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Heroin Starting methadone on monday and need advice!

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You said it right here.



You really gonna tell me that when you said "the only real treatment is abstinence.. Period", that a reasonable person wouldn't interpret that to mean "abstinence is the only way"?

You're giving your opinion, I am too the difference is I'm actually saying it's my opinion.

I was a heroin addict a long time too, hell I probably still am. You can give your opinion, but I'm gonna give mine too.

If you just wanna emphasize that methadone is very hard to get off and that you should think very carefully about your long term goals and what you think you're ready for in deciding to get on it, I'd be all on board.

But that's not what you said, you said methadone isn't a real treatment and that abstinence is the only real treatment.

Annnd I don't agree and am gonna say as much cause I think what you're arguing puts people at risk. At least in the way you said it.
Here you go they call it “substitution therapy”


You took what I said way too personal , if that’s where your at in your life and it has improved over what it was then great but you sound like if you new what you were getting into regarding maintenance you may have sought out other options ..

I hope things continue to go your way
 
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Pinprick, I regrettably didn't actually notice this comment until just now. There are other comments as well that we should talk about here. First off, I'm your friend and we all do our very best to treat each other with compassion, respect and understanding. Please do not be offended if we try to redirect you a little bit. We do all of this for the community, not our egoes.

In the forums and life in general, making absolute statements is a quick way to alienate people, especially if they are questions that cannot in reality be answered. If you are claiming to know the answer to a question that is unanswerable in a specific, scientifically evident way, then you are only going to be seen as pompous and people will lose respect for you and thus, not attach value to other contributions. I do not want that for you, so please just hear me out.

It was a simple phrase, but when you refer to Methadone Maintenance as a trap, let's face it, you're implying a lot of powerful stuff. A trap, specifically implies that a person didn't know what they were doing, didn't understand and so were caught by the proverbial trap. It makes the personi in question seem like a confused animal who is incapable of making the decisions needed to stay alive. It also pretty much casts Methadone maintenance as not a legitimate treatment, but of something decidedly malevolent. In the same breath, you refute the idea that maintenance is actually a treatment in favor of labelling it as a scam or a lie.

There are people out there, including folks I talked to just yesterday here, who pursue Methadone with the honest intent of changing their lives. Yes, some people enter into Methadone programs and believe them to be "the cure" and by not working on themselves and their real problems, they just develop another addiction on top of Methadone. They no longer spend their dope money on dope, so now they can spent it on booze or crack. However, when you enter into the maintenance program with true intent to get better, it can be an absolute miracle. Everyone makes such a huge deal about "being chained to the clinic", when they're already chained to their drug dependency. It just doesn't make sense. If you want to get off, you can taper at such a slow rate that the withdrawal is nearly unnoticeable. If you fuck up, use Benzodiazepines or whatever, yea it sucks to have to withdraw from Methadone, but if you're doing the right things in your life, not only should you not be afraid, but you will eventually get a prescription allowing for once-weekly and eventually, once-monthly take-homes. Again, if you're ready to change, it can be a miracle.

So please just be careful as with that comment, you probably caused a lot of people to feel badly about themselves for no reason. For me, addiction is not even about the drugs, it's about how you act and how you affect others. I do not subscribe to the "a drug is a drug" shit. I've been in the 12-steps for a while and they saved my life. They make the "drug is a drug" comment despite the fact that they are consuming Caffeine, Nicotine and potential other psychoactive prescription drugs. Last time I checked, Fluoxetine (Prozac) is a drug. Diphenhydramine (Benadryl) is a drug. So where is the line in the sand? I still smoke weed, I take Gabapentin and at one point was on Methadone. I measured my success not by the drugs, but by how my life was improving. As they say in the program, my life was unmanageable. I could not handle even the most basic shit. Now that I'm not drinking or getting high, my life has improved tremendously. It no longer feels unmanageable. My family and I have a good relationship. They haven't seen me messed up for years. I try to make amends to people I've hurt. It's working.

The Only Treatment for Heroin Addiction is Abstinence...

I'm gonna be frank. You're mistaken on an objective level. This is simply misinformation and you're really getting behind it as if you're totally sure, but, I'm telling you that this is wrong. The philosophy that you're preaching is antiquated and not truly based in reality. There are many treatments out there for Opioid addiction, including many that are relatively new. Both Methadone and Buprenorphine maintenance are among the most promising. The thing is, they are not cures. They are only tools that can help you truly recover, but you must also work on yourself. My opinion on Methadone was that is allowed me the time to work on myself. I had much more free time and room in my mind to think. By working on myself throughout the process, I mangaged to get clean and taper off.

To get really brutal, I have to note that spreading this type of philosophy is actually a lot more harmful to the community than I think you realize. The abstinence-only path has really become a "wouldn't it be nice" type of thing, that sounds great on paper, but in reality is a statistical fluke when it actually happens. You know how many people in my life have said "just stop; pull yourself up by your bootstraps; if you want it, you can do it." It's entirely too easy to make judgements like this, I admit, but that doesn't make it right.

Among other things, the abstinence-only philosophy often entails short bursts of sobriety followed by relapse in a cyclical nature. In between relapses, the mind is frequently inundated with powerful cravings that cause extreme anxiety, depression and feeling of worthlessness. The point here is, that even during these periods of sobriety, nobody is actually "getting better". It's just a crash diet in which the weight is lost only to come back shortly thereafter, as the diet is not feasibly sustainable. This cycle of relapse and sobriety opens addicts up to a greatly increased possibility of overdosing, as their tolerance is going all over the place and street drugs are often of dubious potency.

In addition to all of that, there are people in the forums and in real life, myself included, who are proud of the progress that they have made using Methadone and "other drugs" to fix our lives. I'm far from perfect and have used and drank since quitting IV Heroin, but they were all mostly one-offs. Still, looking through the lens of brutal honesty, my life is infinitely better than when my only friend was Heroin. My family thinks so, friends think so and that's what matters to me, not what drugs I'm on. It's about how I am and how I affect those I care about. You are basically telling these people that what they thought was progress was indeed, not actually real and that they are either not smart or vigilant enough to notice.

Please just think about these things before you post dude. When we don't know the answer to something, we do not present it as fact. If you don't believe in something, you don't have a right to tell others that they are wrong. You can only share your opinion. I want you to be a helpful member of the community, but this is just not a good thing.

You can be an addict, be clean, but still use substances. Those can be Nicotine, Caffeine, Cannabis or what have you. What matters is your intentions and how you affect other people and the world around you. If a junkie who used to prostitute herself for Heroin and Crack every day, gets on Methadone, still smokes weed but is able to raise a family, go to college and feel love for herself and her life, is that not what is most important?

Don't anyone feel discouraged. If you all are on maintenance, your sobriety is still just as meaningful as your heart knows it is. People will tell you you're wrong, you're deluded, you're lying to yourself. They are the ones who feel the need to tell you what's wrong with your life because they're not happy with theirs. Ignore them. The fact that someone feels the need to tell people that they're failures and not smart enough to realize it, despite having no real evidence to support it... I just don't understand the intentions.

Be proud people. We're in this together.
I didn’t mean to hurt any bodies feelings I’m just sharing my experience, I said that from the beginning it just seems that a advocate for methadone maintenance took offense .

Ask 100 folks that are on methadone maintenance and I betcha the farmhouse that the overwhelming majority feel trapped by being on maintenance, and that again is simply me speaking from my experience ..YMMV
 

drewbocop

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I can't believe this is even an argument. Of course both bupe and methadone are treatments. Full-stop. You're SUPPOSED to use them as a safe and legal way to obtain a substance that will keep you out of withdrawal and titrate your dose down safely until you quit. It is a medical treatment, controlled, and organized and has helped many thousands of people get off opioids. Whether that's the way you plan to use it is another thing.
 

JessFR

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I didn’t mean to hurt any bodies feelings I’m just sharing my experience, I said that from the beginning it just seems that a advocate for methadone maintenance took offense .

Ask 100 folks that are on methadone maintenance and I betcha the farmhouse that the overwhelming majority feel trapped by being on maintenance, and that again is simply me speaking from my experience ..YMMV

Well perhaps. That doesn't mean it hasn't been of benefit though.

I know I keep harping on this. But the data shows quite clearly how effective substitution is against other methods. And I'll repeat again that that doesn't mean substitution is what everyone should be on, but it means it's highly ill advised when you have people like me as well saying how much it improved their life to say things to dissuade people form getting on it with loaded phrases like "its not a treatment".

If you wanna explain why it wasn't good for you and that if the person's in a similar situation to you, that's fine. It's the way it's been done in this thread that bothers me.

I also wonder what the satisfaction rates would be in the US vs parts of the world where you aren't required to go to a clinic for methadone. Cause for me and my lifestyle, I don't feel trapped at all.

When I was on heroin, that's when I felt trapped. Methadone may not have freed me, but it gave me muuuuuch more room than before. And I think just saying "oh well you shoulda just gotten clean" when someone's telling you they're not ready is a very bad idea, especially when relapse rates with abstinence are some of the highest going around, in fact I think they are the highest, and I think they're among the riskiest too in terms of likely hood to die because of how low your tolerance gets and how easily you can misjudge your next use.
 

birdup.snaildown

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I don't mean any offense. Just stating my opinion.

JessFR said:
You're passing implied judgement

It's just my opinion about a drug. I'm not judging you.

If the methadone program actually worked I'd have a different opinion. I'm critical of the idea of substituting the drug for H, not of the people who end up methadone addicts.

The vast majority of people I've met on methadone are stuck on it for years/decades. Perhaps they needed to take it at first - perhaps - but they don't need to take it for 10 years.

I'm not blaming them. They are victims of a shitty system that forgets about people. When I was taking methadone, nobody tried to reduce my dose for 3 months. I could have easily reduced it. They (the government) don't really want to fix people. They just want to sweep them under the rug.

For the record, @JessFR, I didn't tell you what you should do.

You said there was no alternative. I'm telling you there is always an alternative. Before methadone existed, people had to quit the old fashioned way.

Heroin withdrawals suck.

Sobriety is hard... but, it's better than methadone IMO.

People convince themselves they need to take a drug every day. I don't believe anyone needs to take heroin or methadone on a daily basis for years.

If the methadone program was handled differently, I'd probably have a different opinion. The government should offer therapy along with methadone and carefully monitor doses so they can be reduced as quickly as possible.

Why do they just leave people on methadone forever?
 
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negrogesic

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And I ask you, what exactly has it cost me? I can't say I've really have any significant side effects other than maybe sometimes some mild sedation

What about weight gain? I have always been a shitty eater, poor appetite, etc. On methadone I had a ravenous appetite. I gained maybe 40 pounds. All the weight evaporated when i stopped.

Considering that I was on 380mg/day at the peak, I certainly felt trapped. But i was able to from 380mg/day to 0mg in 18 months and it wasn't that bad. Not so sure I could do that now though, I feel like my resolve isn't quite as strong as it was back then.

I don't regret going on methadone. I probably would have died otherwise.
 

JessFR

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What about weight gain? I have always been a shitty eater, poor appetite, etc. On methadone I had a ravenous appetite. I gained maybe 40 pounds. All the weight evaporated when i stopped.

Considering that I was on 380mg/day at the peak, I certainly felt trapped. But i was able to from 380mg/day to 0mg in 18 months and it wasn't that bad. Not so sure I could do that now though, I feel like my resolve isn't quite as strong as it was back then.

I don't regret going on methadone. I probably would have died otherwise.

That's a potential side effect yes, I haven't noticed any increased hunger myself.

But let's run with that, OK, weight gain, it does happen to some people. That's still likely less of an immediate risk to your health as continued heroin use. Especially in the fentanyl infested areas and especially in the face of how many people die from misjudging their tolerance after a period of abstinence.

And that's not even counting all the risks that come from using heroin that aren't actually caused directly by the drug but the drug environment.

Id still say in most cases that's an acceptable risk.
 

JessFR

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I don't mean any offense. Just stating my opinion.



It's just my opinion about a drug. I'm not judging you.

If the methadone program actually worked I'd have a different opinion. I'm critical of the idea of substituting the drug for H, not of the people who end up methadone addicts.

The vast majority of people I've met on methadone are stuck on it for years/decades. Perhaps they needed to take it at first - perhaps - but they don't need to take it for 10 years.

I'm not blaming them. They are victims of a shitty system that forgets about people. When I was taking methadone, nobody tried to reduce my dose for 3 months. I could have easily reduced it. They (the government) don't really want to fix people. They just want to sweep them under the rug.

For the record, @JessFR, I didn't tell you what you should do.

You said there was no alternative. I'm telling you there is always an alternative. Before methadone existed, people had to quit the old fashioned way.

Heroin withdrawals suck.

Sobriety is hard... but, it's better than methadone IMO.

People convince themselves they need to take a drug every day. I don't believe anyone needs to take heroin or methadone on a daily basis for years.

If the methadone program was handled differently, I'd probably have a different opinion. The government should offer therapy along with methadone and carefully monitor doses so they can be reduced as quickly as possible.

Why do they just leave people on methadone forever?

I don't think you're trying to judge people, but I think saying methadone isn't a treatment and isn't worthwhile would be interpreted by many on it as a judgement.
I think your definition of it working is wrong. What is working? To me working is significant improvement in quality of life.

And as for the suggestion that there's always an alternative, no. You aren't me, I'm me. And I know I woulda kept using and living that way without methadone, potentially for a long time longer. And likely with severe further repercussions.

There wasn't a perfect solution before methadone and there isn't now.

Wanna know why they try and keep people on it? Data. That's how medicine works, studies are done, different treatments are attempted, and they see what has the best outcome regarding people dying, or having health repercussions.

And I've looked at the data, that IS what it said, people on it longer do better. It might not SEEM like that at an individual level, but at a greater scope of view it can be seen. I think you're comparing methadone with some idealized scenario that isn't appropriate for many people.

Methadone is not perfect, I don't think anyone could seriously say it is, especially given the overly restrictive regulations in the United States. But that's more an implementation problem.

Some people regret getting on methadone, some are right to regret it. And I think a lot of that is the responsibility of the system not informing people properly. But that is a long way from saying methadones a bad treatment, or sillier, that it's not a treatment at all cause but doesn't magically cure you. That's as good as saying "well you should just stop". People try and stop, again and again, many die in the effort.

Going just by the data, going by health, abstinence is one of the least successful therapies long term around, if not the least.
Just cause methadone has its downsides or that it's not appropriate for everyone doesn't make it a bad thing.
 

negrogesic

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Methadone is a life saving drug, but is best suited for heavy IV drug users who don't have much chance of quiting successfully.

For all the pill poppers and etc, try buprenorphine first. The only caveat here is that with the ubiquity of pressed fentanyl pills these days, some oral users might be forced to consider methadone.
 

JessFR

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Methadone is a life saving drug, but is best suited for heavy IV drug users who don't have much chance of quiting successfully.

For all the pill poppers and etc, try buprenorphine first. The only caveat here is that with the ubiquity of pressed fentanyl pills these days, some oral users might be forced to consider methadone.


Yep, I'd completely agree with that.

That's why I/my doctor chose methadone, heavy IV heroin user.

I wasn't gonna stop, not even as bad as things were. Maybe I would have at some point, but wtf else would I have gone through in that time? It's crazy to me to say "well you should have just quit". Cause I wasn't gonna, I wanted to stop, but not so badly that I was prepared to detox.

It's saying "well you shoulda done this thing you know you weren't gonna do, rather than the thing you did that has given you 4 years more of your life not continuing down that path".

Personally I have no current intentions to stop methadone. Maybe eventually I will be ready.

Even if I HAD quit. I'd have relapsed. I know cause I did relapse, but cause I was on methadone I was able to stop it again, if I hadn't been on methadone I'd have been all the way down hill again.

I regret nothing in my decision to get on methadone. And have never had even one moment where I've thought that I should have tried to detox.

My choice wouldn't be the ideal option for everyone, but that's ultimately my point, no one thing is.
 
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birdup.snaildown

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Like a lot of discussions with you, this one is confusing me a bit. I never told you that you should have quit. You said there was no alternative. There is always an alternative, IMO... In another thread you said prostitution was inevitable in certain situations with heroin addicts.

I'm not passing judgement on people any more than you were in the abortion thread by stating your opinion. This whole idea of opinions implying judgement bothers me. People should be able to state their opinions.

I don't like Islam. That's not a personal judgement on any individual. I just disagree with the ideology of Islam and it's important (I think) for people to be able to speak their mind.

Does the data indicate people are more likely to quit using opiates if they take methadone? I'm not sure what data you're talking about. I'm always a bit sceptical with stats, but I'm happy to have a look.

I'm sure it does improve quality of life if you're totally strung out and have very little prospect of maintaining sobriety. I mean of course it does, because it's a way to avoid getting clean while also avoiding the pitfalls of street drugs.

Methadone is basically legal heroin.

My advice is: don't take it if you want to kick.
 

negrogesic

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My advice is: don't take it if you want to kick.

That's not advice, thats how methadone works. Occasionally methadone is prescribed in a 21 day detox, but methadone is never for people who want to quit immediately, but for those that want to quit eventually, or even for those that don't want to quit ever but are sick of the lifestyle.
 

negrogesic

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Maybe it's bad advice - in your opinion - but it's still advice.

No its good advice. But by saying its "not advice" i meant that its not so much advice but simply the standard prescribing protocol. Methadone isn't prescribed to someone who wants to get off in 2 weeks (with the exception of the inpatient 21 day methadone taper, which is a rare treatment course since buprenorphine became common).
 

birdup.snaildown

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I don't know man.

You said it took you 18 months.
Jess has been on it for 4 years.

I've known many people who have been stuck on methadone for over a decade.

What's the point?

@JessFR
You said you're on 80mg?
That's pretty low. Why not just stop?
 

JessFR

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I don't know man.

You said it took you 18 months.
Jess has been on it for 4 years.

I've known many people who have been stuck on methadone for over a decade.

What's the point?

@JessFR
You said you're on 80mg?
That's pretty low. Why not just stop?

I'll answer your longer post a little later, just got home, but I'm gonna answer this one quickly first.

Ok first, I would not call 80mg low. From all the methadone doses I've heard, I would call that... ehhh... for someone who stops when they are comfortable and hasn't kept going up regardless, I'd call it a relatively average amount. But it's nowhere near low enough to just stop without severe withdrawal.

As for why I am not tapering of it, well, a bunch of reasons.

1. I'm still not willing to deal with the withdrawal. I'm not that committed.
2. I think it's highly likely that because I'm not committed, that sooner or later I'll relapse, then I'll likely end up quickly back to where I started. I don't think it's worth the risk.

Basically, I'm not at a point where I'm prepared and completely committed to stop opioids for good, I think that even when you are, your prospects of not relapsing still aren't that great. They're not as bad as trying to stop when your hearts not in it, but they're not superb either. And I know my hearts NOT in it.

If I relapse on methadone.... it's far less likely I'm gonna spiral out of control, if I relapse while off it, which I think is greatly more likely, it's gonna be very bad.

Basically, it boils down to this, I don't feel ready. Maybe I will one day, but I don't right now. And yeah, I might well be on it a long time. I knew that going into it. Not cause they told me that, they shoulda, they should give everyone an accurate expectation going in. But *I* knew that I might be on it a long time.

I wouldn't say that methadone is just legal heroin. I wouldn't say that sentiment is entirely wrong, but I wouldn't call it entirely right either.

Thing is, I think we're focusing on different things (fuck I talk a lot look how long this quick reply already is). I'm focusing reducing the harms caused by drugs in my life, I am not focusing on eliminating drugs from my life because I don't feel that right now that's a realistic goal. I think it is for some people and maybe one day it'll be for me, but it wasn't when I got on it and I I still feel exactly the same now.

And frankly, if I get to not live like I was living on heroin for the next 20 years and spend that 20 years on methadone instead, I'm fully on board with that. I'd rather that than endlessly trying and failing to achieve sobriety.

I'm looking at this from a standpoint of how to improve peoples lives based on their specific circumstances. Sometimes abstinence can be the best approach to that, but I think a LOT of the time it's not.

I think being clean is the wrong focus, cause why do you want to be clean? If heroin were totally harmless, what would it matter? It matters because it's not harmless. It's the harm that we're trying to reduce, being clean is just one way to reduce the harm. But it's not the only way. The reduction of harm is my focus, that's my perspective. And that is the standpoint in which I'm saying maintenance is very effective.
 

birdup.snaildown

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I appreciate the reply. I understand this is a sensitive topic. Let me know if you don't want me to continue posting in this thread.

I still don't really get it. You don't want to eliminate drugs from your life, but the drugs you are taking have no rec effect other than mild sedation? If it was me, I'd want to eliminate them.

I'm not sure if you don't want to or you think you can't?

People stay on heroin for a long time because they don't think they can quit. This applies to all drug addictions, including tobacco. Sometimes people use it as an excuse. I know I have.

I understand what you're saying about relapsing.
 

JessFR

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I think I know me. I think that even if I were prepared to go through withdrawal. I think it's highly likely that within a few years I'll relapse, and end up doing the whole thing again. I've seen it happen to others. The data shows how often it happens.

That doesn't mean it happens to everyone, which is why you gotta judge the risks by how you think you'll react and your own experiences. But it happens a lot, it happens more often than on methadone, and it's more dangerous when it happens because people overestimate their tolerance.

Even when people taper off methadone after years not using heroin. From my recollection the odds that they'll have relapsed in the next couple years jumps a lot higher than the people who didn't.

I'd wanna double check that part for how much the difference actually is, but I'm pretty sure it's not small.
 

Pickledlemons

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Every medical professional I have talked to actually suggest staying on maintenance indefinitely because your the risk of relapse and OD/death is less.
 

JessFR

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Every medical professional I have talked to actually suggest staying on maintenance indefinitely because your the risk of relapse and OD/death is less.

Well from a health perspective, that makes sense. It's what the data indicates had the best health outcomes.

But there's more to life than health. Especially on countries like the US, but to lesser extent in most other countries, substitution therapy does impact your life, if does create a barrier that limits your ability to fully exercise freedom. I think the barriers are manageable, but they exist. And they're a bigger impact on some people than others.

But that's not the kind of thing most doctors are going to be concerned about. They're gonna be concerned about how likely you are to die as a result of your drug use. And while they should discuss in full what your other options are, if you're gonna emphasize one, most will emphasize the one that most effective at reducing health risks.

That's.. Kinda their job.

EDIT: btw if anyone's interested I can dig up some data. I've mentioned it a lot but I have a bit of a standing policy not to go out of my way to prove data unless it's challenged as untrue. Since a very large amount of the time, people either dismiss data or don't believe in it.

Even when it's challenged as untrue, I am still usually only providing it for the benefit of others who might view the thread and might find it more helpful to know about. 90% of the time you can put up all the mountains of evidence you've been asked got and it's all just written off on a sentence.
 
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