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Gateway Drugs

Postby palmspringsbum » Thu Aug 31, 2006 3:05 pm

The Crookston Daily Times wrote:Thursday, August 31, 2006

Sugar a 'gateway' substance?

By Natalie J. Ostgaard, City Editor
The Crookston Daily Times
Published: Wednesday, August 30, 2006 2:55 PM CDT

<table class=posttable align=right width=300><tr><td class=postcell><img src=bin/adamek-margaret.jpg width=300></td></tr><tr><td class=postcap>Margaret Adamek, Ph.D. speaks in the CHS auditorium Tuesday. (Natalie J. Ostgaard, Photographer) </td></tr></table>Sugar is not something people group in the same category as marijuana or cigarettes. Yet, it is actually a "gateway" substance that could lead to addiction to harder drugs such as amphetamines, according to Margaret Adamek, Ph.D.

Adamek, founder and director of the Sugar Project and Special Projects Director at the University of Minnesota's Center for Urban and Regional Affairs, talked Tuesday evening about dysfunctional foods - refined carbohydrates and sugars in particular - and their profound effects on people. About 25 people attended her presentation at the high school.

While citing numerous statistics and research from a number of sources, she showed how the United States is experiencing a public health crisis due to an interlocking web of socio-economic factors such as the agricultural industry, health and environment that create dysfunctional eating patterns in the population.

"We're in the middle of an obesity epidemic," Adamek asserted, "that radically transformed over the last 20 years."

<span class=postbold><b>Statistics</b></span>

Adamek brought forth statistics on Americans from several reliable sources to drive home her point:
<li>Administration of amphetamines to children has risen 3,000 percent in the last 10 years, and 85 percent of all amphetamine prescriptions are administered to children.</li>

<li>Nearly a third of children are overweight. Obesity rates among children have doubled in the last 10 years and tripled for adolescents.</li>

<li>The adult obesity rate is a whopping 64 percent.</li>

<li>About 40 percent of girls and a third of boys born in 2000 will acquire type II diabetes by the time they turn 50. Between 1990 and 1998, the prevalence of diagnosed diabetes increased 33 percent.</li>

<li>Increasing numbers of children are diagnosed with attention deficit disorder, depression and generalized anxiety disorder. Children who are obese also tend to be depressed.</li>

<li>Since 1970, consumption of high-fructose corn syrup has increased 4,000-plus percent, and we eat 300 calories more per day due to carbohydrate consumption. In the same period, refined carbohydrate consumption rose 50 percent.</li>

<li>One-third of children and a fourth of adults eat fast food every day. This is besides the processed foods they receive at school and home.</li>

<li>Between 1983 and 1999, sugar intake rose 30 percent to 158 pounds per person per year.</li>

<li>Since 1977, soft drink consumption is up 135 percent.</li>

<li>Junk foods - dense, nutrient-poor foods with no dietary benefit - comprise 27 percent of the average daily food intake.</li>

<span class=postbold><b>Research</b></span>

Everyone knows high sugar consumption as well as other refined carbs and fats can lead to obesity. But, Adamek pointed out, more and more research is proving a correlation between high intake of these foods and a whole slough of problems such as diabetes, depression, anxiety, attention deficit disorder and various addictions.

Adamek referred to research conducted by Dr. Kathleen DesMaisons, president and CEO of Radiant Recovery(r), an innovative diet-based treatment program for alcoholism, depression, addiction and compulsive behaviors. Her research into the theory of "sugar sensitivity" spawned the field of addictive nutrition.

DesMaisons determined four neurochemical roots of the problem, which "sugar sensitive" people are born with: volatile blood sugar (diabetes, fatigue, moodiness, lack of concentration and emotional outbursts); and low levels of serotonin (depression, aggression, poor attention and impulsive behavior); beta endorphin (chemical dependence, and a sense of victimization and alienation); and dopamine (drug and alcohol addiction, low self-esteem, violence and anger).

"Someone with carbohydrate sensitivity is affected 35 times greater when ingesting the same amount as someone who is not carb sensitive," Adamek explained. "The intensity of the reaction created big peaks and valleys with moods and blood sugars."

The biochemical result is that sugar has an addictive drug effect on the brain. Children who are addicted to sugar are much more likely to become addicted to other substances as they get older, she added.

Families from certain ethnic groups tend to have more alcoholism, diabetes, obesity and depression run through their family trees, she added.

Dieters typically use artificial sweeteners to save on carbs. This does not work as well as it seems, Adamek noted, because research indicates that the sweet taste alone stimulates the addictive opiate response in the brain.

<span class=postbold><b>Choices, changes and a plan</b></span>

Do these statistics and research mean anyone suffering from sugar sensitivity is doomed? Hardly, Adamek stressed.

"There is hope and, with a little hard work, you can change your eating habits and consequently your life."

Adamek said the standard medical approach to solving the previously mentioned emotional and physical problems has been to prescribe drugs for the symptoms: Paxil for anxiety, Prozac for depression, insulin for diabetes and Ritalin for ADHD.

"We have another line of defense, however," she said. "Food."

DesMaisons developed a seven-step approach to gradually remove refined carbohydrates and processed food from one's diet and replace them with quality protein and complex carbohydrates, fresh fruits and vegetables and essential fatty acids. While the exact steps may vary depending on factors such as age and dietary restrictions, the plan includes regular meal and snack times, keeping track of eating and emotional patterns and changing food choices.

When feeding children, it is important that they get enough healthy food for their size and age and at regular intervals, she said. Fruit juice, while good in small amounts, can also be easily overdone.

"A 20-ounce bottle of apple juice is far too much for an 8-year-old," she noted. "Just one small glass a day is sufficient.

"This is nothing you haven't heard before," Adamek said. "These are just simple, healthy eating strategies you can use the rest of your life."

She is happy to see schools moving toward healthier food choices for students, but there is still a long way to go, she said.

"A few innovative projects are going on that incorporate fresh food from local farms," Adamek explained. "But many schools still regularly use a lot of processed foods in their lunch programs."

So families need to take the helm and move toward cutting the junk out of their diets themselves. In time, she said, children will stop resisting the change and learn to like the foods, which incidentally don't have to cost an arm and a leg.

"This is doable on fixed incomes. There are a lot of inexpensive proteins. Eggs are always fairly cheap."

Adamek stressed that anyone following DesMaisons' diet will feel much more energetic, happy and healthy overall. It has also been known to alleviate many of the emotional problems associated with dysfunctional eating.

Check out the website for more detailed information, diet tips and community forums.

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Smoking May Boost Problem Drinking in Teens

Postby palmspringsbum » Wed Nov 29, 2006 2:01 pm

Forbes wrote:Smoking May Boost Problem Drinking in Teens

11.29.06, 12:00 AM ET

WEDNESDAY, Nov. 29 (HealthDay News) -- Smoking may prime the adolescent brain to be more vulnerable to alcoholism and other addictions, a new study suggests.

"The younger they start smoking, the more their brains appear to be more susceptible to other addictions," said study co-author Richard Grucza, an epidemiologist at the Washington University School of Medicine in St. Louis. "So, the longer we can delay these behaviors, the better."

The findings are published in the December issue of Alcoholism: Clinical & Experimental Research.

"Everybody knows that smokers, especially in adolescence, have a higher likelihood of alcohol problems and dependence," Grucza said. "We wanted to see if that was solely attributable to the fact that they drink more than nonsmokers do or if the story was more complicated."

Grucza and a colleague reviewed survey data on the smoking and drinking practices of nearly 75,000 subjects aged 12-20, collected from 2002-2004 by the U.S. National Surveys on Drug Use and Health.

Compared to adolescent nonsmokers who drink alcohol, they found that adolescent smokers have more than a 50 percent higher risk of an alcohol-use disorder -- anything from alcohol abuse and dependence to alcohol-related trouble with the law.

The researchers also found that the smokers' risk of an alcohol-related disorder is elevated even when they drink the same amount of alcohol as nonsmokers, and that the risk is especially high among younger smokers and lighter drinkers. Among 15- to 17-year-olds who drank fewer than eight drinks a month, the prevalence of an alcohol problem was 20 percent in smokers, compared to only 5 percent in nonsmokers.

"This study provides additional important evidence that both smoking and drinking behaviors among U.S. youth are serious epidemics and also pediatric diseases -- ones increasingly understood as having origins and roots in early life behaviors and conditions," said Dr. Elissa Weitzman, of the Harvard School of Public Health, who was not part of the study. "Smoking and drinking present a troubling nexus of interacting risks. Use of one is a good indication that use and abuse of the other may be present, too," she said.

Weitzman said her own research has shown that youths who became regular smokers by age 15 were at a fivefold higher risk of developing an alcohol-related disorder by ages 18-21, compared to their nonsmoking peers who drink alcohol.

"The evidence is accumulating that early and youthful smoking and drinking are signposts of serious health problems and not -- as many continue to contend -- rites of passage typical of youthful exploration," she said.

"Youth, their parents and family members, health-care providers, teachers and counselors all would do well to take seriously the strong indication for other substance use from observation of use of just one of these substances," Weitzman said. "This may be especially the case for tobacco, where youthful smoking provides a stunning indicator of risk for problem levels of drinking in adolescence and young adulthood."

Grucza cautioned that his study documents only an association between adolescent smoking and problem drinking. "We're going to look further to see if it's a true cause-and-effect relationship," he said. "Even if it's not, then seeing who smokes can help us identify who's at risk for alcoholism and other addictions."

His findings mirror those of researchers who have studied animal models of addiction. "There are fairly striking parallels in the animal literature, which show that nicotine exposure during the animal equivalent of adolescence affects the brain's central-reward circuitry that is involved in all addictions," he said. "The adolescent brain is still very much in development. Unlike most people who start smoking in adulthood, adolescents who start smoking quickly become dependent on nicotine."

The health consequences are severe, Grucza added, because smoking and alcohol -- either separately or together -- account for more than 20 percent of deaths each year in the United States.

Although rates of adolescent smoking and drinking have declined since the 1970s, they've flattened out during the past decade and remain at alarmingly high levels, Grucza said.

"When people talk about 'gateway' drugs, they often focus on illegal drugs such as marijuana," Grucza said. "But the biggest public health problems are smoking and alcohol, with smoking being the single most important preventable cause of death."

"We need to look earlier in the 'gateway' series and see how smoking affects that process," Grucza said.

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Researchers say smoking pot not always path to hard drugs

Postby palmspringsbum » Tue Dec 05, 2006 11:30 am

Most people who experiment with marijuana do not go on to use harder drugs, Dr. Capretto said.

The Pittsburgh Post-Gazette wrote:Researchers say smoking pot not always path to hard drugs drug use

Tuesday, December 05, 2006

By Anita Srikameswaran, Pittsburgh Post-Gazette

Contrary to popular belief, smoking marijuana need not be a steppingstone between using alcohol and tobacco and experimenting with illegal drugs such as cocaine and heroin.

Researchers led by Ralph E. Tarter, a professor at the University of Pittsburgh's School of Pharmacy, found that nearly a quarter of the young men they studied used marijuana before they began drinking or smoking cigarettes.

It's the reverse of what's known as the "gateway hypothesis," in which drug use is thought to progress from alcohol and tobacco to marijuana to hard drugs.

The researchers determined also that the likelihood of developing a substance abuse problem was similar in youngsters who followed the traditional gateway drug use pattern and those who followed the reverse pattern.

"This is actually quite novel, this idea," Dr. Tarter said. "It runs counter to about six decades of current drug policy in the country, where we believe that if we can't stop kids from using marijuana, then they're going to go on and become addicts to hard drugs."

But the data doesn't support that contention, he noted. The findings were published in this month's American Journal of Psychiatry.

Marijuana was the first drug used by a 26-year-old man from Beaver County who is undergoing addiction treatment at Gateway Rehabilitation Center. He was 15 the first time he tried it, on a Saturday with a group of friends.

At their suggestion, he began smoking cigarettes when he started using marijuana.

"That's how they taught me how to hold in the smoke of the weed, because cigarette smoke is stronger than marijuana smoke," he explained.

Smoking pot soon became a weekend thing.

Then, "I started smoking in the morning before I would go to school," he recalled. "Sometimes I would sneak away and go smoke during lunch. Then after school I would smoke."

Eventually, he was using marijuana "all day, every day," he said. If he didn't smoke, he'd get headaches and have problems sleeping. Two years ago, a friend introduced him to snorting cocaine, and he began using that in addition to smoking pot.

Now married and a father, he realized he was spending all his money on drugs, instead of his family. So he checked himself into rehab in the hope of overcoming his addictions.

In Dr. Tarter's study, which was funded by the National Institute on Drug Abuse, researchers monitored more than 200 young men at intervals from the time they were 10 to 12 years of age until they were 22. They fell into one of three groups: those who used only alcohol or tobacco; those who started with alcohol and tobacco and then used marijuana; and those who used marijuana prior to using alcohol and tobacco.

Among those who used marijuana, nearly a quarter followed the reverse of the gateway pattern. They tended to have less parental supervision and to live in neighborhoods with poor physical environments where illegal drugs were more available.

In general, the marijuana-users were more behaviorally deviant, less involved with school and had friends their parents didn't like, the researchers found.

"That all makes sense to me," said the Gateway Rehab Center patient. "If I had stayed with the crowd I grew up with, I don't think I'd have had this problem. I started to hang with the wrong crowd."

Some of his friends have used harder drugs, such as cocaine, while others used marijuana now and then, but never progressed further into addiction, he said.

It was easier to obtain marijuana than alcohol or cigarettes as a teenager, he added.

"You always had to show a form of ID to get those," he said. "But I could always go to the person who was selling the weed to get it, and they wouldn't ask for ID. It was never hard to get for me."

Gateway's medical director, Dr. Neil Capretto, said a few patients have told him that the first drug they used was heroin, which is "very available now in many neighborhoods, whether it be inner-city Pittsburgh or upper-middle-class suburbs."

He praised the Pitt study, saying "it really shows the complex nature of addiction. What they're showing here is what we've been seeing in practice for years."

Most people who experiment with marijuana do not go on to use harder drugs, Dr. Capretto said.

Still, "the vast majority of people who we see who do cocaine or heroin have done marijuana in the past, or are likely to do it at some time in the future," he noted. But "if we could push a button and all the marijuana would go away, by no means will that stop the drug problem in this country."

Dr. Capretto described the mother of a patient who was relieved that, unlike her other son who was addicted to heroin, her younger boy's dropping grades and mood changes were due to marijuana use.

"I said, 'That's not necessarily good news,' " he recounted. "Something's still wrong. Whether it be a young person on alcohol, tobacco or marijuana, [even] if that's all they ever do, that's a problem right there."

According to Dr. Tarter, drug use prevention messages should minimize "slippery slope" scare tactics and emphasize healthy living. Interventions to foster values and attitudes that resist illegal behaviors and to strengthen parenting skills could be helpful.

It's possible to identify children who are at high risk for drug use years before they begin experimenting, Dr. Tarter said.

"Nothing is carved in stone, especially at this age," he said. "But the longer you wait, the harder it is to change."

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Caution: Marijuana may not be lesser evil

Postby palmspringsbum » Fri Feb 16, 2007 10:44 pm

USA Today wrote:
Caution: Marijuana may not be lesser evil

Updated 2/6/2007 2:47 PM ET
By Rita Rubin, USA TODAY

<table class=posttable align=right width=300><tr><td class=postcell><img class=postimg width=300 src=bin/usa_today-joint.bmp></td></tr><tr><td class=postcap>Studies show "the earlier someone starts using marijuana, the greater their vulnerability to addiction disorders and psychiatric disorders," says psychiatrist Yasmin Hurd</td></tr></table>Tyreol Gardner first smoked marijuana when he was 13.

"The main reason I tried it was curiosity," Gardner recalls. "I wanted to see what it felt like."

He liked what it felt like, and by age 15, he was smoking pot every week. He supported his habit with the money his parents gave him for getting straight A's on his report card. They didn't have a clue.

"By 16, when I got my license, it turned into a fairly everyday thing," says Gardner, now 24. "I believe it is very addictive, especially for people with addictive personalities."

Millions of baby boomers might disagree. After all, they smoked marijuana — the country's most popular illicit drug — in their youth and quit with little effort.

But studies have shown that when regular pot smokers quit, they do experience withdrawal symptoms, a characteristic used to predict addictiveness. Most users of more addictive drugs, such as cocaine or heroin, started with marijuana, scientists say, and the earlier they started, the greater their risk of becoming addicted.

Many studies have documented a link between smoking marijuana and the later use of "harder" drugs such as heroin and cocaine, but that doesn't necessarily mean marijuana causes addiction to harder drugs.

"Is marijuana a gateway drug? That question has been debated since the time I was in college in the 1960s and is still being debated today," says Harvard University psychiatrist Harrison Pope, director of the Biological Psychiatry Laboratory at Boston's McLean Hospital. "There's just no way scientifically to end that argument one way or the other."

That's because it's impossible to separate marijuana from the environment in which it is smoked, short of randomly assigning people to either smoke pot or abstain — a trial that would be grossly unethical to conduct.

"I would bet you that people who start smoking marijuana earlier are more likely to get into using other drugs," Pope says. Perhaps people who are predisposed to using a variety of drugs start smoking marijuana earlier than others do, he says.

Besides alcohol, often the first drug adolescents abuse, marijuana may simply be the most accessible and least scary choice for a novice susceptible to drug addiction, says Virginia Tech psychologist Bob Stephens.

No matter which side you take in the debate over whether marijuana is a "gateway" to other illicit drugs, you can't argue with "indisputable data" showing that smoking pot affects neuropsychological functioning, such as hand-eye coordination, reaction time and memory, says H. Westley Clark, director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration.

Adolescents have the greatest rates of marijuana use, and they also have the greatest amount to lose by using marijuana, scientists say.

"Adolescence is about risk-taking, experimentation," says Yasmin Hurd, professor of psychiatry, pharmacology and biological chemistry at the Mount Sinai School of Medicine in New York who last summer published a rat study that found early exposure to THC, the psychoactive ingredient in marijuana, led to a greater sensitivity to heroin in adulthood.

"All of the studies clearly show the earlier someone starts taking marijuana, the greater their vulnerability to addiction disorders and psychiatric disorders. I'm so shocked still that so many parents are not considering enough the dangers of early drug use."

<span class=postbold>Use is more common </span>

Marijuana use by adolescents in the USA declined slightly from 2005 to 2006, but it's still more common than it was 15 years ago, according to "Monitoring the Future," an ongoing study by the University of Michigan that tracks people from the eighth grade through young adulthood. It's paid for by the National Institute on Drug Abuse, or NIDA, part of the National Institutes of Health.

In 2006, 11.7% of eighth-graders said they had used marijuana during the past year, compared with 6.2% of eighth-graders in 1991. Among 12th-graders, 31.5% said they had used marijuana in the previous year; in 1991, 23.9% said they had.

"You are at school, and your main job as an adolescent is to learn and memorize," NIDA director Nora Volkow says. But if you keep becoming intoxicated by smoking marijuana, she says, you'll fall further and further behind in your studies. "How are you going to catch up?"

In a study comparing heavy marijuana users with people who'd had minimal exposure to the drug, Pope found that the former had lower verbal IQ scores than the latter. In a 2003 paper, he and his co-authors postulated three potential reasons: innate differences between the groups in cognitive ability that predated first marijuana use, an actual toxic effect of marijuana on the developing brain or poorer learning of conventional cognitive skills by young marijuana users who skipped school.

<span class=postbold>Wasted years</span>

By the time Gardner was a junior, he started skipping high school regularly to smoke pot. "I would always find somebody who wasn't at school that day and get high with them," he says. Gardner says he missed 50 days in the first semester of his senior year. His parents discovered his stash of marijuana and sent him to a psychiatrist. His grades plummeted; his college plans evaporated.

When he was 16 or 17, Gardner says, he was charged at least twice with possession of marijuana and underage possession of alcohol. The court sent him to a three-month outpatient treatment program. He attended weekly sessions and underwent urine checks.

But it didn't stick. He celebrated the end of the program by getting high on pot and alcohol. By 18, "I was pretty heavy into cocaine," Gardner says. Crystal meth and intravenous heroin followed.

"I was always looking for the ultimate high. It was like a constant search, and I never found it. … By the end, it was a living hell for me."

Finally, Gardner says, his parents persuaded him to enter an inpatient treatment program in Winchester, Va. They spoke from experience. When he was 8, Gardner says, his father stopped using drugs while in prison for possession. "My mom got clean while he was in prison."

Gardner says he has been off drugs and alcohol for 14 months. He works in a Winchester factory that makes patio decking. He graduated high school because a teacher took pity on him and let him try to make up the work he had missed. More than six years after graduating, Gardner hopes to go to college to study psychology.

Research shows marijuana users are significantly less satisfied with the quality of their lives than non-users, a revelation "as telling as any very fancy story of molecules," Volkow says.

Yet, she says, "I think there is a general sense that marijuana is a relatively benign drug and does not produce addiction." Although over the past decade, "research clearly has provided unequivocal evidence that … some people can become addicted to marijuana."

Stephens has conducted seven large treatment studies of marijuana dependence, or addiction. "There's never any shortage of people who meet this definition," says Stephens, who edited the 2006 book Cannabis Dependence.

<span class=postbold>Pot as predecessor</span>

Pope has studied heavy marijuana users, whom he defines as having smoked pot at least 5,000 times, or once a day for nearly 14 years. On average, his subjects, ages 30 to 55, reported having smoked marijuana 20,000 times.

Pope required the volunteers to abstain from smoking pot for 28 days and used urine samples for confirmation.

"We had them rate various symptoms on a day-by-day basis," he says. "We were able to show there is a clear withdrawal syndrome."

His research found the most common symptom of marijuana withdrawal was irritability, followed by trouble sleeping and loss of appetite. Symptoms began to subside after a week and disappeared by the end of two weeks.

"We've had some people in our study who reported quite a lot of craving. They were quite miserable not being allowed to smoke marijuana," Pope says, although "certainly, one does not see craving even remotely to the degree you would … with heroin or alcohol or cocaine."

Marijuana today is more potent and therefore more toxic than marijuana grown in the 1970s, Volkow says. Back then, she says, plants typically contained only 2% THC. Today, she says, marijuana plants typically contain 15% THC.

Even if today's marijuana is more potent, Stephens says, he's not convinced that makes a difference.

"The evidence of its increased potency is overrated," he says. Samples of marijuana grown in the 1970s might have appeared to be less potent than they actually were because they weren't fresh when tested. And, Stephens speculates, marijuana users might just smoke more of less-potent pot, and vice versa.

<span class=postbold>A family problem</span>

Rachel Kinsey says drug addiction runs in her mother's family, although not in her immediate family. Kinsey, 24, started drinking alcohol at 14 and smoking marijuana at 15 — "definitely a predecessor for everything else I used." She began using Ecstasy and cocaine at 17, then heroin at 18.

"I did graduate high school, and I went off to college, but I withdrew after a month," says Kinsey, of Richmond, Va. She used the diagnosis of mononucleosis she'd received the week before college as an excuse.

"I don't think I was ready for the responsibility, and I wanted to continue to use while I was in college. I was at the point where I just didn't care about college. I was already using heroin."

She moved in with her boyfriend and his father, both of whom used heroin. At 19, she got pregnant. She moved back in with her mother, substituted methadone for heroin and gave the baby up for adoption. Practically as soon as she delivered, she was back to using heroin.

About five months after her son was born in May 2003, Kinsey entered inpatient addiction treatment. During the 30-day program, she became involved with a man who went back to using cocaine after ending treatment. Kinsey says she didn't want to go back to using cocaine or heroin, "but for some reason I thought it was OK to drink and go back to smoking weed."

When she turned 21 in fall 2003, "it was off to the races. For some reason, I felt (turning 21) gave me the right to drink if I wanted to."

From January to August 2004, Kinsey says, she was charged three times with driving under the influence of alcohol and marijuana.

<span clas=postbold>'Not worth the risk'</span>

With the help of another stay at a treatment center, Kinsey hasn't used drugs or alcohol since Aug. 25, 2004, the day after her last DUI arrest. She's halfway toward graduating from nursing school and works as a nurse tech in a hospital. For the first time, she has signed a lease on an apartment and pays rent.

She can't drive until September 2008 and then only to work, to school and to 12-step meetings.

If she had to do it all over again, she says, she never would have started smoking marijuana.

"You never know where it's going to lead you," she says. "You don't know that you're not going to become an addict, so it's not worth the risk."

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