The Many Roads to Long-Term Recovery (06/14/2017)
During my forty years as a professional in the field of addiction treatment I have spoken to hundreds of men and women in recovery, always curious, what made the difference between their continued use or choice to take the path to recovery. For each individual there are unique factors but several common themes continued to surface; these themes appears to be, experienced in different ways by different individuals. I have witnessed three general themes that emerge and seem to be consistent for many in long term recovery. These themes are: continued clean time with the establishment of a support system, an acceptance of a lifestyle change, and the experience of a significant life changing event leading to an openness in exploring an aspect of themselves that had previously been off limits.
Clean time is defined differently by various individuals or groups associated with addiction treatment and recovery programs. Some discount an individual who is on medication assistant treatment like methadone, suboxone or naltrexone as being clean. Other very conservative individuals may include the addiction to nicotine as an exclusionary factor. Although, I understand the validity of many of these viewpoints, for this article I will include all of the examples cited as individuals in recovery. I base my thinking upon the belief that the primary characteristics of active addiction are; the inability to remain abstinent, the lack of behavioral control, the craving for the substance of use, the lack of awareness of significant life problems and the lack of a healthy emotional response to life situations. Personally, my view is that if an individual addresses these issues successfully whether they are on medication assistant treatment or not seems to be a moot point. The overall lasting change in mind, body and spirit is that which is celebrated.
A critical next step after acknowledging ones’ problem is preparing for the path to recovery with the establishment of clean time. Some people may require medical detoxification, which is a significant step that allows the body to begin the healing process. The likelihood that one will remain clean just after detoxification is slim. Anyone who has been around addiction and recovery for just a short time knows that this step, yet crucial, is usually not enough for most to maintain long term recovery. Recovery is directly related to the length of time a person is away from their substance of abuse, positive changes in their belief system and making the necessary lifestyle changes required to sustain this state of well being.
The first reoccurring theme reported, is the establishment of a support system. Significant emphasis is placed on the establishment of a positive recovery network, a social support group knowledgeable of substance use disorders, a life lived while in active addiction, and the consequences suffered as a result. Gaining a sense of belonging for some whom may have isolated themselves for so long provides the opportunity to identify with one another, normalize experiences and create motivation for everlasting change. For countless individuals in recovery having this support system in place is essential for their continued success. This level of understanding is often found within mutual support groups like 12 step programs, and yet others find this support within their family, friendships and religious practice participation.
The key, I believe is establishing relationships that are supportive, knowledgeable, honest, meaningful, caring, compassionate and reciprocal. One individual shared about her network of peers that she established after completing a long term residential treatment program. Twenty years later they still remain friends and are instrumental in each other’s recovery process. Even though they did not see each other frequently they always remained in constant communication and had the comfort of each other’s nonjudgmental support. Alternatively, others may find this support within the fellowship of their Alcoholics or Narcotics Anonymous 12 step groups or other mutual support groups.
Another frequent emerging theme is the acceptance of a lifestyle changes. This seems to have a lasting positive impact on individuals in maintaining long term recovery, although difficult and awkward for some who have had significant interpersonal collateral damage. The significant change in lifestyle is a practice that may begin in rehab and continue after discharge. Some of the lifestyle changes reported includes the adoption of healthy patterns of exercise and having a regular schedule of either educational, vocational or recreational activities and for many attendance at mutual support groups. Living a life that provides stability, with a predictable routine which also includes regular doctor visits, a well balanced diet, establishing healthy sleeping patterns that allows for quality sleep and awake time, all promote a healthy lifestyle change.
Establishing a consistent sleep pattern in early recovery is significant to the attainment and maintenance of one’s long term recovery. Some individuals reported struggling with the development of healthy sleeping patterns after years of substance use. They talked about various medical, clinical and behavioral options available. Some required professional consultation by an addiction specialist utilizing several behavioral methods such as meditations, sleep apps and scheduled exercise to coincide with improvement in their sleep. Others reported their history with addiction and current state of recovery to their health care professional and found medical alternatives to be safe and beneficial. Suggestions like nonprescription approaches such as melatonin have yielded successful results for some and others have been prescribed medications such as Trazodone to assist with the development of healthy sleeping patterns.
The last most frequent theme reported is the experience of a significant life changing event. Most individuals often talk about a significant life event that made the difference. Frequently, it was something very subtle, like someone providing a compassionate, caring but firm offer to help when they felt helpless. The life experience provided an opportunity to realistically confront their unhealthy thinking and behavioral patterns that reinforced their substance use and to find hope.
One individual shared their experience of being in the same environment as a group of young adults with developmental disorders. He and the others were at a Catholic Charities owned lake that hosted outings for young adults in rehabilitation for addiction and young adults with developmental disorders who resided at a group home. He stated that although the groups did not interact and were at different parts of the lake it was significant enough for him to question what he was doing to himself and to begin a more determined meaningful path to recovery. Others have spoken about “being just sick and tired of being sick and tired”. These moments often lead to an openness to explore the possibility of a “ah ha” moment or the point of enlightenment. Their experience seems to be a turning point that establishes insight and the desire to return to or establish a healthy value system, the opportunity to see themselves and their circumstances differently.
This openness has also allowed some individuals to accept the fact that their addiction may be more complicated and include an undiagnosed mental health disorder. Understanding that a pattern of relapse was related to an untreated mental health disorder has provided answers to a pattern of moralistic and judgmental thinking that continued to feed their addiction.
Individuals in long term recovery are very open to sharing their experiences. This is part of the success of the self help movement. The similarities and differences in their stories still amazes me, and the varying degree of consequence which was required to inspire change. One individual may have had to face heartbreaking experiences while another simply missed work as a result of their substance use and turned the page. As an addiction’s professional I needed to learn very early on that I did not have right nor the knowledge to know who would benefit from treatment and who may not. Today’s medication assistant and evidence based treatments have helped the profession provider turn a corner. I understand it is my responsibility to be open to each individual and their unique story and the new treatment alternatives that may play a part in the path to recovery for men and women in need.
Laurel’s Story of Triumph (02/27/2017)
I am such a better person when I am not using heroin and other drugs. When I was doing all that it was all I really cared about. I was so selfish; I just cared about me. I was either nodding off, looking for drugs, or dope sick. It takes all your waking hours. I feel really guilty about it now because the drugs always came first. It is the lowest level of survival. I wanted to stop but it is not something that anyone else can force you to do. You have to really want it bad, you have
to want to do it for yourself. I wanted it but I couldn’t figure it out. I was sent to an inpatient facility and I was able to figure it out and then I could stop. I want to be a better person and be proud of myself, and I want other people to be proud of me.
I had a lot of issues that I was holding back. I never got over my dad’s death and I was really resentful against my mom for being a meth addict and never really being there for us as much as we needed her. I was always stuck watching my little brother and the whole thing was very depressing. I am not very confident and I don’t have much self esteem but when I was high those things didn’t seem to be a issue yet I became addicted so it was a bad trade out.
We were left alone a lot so we had a house where people could come over and party a lot. My sister is almost the same age as me but she only wanted to use occasionally and I wanted to use everyday-all day. If I didn’t have it I was irritable. There is something different in the mind of a addict but I only have choices in my life if I don’t use. My heroin clean date is on the day my dad died. That is a big motivator for me. I recently found out that he was a heroin addict too. So it is a family disease and that only makes me realize that with two addict parents I have a lot of responsibility to protect my sobriety from the cravings that come. For now I am grateful to not wake up craving and needing drugs before breakfast and I am happy for the sober family members and friends who are helping me move into my new life.
Kimberly’s Story of Triumph (02/20/2017)
I started using when I was 11 although in my first stent I wasn’t addicted, that didn’t happen until I was 16. By 17 I was a full time cocaine addict but I got bored with that so I moved on to heroin. I locked onto heroin for the next six years. I remember the day I got clean from drugs. I was sitting in an alley that reeked of urine and was littered with trash and auto parts. I had on the only clothes I owned which was a pair of flip flops, a T shirt, and some shorts. They were passing around a needle with heroin in it and it was my turn. Suddenly out of the blue I looked at it and knew I didn’t want to do it. I said, there has got to be a better way to live and I walked away. I think some kind of fear or self preservation took over.
I ended up at my Mom’s house and she is a God-fearing woman. I was feeling bad because I was starting to go into withdrawal so she asked me if I was ready to stop all this and I knew that treatment was my best choice. She brought me to the treatment center and she was playing spiritual music in the car and praying for me. I am sure that the only reason I didn’t run off was because I knew she loved me.
The first few weeks in treatment were terrible. My thinking was foggy and I felt delusional but somehow I just did what people told me to do because I didn’t have a better place to go. After a few weeks things started to get better. It was a period of transformation, it felt like magic as I started thinking clearly and understanding why I was so gaga for heroin.
First and foremost I think I had to accept who I was and what my challenge in life was going to be. Knowing that my brain is different and suffers from addiction is important. I just had to accept that this is the way it is. To make sure I was going to be safe and stay safe I had to put a network of people together who were liked minded. People who are musicians like to be around musicians, athletes like being around other athletes, and that is why a person who is an addict needs to be around other people who are successful at beating the disease of addiction.
For me another important part of recovery is be humble and find a purpose that is greater than myself. Addiction is a very selfish disease and once I get the drug inside my brain I have a thousand reasons to use it. My best thinking will keep me going back to the same thing. I have been obsessed over heroin so I need to stay away from it by taking care of my real needs which don’t include heroin or any other drug or addiction.
I can’t be complacent and I need to stay strong because after eight years of recovery I relapsed when I was given Vicodin for a surgery. The next thing I knew I was drinking and using again. Just like that. I am not the same person when I use and that is why I have devoted the rest of my life to being the best version of me that is only possible when I am sober.
Dr. Richard Ries talks about regaining control from opiate addiction (02/08/2017)
|Dr. Richard Ries is Professor of Psychiatry at the University of Washington Medical School in Seattle, Washington. Dr. Ries serves as Associate Director of the University of Washington Addiction Psychiatry Residency Program. He is board certified in Psychiatry and certified in Addiction Medicine by the American Society for Addiction Medicine, and in Addiction Psychiatry (1993) by the American Board of Psychiatry and Neurology. Dr. Ries is Director of Outpatient Psychiatry, Dual Disorder Programs, and the Chemical Dependency Project at Harborview Medical Center. He is director of substance abuse education at the University of Washington Medical School and director of the Division of Addictions for the Department of Psychiatry.|
Moving from Dark to Light -Ed Reading describes how surrendering control of addiction can lead to recovery. (01/06/2017)
I am frequently asked about when spirituality begins in the life of the addicted person. There is some, “common knowledge” (based on common experience) that says that once a person enters recovery, the spiritual life begins. Other common knowledge says that in addiction, spirituality is the first thing to go, and the last to return. Also, some say that the spiritual life is absent during active addiction, and only surfaces once recovery begins. These are interesting points of discussion among recovering people, and can put some people into a frame of mind to try to explain the way they understand their own experience of spirituality.
I frequently try to help them understand that these, somewhat simplistic, understandings of spirituality have some shortcomings. This is because the common understanding of spiritual life is that part of life which is seen “through rose colored glasses”. This is not so. There is a more realistic approach to understanding the spiritual life, but it takes a broader understanding of spirituality. The spiritual life is experienced in the good experience of life as well as the bad experiences.
As human beings, we all have a spiritual core to who we are, and what makes us who we are. The human condition is, by its very nature, always spiritual. What we need to realize is that the spiritual life includes both the “dark side” of spirituality as well as the “light side”.
The Dark Side – During active addiction the spiritual life is very active, but it is all very dark. Some of the signs of the dark side of the spiritual life include (among other things): isolation, self-centeredness, depression and hopelessness, loss of control, despair, being stuck in the status quo, being egotistical, and fear.
The Light – As recovery begins, the symptoms of the dark side of spirituality begin to break down. This usually begins with a “sliver of hope”…when surrender takes place, hope and change can begin. Eventually, all of the dark side symptoms begin to move towards the light. The symptoms of the Light side of the spiritual life include (among other things): the experience of community/fellowship, becoming more other-centered, having hope for the future, being able to make decisions for personal growth, humility and love.
Moving from Dark to Light – This is the way the active addict lives…it is all the addict knows. The active addict is trapped in a downward spiral with all of the symptoms of the dark side of the spiritual life. The entire time, the human spirit tries to get out of this spiral…but can’t, because the addict is trying to control it. They are fighting it, and at the same time digging themselves deeper and deeper into the hole leading to death. There is only one way out. The addict must stop fighting it. They must “surrender” to the reality of the addiction being in control, rather than the individual person. Once the addict “lets go” of any attempt to control addictive disease, they can begin to take control over their decision-making which can lead to recovery. The first step in this process is being aware that they have lost control over the use of the object of their addiction (alcohol, opiates, cocaine, gambling, sex, etc.). They cannot do this alone. One cannot only “not do it alone”, one really needs to “let go” of that control, and allow others to take over. The “other” may be other people, and the “Other” may be a Higher Power that many people call their “god”. Their experience of the god of their own understanding needs to be a spiritual experience which need not be “religious”, but for most Americans a religious-spiritual experience is common. Some need medical assistance with detoxification/withdrawal. Some need a level of care which provides treatment leading towards recovery. What we know works best for most, is a combination of formal treatment, including medical, addiction counseling and active participation in self-help groups.
Contradiction? – Finding Power by giving up Control. Finding Healing by Surrendering to the Disease. These appear to be contradictions, but when dealing with the spiritual life, things that seem to be opposites are sometimes not “opposing” but rather “two sides of the same coin”. This is part of the experience of the spiritual life.
So, if you feel hopelessness and despair, raped by the addiction, I hope that you “give up” and allow others to introduce you to a way of life that gives you hope by finding a way of life that leads to ultimate transformation.
Angie Tells Her Story of Triumph (11/22/2016)
Dallas’s Story (10/19/2016)
“My road to recovery was a rocky one. My wife passed away while I was in the midst of my addiction. At her funeral I was in withdrawal but I asked my mother to attend because I needed her strength. I was ashamed and confused. It was like I was the one that died and was having some kind of spiritual experience. My death experience was very painful. I cried a lot and inside I knew that I wanted to be dead too. Actually I already felt dead because my addiction was killing me every day. I knew I was ready for something big or drastic. Overdose, another trip to prison, or treatment. I’d overdosed before and I had been to prison six times but I wanted to try something new. My mother suggested treatment which I found to be the most terrifying choice of all but I promised her I would do it. I have broken promises to her before but somehow I wasn’t ready to break this one.
Being in prison is a lot like being a heroin addict, you don’t have enough choice but I was determined to be a person who was not incarcerated and not on heroin. A woman came to speak at our treatment program who spent years as a heroin addict and time in prison. She was out now had been clean for 12 years. I made up my mind that I wanted to be like her. She told us when you get out of this program don’t go home and pet your dog or go kiss your girl friend. Go straight to a AA meeting and then keeping going to them. Sometimes I went to three meetings a day just so that my mind would be occupied and I wouldn’t fall back into the old stuff cause I’d been using heroin for 21 years.
Opiate addiction is a living hell you know what I mean. The things you do, the degradation you sink to and it’s just a dank, dark, dirty, dreary place. I spent my first year out of prison constantly going to meetings and reflecting on my life. While I was using I committed felonies to get money to buy heroin and then I would be back in prison. I never really reflected on how severe my problem was. Fortunately for me I had a praying mother who stuck with me through all this and when I did get clean we developed a spiritual bond that got stronger with time. I was the oldest child and my other brothers never got into drugs or crime. I realized later that I should be dead after all the things that I put myself through but I believe that God had another purpose for me.
I have never relapsed and I know that it is rare. I don’t put myself on a pedestal but I always let people in meetings know that if I could get clean than anyone can. I was a back in the alley door way dope fiend with six trips to the pen. I am not better than anyone but I did it!
When I was in prison I dreaded getting out into the world and conforming. I didn’t want to go find a job and settle down. But when I got sober I started seeing things a different way and I found meaning and purpose in life. Now I work two jobs, I go to meetings 4-5 times a week and my son has never seen me drunk or high once. I am just dealing with life on life’s terms and I use my recovery to deal with whatever happens.
I believe that I have changed because of the work that I put into developing a deeper spiritual connection with a higher power. Addiction keeps you from having that relationship. I feel like the foundation that I built to working the steps, doing the work that is outlined in the big book helped save my life. I mean today it is Life 101. I would rather do it sober, I would rather help people. After I was five years clean I lost my father, an uncle, and a child. That would have been the perfect excuse for me to use again but I didn’t.”
Ellora’s Story (06/30/2016)
I started experimenting with opiates when I was a teenager and as I grew to rely on the emotional relief I got from them I formed a bond with this chemical. Before long it was costing me too much money so I switched to heroin. After almost five year into this downward cycle I was desperate to get off. I even tried to use suboxone and booze to stay away from the heroin but I was relapsing once a week. I didn’t have the mental capacity to reach out for help as I would today. I didn’t really know what I needed to know so I was ready to kill myself. I was victimizing myself plus I had a lot of self pity which put me into a sick place Over years of use I had developed a better relationship with heroin than I had with myself. Without heroin I didn’t have the skill set or the self esteem to deal with life. I used heroin to cover up my feelings- who’d have thought!
During my use I was lying to myself. I told myself you can’t get through this without dope, you just can’t do it. I lied to myself so I could keep using. I don’t know how this happened but there was a time in my life that I didn’t think about my thinking. I was only thinking about how I could get more heroin. Now that is no longer my motivation I have worked on improving the quality of my thinking and I am less selfish and more considerate towards others..
For me the withdrawal process was really challenging, I don’t know how to explain it but I really did want to die. I wanted to die because I was in this place of constant physical, mental, emotional and spiritual pain and I had no idea that I was going though it for months. I would pick up and then go without it for a few days. It was terrible because I was torturing myself and torturing my family.
Then one day I was arrested and I was forced into treatment. I can remember my first day of in-patient treatment program and being asked,” do you really want to get clean?” I spoke to the truth, part of me was ready and part of me was not. I was really unsure in so many ways about giving my life over to a group of women in recovery who knew how to live a sober life.
Letting go of heroin was a grieving process for me. It was very saddening in a lot of ways. I feel like a baby saying this but I was grieving the loss of heroin. But I was in an all women’s treatment facility and I WAS REALLY DESPERATE! Somehow I realized that I was done with my heroin habit for good and I put my full trust in this recovery program, trust for a heroin user is a big deal. I had such tunnel vision and had little perspective but with some clean time I was open to listening to others and participating in group sessions. I am the kind of a person who can learn from other people and their experiences even though I wasn’t able to identify emotionally at first. I wanted to cry over things people were telling me about their lives but I couldn’t. It wasn’t part of my nature at that time but I still was open to changing my values.
I am still learning how to manage stress over feelings. I couldn’t even cry. Now when things come up or I am stressed I realize that I am not my thoughts. I go with the flow and make adjustments. I know I am onto something because this is also what I hear from people who have decades of sobriety and I have learned to lean into things. I’ve learned so many skills from the others in my group that I can use in my everyday life. Now there is hope. When I was using I really didn’t enjoy living and now I like being alive and I like my life. Before I didn’t know that I was carrying around those feelings. I couldn’t recognize that I didn’t like living, that’s how much I was out of touch with my emotions. Today I am glad to be alive but my happiness depends on my sobriety because there are no guarantees in life.
After the treatment program I am more emotionally mature. Maybe I would never have gotten to this better place without all the trouble I put myself and my family through. Through my narrow perspective I saw my life as horrible but in sobriety I’ve realized that I was a selfish person, a horrible daughter, and a horrible sister. When I was using I didn’t think about that but in sobriety I can see it for what it was and I can do something about it. My past failures don’t define who I am now. I couldn’t have foreseen all the growth and good things that were ahead of me. It is my story, it is my narrative. I am alive today and living a different life. People get ready to change at different times and for different reasons but sometimes they wait too long and miss their opportunity by dying or ending up in prison.
Today I am alive and can value so much of the goodness in the world and I am not limiting myself to an obsession with drugs. This has opened up a lot of space in my life allowing me to reconnect with my family, it has opened my life to authentic friendships and made me more intellectually curious which has propelled me on a very satisfying educational journey. I am no longer limited to satisfying a drug habit. I feel limitless and I am out of my cage.
The Lonely Road of Staying Clean (06/16/16)
Stories of opiate addiction and the struggle to stay clean are running rampant all over our nation. The Washington Post recently published a great story on the challenges recovering addicts face. Take a look at the story by following the link below.
Leave a comment telling us what you think.
Dr. Mendenhall on Beginning Recovery (06/09/16)
Andrew B. Mendenhall, M.D.
Co-founder of HealthWorksNW
Medical Director, Hazelden
Jims Story (06/02/2016)
I was addicted to heroin and had been shooting it for the best part of 35 years. I was in a place where I had no way out. I had no direction in life, life meant nothing to me. I burned everyone I knew because that had become a way of life but God intervened. He arrested me or got me arrested. I was given a public defender to represent me and she asked me if I wanted help with my addiction. I never had anyone offer me help before, my parents were addicts and they never did and I really had no family support system because everyone else knew to stay away. I didn’t trust anyone especially myself but the public defender asked me if I had the courage to stand up and do something good for myself because I had a lot of important information trapped inside of me that would allow me to help other people. I wasn’t sure if I believed it but she told me to do my job and she would do hers. That was the very first day that I thought I had a chance at a new life, a life that didn’t including using heroin.
I had a lot of doubt and fear that I was going to prison for the rest of my life. I had the habitual criminal act filed against me and the public defender went to the judge and told him that she thought that I was worth saving and the judge agreed that if I was to get a veterans organization to get me into long-term treatment that he would go ahead with the recommendations.
It was very scary and uncomfortable but given the opportunity to go into a treatment program I had to learn a whole new way of life. I have accountability now which I never did before. My word had to be impeccable instead of just manipulation. It was a total life change.
I had a lot of help. I was introduced to a drug and alcohol treatment program that could also help me with my PTSD and other mental issues. At an early age I was diagnosed with ADHD and was living with my father who was a biker outlaw who was selling heroin. I went to see him and told him I forgot my Ritalin he said, I have something for you and he gave me my first shot of heroin at 12 years old. It relieved me of all the pain, suffering and turmoil in my life and replaced it with the feeling of warmth and belonging. Over time I learned to love it and wanted it every day and was willing to do anything to get it.
When I finally quit using it I had to have something to replace that sense of belong I got from dope, gratefully I found peace and comfort in the 12 step program. I found a network of sober friends who have embraced and supported me and that has given me the strength and courage to carry on.
When I started seeking professional help to identify my feelings and then embrace them whether those feelings were fear, doubt or love. I had to learn to identify those feelings before I could accept them. And this program has helped me with that. I now know that the opposite of fear is faith and this is the place I go to get my inner peace so I can be a giver of hope to people who suffer from addiction and suffer from hopelessness. I have compassion for people who are trapped there and I want to provide some service to them I know now that people don’t have to live that life anymore if they are able to take a few suggestions then they can grow past their limitations.
I always had negative thoughts about myself and considered myself to be useless, worthless and no good. I had nothing to live for and I was nothing on earth, just a useless barnacle on the bottom of the ship and that is what I saw myself as. Flipping the script helped me take these experiences and be a good example for others. That is my whole motivation for living today. When I see that addict shooting dope in a doorway I know how that feels so I come up to them and engage them. They offer me some of their heroin I thank them, tell them a little about myself and hand them my card and ask them to call me when they are ready to put the needle down so they too can move forward and get hope back in their life. My favorite slogan is you may be but one in the world but to one you may be the world.
For me recovery was one step at a time as my life was so unmanageable that one step at a time made sense to me. My life was so stressful that I had to put my faith in a higher power to restore me to sanity but that required turning my life and my will over to the power of God. This required me to do a moral inventory and then share it with God and other individuals as a means of cleansing my soul. Through this I was able to find my soul and have a conscience which I never really had before. I went through all the things that I had done in the past and confessed and that put me in a new place where I could start with a clean slate. So now I do a daily personal inventory and keep working on having a person relationship with God through prayer and meditation. My life’s work is to give back to others what God so generously gave me. I know it was God who saved me because no one in the universe could have saved me.
On the sentencing day the judge looked at me and said, you are a career criminal, you have 39 felony convictions, what can you tell me that will make me think you have changed? I said, your honor, I am no longer the person I was. I believe that I have a relationship with God and he has set me on a path to help others. I think that it blew him way- I demonstrated a sense of humility and clarity that I had never before possessed. Ok, I am going to give you a chance to remain in treatment but you are going to have to report to me personally and I want to see a progress report every 30 days. And I you fail this program I will bury you so deep into a prison cell that they will have to pump daylight in. I agreed with the knowledge that this would be the first day of my new life.
Humility was not something I knew before. I was so grandiose plus I had a death wish everyday and it didn’t matter to me if it was by someone else’s hand or if I with overdose but look what happened, I didn’t get my way. It was all God, I am not my own man anymore, I am God’s man.