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Struggling With Temptation To Abuse Meds

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Justmehere

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This is the start of my 4th week out of the intensive treatment program I was in and the 4th week since my therapist suddenly quit.

I had intake number #53 today. No joke. Turns out they will take me, with a deposit of money that beyond anything I can come up with. ($12,000) A therapist who claims k treat trauma who turned me down refgered me to this clinic, because they can offer a higher level of support. However, this clinic was very clear that they "are not trauma informed."

I was volunteering today for a short while at a non profit that helps people without homes. I had a massive panic attack and had to walk out. Nothing in my external environment triggered me, just a though about my old therapist being gone and my treatment falling through and being in all this pain, now will all this trauma opened up and more symptomatic than ever...

And someone offered me smack. I asked what that was. Heroin.

For a moment, it seemed like a possibility.

The only thing that stopped me: the knowledge that it would run out and tall the panic would be back and heroin withdrawals.

I have never had an alcohol or substance use problem in my life - there is so much addiction in my family, I have made an extra effort to stay away from more than the very rare drink. I've never been really tempted.

Until now. Between my now old psychiatrist calling in valium (and who quit my care two weeks ago with no refferals) and the local hospital/partial hospitalization program (who had deemed me "unable to benefit from outpatient or inpatient treatment") offering me piles of Ativan, and my primary care doc who is willing to do anything to try and stop the anxiety and is also wanting to restore to benzos... and every skill I know either failing or backfiring because now apparently every coping skill I learned in therapy is tied in a classical conditioning type of way to the memory of this therapist (that's bad) and weird intense feelings of abandonment or I don't even know what and this endless panic that lays for hours and hours where I'm shaking and vomiting and dripping with sweat... that starts almost every day at 5pm-ish....

Heroin is becoming a serious temptation. He managed to turn down everything valium, which I threw out after 24 hours... but now... all I can think about is going back and saying yes to anything I can...

Any drug.

I remember once hearing that there are no old heroin addicts. They either get clean or die. My sudden intense draw Is partly a sucidial one.

I need to stop this bad spriap down in a hurry. I need to run from this.

I could use any advice.

5 weeks ago, my prognosis was that I would be "mostly asymptomatic" in 3-6 months. Not ptsd free, but not in need of weekly trauma therpay but occasional support. Then, my whole life fell apart, I fell part, and burned down all my recovery.

Now, I'm deemed beyond all help and struggling to avoid making this bad decline even worse.

I'm very open to any ideas and feedback, no matter how honest or blunt.
 
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For a start, you're right that you need to avoid the heroin. And maybe the other stuff too. It sounds like a really bad idea, especially without competent support to help you deal with things and supervise the medications.
and every skill I know either failing or backfiring because now apparently every coping skill I learned in therapy is tied in a classical conditioning type of way to the Link Removed of this therapist
I'm not sure I understand this. I can understand how it would be "bad"! And, I can understand how remembering those coping skills would stir up the (legitimate) grief over the loss of the relationship. But the skills are still valid, aren't they?

I still find this all enormously confusing and maybe I wouldn't know what to say, even if the situation made sense. As it is, I'm a little afraid of saying something totally not helpful just out of ignorance. Can you explain the problem with the coping skills a little more?

That last clinic sounds like a rip off and like they probably won't be much help. It's awful how hard it can be to FIND competent help! What about working with someone via Skype? Or something online? It wouldn't be ideal, but it might be better than nothing?

5 weeks ago, my prognosis was that I would be "mostly asymptomatic" in 3-6 months.
That's a pretty good prognosis, so you must have been doing something right. I suppose moving forward assumed continued therapy. Have you contacted the inpatient place to see if they have any suggestions?

Hang in there! :hug:
 
My brother is a heroin addict. He started when he was 19, it was an extension of his self-medicating in order to cope with his bipolar. He tried to get clean three years ago - so that was after 11 or so years on it. Did the process through a methadone clinic, tried to drop the methadone, and had a total psychotic break. After that, he went back on methadone, and now is actually taking his bipolar meds and doing OK. He'll be on methadone for the rest of his life. It is very, very rare to get completely clean.

He's one of the rare stories of people who survive. The time I spent with him, trying to get him just to not die, moving in and out of flophouses in SF, was just one horror after another.

Heroin eats you alive. Don't do heroin. If you want to die, find a way that isn't going to torture you for a few years before it decides to choke you on your own vomit.

I'm gonna work on a more helpful post - but really wanted to get this out there. You can PM me if you want.
 
Then, my whole life fell apart, I fell part, and burned down all my recovery.
What happened, if you don't mind my asking? I've followed bits and pieces from your posts, but maybe if you share the whole picture there could be better advice?
and the local hospital/partial hospitalization program (who had deemed me "unable to benefit from outpatient or inpatient treatment")
Just asking - did they mean that you wouldn't benefit anymore at that facility, or that you would not benefit, period?
offering me piles of Ativan, and my primary care doc who is willing to do anything to try and stop the Link Removed and is also wanting to restore to benzos.
Please - take the ativan. Don't do the heroin. If you need it, take it. Benzo addiction vs. heroin addiction? No contest.
Turns out they will take me, with a deposit of money that beyond anything I can come up with. ($12,000) A therapist who claims k treat trauma who turned me down refgered me to this clinic, because they can offer a higher level of support. However, this clinic was very clear that they "are not trauma informed."
What do they say they will treat you for, since they don't do trauma? Is there an aspect of that diagnosis that makes any sense to you?

There is always a way. There is always a way. Sometimes it is a bitch to figure out what it is. But there is always a way out. It's so exhausting and painful, I know - my heart hurts for you. But let's throw everything at the wall and see if we can find the way through this, yeah?
 
@scout86 - thanks for the feedback -
I'm not sure I understand this. I can understand how it would be "bad"! And, I can understand how remembering those coping skills would stir up the (legitimate) grief over the loss of the relationship. But the skills are still valid, aren't they?

They are still valid! They should still be good and useable.

The skills themselves I think are good, but I built a weird association with them in my head. Maybe. For example, when I used to do this one deep breathing excercise in the past, it was just doing that deep breathing excseeise.

Now, when I try to do it, pretty quickly into it, I remember how my therapist demonstrated it and even though im focused on the deep breathing excercise, my mind and body start to feel this weird dread. There is not much thought to it. If I sit with it long enough, it brings up the loss of this therapist. It is just this therapist. Just one person. But I will be sitting there doing the deep breathing excercise I learned in her office, an start thinking of her, of ER being gone, and then I panic even more and then I'm trying to think about anything else or reassure myself and then I can usually get my brain to move on to another more comforting subject, but the anxiety is through the roof in my body.

I'm not actually sure why it doesn't work right or why all these good coping skills now freak me out o even try. I'm a mess. It is confusing to experience and hard to explain.

But it helps to try and you ask good questions and bring up good points.
 
How good are you at "feelings"? I'm not so good at them myself. (Which is why I asked!) Sometimes I don't know what the actual feelings are. I get "fear", "dread", stuff like that, but sometimes more elaborate feelings just come through in kind of a "really good" or "really bad" way that can be confusing and frightening. I wonder if that's not part of what you're running into?

I never got REALLY attached to anyone until I was in my 30's. Then I met someone who really cared about me and took the time to get to know me. Which I'd always thought was totally impossible. And, when he knew me better than anyone else ever has, he still, somehow, found me to be lovable. Weird deal! It's still hard to believe.Then he died. And I thought the world had come to an end. If it had been an option, I'd have curled up on his grave and died myself. There were a lot of things I learned from him that were good and valuable. When he died, things kind of spun out of control for a few years. I think I mostly lived through it because I knew it was what he would have wanted. To this day, when I remember things I learned from him, it's very bittersweet. I can't remember the good without also remembering the loss. But, I WANT to remember the good. And it gets easier with the passage of time.

I wonder if part of what you're dealing with, when you try to use those coping skills, isn't "grief". It would be a totally legitimate thing to feel. And it's definitely a "bad" feeling!
 
I feel haphazard inside, and I am wrestling with typing a response because it's coming out very haphazardly and disjointedly. Please bear with me. I so appreciate the feedback.
My brother is a heroin addict. He started when he was 19, it was an extension of his self-medicating in order to cope with his bipolar. He tried to get clean three years ago - so that was after 11 or so years on it. Did the process through a methadone clinic, tried to drop the methadone, and had a total psychotic break. After that, he went back on methadone, and now is actually taking his bipolar meds and doing OK. He'll be on methadone for the rest of his life. It is very, very rare to get completely clean.
This is a very good reminder of the hell of the drug... thank you. I'm sorry for what both you and your brother have been through. It is one nasty drug. Not a good path. I have to run from it. I have to.
What happened, if you don't mind my asking? I've followed bits and pieces from your posts, but maybe if you share the whole picture there could be better advice?
In a nutshell, the plan was for me to come back from the PTSD intensive treatment program, continue working with my now former trauma therapist on processing all the family trauma I had been processing (most of it for the first time ever) and been in 3-6 months consider doing some family therapy, and then, if things progressed as expected, my therapist would write a letter I needed to return to school.

Instead, I came back on Friday May 1st. My local (also now former) psychiatrist increased the new medication the PTSD intensive treatment center put me on ("not because you absolutely need it but because it will help you be less obessive and stubborn") and I spent the weekend as planned with my friends. It was a good weekend. A really good weekend. Then on Monday, I MELTED DOWN. It was partly due to seratonin syndrome that the increase in medication caused. IIt was partly due to the doctor increasing the medication that comes with a black box warning that it can cause "sudden impulsive suicidality" - and I didn't know about this warning. It apparently isn't the typical SSRI warning of the risk of possible increase in suicidal thoughts or behaviors.

The melt down was probably partly due to multiple adverse effects of the sudden 6 fold increase in this medication on that Monday. It was also due to ... I don't know what. There was more to it.

I woke up anxious, but ok. Then someone sort of attempted to assault me. I responded to the assault initially with the right things, and then I suddenly was drawn to call old abusers. Even my father. Whom I never contact. I got the expected verbal abuse back from all of them. When I realized I was rennacting trauma by calling them, I became very panicky. I remember thinking I am failing, I have failed... without much thought, I suddenly grabbed a whole bottle of pills and swallowed it and then two other bottles. Then I freaked, and I puked them up, dragged myself to the ER. They didn't really take it seriously at all. They should have. I texted the therapist. I was a mess on text. I told her I had to go to the ER I was suicidal, I needed to reschedule, and she told me to come in for my appointment and I lost it. I VENTED at her on text. I went on and on about how no means no, I can't come in... She continued to push me to come in, gently. Concerned. I went to the building. I walked in and I walked out. I called her and said I can't do it.. I still don't quite understand why. She called me, and told me I needed to come in and still my efforts to reschedule didn't work. I went in with the intent to reschedule. I screamed at her. For about a minute. I was dripping sweat from the seratonin syndrome effect and I was a shaking mess, and she....

I scared the hell out of us both. I just yelled, but I yelled "no I said no, f you, I said no...."

I feared she would quit and I began to look for another therapist.

At my next appointment 3 days later, she quit. Terminated me. Tearfully. Said she was shocked that she had to do that. She said we would have two weeks to transition. A week later, she canceled all the transitional sessions on text too. I can't really write much about this because it is so mind baffling.

The three places she referred me to all turned me down.

I have been left with all the trauma we opened up in the intensive treatment and now this loss of the first person I was probably attached to ina remotely healthy way - and I lost it by basically traumatizing both of us. And suddenly. She kept saying if that one day had not happened, we would be working together still, processing the rest of the trauma.

I haven't been able to get back to my contractual part time job, to any regular volunteer work (today was a one time event.) I am tearful, and I have lots of panic attacks. I keep losing any sense that I will exist. It is some kind of attachment and dissociative related thing - at least that is what I have been told.

I have continued to be suicidal, but less impulsively so. I have gone from feeling ok or even better being alone, to being in a state of overwhelming sadness and fear when I am alone. I'm having flashbacks about family/childhood trauma left and right, and I am having nightmares about childhood neglect and abandonment that I have never had before. A lot of childhood trauma stuff is very stirred up - and a lot of grief (that is the right word!) is very stirred up about all trauma, and about this therapist being gone. So gone. I cry. A lot. I panic. A lot. I shake and shiver and... I'm exhausted. I obsess a lot too. I keep trying to eat but I have lost about 15 lbs in the past three weeks (and every notices and not in a good way.) I have been self injuring after intakes for new treatment. I get so stirred up by every intake... I've been had an obsessive level of intakes! The self injury had stopped, for a long time. Now? The damage I have done is pretty bad. ugh. I'm a mess.

My friends... it's a mess there too. I reached out to two friends (they both know each other). One of them handled it well. The other did not. The other told other mutual friends I was struggling, and some weird things about how they should help me, and it's been a mess. I have cut ties with most friends I have in order to get space from a lot of really intense rescuing and wild assumptions and attempts to co-dependently care take or pressure me into changing...

Then my mother decided to fly out. She got here yesterday. She lives 1,000 miles away, and knew I wasn't doing well. She is now here, in town. Much of the time she is very dissociative, and when she is not, she is trying to rescue me from myself while making me feel so incapable. I am struggling to hold boundaries with her of any kind. It's a mess.
Just asking - did they mean that you wouldn't benefit anymore at that facility, or that you would not benefit, period?
They believe I would not benefit, period. They would not explain to me why. I did request my medical records to try and find out why.
Please - take the Ativan. Don't do the heroin. If you need it, take it. Benzo addiction vs. heroin addiction? No contest.
You have a good point. They did give me Ativan while in the ER, and it didn't do much. That scared me. It made me sedated, but I was still hyperventilating. So a friend called my doctor and they called in Valium, and I took it... and then I couldn't quite stop taking the Valium. I took 3 times much as prescribed - int he first 24 hours. Valium made the anxiety actually stop. But then it would begin to wear off and ti was driven to take more. So after 24 hours, I tossed it.

if I am at the point where illegal drugs are seeming like a possible option, then yeah, it might be time to try the Ativan again.
What do they say they will treat you for, since they don't do trauma? Is there an aspect of that diagnosis that makes any sense to you?
Their main focus is people with psychosis. My old psychiatrist told me he believes all forms of dissociation are actually psychosis. No one has ever before said I have psychosis. (I even called the treatment team out of state and they told to me to run from any place that believes I am psychotic or that dissociation is always psychosis.) My old doctor and several other therapists and clinics refereed me to this place. They occasionally take people with eating disorders or mood disorders or other problems. They say they have worked with people with PTSD before. They offer a model where there is therapy during the week 2-3 times a week, and then a treatment team that helps overall stabilization - "but we call it synchronization with the mind heart and environment rather than stabilization." They have licensed therapists come and meet in the home or other places and help the person basically deal with life, get back to work, etc. That part of it makes sense. They also have a focus on basically what is working well for the client and maximizing it rather than always focusing on the pathology that needs to change. That might be a good shift for me right now.

Nothing else about the clinic fits for me. It's really into some spiritual beliefs that I would support others using if it worked for them, but that I would struggle with. They really focus on "emptying the soul as a path to health."

I get panicky just thinking about that.
There is always a way. There is always a way. Sometimes it is a bitch to figure out what it is. But there is always a way out. It's so exhausting and painful, I know - my heart hurts for you. But let's throw everything at the wall and see if we can find the way through this, yeah?
I want to believe so much there is a way...

I feel so lost in all of this. I have worked so hard and I have tanked it all, again. This is my pattern. Moments before I reach success, I tend to tank my life in massive ways. I just did it again. I had this great prognosis and future, and I'm tanking it.

I'm really glad for this forum and for your responses and helping me think this through. There had got to be a way through. Somethings gotta shift!
What about working with someone via Skype? Or something online? It wouldn't be ideal, but it might be better than nothing?
This is a good idea! Googling now...
That's a pretty good prognosis, so you must have been doing something right. I suppose moving forward assumed continued therapy. Have you contacted the inpatient place to see if they have any suggestions?
I did call them. They were really at a loss. They suggested I move to another state with better mental health resources. They also kept telling me "your recovery is not over..."
How good are you at "feelings"? I'm not so good at them myself. (Which is why I asked!) Sometimes I don't know what the actual feelings are. I get "fear", "dread", stuff like that, but sometimes more elaborate feelings just come through in kind of a "really good" or "really bad" way that can be confusing and frightening. I wonder if that's not part of what you're running into?
I think this is a big part of it! I feel stuff, just stuff, so much stuff, that I have purposefully never left myself feel for a long time... and then I started to let myself feel... and then... now I'm here. Scared of my own feelings that are really confusing to me.
I never got REALLY attached to anyone until I was in my 30's. Then I met someone who really cared about me and took the time to get to know me. Which I'd always thought was totally impossible. And, when he knew me better than anyone else ever has, he still, somehow, found me to be lovable. Weird deal! It's still hard to believe.Then he died. And I thought the world had come to an end. If it had been an option, I'd have curled up on his grave and died myself. There were a lot of things I learned from him that were good and valuable. When he died, things kind of spun out of control for a few years. I think I mostly lived through it because I knew it was what he would have wanted. To this day, when I remember things I learned from him, it's very bittersweet. I can't remember the good without also remembering the loss. But, I WANT to remember the good. And it gets easier with the passage of time.
I'm so sorry he passed away, and that you have had to go through this pain. It really helps to read this too. I feel so alone in what I feel.
I wonder if part of what you're dealing with, when you try to use those coping skills, isn't "grief". It would be a totally legitimate thing to feel. And it's definitely a "bad" feeling!
Grief. That's it. One of the intake therapists I met with recently said "you seem to be in the shock phase of grief."

At the intensive PTSD treatment center, they said I had a lot of grief work to do. I think I am grieving a lot more than just the loss of this therapist and the treatment that was finally working for me...
 
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I feel like how I am writing right now is not my typical self, but it does reflect how I am now. Rambly and disjointed and I almost obsess, almost perservate, ruminate on things. Like I'm stuck in a loop and everything comes out a bit mixed up. I want the old me back. The old me from a few months ago.

But this is where I am at now. There has to be a path through this. I've been through so much loss. I think that is one of the hardest things about all of this. I keep thinking of what I did to survive this or that bad time or trauma in my life, because I am trying to think of how to endure things now, and there is the horrible pain of being in this horrible pain once again. "Here I am again." Only this time, it feels more hopeless than ever.

A number of clinics and therapists have refered me to the group where my old therapist is. Then I have to tell them, that's actually where my old therapist was. It feels like I have hit a big dead end.

I did manage to make an appointment with another therapist in the same group. I did it because they are the only ones around who usu a type of trauma therapy that really works for me. My old therapist is one of the co-founders of this small group of trauma therapists.They meet in different offices, but they are all under the same group name. This possible new therapist is new to the practice, meets in a different office than my old therapist, but she is the coordinator for new possible patients, and figures out which therapist they go to. She mentioned my old therapist as someone she could connect me up with but also offered to meet with me herself. I told her I would be glad to just meet with her. I didn't mention that yeah, um, that other therapist fired me... I did do an intake session with her. It actually went well. It felt doable. The therapist said it seemed like a good fit between us, and "let's take the next step."

I saw her early last week and I have a second appointment scheduled with her next week. I was clear that my old therapist used the same method of trauma therapy (which is really really uncommon where I live - and this group trains all area therapists in that technique.) I told her I didn't want to say the name of the old therapist because I wanted to feel like I could talk freely about how it fell apart without feeling like I was talking bad about someone she might know. She said she was ok with that.

If I go back to this therapist, she going to figure it out sooner or later that a senior therapist in this small group of therapists already fired me as a client! Frankly, knowing me, I will probably slip and say the old therapists name myself.

If seeing this new therapist in the group was an idea my old therapist would support, then it seems like my old therapist would have refereed me to her to begin with.

It's going to be another dead end.

I'm terrified to go back. My second appointment is next week and I'm terrified that any day I will get a call, text, or letter telling me that she knows my old therapist fired me and thus she can't help either. I'm usually an overly honest person, especially in therapy. But on this, I am trying to hide this fact just to see a therapist that uses the same type of therapy in my area. It was working for me...

I don't know how to risk having hope again, and I get really scared when I think it could be taken away again.

I'd do almost anything to feel better right now, and that's what scares me the most about me right now.
 
@Justmehere, thank you for taking the time to write it all down. And it was absolutely cogent.

One thing I would suggest - but only if you can feel pretty neutral about it - is sending your ex-therapist the post you wrote, above. It might not do anything at all, but it could give her better insight into your day that day, and that might allow her to reconsider. It's possibly worse for you emotionally, though, to put yourself out there - so I think it's a question of whether you are into going back to that source one more time.

The place you are describing that will take you now does have the strong advantage that they will take you, now. I also don't disagree that working with your daily life stabilization might be just as productive as doing trauma work, maybe even more productive - but I think there is a problem with the cost being so high, and your reaction to the spiritual aspect of the program. Heck, for $12,000 you could possibly move out-of-state for 6 months and work with a therapist you like. I know that's a really random out there idea, but my point is that if you are thinking about figuring out how to come up with that kind of money for a place that gives you a bad vibe, I wonder what else might be possible for you if you can harness some resource. Will your mom help you out financially? That is often pretty perilous, but sometimes you just have to be selfish.
I did call them. They were really at a loss. They suggested I move to another state with better mental health resources. They also kept telling me "your recovery is not over..."
Can you push a little harder on them for some solid leads? You really are working your ass off here, trying to get a break, and shouldn't feel any hesitation about asking for more specific help. Are they affiliated with any other programs, can they recommend a different facility or a different state, or really anything at all? More names of therapists?

I wish that the ones who were brave enough to take on clients with deep issues would, I dunno, put that in big bold letters on their Psychology Today listing.

What about moving to a different part of your state, or temporarily re-locating, if there were a therapist who you'd be excited to work with? Just wondering if there are some profiles in that Psychology Today that might be worth pursuing, even if they are at a distance.

I have worked so hard and I have tanked it all, again. This is my pattern. Moments before I reach success, I tend to tank my life in massive ways. I just did it again. I had this great prognosis and future, and I'm tanking it.
It will be hard, but do your best to turn away from this thought. It's distorted, and will make everything instantly feel 100 times worse. I think we all have a personal version of this thought. Mine is that I can never make up for all the past mistakes, they just pile up before I can deal with them. But it's not useful for me to think that thought, and it's not useful for you, either.

What happened was you had a bad reaction to a drug coupled with an assault-type situation AND the stress of just having gotten out of your program. Remember, even good stress is stress. You escalated quickly, tried to get help for yourself, but got caught in something of a trauma-reenactment loop; the rage you expressed at your therapist sounds like it belongs to rage against an abuser, and that's where your emotional reasoning was at, so that's what came out. It was a horrible, horrible series of events that anyone would wish could get erased, but that's not the reality. Nor is the reality that you cannot recover from that horrible day. You can.

Sigh. I think if I were in your shoes, I would be meeting again with the program you recently got out of, and really talk with them about whether they can either admit you for a second stint OR get you placed (not give a referral, but get you placed) in a comparable facility. I'm absolutely sure they'd have a policy against it, but I think your situation is maybe unique enough to warrant it.

One thing I do know, in mental health - asking a second time is quite often required, meeting in person is always better than phone, and the better you can get at talking about who you are, what your challenges are AND what your goals for yourself are - the better practitioners respond. The goals part is especially significant. And you do have those. If you take away the timeline, the goals are process trauma, re-integrate with the world, go back to school.

I'm glad you are going to stay away from heroin. And handy hint with ativan: put it under your tongue, it will hit your system faster. It's not a loopy feeling, like valium, and sometimes it freaks me out because I can't always 'feel' if it's working, except it is.
 
I was sort of thinking the same thing, that you need to move to a state with better resources. My local er/hospital will hold you if you go in and say you're suicidal. If they are full, they will offer to send you to a nearby hospital (or you can sit in the er until a bed opens up).

I don't honestly think you're going to get the care you need where you are, given all that you've posted.
 
If seeing this new therapist in the group was an idea my old therapist would support, then it seems like my old therapist would have refereed me to her to begin with. It's going to be another dead end.
You don't know this is true - I understand the hypothesis, but there's no reason to go down the road, mentally. You're giving your old therapist some strategic thought that she really may not have had going on.

You're making more sense than you think. And I think it's sounding like a good plan. I do think you need to disclose to the new therapist. But it's not uncommon for therapists in a group to take on each others' clients, if/when there is a situation where a new relationship needs to happen. Anyway, it happened in the last two practice groups I've been a part of. So I can say it's not uncommon with a sampling group of 2. :)
 
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