Drug addiction is a condition that is characterised by repeatedly taking or administering drugs - whether these are illegal drugs such as heroin, cocaine, or MDMA/ecstasy, or legal prescription drugs - to the extent that you become both physically and psychologically dependent on these substances. Regardless of the type of drug addiction that you have developed, continued drug use can soon become a serious problem and can lead to a range of serious long-term consequences, and may even be fatal.
Disulfiram (Antabuse®) interferes with the breakdown of alcohol. Acetaldehyde builds up in the body, leading to unpleasant reactions that include flushing (warmth and redness in the face), nausea, and irregular heartbeat if the patient drinks alcohol. Compliance (taking the drug as prescribed) can be a problem, but it may help patients who are highly motivated to quit drinking.
We also have a heated swimming pool so you can enjoy the outdoors and the benefits of aqua fitness that extends the summer months. Our activities will also organise crafting workshops, computer skills training, and much more so you can get back or reignite that creative spark that was put on hold all during drug addiction. The grounds of Searidge Drug Rehab feature a large outside space full of green pastures and a stone’s throw of the ocean that will help you enjoy nature’s beauty that is conducive to rest, relaxation and recovery. SASH! vs Olly James - Ecuador (Official Music Video)
Medical professionals need to apply many techniques and approaches to help patients with substance related disorders. Using a psychodynamic approach is one of the techniques that psychologists use to solve addiction problems. In psychodynamic therapy, psychologists need to understand the conflicts and the needs of the addicted person, and also need to locate the defects of their ego and defense mechanisms. Using this approach alone has proven to be ineffective in solving addiction problems. Cognitive and behavioral techniques should be integrated with psychodynamic approaches to achieve effective treatment for substance related disorders.[37] Cognitive treatment requires psychologists to think deeply about what is happening in the brain of an addicted person. Cognitive psychologists should zoom in to neural functions of the brain and understand that drugs have been manipulating the dopamine reward center of the brain. From this particular state of thinking, cognitive psychologists need to find ways to change the thought process of the addicted person.[37]
In order to effectively address drug addiction as well as the co-occurring issues that may be underlying the problem, most patients will require residential or inpatient care. At a residential treatment program, the addicted patient will live at the treatment facility with access to 24-hour care and support that can be critical in helping them to avoid relapse in the early stages of recovery.
Research from NIAAA also suggests that alcoholism can stem from genes. While the specific “alcoholism gene” hasn’t yet been identified, there are known genes that can boost the power of alcohol and reduce the impact of a hangover. People with these gene combinations may get a bigger high from drinking, and they may not feel ill or sick after a long day of drinking. Their bodies just seem primed for alcohol abuse, and that can make them more likely to develop alcoholism.
Having made the decision to reach out for help in overcoming addiction, you may feel overwhelmed by the variety of options available to you – and, of course, choosing the right rehab is absolutely crucial. You need a facility that will best suit your particular needs and wants – but how will you know what those are, when you have never been through this process before?

That characterizes the vast majority of people with addictions. They initially think a few tweaks of their schedule will help them stop their use of substances, but they fail to realize the compulsive nature of addictions and the strong grip it has on their life. Rehab can help you set short and long-term goals in the areas most important to a strong recovery. These areas include goals for your physical and emotional health, relationships, occupational and spiritual aspirations. Philippines Drug War: Inside the Mega Rehab Centre
Patients in drug rehab treatment programs are encouraged to end toxic relationships. Toxic relationships are those that have the propensity to lead to drug abuse. Conversely, patients are encouraged to seek help from other people who can support them on their journey. These supportive relationships could include friends, family members, and even other rehab patients.

A dependency on sleeping pills often begins forming when a person increases their prescribed dose without consulting their physician first. They may believe that taking more pills will improve their quality of sleep. Over time, a person will feel the need to take larger amounts each time in order to fall asleep, which often leads to an overwhelming addiction.


At Casa Palmera, our goal is to aid you in a comprehensive spiritual, physical, and emotional recovery. We offer treatment not only for eating disorders such as anorexia nervosa, bulimia, and binge eating, but also for chemical dependencies such as cocaine addiction, drug addiction and alcoholism. It is extremely important to us that you receive the highest quality medical care from our qualified staff during your stay. Russell Brand Puts His Spin On The 12-Step Program
When you or someone close to you needs drug abuse rehab, it can be hard to know where exactly to find help. Without the proper help, however, substance abuse can lead to potential life-threatening situations. Additionally, drug abuse affects not only the life of the individual user but also the lives of his or her family. Fortunately, there are a variety of effective treatment methods to help individuals overcome their drug addictions.
Our drug addiction experts at Priory possess extensive clinical expertise in the treatment of a wide range of drug addictions and we are able to deliver a broad variety of established therapeutic techniques to tackle your drug addiction symptoms, and address the underlying causes for your drug addiction. We ensure that each individual who seeks drug addiction support with us benefits from bespoke, tailor-made treatment plans, which are specifically designed to meet your unique needs and requirements. You will be involved in any decisions that are made about your care, as well as being placed at the centre of your drug addiction treatment and rehabilitation journey, in order to produce the most positive outcomes for you as an individual. Our highly supportive, non-judgemental addiction treatment environments provide you with the ideal setting in which to receive personalised drug addiction treatment, address your challenges and take steps towards achieving a full and sustainable recovery.
Within the framework of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), substance dependence is redefined as a drug addiction, and can be diagnosed without the occurrence of a withdrawal syndrome.[6] It was described accordingly: "When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped. This, along with Substance Abuse are considered Substance Use Disorders."[7] In the DSM-5 (released in 2013), substance abuse and substance dependence have been merged into the category of substance use disorders and they no longer exist as individual diagnosis.[8] 12 Steps of AA with Father Martin YouTube WMV V8
After the detoxification stage, you will begin rehabilitation. This involves a wide range of different therapies and treatments to help you combat drinking urges and triggers. During this stage, you will also learn coping skills that can be applied to everyday situations after leaving rehab. The rehabilitation stage may take place in an inpatient or outpatient setting, depending on the severity of your alcoholism and what your doctor recommends.
Most severe alcohol withdrawal symptoms occur in the first three to four days after stopping drinking. Detoxification involves taking a short course of medication to help reduce or prevent withdrawal symptoms. Medications such as Valium (diazepam), Librium (chlordiazepoxide), or Ativan (lorazepam), members of the benzodiazepine family, are usually used for detox. Beating Opioid Addiction | Joy's Story
^ Jump up to: a b "Substance use disorder". Pubmed Health. National Institutes of Health. Archived from the original on 31 March 2014. Retrieved 12 September 2014. Drug dependence means that a person needs a drug to function normally. Abruptly stopping the drug leads to withdrawal symptoms. Drug addiction is the compulsive use of a substance, despite its negative or dangerous effects Drug and Alcohol Treatment Centers ► The Problem With Relapse
Usually, however, drug classification under such legislation is not related simply to addictiveness. The substances covered often have very different addictive properties. Some are highly prone to cause physical dependency, while others rarely cause any form of compulsive need whatsoever. Also, under legislation specifically about drugs, alcohol and nicotine are not usually included.[46]
“Residential rehab” and “inpatient rehab” are two phrases often used interchangeably, as they both follow medical detox, and accommodate the physical and psychological needs of individuals in recovery. They also both involve full-time treatment at a rehab facility, allowing for 24-hour monitoring. However, one major difference between the two forms of treatment is the length of the program.
A few people are very sensitive to Antabuse and get a stronger reaction. A quick test of whether you're sensitive to Antabuse is to see if your skin flushes when you put alcohol on your skin. If you're sensitive you may still decide to use Antabuse, but you'll have to be a little more careful about avoiding alcohol. Most people just need to show some common sense when they're on Antabuse.

At this stage, you will have developed a problem with alcohol and will be drinking out of habit than choice. Your use may be starting to have an impact on other aspects of your life and you might be noticing problems with your moods and sleeping patterns. Nevertheless, you are probably still at the stage where you are enjoying alcohol and believe that it is making your life better. Drug Rehab Hotline | Before And After | Drug Rehabilitation Centers Near Me
^ Robison AJ, Nestler EJ (October 2011). "Transcriptional and epigenetic mechanisms of addiction". Nature Reviews. Neuroscience. 12 (11): 623–37. doi:10.1038/nrn3111. PMC 3272277. PMID 21989194. ΔFosB has been linked directly to several addiction-related behaviors ... Importantly, genetic or viral overexpression of ΔJunD, a dominant negative mutant of JunD which antagonizes ΔFosB- and other AP-1-mediated transcriptional activity, in the NAc or OFC blocks these key effects of drug exposure14,22–24. This indicates that ΔFosB is both necessary and sufficient for many of the changes wrought in the brain by chronic drug exposure. ΔFosB is also induced in D1-type NAc MSNs by chronic consumption of several natural rewards, including sucrose, high fat food, sex, wheel running, where it promotes that consumption14,26–30. This implicates ΔFosB in the regulation of natural rewards under normal conditions and perhaps during pathological addictive-like states. Alcohol Poisoning Treatment ► What Is The Best Solution?
Drug abuse can apply to a wide variety of substances, from prescription medication to illicit street drugs. The term is often used to discuss the improper use of substances, especially substances that can be used for medical purposes. Drug abuse is not limited to those with a history of addiction, as many people develop a substance use disorder after taking prescription medications like opioids, benzodiazepines and more. Regular drug abuse can lead to serious patterns of behavior that result in a substance use disorder or addiction.

Inpatient or residential treatment  can also be very effective, especially for those with more severe problems (including co-occurring disorders). Licensed residential treatment facilities offer 24-hour structured and intensive care, including safe housing and medical attention. Residential treatment facilities may use a variety of therapeutic approaches, and they are generally aimed at helping the patient live a drug-free, crime-free lifestyle after treatment. Examples of residential treatment settings include:
Alcohol dependency is different for different people. Although many sufferers share things in common, their relationships with alcohol might at first seem to be nothing alike. This can make it difficult for people to identify themselves as alcohol dependent, even as drinking has an increasingly more damaging effect on their relationships, health, and enjoyment of life.

It is important that you know how to act when triggers or cravings present themselves. If you have a plan in place, it can help to prevent a full-blown relapse. It may be that you will get in touch with your counsellor or sponsor, or perhaps distraction will help. You might find that going for a walk or doing something else to keep you busy can help the cravings subside. Inappropriate Things to Say at a Meeting (Recovery Comedy)
Whether you’re struggling with an addiction to prescription drugs, street drugs, marijuana, or other substances, we’re here to help. At The Recovery Village, we offer specialized treatment services to support you through the rehabilitation process, from detox to therapy, discharge planning, and aftercare. Call our intake counselors at any time for information about our recovery services.
For the average person who does not suffer from alcohol addiction, a drink every now and again is both normal and non-problematic. For the alcohol addict though, a single drink every few days is not enough. The addict’s body has become dependent on alcohol for daily functioning, while the mind is convinced that it is not possible to get through the day without drinking.
The concept of group therapy encompasses a number of equally important goals. For example, one of the goals is to facilitate an environment in which recovering alcoholics can learn from one another. In your case, you have thoughts and experiences that could help someone else in the group. Likewise, what other people have to share could prove beneficial in your recovery. Rehab I'm Me

In the not so distant past, treatment for alcoholism would have required a person to stay in hospital for an unknown period of time. Today, a number of treatments for alcoholism exist that do not require a person to stay in hospital at all. There are lots of different types of programs, some involve the person committing for a couple of hours a day over several weeks, while others require up to 20 hours of attendance a week over an indefinite amount of time. If the person is considered low-risk, to both themselves and others, outpatient care under the supervision of a doctor is usually the best course of treatment. Inpatient programs usually take place in a physiatrist hospital, although some general hospitals run them too. There are lots of different types of programs, some involve the person committing for a couple of hours a day over several weeks. There are also specialist alcohol addiction treatment centers, which offer the same services as a hospital. Individuals who are usually recommended for inpatient treatment are usually those who are suffering severe withdrawals or who have had several failed rehabilitation attempts in the past. If the person suffers from a psychiatric disorder or comes from a family of alcoholics, inpatient care is usually a wise option. Inpatient care usually involves a medically supervised detoxification, which is managed with the use of medication. Cognitive behavioral therapy and an introduction to outside support groups are also an integral part of the alcoholism treatment. People who receive outpatient care will generally undergo the same treatment as those who are admitted for inpatient treatment, although the detoxification medication will vary.
AddictionCenter.com is a referral service that provides information about addiction treatment practitioners and facilities. AddictionCenter.com is not a medical provider or treatment facility and does not provide medical advice. AddictionCenter.com does not endorse any treatment facility or guarantee the quality of care provided, or the results to be achieved, by any treatment facility. The information provided by AddictionCenter.com is not a substitute for professional treatment advice.
Ongoing support and aftercare are essential to this type of sustained, long-term recovery. Many drug abuse rehab centers feature robust aftercare programs, including ongoing individual therapy sessions on a periodic basis, group therapy meetings, and alumni events. Oftentimes, alumni are also encouraged to get involved in their own recovery community by participating in 12-step meetings or residing in a sober living home. If recovering addicts have people they can turn to for support when they are tempted to relapse, they are more likely to stand strong and resist the urge to use again. Drug and Alcohol Treatment Centers ► What You Don't Know
Development. Genetic and environmental factors interact with critical developmental stages in a person’s life to affect addiction risk. Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it will progress to addiction. This is particularly problematic for teens. Because areas in their brains that control decision-making, judgment, and self-control are still developing, teens may be especially prone to risky behaviors, including trying drugs.
Two factors have been identified as playing pivotal roles in psychological dependence: the neuropeptide "corticotropin-releasing factor" (CRF) and the gene transcription factor "cAMP response element binding protein" (CREB).[9] The nucleus accumbens (NAcc) is one brain structure that has been implicated in the psychological component of drug dependence. In the NAcc, CREB is activated by cyclic adenosine monophosphate (cAMP) immediately after a high and triggers changes in gene expression that affect proteins such as dynorphin; dynorphin peptides reduce dopamine release into the NAcc by temporarily inhibiting the reward pathway. A sustained activation of CREB thus forces a larger dose to be taken to reach the same effect. In addition, it leaves the user feeling generally depressed and dissatisfied, and unable to find pleasure in previously enjoyable activities, often leading to a return to the drug for another dose.[17]
Drug addiction is a chronic disease, and relapse is one of its major symptoms. It’s important for a recovering addict to realize that relapse is the rule rather than the exception. Relapse prevention therapy can help addicts learn how to avoid lapses, or how to minimize the severity of a relapse if they do slip. The sooner you seek help after a relapse, the sooner you’ll get back on track with your recovery program.
Alcoholism can creep up on you, working its way into your life almost unnoticed, and by the time it is recognised the original catalysts might seem irrelevant. Though there are many different elements that can lead to alcohol dependency, there are common risk factors shared by almost all alcoholics, and it is worthwhile considering them as understanding paves the way for recovery.
Our alcohol treatment center is located in beautiful Malibu, California overlooking the Pacific Ocean. Our accommodations, treatment program, and renowned philosophy are simply the best. If you are ready to take control of your life, and overcome your alcohol addiction, pick up the phone and call us toll free (888) 920-8849. We look forward to helping you take proactive steps towards getting your life back. Our doors are open and we honor the opportunity to work with you.
Many rehab patients continue to receive treatment for their addictions after leaving rehab. They may have regular clinic visits with a doctor to manage physical symptoms. Patients may also meet with a counselor on a regular, outpatient basis to refine coping skills. In addition to the love and support of family and friends, patients may also attend support group meetings after leaving a drug rehab treatment facility. All of these aftercare services help patients remain drug free and avoid relapse.
Set in the heart of Essex, the facility is close to London and very accessible from the rest of the UK and wider world. Trust your loved ones with us – we will change their lives. The clinic was founded and is operated by people in long-term recovery, and our treatments, facilities and ethos make it the best possible drug & alcohol rehab for you or your loved ones. How to Help Someone Overcome Addiction - Teal Swan

At Gateway Foundation, we employ a variety of addiction therapy services that aid in treatment. Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Trauma Therapy are some of the most common that our therapists use to help patients begin on the road to recovery. Each of these treatments and therapies is part of a larger overall program, specifically designed for individual patient recovery at one of our 17 drug treatment centers. To speak to someone about treatment at a Gateway Foundation center, call 877.381.6538 today.
How the drug is taken. Smoking a drug or injecting it into a vein increases its addictive potential.33,34 Both smoked and injected drugs enter the brain within seconds, producing a powerful rush of pleasure. However, this intense high can fade within a few minutes. Scientists believe this starkly felt contrast drives some people to repeated drug taking in an attempt to recapture the fleeting pleasurable state.
The definition of recovery remains divided and subjective in drug rehabilitation, as there are no set standards for measuring recovery. The Betty Ford Institute defined recovery as achieving complete abstinence as well as personal well-being[21] while other studies have considered "near abstinence" as a definition.[22] The wide range of meanings has complicated the process of choosing rehabilitation programs.
Inpatient drug rehab can help anyone who has successfully completed medical detox, but still needs round-the-clock care for substance abuse and any potential co-occurring disorders. Perhaps your addiction went on for years before you sought treatment. Or perhaps you were dependent on a particular substance for months and you are struggling with cravings. Ultimately, anyone who wants a greater chance at success and a reduced risk of relapse can benefit from inpatient drug rehab. However, it’s important to keep in mind that inpatient rehab centers require a full-time commitment.
Whether you’re struggling with an addiction to prescription drugs, street drugs, marijuana, or other substances, we’re here to help. At The Recovery Village, we offer specialized treatment services to support you through the rehabilitation process, from detox to therapy, discharge planning, and aftercare. Call our intake counselors at any time for information about our recovery services.
  I will start out by writing that the Costa Rica Treatment Center has saved my life...I was at rock bottom. Robert and Eric came and picked me up in Jaco, in very bad shape, and they persistently, lovingly, gently, firmly, medicinally, therapeutically, turned me back around, cared for me taught me, changed me...I lived here for one month, and just felt safe and secure. They slowly brought me back to good health. I have grown spiritually, mentally, physically, and emotionally, and can never repay what has been given to me. From Gernot and Maggie (owners of this beautiful home), Robert (administrator, jefe) full of life and play but very disciplined, Eric (assistant manager, wonderful strong, positive, caring energy), Arturo ( Yoga instructor, who gave me daily 5 am classes, with meditation, and a chef), Donia Sonya ( housekeeping), Sheila(psychotherapist), Diego and Marianna(psychologists), Diego (MD), and other persons, in Recovery, who will remain anonymous, who have given their time and advice, and lent an ear to me...I feel this is the best place for you, if you are struggling with an addiction that is out of your control. They just "know" here, how it feels, they understand, without judgement, and their goal is to help you manage your addiction, and move forward into a good life full of purpose, kindness and happiness...This home is beautiful, spacious, room for togetherness and privacy, serene, alcoves, patios, gardens, my room was so cozy, I was able to get much needed rest. I will continue to keep Costa Rica Treatment Center a part of my life, with much gratitude to all of you for returning me to the old, and new Allison...very, very thankful...
Different rehabs are based upon different philosophies, and this can mean the enhancement of addiction treatment with distinct specialized services. For example, a religious rehab may include worship services or religion classes and other offerings that enhance the spiritual side of recovery while a holistic alcohol rehab may include yoga, meditation, acupuncture and other alternative methods of treatment. Rihanna - Rehab ft. Justin Timberlake
Behavioral programming is considered critical in helping those with addictions achieve abstinence. From the applied behavior analysis literature and the behavioral psychology literature, several evidence based intervention programs have emerged: (1) behavioral marital therapy; (2) community reinforcement approach; (3) cue exposure therapy; and (4) contingency management strategies.[31][32] In addition, the same author suggest that Social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious. Community reinforcement has both efficacy and effectiveness data.[33] In addition, behavioral treatment such as community reinforcement and family training (CRAFT) have helped family members to get their loved ones into treatment.[34][35] Motivational Intervention has also shown to be an effective treatment for substance dependence.

We respect that your time and energy is limited. You want to make up for lost time with your friends and family, and commit yourself to your responsibilities. You are more than your past addiction, and while it is important to maintain strong bonds with the recovery community, it should no longer take up your whole life. Searidge’s aftercare program offers a variety of options that will work with your specific daily responsibilities and needs.
When it’s time to take action, finding the right drug rehab facility can become a daunting task. Most people turn to the internet with search engine inquiries like “rehab centers near me” or “local drug rehab.” Finding a center close by can be helpful, but your search may also offer results for programs that require travel. Inpatient drug rehab centers away from home can offer more opportunities for healing in a new environment.
An alcohol rehab treatment center is a place for healing, learning a healthy lifestyle and receiving support. Today’s proven, evidence-based approach to treating co-occurring disorders is to integrate the services of addiction counselors and medical professionals. Through unified goals and coordinated efforts,the whole person is treated. Tools for maintaining abstinence and physical and mental stability are provided.7Michael’s House is a residential alcohol rehab facility in Palm Springs, California, that does just that. Our caring professionals seek to uncover the root causes of patients’ addictions and mental distress. We help them establish a healthier and more fulfilling lifestyle.
Our highly qualified treatment team possess extensive clinical experience in treating alcohol addiction, and are able to deliver a wide range of established techniques to help you to address your alcohol addiction symptoms, and resolve the underlying causes and triggers for your alcohol addiction. We ensure that each individual who seeks support with us is placed at the centre of their alcohol addiction treatment and rehabilitation journey and is involved in any decisions that are made about their care. This ensures that you benefit from a truly collaborative and personalised treatment experience and the most positive outcomes for you as an individual. Our non-judgemental, highly compassionate addiction treatment environments provide you with the ideal setting in which to address your challenges and achieve and full and sustainable recovery. Rehab Drug and Alcohol Detox Treatment Centers | BLVD Treatment Centers
Nitrous oxide, also sometimes known as laughing gas, is a legally available gas used for purposes that include anesthesia during certain dental and surgical procedures, as well as food preparation and the fueling of rocket and racing engines. Substance abusers also sometimes use the gas as an inhalant. Like all other inhalants, it's popular because it provides consciousness-altering effects while allowing users to avoid some of the legal issues surrounding illicit or illegal drugs of abuse. Abuse of nitrogenous oxide can produce significant short-term and long-term damage to human health, including a form of oxygen starvation, called hypoxia, brain damage, and a serious vitamin B12 deficiency that can lead to nerve damage. Drug and Alcohol Addiction - "Audio Rehab" - Brainwave Entrainment Music Therapy
The cost of inpatient rehab programs depends on the treatment center selected, the level of clinical care recommended, and the length of time in treatment. The amount you pay will also depend on whether you’re able to access insurance benefits to help cover the cost or you’re paying out-of-pocket. Hazelden Betty Ford is in-network with most insurance carriers, and most of our patients use their health insurance benefits to help cover treatment costs. Insurance policies and benefits vary greatly, so it's important to check with your provider about coverage specifics in your case. As a nonprofit treatment center, Hazelden Betty Ford offers patient financial assistance funds as available, on a limited basis, to help offset the cost of addiction treatment for qualifying patients.
Drugs, Addiction, and the Brain explores the molecular, cellular, and neurocircuitry systems in the brain that are responsible for drug addiction. Common neurobiological elements are emphasized that provide novel insights into how the brain mediates the acute rewarding effects of drugs of abuse and how it changes during the transition from initial drug use to compulsive drug use and addiction. The book provides a detailed overview of the pathophysiology of the disease. The information provided will be useful for neuroscientists in the field of addiction, drug abuse treatment providers, and undergraduate and postgraduate students who are interested in learning the diverse effects of drugs of abuse on the brain. Drug Rehab Ranch | What Is Rehab Like? | Drug Rehabilitation Centers Near Me
Tobacco: Nicotine replacement therapies have several forms, including the patch, spray, gum, and lozenges. These products are available over the counter. The U.S. Food and Drug Administration (FDA) has approved two prescription medications for nicotine addiction: bupropion (Zyban®) and varenicline (Chantix®). They work differently in the brain, but both help prevent relapse in people trying to quit. The medications are more effective when combined with behavioral treatments, such as group and individual therapy as well as telephone quitlines.
More problematically, they are also not removed from their home environment which has proven to facilitate the drug-taking behaviour which has led to addiction, and are still able to contact their dealer/s if the temptation to relapse proves overpowering. Their whole recovery rests upon their strength of will – which in some cases may not prove sufficient at critical times. Top 10 Luxury Drug Rehab Centers In USA
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