I was 13 the first time I tried smoking pot. Earlier that day I had tried my first cigarette and my first (half) beer. The afternoon culminated with me trying my first hit of acid, so the weed had little impact on me. I would engage with weed a few more times over the next two years but failed to see what my friends were finding so exciting about it. At 15, I came to the realization that I didn't like alcohol or drugs period and declared myself straight edge. I would remain that way for the next 15 years.
Anxiety problems tend to manifest themselves in adults around the age of 30, but looking back on it now, I realize how much of my life has been shaped by it. From as far back as I can remember I was having panic reactions in certain situations, and was unable to identify what was going on. Around the age of 20, after someone I was close to went through a horrific tragedy, I broke down completely. I was told by my doctors that I had issues with anxiety and depression, and that in order to regain control of my life I would need to be on some sort of mood-stabilizing medication. After reconciling the need to be on a long-term drug regimen with the values I ascribed to being straight edge, I began taking the medication. I figured, this was a medically prescribed drug and that it wasn't like the other "bad" drugs that had no medicinal purpose. Over the course of the next ten years I would be prescribed about a half dozen or so different types of medications. The doses were varied, and they were tried in combination with one another in the hopes of finding a balance between relief from the anxiety symptoms and minimizing the amount of sides effects.
The side effects were brutal. I can remember reading an interview with the the lead singer of the band 16 just before I started taking the pills, where he talked about how he went off antidepressant and anxiety drugs because when he was on them he didn't want to masturbate. I thought: Wow, can that really happen to a person from just a little pill? What I didn't know at the time was that many people can experience sexual side effects like loss of libido while taking certain anxiety drugs—I would be one of these people. This is not to say that I lost complete interest in sex, just that, depending on the medication, it was a lot lower on the fun activity list than it was when I was not on the pills.
But that wasn't it for the side-effect party. At night, I couldn't fall asleep, and yet I was always tired during the day. I also quickly began to put on weight. I feel weird talking about this because all my life I have been heavy. As a young person, this of course was a source of ridicule from some of my more evil peers, so by the time I was an adult I was fairly confident in the way I looked—ESPECIALLY as my band got going. The fact that I was 300-plus pounds didn't bother me at all. I felt good and was happy with the way I looked.
At times, the side effects would get so frustrating to deal with that I would decide that I needed to drop down my dosage, only to find myself falling apart again a few weeks later. To make matters worse, this time in my life coincided with the period that Fucked Up found itself becoming more of a real band, and ultimately my job.
The vocation of lead singer in a band is not one that naturally lends itself to managing an anxiety disorder. The day of the show could, at times, feel like one prolonged panic attack. I can see now that my bloodletting stage antics that helped us gain a reputation for being a "crazy" live band in the early days were more born out of a self-harming panic reaction than any great sense of stagecraft. And since this was now my job, I also found myself touring a lot more, which only served to exasperate the anxiety attacks. On one occasion after dropping my dosage before a particularly long European tour (a TERRIBLE idea) I found myself in a Danish hospital getting an emergency supply of Ativan to cope with the returning panic attacks. The other side effect I noticed with the Ativan that seemed particularly frustrating was that the muscle relaxant it contained numbed my throat in such a way that I couldn't get my voice to sound the way I like. This resulted in a constant need to balance the issues I had with anxiety with the need to be able to perform my job. I had resigned myself to the idea that this was the only way to deal with an anxiety disorder—and thus I should just deal.
Weed vs. Anxiety
Things all changed for me the next time we went to Europe in the summer of 2010. Again, I had made the mistake of misgauging my need for Ativan and went with none. About a week or so into the tour, I could feel myself beginning to spiral, and following a hellacious post-show-sitting-in-the-hotel-shower meltdown in Koln, Germany, we hit Holland, and I decided to try and save myself from another European hospital visit and try pot.
I have no idea where I heard that pot could help with anxiety, but I would guess it was from the internet or from someone in Iron Age. Wherever I heard it, I considered it to be sage enough advice. Backstage at a festival the next day in Nijmegan, Netherlands, I tried smoking pot again. It seemed that, almost instantaneously, the anxiety subsided, and I relaxed. It was from that moment that I realized I had totally misjudged this plant and medical marijuana as a whole as some hippy bullshit. For the rest of that tour I smoked weed and found that my anxiety stopped being an issue.
When I got home from tour, I made an appointment to see my family doctor. She had been treating me for the previous eight years, so I just assumed she would be excited by my new discovery. But when I suggested that I was thinking of giving up the pharmaceuticals and switching to cannabis, she was less than enthusiastic about the idea. My argument was that I had been on the pills now for the better part of ten years, I had mixed feelings (at best) about the experience, and here was something that worked with none of the side effects—AND you can grow out of the ground! She still had concerns, and it would take three years and for me to lose almost 120 pounds to assuage them.
One of the common side effects of some of the anti-anxiety medications is weight gain, and some studies have linked cannabis use with weight loss in "overweight" people. Losing weight wasn't in my head at all when I started pot, so I didn't notice this unintended side effect at first, but I began feeling less compelled to drink as much soda and eat as much fast food. I only really started noticing that I was losing weight when people who came to see the band began remarking about it, and some even said if I lost too much they would stop coming to the shows. (Very early on, Fucked Up garnered the devotion of punk fans who also loved fat hairy men, so I guess one negative side effect of the weed is that it cost the band some of its fanbase!)
It was the other side effects of the medication that I had found more impactful on my life: I was able to sleep, at least more fitfully than I had before, plus—without getting into details—the sexual side effects were gone too, and I now have three kids. I was also more alert when I was awake. I felt happier and more in control. I was also able to get over my lifelong obsession with soda pop—one that had ballooned to a point where I was drinking about three to six liters a day of the stuff while on the pills.
Given that I was losing weight for the first time since she had started seeing me, this raised some concerns in my doctor. Following a full physical and various tests to ensure that there wasn't another reason for my polymorphic shape shift, I explained that the only thing that I had really adjusted in my lifestyle was the switching to cannabis in place of the meds. It was at this point that I could tell that she was starting to come around more to the idea of me using medical marijuana. She suggested that I look at what it would take to get medically approved as a marijuana user (it seems to be very common, amongst other medical users that have gone through the process with their doctor, that the onus of education about cannabis falls on the patient). And thus began my dance with the Canadian medical marijuana system.
Navigating Canada's Medical "Marihuana" System
The year was 2012, and at the time the program in place providing patients with medical marijuana was the government's Marihuana (how the Canadian government chooses to spell it, for whatever reason) Medical Access Regulations program (or the the acronym for the regulation, MMAR). The Canadian government first introduced a medical "marihuana" program on July 10, 2001. Under the program, patients who qualified were allowed to legally possess dried cannabis buds. There were two categories of people that Health Canada felt were worthy of medical cannabis. Category 1 patients were those with "symptom(s) treated within the context of end-of-life care" or those with symptoms resulting from cancer, MS, AIDS, spinal injury/disease, epilepsy, and severe arthritis.
The second category, the one into which I fell, was much broader. Patients in Category 2 must have "a debilitating symptom that is associated with a medical condition or with the medical treatment of that condition other than those described in Category 1." This category was left to the doctor's discretion and was largely confined to the realm of anecdotal evidence as far as the medical community is concerned. If your doctor determined a need, they would then decide on a dosage of grams per day and fill out a monstrous series of forms.
If accepted into the program, the patient was offered one of three ways to obtain the weed: grow it themselves, designate someone else as their grower, and be part of what is sometimes been referred to as a "compassion garden," or buy it from Health Canada directly (provided by a subcontracted supplier). While I waited for her to read the forms and do some research into cannabis, she agreed to set me up with a dispensary in the meantime.
A grey market dispensary was a very different thing in Toronto just two years ago. With the number of dispensaries is Toronto exploding to about three-dozen storefronts in the past six months, now it's simply a matter of heading into any hood and looking for a sandwich board with a pot leaf on it.
Before this retail pot explosion, cannabis dispensaries were forced to operate somewhat clandestinely. The first medical dispensaries began opening up in Toronto and Vancouver in the mid-90s as a way to provide cannabis to people with a medical need. Four years ago, the number of dispensaries had grown, but they were not yet a common sight in Toronto. Many had undisclosed locations and minimal nondescript signage, if any at all, and patients were forced to rely on word of mouth from other clients—which is exactly what I had to do.
Finding out a friend was a member at one of the longer-running and well-respected dispensaries in Toronto, I asked them to get me an application to join. The membership procedure required me to fax them my application including a section on my diagnosis filled out and signed by my doctor AND required my doctor to provide them with a confirmation of diagnosis through a separate communication. Only then, and with the additional referral provided by my friend who was a member, I was given the location to have a face-to-face meeting. There, I was required to sign separate forms promising to abide by the rules of the club (no reselling, no buying for other people, no bringing friends with me, never revealing the club's location or loitering around it, etc., etc.). It was explained to me that this was done because the club was selling something illegal and thus not really offered protections from police. In the past, cannabis clubs had been robbed only to find themselves the subject of the investigation of the responding police. Though varying slightly from club to club, this style of membership served as sort of an industry standard for the dispensaries operating on the more legitimate side of the grey medicinal marijuana market across the country.
Once I was approved, the club was able to offer their members a diverse range of strains provided to them by the local growers that supplied them and, through the collective pooled anecdotal evidence provided by the membership, a knowledge of which strains seemed to provide the best relief for which ailment. Bud tenders dispensing the cannabis there became my pharmacists in their knowledge of the medicines they sold. I was able to purchase medical cannabis in a variety of delivery methods (edibles, topical, concentrates, and dry buds) at a more consistent basis, theoretically, than I would have with my "street pharmacists" (who, to be fair, also had amazing knowledge of the fare they sold).
I now had decent access to my medicine but was still hoping to have my doctor gain me access to the MMAR because, let's face it, weed is kind of expensive. If I was in the MMAR, I could give my growing right to a designated grower who would grow my medicine for me, drastically cutting the cost. Many of these home cultivators were able to produce their medication for around $2 a gram after covering expenses. Given that the price for cannabis is seemingly set in Toronto at around $8-$12 [$6-$9 USD] per gram, and many patients require multiple grams per day, that would be a substantial savings.
That was the similar logic used by Toronto-based marijuana activist (and full disclosure, a friend) Matt Mernagh. Mernagh has been using cannabis to treat seizures and chronic pain for over ten years and had been unsuccessful in his repeated attempts to find a doctor willing to help him enter the MMAR program. Following an arrest for growing his own cannabis in 2008, he and his lawyer Paul Lewin argued that there was, practically speaking, a "massive boycott" of Canadian doctors toward medical marijuana. Three years and a constitutional challenge later, Ontario Superior Court Judge Donald Taliano agreed that sick people like Matt were forced to resort to crime to get the medication because of the program's lack of effectiveness. He ordered that the government of Canada had to make changes to its medical marijuana program or he would overturn all of Canada's marijuana laws. The Canadian government managed to avert this from happening following an
appeal court decision and by basically blowing up the Canadian medical marijuana system.
How the Lack of Government Research Impacts Medical Cannabis Users
It was around this point that my interest in cannabis intensified. Medical cannabis was still an area I was unable to find much information about. The Canadian cannabis system was changing rapidly in the wake of the Mernaugh decision. I immersed myself in the community in the hopes of learning all that I could and watched it unfold.
Former Health Minister Leona Aglukkaq announced the proposed changes to the MMAR in December of 2012. The old program was to be done away with and in its place was the eloquently named The Marihuana for Medical Purposes Regulations (MMPR). Effectively, the Canadian government was getting out of the weed game. No longer would doctors be referring patients into a government program in which they would be getting cannabis directly through Health Canada provided to them by a single supplier; now it would be the doctors prescribing the weed themselves to the patient who would then would get the cannabis from a licensed producer at the pharmacy, like any other prescription. This move completely ignored the complaints patients and doctors had had about the previous system and replaced it with a system that seemed to further exasperate the situation.
Pharmacists immediately protested this move and basically refused to sell it, echoing much of the Canadian medical community's concerns about medical marijuana as a concept and adding further concerns for the need for greater security in the wake of
increased threat of robberies (a position they have since reconsidered). Health Canada remedied this by announcing that the cannabis would now be delivered to patients via the mail. This move almost perfectly coincided with the Conservative government's decision to get rid of door-to-door mail delivery in Canada, replacing it with public mega mailboxes, which, given the concerns expressed by pharmacists about robberies, was a bit of puzzling move. The complaints from the doctors and patients were not moved on as quickly.
With the MMPR, doctors would now have more onus on them as the sole prescriber of cannabis, but it didn't serve to address any of their concerns. Under the new system, patients would still be stuck trying to convince reluctant, under-informed doctors to pursue cannabis as a course of treatment. If the doctor did agree to prescribe weed, there were still the same questions about dosage. To remedy this, Health Canada provides doctors with a handy "Daily Amount" document. This also provides insight into Health Canada's understanding of cannabis. It offers ten brief, and at times redundant, points on how to proceed with prescribing something that "while pointing to some potential therapeutic benefits, the scientific evidence does not establish the safety and efficacy of." Directing doctors to keep it slow and low with dosing, it suggests several times that sticking within the 1-3 gram dosing range. It dismisses strain differentials as being anecdotal and lacking in "scientific or clinical evidence." It also points out that same lack in clinical studies about edibles or topicals, noting that none of these are provided under the MMPR. Still, doctors would only have the option of prescribing cannabis in a dried bud form for smoking or with the option of directing the patient to vaporize it.
This of course is ignoring the demands of patients. Many people using medicinal marijuana are unable or unwilling to smoke or vaporize their cannabis. Patients with conditions of the skin, like psoriasis, find that the application of weed-based topical provides relief. Other cannabis patients, with respiratory or other ailments that make inhalation not an option, have turned to edibles for years. Patients unable to ingest cannabis through inhalation or as an edible have even been able to find the benefits from cannabis when delivered as a suppository. All of these (though less with the suppositories) are available from any decent grey market dispensary.
Some 6,000 of the soon-to-be-former MMAR patients responded by filing a class action lawsuit on behalf of the newly formed Cannabis Rights Coalition or MMAR DPL/PPL Coalition Against Repeal. Lawyer John Conroy filed a suit on the basis that the proposed changes to the MMAR prohibiting Patient of Caregiver "production and limiting position to 'dried marihuana' and other restrictions violate the constitutional rights of patients."
Filed officially on behalf of Neil Allard, they were granted an injunction preventing the government from forcing the existing MMAR patients to switch over to the new system. But for the rest of us, it was the new system and the licensed producers.
The licensed producers (LPs) are the most interesting and perhaps enduring legacy of the introduction of MMPR. With the creation of these licensed mass grow-ops the government had trojan-horsed a legitimate private sector into Canada. The very nature of how the new system is set up almost required the involvement of corporations. These new LPs required investments in the millions in order to meet the government-strict criteria to be considered to be granted a license, and the average basement grower simply couldn't throw up a couple more lights and hope for approval. To date, there are 30 licensed producers in Canada.
Once getting approved, the struggle for riches from cannabis was far from over. The LPs are limited to what can be used to produce the cannabis, the way they promote their products and what they do with the plants once it is grown. The cannabis and facilities are subject to rigorous screening, forcing some LPs to resort to drastic measures like irradiation in order to meet the government's standards. They are also limited in how they promote cannabis and themselves: unable to sponsor non-educational events or even post pictures of their weed on their own websites, and outside of promotional limitation, they are not allowed to produce any of the cannabis-derived goods (edibles, concentrates, topicals) that the market demands.
But the inability to effectively promote, offer many of the products demanded by their consumers, or even cultivate plants en masse without any other biological contaminants showing up (while not being allowed to use any pesticides or herbicides) weren't the only problems. Once again, doctors have seemingly demonstrated an unwillingness to sign people up to the program—perhaps the greater impediment keeping the Canadian medicinal marijuana market from coming anywhere close to the potential mid-six-figure number of patients many have estimated.
With the current numbers of patients registered in the MMPR sitting just above 30,000, licensed producers looking for returns on the multi-million dollar investments are forced to look at what the problems were. One of the biggest problems seems to be the knowledge vacuum around medical cannabis. The LPs have been put in the position of hiring people to engage in outreach to Canadian doctors through an industry group called Canadian Medical Cannabis Industry Association, made up of many of the approved LPs. They launched initiatives such as the "5 City Continuing Medical Education Program," an "educational initiative" hoping to enlighten the frontline prescribing doctors and nurse practitioners about the benefits of medicinal cannabis. One member of this organization, Tweed, has taken further steps in trying to making cannabis a part of the Canadian medical landscape by participating in mainstream medical conferences like the Canada Primary Care Update.
Another outgrowth of the MMPR was the advent of cannabis clinics. These clinics serve as a place for weed-weary doctors hesitant to sign the forms to send patients to see a doctor who chooses to specialize in cannabis. While certain doctors and their practices being more sympathetic to pot is nothing new, what is new is the new breed of clinic that is opening in the wake of the MMPR. Places like Canadian Cannabis Clinics, Bodystream, Cannabinoid Clinic and others have opened up all over the country. Patients are given an assessment by a doctor to determine if there is a need, and if so, the amount per day in grams that they require (based on what, I have yet to figure out). After this, the patient meets with a "consultant" who helps steer them to a LP and select their strains. Given that the LPs are currently not allowed to supply "promotional product" (trust me, I have tried), I have a hard time believing that the consultant has any greater knowledge of the LPs' wares then anyone reading the descriptions of the website. The patient then makes an order from the given LP's website and waits a few days for the medicine to show up.
This process has to be repeated every three months, and getting to see the doctor for a renewal can be tricky. I know this because I'm currently waiting for an appointment to get back into my clinic, and I'm at one of the better ones. Patients at different clinics have told me horror stories about overworked, understaffed clinics trying to cope with the massive public demand for medical cannabis, such as patients having to drive for hours only to find the doctor has quit, or not being able to see a doctor for months on end.
Rise of the Dark Grey Market
In capitalist tradition, where there is a hole in the legitimate market, an illegitimate market prospers. The dispensary model, with its product range, knowledgable pot-positive staff, and general conduciveness to buying cannabis (being able to see it and smell it before you buy it), continues to hold the appeal of many medicinal cannabis users. At the same time as the LPs have been emerging, the dispensary scene in first Vancouver and now Toronto has exploded.
In April 2014, I went with VICE to Vancouver to shoot the first Canadian Cannabis. Our intention was to document the MMAR legal challenge over the incoming MMPR and to look at the general direction of weed in Canada at the time. Once in Vancouver, what was even more shocking was the abundance of dispensaries. At the time there were about 30 storefront medical cannabis retail outlets in Vancouver. With an incredible selection of products and many even having on-site naturopaths to sign the required medical forms, it was no surprise that they were proving to be popular with marijuana users. They proved so popular that by the time we came back to film a third episode specifically about dispensaries 18 months later, there were almost 200. The dispensary Eden had five locations at the time and 15,000 members alone, and Weeds Glass and Gifts had some 20 locations spread throughout the province of BC. However, hitting what appears to be a saturation point and the city of Vancouver's decision earlier this year to regulate the existing dispensaries has seemingly slowed the spread.
The end of the Vancouver dispensary boom has seemingly signaled the dawn of one in Toronto. Like Vancouver, Toronto's history of compassion clubs dates back to the mid-90s with places like CALM opening to serve the needs of patients looking for cannabis treatment. For a multitude of reasons, most significantly being the threat posed by law enforcement, dispensaries in Toronto (like the dispensaries that would open in the rest of Canada) are forced to operate under the cover of secrecy. Consequently, Toronto is a little behind Vancouver in terms of dispensary growth.
But what a difference an election makes. In the post-Trudeau Toronto, bolstered in part by talk of marijuana legalization, dispensaries have moved out of the shadows. Six months after the election, some estimates have the number of dispensaries in Toronto at close to 80 with more opening almost every day it seems. Weeds alone already has at least five downtown locations in just about all the major shopping areas.
Given the city's population, this is the biggest marijuana market in Canada. While, for the most part, these places are abiding by the traditional dispensary model of requiring a doctor to permit the patient to use cannabis, they are also accepting cannabis packaging and cards from licensed producers. As the LP packaging has the patient's prescription information printed on the side, it's a natural stand-in for a paper prescription. Some of the new Toronto dispensaries are taking it a step further, however, and offering access to cannabis to anyone who can provide a prescription container of theirs for anything that could be treated instead with cannabis. These dispensaries say they are fulfilling a need of patients to have access to their chosen medicine.
From my perspective, this is the best it has ever been for medical cannabis. In five years, I've gone from panicking because the one person I knew who sold weed wasn't calling me back, to having dozens of places to purchase weed, legal or otherwise. But, while ideal for me, I know it can't last. The fear that dispensaries are cutting into the LPs' potential market is leading the two into conflict with one another. LPs, with multi-million dollar investments at stake, are naturally protective of the market that is by word of the law legitimately theirs. On the other side, dispensaries and many of the people behind them have been doing this work in cannabis for years. Access to medical cannabis was a hard-fought battle, and many cannabis advocates have had to pay for their belief with their freedom. Why should they be cut out of a system that they helped bring about? They argue that they are still necessitated by providing services and products that patients need that aren't being offered by the MMPR program.
One thing the LPs and dispensaries agree on is that there is still a problem with access to the medical cannabis demanded by patients. The mainstream Canadian medical industry is slowly embracing cannabis, but this isn't happening fast enough for patients who are fed up waiting for a system to get figured out. The increased presence of illegal dispensaries is indicative of demand for cannabis not being met by doctors' willingness to allow people access.
The courts in the end agreed with the Cannabis Rights Coalition, that the MMPR did not address the needs of patients. The Honorable Michael Phelan handed down a decision that declared the MMPR needed
provision to allow patients to grown their own cannabis. With the new Liberal government's decision not to appeal announced on March 24, one of the issues facing medical cannabis users seems to have a solution coming.
The Future of Weed in Canada
From my perspective, a drug is a drug, and it all comes down to side effects and whether or not they are manageable for an individual. I had been using the various pharmaceuticals for years and opted to try something new, and it worked for me. It also forced me, out of necessity, to take a more proactive involvement in my own health. I couldn't turn to a skeptical medical system for advice about cannabis, I had to learn it myself from articles, books, or others that had been through the same process. Because of the Canadian Cannabis series I've shot with VICE, I have had an intensive immersion study of cannabis. Now, almost every day someone asks me about medical cannabis: How do they get into the program? Where can they find good edibles? What is CBD?
All but one of the past five Liberal prime ministers have made some noise about reforming or doing away with Canada's anti-cannabis laws, but under Justin Trudeau, legalization has never seemed more likely. It was announced fortuitously enough on this 4/20 that Canada has informed the UN that the Liberal government will introduce legislation to legalize cannabis in the spring of 2017.
With legalization, many of the problems with the medical cannabis system will be subsumed by new problems brought about by the mass recreational system. All anyone needs to do is look at the moves the LPs are making as far as the level and scale of production to see that they are gearing up for a recreational market. Questions of monopolies, supply chains, taxation, and revenues will unduly further diminish the voices of medical cannabis patients.
As a medicinal cannabis user, I want to see a medical cannabis system that puts patients and patients' needs at its core. The primary patient concerns of access and price are also what stands at the core of keeping this as a desirable market to the many people that stand profit from it as a legitimate sector. The legitimized commodification of this plant opens the door to the creation of a monopoly. Now that patients will have the option of producing their own plants again, it also forces the legitimized sector to be somewhat susceptible to free market forces while remaining regulated.
As a person with a sense of justice, I want to see a recreational or medicinal system that acknowledges the efforts made in cannabis by the people who have been criminalized by their association with cannabis. As a country, Canada is on the cusp of admitting that the prohibition of cannabis has failed and that it is harmless enough to now allow people to make billions off of the sales of it. Shouldn't the people that have been saying that all along be allowed to participate? Under the current parameters of the MMPR, the only people who were allowed to apply for licenses to produce cannabis were people without past legal entanglements with cannabis. The regulated cannabis market should be opened enough to allow the very people that have developed that very strains, plants, and culture that so many others stand to profit from.
Above all this we need to see the end of the arrests for cannabis. No matter what is about to happen with who will control it, we are about to see weed legalized, and thus, it should be decriminalized immediately. Above access, price and control of the industry, no more people should have to have their lives upheaved for the possession of a plant.
This week close to 15,000 got together in downtown Toronto on a weekday afternoon to smoke weed and disobey cannabis laws that they find unjust. For the past ten years, the annual 4/20 protest has grown. Started by a handful of people who wanted to have a public smoke-out similar to one held in Vancouver, the Toronto version, much like its west coast counterpart, has taken on a mini-festival-rally vibe in recent years. This one was by far the biggest yet, as people stood shoulder to shoulder in Yonge-Dundas Square passing joints, munching edibles, dabbing concentrates, and generally celebrating cannabis. There was a sense of completion to the festivities as the 15,000 people, medical and recreational user alike, all knew that by this time next year, cannabis is Canada is going to be drastically different.
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