A liquid dose of methadone at the clinic in Rossville, Ga. The medication is only available at designated opioid treatment centers and that won't change. But more clinicians will be able to ...Methadone has been an unique, versatile, cost effective, synthetic opioid utilized in nociceptive as well as neuropathic pain.[1,2] Initially limited to de-addiction centers as a drug assisted rehabilitation for treatment of opioid dependence and substance abuse to heroin, it gradually paved way in cancer pain practice by utility as a second line drug and …The discovery of methadone by the Germans in the later stages of World War II is described. At that time, methadone was not recognized to be a narcotic analgesic. The first report of the properties of methadone published in the United States in 1947 is summarized, and its early use in the treatment of the opioid abstinence syndrome is noted.Medication-assisted treatment (MAT) is the use of medications with counseling and behavioral therapies, to provide a “whole-patient” approach to treatment of substance use disorders. MAT is primarily used for the treatment of addiction to opioids such as heroin and prescription pain relievers that contain opiates. The prescribed medication ...This methadone clinic Mead OK has treatment facilities spread over Oklahoma in cities like Ardmaor, Lawton, Mead and Oklahoma City. From these units, they offer …Find patient medical information for methadone oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings. ... call a poison control center right ...Feb 2, 2024 · Methadone to treat opioid addiction will be easier to get soon under new rule : Shots - Health News Bureaucratic hurdles mean just one-in-five people with opioid addiction get access to medication ... Maryland, Oklahoma, and Virginia are among the top states with the most companies designated as essential businesses during the pandemic. A study by LendingTree has ranked states a...Opioid agonist therapy (OAT) is a treatment in which prescribed opioid agonists are given to patients who live with Opioid use disorder (OUD). In the case of methadone maintenance treatment (MMT), methadone is used to treat dependence on heroin or other opioids, and is administered on an ongoing basis.. The benefits of this treatment include … Additionally, you can visit this website link for listings and locations of OTP clinics throughout the United States. TDMHSAS Rules for Non-Residential Opioid Treatment Facilities. For more information, contact: Ira Lacy Opioid Program Manager Dept. of Mental Health and Substance Abuse Services Phone: (615) 741-6995 Email: [email protected] This methadone clinic Lawton OK also offers the internationally acclaimed medication-assisted treatment (MAT) to patients. Transitions Treatment Services Lawton considers each patient individually and in that manner, drafts unique treatment schemes that address the needs of patients. Prescription of methadone helps keep opioid withdrawal ...Lawton, OK 73507 (580) 355-8888 Lindsay Dr. Robert Michael Westcott 409 South Main Street Lindsay, OK 73052 (405) 756-1240 McAlester Dr. Nelson C. Onaro 320 East Delaware Avenue McAlester, OK 74501 (918) 423-5916 Dr. Gerald D. Wootan ... Call To Find a Methadone Clinic 800-865-3138.The discovery of methadone by the Germans in the later stages of World War II is described. At that time, methadone was not recognized to be a narcotic analgesic. The first report of the properties of methadone published in the United States in 1947 is summarized, and its early use in the treatment of the opioid abstinence syndrome is noted.Methadone is a synthetic, long-term opioid agonist medication used in the management and treatment of opioid use disorder (OUD) and for analgesic purposes in chronic pain. The drug is approved by the U.S. Food and Drug Administration (FDA) for treating moderate-to-severe pain that has not responded to nonopioid medications or as …Lawton Treatment Centers. Find rehab in Lawton, Comanche County, Oklahoma, or detox and treatment programs. Get the right help for drug and alcohol abuse and eating disorders. Other common side effects of methadone include: constipation. headache or dizziness. fatigue or drowsiness (especially soon after a dose) loss of appetite, nausea and vomiting. Methadone affects everyone differently. Your chances of experiencing side effects may depend on: if you regularly use methadone. if you take methadone while also taking ... The purpose of this narrative review article is to discuss the pharmacology of methadone, the evidence surrounding methadone's use in acute pain management and both chronic cancer and non-cancer pain settings, as well as highlight pertinent safety, monitoring, and opioid rotation considerations. Methadone has a unique mechanism of action when ...3201 West Gore Boulevard Suite 304 Lawton, OK 73505. Phone Number: (580) 353-6760. Get Help Now - 918-771-0191. ... Call to Find a Methadone Clinic 800-813-6196 Who …Oklahoma has its methadone clinics and (buprenorphine) suboxone doctors concentrated mostly in and around its metropolitan urban centers. With the recent rise in opioid …See more reviews for this business. Best Veterinarians in Lawton, OK - Freeman Veterinary Clinic, Oak Ridge Animal Center, Bower Robert DVM, Meadow Wood Animal Hospital, Chambers Veterinary Clinic, Creekside Animal Hospital, Lawton Veterinary Hospital, Hergenrether Animal Hospital, Animal Birth Control Clinic, Gore West Animal …Clinton Indian Health Center - 10321 N 2274 Rd. Exit Disclaimer: You Are Leaving www.ihs.gov Clinton, OK 73601 - 580-331-3300. El Reno Indian Health Center - 1801 Parkview Drive Exit Disclaimer: You Are Leaving www.ihs.gov El Reno, OK 73036 - 405-234-8400. The Indian Health Service (IHS), an agency within the Department of Health and Human ...Other common side effects of methadone include: constipation. headache or dizziness. fatigue or drowsiness (especially soon after a dose) loss of appetite, nausea and vomiting. Methadone affects everyone differently. Your chances of experiencing side effects may depend on: if you regularly use methadone. if you take methadone while also taking ... Home / Methadone Doctors / Oklahoma / Lawton / J. Ross, M.D. Address: 1320 NW Homestead. Lawton, OK 73507. Phone Number: (580) 355-8888. Call: (888) 217-1376. Local Lawton, OK Methadone Clinic. We are your preferred local Methadone treatment clinic. Visit our location in Lawton near zip code 73501 today for treatment options. There is also a methadone clinic in Lexington, Oklahoma if you live closer to that area. Starting Methadone Treatment.Apr 16, 2024 · Methadone is among the few medications used during medically supervised detox and withdrawal management as well as for maintenance treatment for people who are addicted to heroin, fentanyl, or other opioid drugs.2. Methadone is a full opioid agonist, which means it can eliminate or relieve symptoms of opioid withdrawal as it attaches to and ... A sample methadone taper may look like this: The lower dosage is between 20 percent and 50 percent (as tolerated) each day until it is down to 30 mg per day. Taper dosage down 5 mg to 25 mg after three to five days. Keep lowering dosage every three to five days until down to 10 mg per day.1307 SW Washington Ave. Lawton, OK 73501. Hours. Contact. 580-355-7500. Website. Clinic Description. Transitions Treatment Services Lawton is one of the …A 2017 systematic review and meta-analysis showed a reduction in pooled all-cause mortality among people with opioid use disorder who were treated with methadone (from 36.1 per 1000 person-years ...Robert W Dail Memorial Treatment Center 734 Hospital Road Commerce, GA 30529 Conyers Alliance Recovery Center Conyers 3430 Highway 20 Conyers, GA 30013 Cumming Brand New Start Methadone / Suboxone Treatment Centers Cumming 514 West Maple Street Suite 1206 Cumming, GA 30040 Dallas Dallas, Ga Methadone Medicare TreatmentSee more reviews for this business. Top 10 Best Podiatrists in Lawton, OK - April 2024 - Yelp - Southwest Foot And Ankle Clinic, Cain Bryan L DPM, John K Cauthon, DPM, Duncan Foot & Ankle Clinic, Nayfa Terry M DPM, Plains Family Foot Clinic.Respiratory depression may occur when pain is abruptly relieved and the sedative effects of opioids are no longer opposed by the stimulating effects of pain. This is a rare event. In methadone maintenance programs, effective methadone doses today generally fall in the 60- to 100-mg/day range. 4, 5 Methadone doses greater than 40 to …The most effective dose is 80 to 100 mg per day. 47–50 Patients who receive more than 100 mg per day must be closely monitored for side effects. 44,46,50. The maintenance phase begins at ...Lawton Treatment Centers. Find rehab in Lawton, Comanche County, Oklahoma, or detox and treatment programs. Get the right help for drug and alcohol abuse and eating disorders.• Methadone dose ≥100 mg/day. Quick reference guide and links to contents: o Prescribing decision support algorithm o What is the QT interval, how to measure it & adjust for heart rate o Reference ranges for prolonged QTc interval (men QTc >440 msec, women QTc >470 msec) & age-related differences (children/older adults)Comfortan® 10 mg/ml Solution for Injection for Dogs and Cats. Species: Cats, Dogs. Therapeutic indication: Pharmaceuticals: Neurological preparations: Tranquilisers, Analgesics. Active ingredient: Methadone. Product: Comfortan® 10 mg/ml Solution for Injection for Dogs and Cats.We Service areas in and around Lawton, Duncan, and Davis Oklahoma. (580) 394-2586. View Email. Lawton, OK 73505 ... Programs typically meet at the clinic a couple of times every week for a few ...Oklahoma has its methadone clinics and (buprenorphine) suboxone doctors concentrated mostly in and around its metropolitan urban centers. With the recent rise in opioid …The effects of a methadone overdose are: • Slow and shallow breathing, blue fingernails and lips, stomach spasms, clammy skin, convulsions, weak pulse, coma, and possible death. Which drugs cause similar effects? Although chemically unlike morphine or heroin, methadone produces many of the same effects. What is its legal status in the United ...Maximum initial dose: 30 mg. Maximum day 1 dose: 40 mg. Adjust dose over the first week based on control of withdrawal symptoms at 2 to 4 hours after dosing; titrate carefully as methadone levels will accumulate over the first several days of dosing. Short-term Detoxification: For a brief course of stabilization followed by a period of ...Buprenorphine prolonged-release injection (Buvidal) is licensed for treating opioid dependence within a framework of medical, social and psychological treatment in people aged 16 years and over. It is administered as a weekly injection (8 mg, 16 mg, 24 mg, or 32 mg) or monthly injection (64 mg, 96 mg, or 128 mg) by a healthcare professional and ...Robert W Dail Memorial Treatment Center 734 Hospital Road Commerce, GA 30529 Conyers Alliance Recovery Center Conyers 3430 Highway 20 Conyers, GA 30013 Cumming Brand New Start Methadone / Suboxone Treatment Centers Cumming 514 West Maple Street Suite 1206 Cumming, GA 30040 Dallas Dallas, Ga Methadone Medicare TreatmentLawton Treatment Centers. Find rehab in Lawton, Comanche County, Oklahoma, or detox and treatment programs. Get the right help for drug and alcohol abuse and eating disorders.As life-changing as methadone is, the catch is that taking the tightly regulated medication requires reporting to a special clinic nearly every day to get one’s dose. When the Covid-19 pandemic ...Early clinical guidelines recommended patients reduce to a low methadone dose (eg, 30–40 mg or less) before transferring to buprenorphine or to discontinue methadone for several days before initiating buprenorphine dosing (Lintzeris et al., 2001; Center for Substance Abuse Treatment, 2005; Lintzeris et al., 2006). Yet, these …Currently, there are three types of medications approved by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder: Buprenorphine. Methadone. Extended-release injectable naltrexone. Buprenorphine and methadone are the gold standard for treatment. There are decades of evidence proving their effectiveness. It is available in multiple generic and brand versions. Generic methadone is covered by most Medicare and insurance plans, but some pharmacy coupons and cash prices may be lower. Get methadone for as low as $12.97, which is 72% off the average retail price of $47.00 for the most common version, by using a GoodRx coupon. This methadone clinic Lawton OK also offers the internationally acclaimed medication-assisted treatment (MAT) to patients. Transitions Treatment Services Lawton considers each patient individually and in that manner, drafts unique treatment schemes that address the needs of patients. Prescription of methadone helps keep opioid withdrawal ...Tulsa. Ardmore. Southern Oklahoma Treatment Services - Transitions Treatment Ardmore. 905 Holiday Drive. Ardmore, OK 73401. Mead. Southern Oklahoma Treatment Services …Start Methadone Detox Today. Call for free at 580-470-0686 or get a text to get help finding a methadone detox center or recovery program near you. A recovery support specialist can verify your insurance coverage and treatment options over the phone. Methadone is a synthetic opioid medication. It is prescribed to help treat serious opioid ... Looking for the best methadone clinics in Lawton, OK? Search our directory of methadone clinics in Oklahoma or call our helpline 800-530-0431. Methadone is the most studied medication for opioid use disorder (OUD). Of all OUD pharmacotherapies, it is used to treat the most people throughout the world and has by far the longest track record (nearly 50 years).77,78 Numerous clinical trials and meta-analyses have shown that methadone treatment is associated with significantly higher rates of treatment retention and lower rates of ...1307 SW Washington Ave. Lawton, OK 73501. Hours. Contact. 580-355-7500. Website. Clinic Description. Transitions Treatment Services Lawton is one of the …Opioid treatment programs (OTPs) like Methadone clinics offer medication to assist someone with an addiction to opioids. Methadone is a synthetic opioid given at minimal doses under the supervision of medical staff daily. It has a long history of successfully helping people with opioid use disorders (OUDs), as it blocks the effects of …The discovery of methadone by the Germans in the later stages of World War II is described. At that time, methadone was not recognized to be a narcotic analgesic. The first report of the properties of methadone published in the United States in 1947 is summarized, and its early use in the treatment of the opioid abstinence syndrome is noted.See more reviews for this business. Best Veterinarians in Lawton, OK - Freeman Veterinary Clinic, Oak Ridge Animal Center, Bower Robert DVM, Meadow Wood Animal Hospital, Chambers Veterinary Clinic, Creekside Animal Hospital, Lawton Veterinary Hospital, Hergenrether Animal Hospital, Animal Birth Control Clinic, Gore West Animal …According to Samuel Kelton Roberts, associate professor of history, sociomedical sciences, and African American and African diaspora studies at Columbia University, methadone maintenance1 is one of the most closely regulated medical protocols. “Perhaps not entirely by coincidence, it is also one of the most stigmatized, controversial, and misunderstood,” he said. Stigma alienates patients ...Here are 6 ways treatment could shift. T he federal government is reforming methadone care for the first time in over two decades. But how far do the changes actually go? To many methadone clinics ...Feb 8, 2024 · Opioids, used medically for pain relief, have analgesic and central nervous system depressant effects, as well as the potential to cause euphoria. Opioid use disorder (OUD) can be related to misuse of pharmaceutical opioids, heroin, or other opioids such as fentanyl and its analogs. OUD is typically a chronic, relapsing illness, associated with ... To explore treatment options and rehab programs available to you, contact a treatment provider today, risk-free. Methadone clinics provide medication to help … Abundant evidence shows that methadone, buprenorphine, and naltrexone all reduce opioid use and opioid use disorder-related symptoms, and they reduce the risk of infectious disease transmission as well as criminal behavior associated with drug use.15 These medications also increase the likelihood that a person will remain in treatment, which itself is associated with lower risk of overdose ... Population Served: 18+ Years Old. Transitions Recovery Center (TRC) is a secure 52-bed forensic inpatient unit within the Oklahoma Department of Mental Health and Substance …Opioids, used medically for pain relief, have analgesic and central nervous system depressant effects, as well as the potential to cause euphoria. Opioid use disorder (OUD) can be related to misuse of pharmaceutical opioids, heroin, or other opioids such as fentanyl and its analogs. OUD is typically a chronic, relapsing illness, associated with ...SAMHSA published a Methadone Take-Home Flexibilities Extension Guidance in November 2021. SAMHSA is updating this November 2021 Guidance in full by revising the standards applicable to OTP provision of methadone for unsupervised use. This newly revised April 2023 Guidance (hereinafter “the Guidance”) will be effective upon the expiration of ... Methadone is a medication used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates. Methadone has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. When taken as prescribed, it is safe and effective. It…. Aug 23, 2023 · Common methadone side effects may include: dizziness, drowsiness; nausea, vomiting; increased sweating; or. pain, redness, or swelling where the medicine was injected. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. Although methadone’s duration for pain-relieving action is typically between 4 and 8 hours, the half-life is longer than some other opioid pain relievers. In fact its peak respiratory depressant effects can persist longer than its pain-relieving effects. Bottom line: The length of time it takes for methadone to work varies dramatically by ...Methadone is a form of medication assisted treatment (MAT) used to treat opioid use disorder. Below is a list of methadone treatment programs in Connecticut. ... Stamford Clinic 115-125 Main Street Stamford, CT <06901 203-356-1980. Regional Network of Programs Kinsella Treatment Center. 1438 Park Avenue Bridgeport,CT 06604 203-335 …T he federal government is unveiling new regulations meant to modernize methadone treatment, the first major update to patient care standards at methadone clinics in more than 20 years. The new ...Methadone, buprenorphine, and extended-release naltrexone are the three medications currently approved by the U.S. Food and Drug Administration (FDA) for treating opioid use disorder (OUD). Box 2-1 provides a full list of them. All three medications reduce opioid cravings and help to sever the ties between opioid use and established situational …Abundant evidence shows that methadone, buprenorphine, and naltrexone all reduce opioid use and opioid use disorder-related symptoms, and they reduce the risk of infectious disease transmission as well as criminal behavior associated with drug use.15 These medications also increase the likelihood that a person will remain in treatment, which itself is associated with lower risk of overdose ...Common Misconceptions. Four common misconceptions of health providers result in the undertreatment of acute pain in patients receiving OAT: 1) The maintenance opioid agonist (methadone or buprenorphine) provides analgesia; 2) use of opioids for analgesia may result in addiction relapse; 3) the additive effects of opioid analgesics and …Medications for Opioid Use Disorder (MOUD) services which includes Office Based Opioid Treatment (OBOT) and Opioid Treatment Providers (OTP)/methadone clinics are …Methadone is more addictive than Suboxone. Withdrawal symptoms from methadone can increase dependence on the medication. Some people stay on methadone for life in order to stay away from opioids ...Methadone (Dolophine, Methadose) is an inexpensive drug used to treat severe pain. It is slightly more popular than comparable drugs. It is available in multiple generic and brand versions. Generic methadone is covered by most Medicare and insurance plans, but some pharmacy coupons and cash prices may be lower. Get methadone for as low as $12. ...methadone, buprenorphine, and naltrexone in the treatment of addiction involving opioid use. • The treatment setting described as Level 1 treatment in the ASAM Criteria may be a general outpatient location such as a clinician’s practice site. • The setting as described as Level 2 in the ASAM Criteria may be an intensiveSAMHSA’s National Helpline – provides 24-hour, free, and confidential mental and substance use disorder information and treatment referral in English and Spanish. Call 1-800-662-HELP (4357) or TTY: 1-800-487-4889 or text your zip code to 435748 (HELP4U).. Find additional treatment and support options. There are many treatment options ...After detox your key worker will carry on supporting you for at least 6 months to help you stay off heroin. This support may include help with issues such as housing or getting back into work or education. Find out how to get help for heroin addiction, including details of the 2 main approaches to treatment – maintenance therapy and detox. Currently, there are three types of medications approved by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder: Buprenorphine. Methadone. Extended-release injectable naltrexone. Buprenorphine and methadone are the gold standard for treatment. There are decades of evidence proving their effectiveness. In Oklahoma, quitclaim is a term used in property law. A grantor signs a quitclaim deed to disclaim any interest he may have in a property by assigning his interest to a grantee. Q...What's Next? What Is Rehab Like?Why Call an Addiction Hotline?How to Sober UpTapering off of alcohol Sponsored Get matched with an affordable mental …Methadone, buprenorphine, and extended-release naltrexone are the three medications currently approved by the U.S. Food and Drug Administration (FDA) for treating opioid use disorder (OUD). Box 2-1 provides a full list of them. All three medications reduce opioid cravings and help to sever the ties between opioid use and established situational or …Jan 23, 2024 · SAMHSA published a Methadone Take-Home Flexibilities Extension Guidance in November 2021. SAMHSA is updating this November 2021 Guidance in full by revising the standards applicable to OTP provision of methadone for unsupervised use. This newly revised April 2023 Guidance (hereinafter “the Guidance”) will be effective upon the expiration of ... See full list on cciwa.org A proposed safe and conservative approach is a 1:3 methadone to morphine ratio (10mg methadone/day = 30mg oral morphine/day).3 However, literature suggests patients may end up on as high as 1:4.7 methadone to morphine ratio …Specialties: Healthy weight loss with medications and proper instructions. Many patients will say "Now it makes sense. I never had a doctor spend the time to help me understand how to be successful." First visit by appointment. Return visits do not require an appointment. Established in 1940. Established by C.J. Gramolini, D.O. in 1940 in Lawton, OK. Continued by G. Gramolini, D.O. in 1986 ...
Methadone is often applied in the treatment of opioid use disorder, but some factors may lead you to create psychological and physiological dependence on it, too. Living with metha.... Lizzo bathing suits
Sep 13, 2021 · Available as. Oral solution, tablets. Methadone is prescribed to help you keep off street drugs such as heroin. It can help to prevent the unpleasant withdrawal symptoms which can occur when you stop using drugs like these. It is taken by mouth as an oral liquid and it works as a substitution treatment. Many people choose to stay on methadone ... The U.S. estimated economic cost of opioid use disorder ($471 billion) and fatal opioid overdose ($550 billion), prior to the pandemic, totaled $1,021 billion. [ 92] Among the 39 jurisdictions reviewed in this analysis, combined costs of opioid use disorder and fatal opioid overdose varied from $985 million in Wyoming to $72.6 billion in Ohio.1 Methadone Clinics (Low Cost & Fast Options) Lawton, Oklahoma. In Crisis? In Crisis Now? For medical emergencies, including overdose, call 911. If you or someone you know is experiencing a mental health or emotional crisis, please call 1 … Methadone is a cornerstone therapy for opioid addiction and a public health strategy for HIV/AIDS and hepatitis C reduction. Methadone is also used for acute and chronic pain. As use for chronic pain has grown, so too have adverse events. Constitutive and acquired (drug–interactions) inter- and intra-individual variability in methadone ... This methadone clinic Mead OK has treatment facilities spread over Oklahoma in cities like Ardmaor, Lawton, Mead and Oklahoma City. From these units, they offer … Currently, there are three types of medications approved by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder: Buprenorphine. Methadone. Extended-release injectable naltrexone. Buprenorphine and methadone are the gold standard for treatment. There are decades of evidence proving their effectiveness. Federal statutes, regulations, and guidelines govern medications for opioid addiction. SAMHSA’s Division of Pharmacologic Therapies (DPT), part of SAMHSA’s Center for Substance Abuse Treatment (CSAT), manages the day-to-day oversight activates required to implement federal regulations surrounding the use medications … Methadone is a cornerstone therapy for opioid addiction and a public health strategy for HIV/AIDS and hepatitis C reduction. Methadone is also used for acute and chronic pain. As use for chronic pain has grown, so too have adverse events. Constitutive and acquired (drug–interactions) inter- and intra-individual variability in methadone ... Opioids, used medically for pain relief, have analgesic and central nervous system depressant effects, as well as the potential to cause euphoria. Opioid use disorder (OUD) can be related to misuse of pharmaceutical opioids, heroin, or other opioids such as fentanyl and its analogs. OUD is typically a chronic, relapsing illness, associated with ... Methadone comes as a tablet, a dispersible tablet (tablet that can be dissolved in liquid), a solution (liquid), and a concentrated solution to take by mouth. When methadone is used to relieve pain, it may be taken every 8 to 12 hours. If you take methadone as part of a treatment program, your doctor will prescribe the dosing schedule that is ... Published: July 31, 2023 11:26am EDT. Drug deaths in the US involving both opioids and cocaine have increased dramatically in the past decade, according to a new report from the Centers for ...Addiction, or substance use disorder, is defined by a lack of control over the use of that substance. People being treated for opioid use disorder take methadone under close supervision to ensure ...Mar 13, 2024 · Methadone Side Effects. With short-term use, you may notice side effects like: Restlessness. Upset stomach or vomiting. Slow breathing. Itchy skin. Heavy sweating. Constipation. Sexual problems. Compare accredited drug and alcohol rehab centers in Lawton. Browse a wide range of treatment options, including luxury residential facilities, outpatient methadone clinics, …Get ratings and reviews for the top 11 pest companies in Oklahoma City, OK. Helping you find the best pest companies for the job. Expert Advice On Improving Your Home All Projects ...We Service areas in and around Lawton, Duncan, and Davis Oklahoma. (580) 394-2586. View Email. Lawton, OK 73505 ... Programs typically meet at the clinic a couple of times every week for a few ....
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