counselor the chance to work out bug as they arise, rather than of a sudden facing a slew of unexpected issues at one time upon leaving residential treatment. Overall, methadone clinics provide a way to brainstorm and sustain recovery while remaining independent.

Signs That Your Addiction Needs Help

Addiction doesn't usually develop overnight, and it tin be difficult to spot whether your utilise of a medication or drug has evolved into dependence. There are several signs to watch out for if you suspect yous may be struggling with addiction, and not all of them are obvious. Here's a list of the most common signs you need to seek treatment:

• Inability to stop using: By the time most people seek treatment, they accept tried and failed to stop using a substance on their own at least once. You don't demand to brand a big announcement that you are quitting for this to apply to you lot. If y'all find yourself internally proverb "not today" and then using the substance anyway, you may be addicted.
• Use despite wellness issues: Most people tin can experience it when their drug or alcohol use has become a problem considering the continued apply gives rise to health issues. If someone keeps drinking booze despite feeling tired and sick every day, or keeps taking too many painkillers despite problematic constipation, addiction is a probable explanation.
• Problem apply: Many addictions begin with using the drug to avoid dealing with problems in life. If instead of processing your emotions and taking steps to improve a situation, yous plough to drugs, your hazard of addiction skyrockets.
• Obsession: People with an habit spend inordinate amounts of fourth dimension thinking about their drug of use. This tendency is at its worst when someone is nearing the end of their supply and becomes frantic about where and how to go more.
• Adventure-taking: If you have ever considered entering a risky or illegal state of affairs to obtain your drug of use, you're a good candidate for treatment. With illicit drugs similar heroin, risk-taking beliefs is already in that location at the commencement. But thinking nigh getting opioids on the street when you previously had a prescription is exactly the blazon of adventure-taking addiction encourages.
• Increased dosages: All drugs of use carry the effect of tolerance. When you find yourself needing one more beverage, smoke or pill to accomplish the same high, it'south considering your trunk is developing a dependence.

All these signs are accompanied by things like loss of interest in social activities and hobbies, reduced performance at work or school and a full general feeling like you're non yourself anymore. By its nature, habit tells you it's non a problem, that this is simply a phase and y'all'll get over it eventually. But if you see any of these signs in your life, it'southward time to give serious consideration to addiction treatment.

What Happens at a Methadone Dispensary?

If you're non sure how to get into a methadone dispensary or how their maintenance programs work, yous're non alone. The process can exist hard to get information on, only it's straightforward one time you have chosen a program. Nigh programs operate on similar parameters, and you tin break the process downwardly into 3 phases.

i. Assessment and Induction

When you select a methadone dispensary for handling, the first phase involves a meaning corporeality of paperwork and discussions with medical professionals. On your commencement visit, you lot volition receive a consummate physical assessment to estimate your full general wellness and the effects your addiction has had on your body. The drug screen will help confirm that you are in an advisable country of withdrawal to begin methadone treatment and that you accept not left whatsoever other drugs out of your history. Basic medical factors like height and weight also play into the initial dosage your dr. prescribes.

You lot volition likewise receive a consultation with an intake advisor to found your history of addiction to opioids. This procedure can be a bit uncomfortable if you're not used to speaking openly about your addiction, merely information technology's important to be straightforward and truthful with your counselor. If you are abusing multiple drugs or have mental disorders forth with your habit, the intake counselor needs to know then they can assistance tailor the plan and counseling services to your private needs.

Depending on the results of your assessments, your physician volition decide whether or non to allow you to begin taking methadone the same 24-hour interval. Earlier being given your first dose, you volition review the plan policies and procedures. You lot'll need to sign a consent form stating that you voluntarily agree to treatment and are willing to comply with conduct requirements.

two. Stabilization

The get-go few days of switching over from opioids to methadone are called stabilization. You will start off with a low dose of methadone, betwixt 10 and 30 milligrams. The medication comes in the class of a pill, dissolvable tablet or oral solution.

For three days, you'll receive the same dose to let the medication to build upwardly in your arrangement. Afterwards 3 days, information technology's time for you and your doc to evaluate how well the methadone is working. If you're still experiencing withdrawal symptoms, your doc volition increase the dose once every three days until yous reach the maintenance level that works best for you.

3. Maintenance

One time you and your doctor have found your ideal maintenance dose, y'all go on to take information technology daily until y'all tin safely stop opioids completely. Clinics offer accept-domicile privileges to patients who demonstrate acceptable delivery and progress during treatment. For the first 90 days, you will have to visit the clinic daily to receive your methadone, except for one take-home dose per week to embrace days when the dispensary is closed. Equally you progress in treatment and meet certain criteria, you volition get eligible for larger take-home supplies.

The maximum supply of take-home medication outlined past federal constabulary is one month, only many states implement more stringent restrictions. The maximum supply can simply be obtained after 2 years of continuous, successful treatment.

Frequently Asked Questions About Methadone Clinics

It's perfectly normal to be a piddling nervous nigh starting a methadone program, and you probably have several more than questions almost the process. Hither are five of the nigh common questions related to starting and standing methadone maintenance treatment:

i. What Should I Bring to My First Date?

You lot'll demand to bring valid photo identification, whatever prescriptions yous are currently taking, an insurance card if you plan on using it to pay for treatment and payment for the first mean solar day'due south medication fee. Significant patients should bring proof of pregnancy, and in some cases, written permission from their OB/GYN is required.

2. What If Methadone Doesn't Work for Me?

Unlike other types of treatment, methadone works the aforementioned way for everyone. Every bit long as you aren't taking any medications or drugs that have negative reactions with methadone, you lot can rest assured that you will feel relief from withdrawal symptoms in one case your maintenance dose is established.

3. How Long Practice I Have to Take Methadone?

Methadone maintenance is different for everyone, but the minimum recommended length of treatment is 12 months. Many individuals proceed to benefit from methadone for years. It is possible to safely withdraw from methadone, every bit long as you lot work with your medico to lower your dosage slowly.

iv. Is It Safe to Have Methadone While Pregnant or Breastfeeding?

Yes, methadone is safe during pregnancy and breastfeeding. Opting for methadone treatment is much safer for your baby than continuing opioid use or going through withdrawals. Minimal amounts of methadone may make information technology through into breast milk, but the benefits of the medication outweigh the very minimal risks. Methadone can reduce the likelihood of withdrawal symptoms like contractions and premature labor, and prenatal care tin can reduce potential pregnancy and birth complications from methadone treatment.

v. Will Methadone Show up on a Drug Screen?

Unless your employer specifically tests for methadone, information technology will not bear witness up on a drug test for opioids like heroin or morphine. Methadone is a legal medication, and as long as y'all are post-obit the guidelines of your plan, y'all won't have any problem with drug screens.

Forms of Treatment at a Methadone Clinic

Addiction recovery is a little bit different for everyone, and people need options to receive the all-time private treatment. Most methadone clinics offering a few forms of treatment that can benefit patients. The cadre of methadone clinic care is, of course, medication-assisted handling (MAT).

1. Medication-Assisted Treatment

When a person uses opioids, the drugs cross the blood-encephalon barrier and attach to receptors in the brain. This triggers a sudden release of neurotransmitters that produce the euphoria associated with an opioid high. The high interacts with the encephalon's reward system and reinforces the behavior that produced the initial inundation of feel-practiced chemicals. Every time someone uses opioids, the brain gets a little slower and less efficient at producing its ain reward chemicals.

Over fourth dimension, the encephalon stops making these chemicals birthday, because it gets them from the opioids. Nevertheless, this means when opioids are removed, the brain can't function properly and throws a person's system into withdrawal.

Medication-assisted handling for opioid addiction uses methadone or buprenorphine to end withdrawals before symptoms become bad enough to make a person give in and start using opioids again. These two medications are partial opioid agonists, which means they demark to the aforementioned receptors as drugs like heroin and prescription painkillers. Just instead of making someone feel high, they simply help people feel normal enough to live their lives without extreme withdrawal symptoms.

Methadone dispensary MAT also focuses heavily on counseling and behavioral therapy to accept a whole-patient approach.

2. Other Treatments Offered at Methadone Clinics

The types of other handling offered past methadone clinics tin can vary. These three are the most common to run across as part of an MAT program:

• Cerebral-behavioral therapy (CBT): Drug use and addiction are associated with specific behaviors and idea processes that drive a person to use drugs to cope. CBT helps people change ingrained behaviors and acquire healthy coping skills.
• Medical detox: Some people'southward addictions are and so severe that withdrawal causes intense, dangerous physical reactions. With medical detoxification, the patient remains under the shut supervision of medical professionals until withdrawal is over.
• Group counseling: In improver to private sessions, the social aspect of grouping counseling tin benefit people in recovery. Beingness able to talk almost issues with other people who understand your situation tin can be immensely freeing.

How to Use Methadone Safely

While methadone treats addiction, it is as well an addictive substance. Healthcare providers must carefully and precisely administer methadone. They manage this dosage by periodically adjusting information technology when needed as part of the induction procedure.

In some cases, individuals who accept consistently followed country and federal guidelines may be allowed to take methadone at home between program visits without straight supervision. If you are taking methadone at home, make sure that you only take the corporeality your healthcare provider has prescribed to y'all, and accept it at the right times. Even if y'all miss a dose or experience that the methadone is not working, never take more than than your provider has prescribed or share methadone with others. You should avert drinking booze while taking methadone, every bit the combination can increase the take a chance of an overdose.

It's important that yous carefully monitor how the medication affects you earlier driving or operating machinery. If it causes you to feel drowsy, avert these activities.

You should store methadone in a place that's room temperature and away from light where pets and children cannot reach it. Since overdose tin occur, it's important to call 911 if you think you have taken too much methadone or if you experience whatever astringent side furnishings.

Common Side Effects of Taking Methadone

Although methadone is a less potent drug than heroin or prescription painkillers, it is still an opioid agonist. There may be side effects to MAT with methadone, including:

• Drowsiness
• Dry mouth
• Retention of urine
• Lightheadedness
• Gastrointestinal distress

In some patients, methadone can crusade psychological side furnishings like anxiety, delusions and paranoia. Insomnia is a fairly common symptom besides, though it tends to get better over fourth dimension. In general, these side furnishings are significantly less unpleasant than going through opioid withdrawals. However, some people can have more than astringent side effects that interfere with the efficacy of the medication, such equally:

• Heavy sweating
• Nausea or vomiting
• Restlessness
• Slowed animate
• Depressed respiratory function
• Irregular heartbeat

If you experience whatsoever of these rarer symptoms while taking methadone, tell your medico correct away. It may exist a sign that your dose is too high or that another course of handling may be better for you.

To minimize the side effects of methadone, you must be open almost whatsoever other medications you are taking and to avert alcohol. Mixing methadone with other substances can be dangerous, and rob the medication of its ability to aid yous.

Avoiding Relapse During and Afterwards Treatment

The temptation of relapse is something everyone struggles with during recovery. Even when handling is going well and methadone is minimizing withdrawal symptoms, you may have a hard time with cravings. Keep the following tips in mind:

• Practice mindfulness and be aware of your emotional country
• Minimize complimentary time
• Invest in building healthy relationships
• Place your triggers
• Build a support network
• Proceed an emergency contact list

Preventing relapse is easier when you know its mental and emotional signs. If y'all're feeling moody, wanting to isolate yourself or struggling with acrimony, you are at higher risk of turning back to opioids. Mental signs include glamorizing your by drug use or fantasizing near using drugs again.

One of the critical elements of relapse prevention is to keep physically healthy. Addiction takes a toll on the body, which can, in turn, affect your mind and emotions. Focusing on the three nearly significant elements of health can strengthen your body and resolve for recovery:

• Nutrition: People struggling with addiction don't commonly pay much attention to diet, which can brand recovery harder. Good diet is linked to meliorate mental health, which can strengthen your resistance to relapse.
• Exercise: Studies accept suggested that exercise combined with other treatments can take a significant positive affect on relapse rates. In add-on to keeping y'all physically good for you, practice helps go on you occupied and distracted from cravings.
• Sleep: American adults have a hard time getting enough sleep altogether, and addiction makes it even more challenging to go a good dark's sleep. Withal, doing what you can to meliorate your sleep quality and duration will make it easier to stay emotionally salubrious throughout recovery.

During handling, you and your advisor will work together to create a relapse prevention plan. The strategies you lot acquire to cope with cravings are lifelong tools yous can use throughout your new, sober life.

Accept Methadone Clinics Developed a Bad Reputation?

Many people believe methadone clinics increment criminal offence and exist to hook people on drugs. The almost pervasive misconception people have is that methadone treatment simply means swapping out one addiction for some other. This incredibly harmful perception is rooted in the fact that methadone is an opioid, but does not take into business relationship the stark differences in dominance.

People don't usually understand what a methadone clinic is for. Methadone does non get anyone high when information technology is used every bit directed by a physician, and information technology profoundly increases the chances of sustaining addiction recovery. While methadone treatment clinics may accept received a bad reputation, they are actually positive resources for individuals and communities.

Throughout methadone clinic history, at that place has been one constant — they are there to help people overcome their addictions. The stigma around methadone clinics is part of a greater consequence. People tend to view habit as a personal or moral failure, and believe methadone maintenance handling is a scam in some way. This mental attitude is harmful to people in recovery, and information technology affects a huge portion of people seeking treatment. One study estimates that 78% of people undergoing methadone maintenance handling have experienced stigma.

The bottom line is MAT with methadone works. That'southward why it has been in use for decades, and why more and more people are flocking to methadone clinics as a response to America's opioid crisis.

Finding and Choosing the Correct Methadone Clinic

Starting the journey to methadone clinic recovery starts with finding the right program. There are many factors to consider, but these three can help you narrow downward your options quickly and with confidence:

• Proximity: One time you enter a handling programme, you'll exist attending the clinic every day. Starting off with a query like "where is the nearest methadone clinic" will bear witness y'all the locations most convenient to you.
• Experience: Your recovery journey should be guided by professionals you trust. Choosing an established clinic increases your chances of getting the best intendance possible.
• Individualization: Some methadone clinics offering better flexibility in treatment plans than others. If a dispensary doesn't have options to fit the different needs of individuals, you likely won't receive the virtually constructive care from that provider.

Another consideration in choosing a methadone clinic is how you lot'll pay. Many clinics accept Medicaid, and some commercial insurance plans volition embrace methadone maintenance treatment. Be sure to contact your prospective treatment facility to find out more about their payment and insurance policies.

Make Recovery a Reality With MedMark Treatment Centers

If you're ready to find out more about starting your recovery from opioid habit, MedMark is here to aid. We have clinics located in five states, all staffed with empathetic staff and licensed medical professionals. Our addiction treatment services are designed to provide all the support and education you lot need to build healthy coping skills and get your life back.

MedMark facilities are land-licensed and federally certified. We are also accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). This reflects our dedication to continuously welcome feedback, improve our services and encounter or exceed industry care standards while helping the community. Contact us today to larn more nigh MedMark, find a methadone clinic about you and learn more near the side by side steps on your new path to recovery from opioid habit.

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Source: https://medmark.com/resources/comprehensive-guide-to-methadone-clinics/

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