Posts Tagged ‘cnn’
The Genetic Link to Addiction
Wednesday, October 21st, 2009
An article on CNNMoney.com today spoke about the genetic link to addiction. Although widely acknowledged throughout the addiction treatment community, it’s nice to see additional research showing the link between addiction and genetics. According to Dr. David Goldman, the director of the Laboratory of Neurogenetics at the National Institute on Alcohol Abuse and Alcoholism, said that according to the massive study they completed of addiction in twins, addiction ranks “among the most heritable of mental illnesses.”
Dr. Goldman also said that social cues and environment obviously contribute to addiction, a valid point. Someone with the “alcoholic gene” who is never exposed to alcohol may never lead themselves down a destructive path. After all, genetics load the gun, and environment pulls the trigger.
“What’s interesting,” Goldman says, “is that the more addictive the substance, the stronger the role of heredity in causing an addiction to it.” Therefore, if someone is using crack cocaine or opiates and has the genetic predisposition towards addiction, the greater the chance of getting hooked. Other environmental things, such as abuse or other instances of trauma, can severely influence the nature of addiction.
Dr. David Oslin, a psychiatrist at the University of Pennsylvania, had this to say about the study, “It reinforces for the patients that they are not just a bad person or lack will power. It resonates with the notion that their brain may work a little differently than other people’s and that this really is an illness they can treat like any other.”
As a family member or a loved one, be sure to be aware of the genetic triggers in your family- if a parent struggles with alcoholism, be sure to be aware of your genetic history and approach your drinking carefully. After all, there’s only so much one can do after addiction has taken hold.
Be sure to check out our new Wikipedia page, located here.
For any questions or help with yourself or a loved one, call us directly at 877-320-0247.
Tags: addiction, addiction genes, addiction intervention, AiR Assistance in recovery, alcohol, alcoholism, assistance in recovery, chemical dependency, cnn, genetics, gentetics of addiction, intervention, recovery, recovery assistance, substance abuse
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AiR's discussion on CNN, Oct 1st
Saturday, October 3rd, 2009
16 states across the nation, more people die from drug-related incidents than die in traffic accidents. AiR’s founder and CEO, Andrew Wainwright discussing why drug deaths might be on the rise ““ the CDC points to the increase in abuse of prescription medication.
Aired October 1, 2009 – 07:00 ET
CNN AMERICAN MORNING HOST JOHN ROBERTS: Some shocking new statistics coming your way from the Centers for Disease Control. In 16 states across the nation, more people die from drug-related incidents than die in traffic accidents. So what could be done about it? We’ll find out. 38 and a half minutes after the hour.
(COMMERCIAL BREAK)
ROBERTS: Welcome back to the Most News in the Morning. Startling new statistics as we said from the Centers for Disease Control. In 16 states and counting, drugs now kill more people than car accidents. While traffic accidents remain the biggest injury- related cause of death across the country, drug overdoses are on the rise. Why is this happening?
Andrew Wainwright is the president and CEO of Assistance in Recovery Incorporated and kicked his own addiction a decade ago. He joins us from Minneapolis this morning.
So Andrew, according to the Centers for Disease Control, drug- related deaths in the United States have doubled from the late 1990s to 2006. Why the rise?
ANDREW WAINWRIGHT, PRESIDENT & CEO, ASSISTANCE IN RECOVERY, INC.: Well, I think two important factors, John. One, in the mid 1990s, a mandate came down from Jaco and others saying we were under prescribing for pain medically, across the board. And we needed to write more prescriptions for pain. So that began and docs began to do that. We saw a rise in the writing of prescriptions.
At the same time, we saw the big pharmaceutical companies begin the kickoff primarily in January of 1996. (INAUDIBLE) Pharma kicked off OxyContin. So we saw the rise of the selling of pharmaceutical drugs, heavy narcotics both to the consumers and to the docs. So I think the combination of those two factors – in the mid ’90s, exactly where we are, the swing of the pendulum where we have unintended overdoses. And this is interesting, in hospital and on the street today.
ROBERTS: Is it just because of the availability of drugs? Or is it also a public perception issue? I ask you that because Margaret Warner, an epidemiologist for the Centers of Disease Control talked about this yesterday. And here’s what she said. She said, “People see a car accident as something that might happen to them. But as far as drug overdoses go,” she says, “maybe they see it as something that’s not going to happen to them.”
You know, you get in a car. You know you’re going out there in the flow of traffic. You have a license, you have insurance. You know that it’s possible that you could get into a car accident. When taking drugs, do people say, I might overdose? I better be careful here or better still, I’m not going to do it at all?
WAINWRIGHT: Well, I think we also have, let’s say 40 good years of education without car accidents. If you remember back there was a time when nobody wore seat belts. And then we saw the rise of air bags and all kinds of other safety insurance to make sure that we got safer. We’re raised with years of commercials and high school showings of drunk driving and all those things what happens to people.
I don’t know if we’ve seen that piece of education for the general public around drug addiction from prescription drugs. We certainly see it in the DARE program and others for narcotics that you find in the street but prescription drugs, they sort of see it safe. They come from your doctor. They’re prescribed. They come in a clean bottle. They’re sold to you from a clean environment. You take them home to your house where you take them. And it doesn’t seem there’s a lot of danger there.
It’s very far removed from what you see in the evening news, the drug wars in Mexico. It doesn’t seem that it’s the same thing as the narcotics that I’m taking at my house. So it shouldn’t have the same result. And so the study comes out like the ones that we’re seeing from the CDC and we’re really surprised that people, us, our kids, our friends and neighbors are overdosing. We can’t really put the two together.
So I think we’re talking about a missing educational component that this is serious narcotics that’s being probably today, over prescribed or made overly readily available or the ones that we have in our homes aren’t being destroyed quickly enough as they are being diverted to the street. All of the things I think we’re beginning to get educated about.
So I think we should be happy on some level that A, the CDC did the study; B, CNN wants to talk about it; and C, it’s going out to America saying this is a real problem and we need to get more education and understand what’s going on so that we can stop it.
ROBERTS: Well, we here at CNN always want to talk about the important topics. You know, Centers for Disease Control in terms of this idea for prescribing, its report said that one in five adults now is prescribed an opiate every year. And you talk about education, there is one new area where we seem to be getting it as a nation, and that is the danger of our children getting a hold of prescription drugs that were prescribed for adults. Let’s take a look at this PSA, I think, that many are familiar with now.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: The yellow one – this is for my postpartum depression. This one, sciatica – whatever that is. I got these after my hysterectomy – or my prostatectomy – some “ectomy.”
(END VIDEO CLIP)
ROBERTS: And are PSAs like that helping to illuminate the problem, at least, of young people getting drugs out of their parents’ medicine cabinet?
WAINWRIGHT: I can only say I hope so. But I think that education is key at all areas of – of going to war against, you know, what’s becoming an epidemic for us culturally. I think it’s going to be a lot of education, needs to be a lot of time, because this has become, really, a cultural issue. I think it’s -
Well, you can look at pharm parties for high school kids. I think it’s culturally part of what we do is we have heavy narcotics in our home. We’re not loathe to share them with our friends and family if they are in pain. It’s sort of, you know, we carry these in our purse, we carry them on the plane, it’s part of who we are culturally. I think a big piece of that needs to change, and so I think, yes, the PSA is going to help. It’s going to take a lot of them, and I think it’s going to take a lot more of you and I and folks like us talking about this, making it important for everybody.
ROBERTS: All right. The National Highway Traffic Safety Administration says that the (ph) decline of road fatalities, which is one reason why drug deaths in some states have surpassed traffic fatalities is because of advances that were made in reducing traffic fatalities, but the safety administration says that it’s – it’s one of the great public health triumphs over the last few decades, to lower the number of deaths on the roadways. What can be done to make similar strides in drug abuse?
WAINWRIGHT: Well, you’re talking – you know, I’m a “change the world” guy, so I would – you know, I think it’s great that we lowered it 1 percent or 2 percent or whatever it was for traffic fatalities. You know, I’m all for making big changes. So I think that the pendulum began to swing in one direction in 1995 when we had these two major incidents happen around overprescribing of heavy narcotics. I think what – the CD (ph) study is great because it gets us talking about it, so we’re hoping that the pendulum is going to swing as far as this can go in this direction and we’re going to push it back the other way.
So let’s pick a mean, let’s say 1996, 1997, 1998 – that somewhere in there we’re going to say that’s the gold mean where we’re prescribing enough to manage and treat the pain that America is presenting with but we’re not overprescribing and allowing drugs to be (INAUDIBLE) in the street. And then we’re going to culturally change how we understand and think about the use of these kinds of prescribed drugs.
ROBERTS: Andrew Wainwright – a “change the world” kind of guy. You managed to change your world. You changed many other people’s. See if we can keep going from here. Thanks for being with us this morning. Appreciate it.
WAINWRIGHT: Thanks, John.
ROBERTS: Forty-seven and a half minutes now after the hour.
(COMMERCIAL BREAK)
Learn more about:
Drug Addiction
Alcoholism
Eating Disorders
Sex Addictions
Gambling Addictions
Tags: america, american morning, andrew wainwright, cnn, drug abuse, drug use, prescription drug abuse
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Overdose News
Thursday, October 1st, 2009
According to an article posted yesterday night on USA Today, prescription drugs and other pills are now the leading cause of overdosing, ahead of things like heroin and cocaine. According to the Center For Disease Control, prescription pills now account for the majority of the over 26,000 fatal overdoses each year. In previous years, up through the 1990s, the majority of overdoses were brought on by illicit substances like heroin. However, with the upswing in prescriptions and the lack of knowledge surrounding the abuse of these pills, the dangers have continued to increase and, as a result, created a dangerous epidemic of abuse and addiction.
Leonard Paulozzi, a researcher at the Center for Disease Control, said that the numbers show that overdoses in rural areas have now come to equal those in cities, which is lead, according to Paulozzi, by the availability of prescription pain killers and opioids. With chronic pain become a new term, the prescriptions of opioid pain killers have started to increase, and therefore leading to additional overdose danger. And with a rise in stress and depression, the dangers of addictive behaviors are brought to the forefront.
“At the high doses used by drug abusers, the margin of safety is small,” Paulozzi said. “Combining such drugs on your own or using them with alcohol increase the risk.” The number of overdose deaths due to prescription drugs, like morphine or codeine, has more than tripled since 1999, according the new CDC figures. “The biggest and fastest-growing part of America’s drug problem is prescription drug abuse,” says Robert DuPont, former White House drug czar and former director of NIDA.
We’ve been speaking out on the dangers of prescription drugs for years, and will continue to do so until the appropriate levels of education and awareness of the dangers are reached. Here’s a clip of our CEO, Andrew Wainwright, on CNN’s American Morning talking about the dangers of prescription drugs.
For assistance with prescription drug problems, or if a loved one is struggling with addiction, please visit our main site or call us directly at 877-320-0247.
Tags: addiction, addiction intervention, AiR Assistance in recovery, andrew wainwright, chemical dependency, cnn, cnn american morning, intervention, overdose, prescription drug abuse, prescription drug overdose, recovery assistance, substance abuse, Treatment, vicodin addiction
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AiR's CEO on CNN Thursday, October 1st at 7:30 ET
Wednesday, September 30th, 2009
AiR’s founder and CEO, Andrew Wainwright, will discuss tonight’s wire story
“In 16 states, drug deaths overtake traffic fatalities.” Experts said the
startling shift reflects two opposite trends: Driving is becoming safer,
and the legal and illegal use of powerful prescription painkillers is on
the rise.
CNN’s American Morning host, John Roberts, will be talking with Andrew
about AiR’s take on why drug deaths might be on the rise ““ the CDC
points to the increase in abuse of prescription medication, something he’s
talked with CNN’s American Morning about before ““ and what can be done
about it. Why are so many people abusing Rx drugs? What can be done to stop
it.
Check local listings
Tags: air, amercian morning, assistance in recovery, cnn, drug deaths, prescription drug abuse
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Intervention through the years
Wednesday, August 19th, 2009
A New York Times article brought up by AiR staff member Dave Kelly talks about different intervention approaches and how an intervention could have saved Michael Jackson. There were a couple of pretty good points in this article, namely around denial when dealing with addiction: “Denial is at the core of addiction, and breaking through it, many experts say, can require extreme measures, particularly with celebrities, who can procure an endless supply of drugs and are cocooned by people with an interest in keeping the star’s earnings flowing.” According to sources close to the Jackson family, there were multiple attempts made by Jackson’s family at an intervention. So the question remains- why aren’t Jackson’s employees, who held his family at bay, held liable for his death? They obviously knew of Jackson’s drug use; in fact, according to sources close to Jackson, they would often pick up his multiple prescriptions. Maybe we need to develop laws that, instead of forcing drug addicts into jail, create accountability for employers and employees who refuse to confront an addict.
Kurt Cobain, the former front man of Nirvana, is also mentioned in the article when talking about harm reduction- a controversial method of “managing” or cutting down ones drinking or using. Cobain apparently asked to do this around his heroin use, and was instead escorted to treatment, of his own choice. A doctor from Seattle talks about harm reduction and motivational interviewing as a method to help addicts “slow down” their using.
The problem with motivational interviewing- and harm reduction- is that by the time an intervention is needed to help a loved one, they are usually too far along to simply “slow down.” Harm reduction creates a pocket that allows addicts to make excuses when they slip up or go on a binge. Via intervention, we at Assistance In Recovery can create a healthy family system surrounding the addicted loved one, regardless of whether or not they choose to get help.
In the end, getting help for an addiction is a choice. But via intervention, we can make that choice easier for your loved one. Intervention, in the end, is the most caring thing you can do for a loved one- and one of the hardest. Make your choice.
Tags: addiction, addiction intervention, AiR Assistance in recovery, alcohol, assistance in recovery, cnn, drugs, intervention, michael jackson, michael jackson drug abuse, michael jackson intervention, pain killers, recovery assistance, substance abuse
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Intervening against an adult's will- a tough task
Wednesday, July 15th, 2009
An article on the CNN website on Friday afternoon touched on how difficult it can be to intervene on an adult. This article, of course, was brought up by the death of Michael Jackson (details of his drug use can be found here, here and here) and the efforts of his sister to perform an intervention. However, Jackson had his security guards shut down the family and the entire process- eventually leading to his early demise. Could he have been saved if his family had a professional interventionist available to guide them through the process? We think yes. We believe that once you are aware that a problem exists, it is no longer an option to do nothing.
We feel that addicts, much of the time, have trouble asking for help for themselves. This leaves it to family, friends and coworkers to step in and create change- build a “soft bottom” for the addict/alcoholic, one that doesn’t end in prison or death. Through the intervention process, we at AiR can create a change in the family dynamic. By setting boundaries and removing the primary enabling behaviors, we can actually change the family system from one of enmeshment to one of healthy boundaries. This provides a path for a family to start the healing process.
Here’s an excerpt from the article, wherein Dr. Marvin Seppela, Chief Medical Officer of the Hazelden Foundation, talks about the intervention process:
‘A more formal, direct intervention involves family members confronting the person and encouraging the addict to seek help. Before this meeting, a professional interventionist typically meets with family members or friends of the addict to get a history of what’s happened, said Dr. Marvin Seppala, chief medical officer at Hazelden Foundation.
Letters are a typical component of a direct intervention: The family members or friends will explain in writing that they are doing the intervention because they love the addict, and that they have observed specific troubling behaviors, as described in the letter, Seppala said.
Beforehand, the professional interventionist will try to prepare for the possibility that the addict will run away and, along with the family, create specific consequences if the person does not agree to go into treatment, Seppala said.
For example, if the person is married, an addict’s spouse may not permit him or her back into the home, Seppala said.’
This is a simplified description of the intervention process; for more details, contact us at 877-320-0247.
Tags: addiction, assistance in recovery, cnn, hazelden, intervention, michael jackson intervention, recovery
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AiR's Andrew Wainwright on CNN's American Morning
Friday, July 3rd, 2009
Suspicions about Michael Jackson’s prescription drug use and sudden death are also putting a new focus on a serious and growing problem, and that is the misuse of prescription drugs in this country. It is now actually the second leading cause of accidental death. This is prescription drug overdoses after auto accidents.
Aired July 3rd, 2009 at 7:10am EST
Andrew Wainwright kicked his addiction more than a decade ago and created an organization to help others do the same. And he joins me this morning.
Andrew, thanks for being with us.
ANDREW WAINWRIGHT, PRESIDENT & CEO, ASSISTANCE IN RECOVERY, INC.: Thanks, good morning.
CHETRY: So you’ve been clean for 12 years now. You know firsthand how hard it can be to battle an addiction to drugs. Tell us your story.
WAINWRIGHT: I was a — I grew up on the east coast in Washington, D.C. and struggled with drugs and alcohol through college. I got sober when I was 26 and sober for 12 years.
And you know, white collar background. Wasn’t expecting to grow up and be a drug and alcohol addict. But these are the kinds of things that happened. I think they were genetically predisposed, and that’s exactly what happened to me. And I think that the rise of prescription drug abuse is beating right into that.
I think that people believe that an addict looks a certain way, and that’s not exactly true at all. I think that lots of folks are — addiction is accessible to lots more folks. I believe it can happen.
CHETRY: Right. And the danger that we’re learning about with prescription drugs is I mean when used as they’re supposed to be, they can be safe and they’re fine. But because they’re prescribed by a doctor, oftentimes people don’t believe it’s a problem.
And this was an interesting stat here that approximately 50 million Americans reported or at admitted to non-medical use of a prescription drug at some point in their lifetime. How big of a problem is it when you’re taking medicine that you’re not necessarily prescribed to treat something that you have?
WAINWRIGHT: I think it’s a tremendous problem and growing. I think that the perception is there’s less stigma, less shame, as it were, taking prescription drugs for off-label uses. Somehow that’s OK. And I think that decidedly (ph) it’s OK because it was given to me by a doctor. Things from doctors are supposed to be good. It’s supposed to make things better, not worse.
And I think there’s a lot of surprise when folks get sick or strung out or addicted from these same meds that are supposed to make them better. And I think that more and more — I think we sort of co- signed it a little bit as a society that since it comes from a doctor that it should be OK. And so, since friends or family tell me that this is why have a prescription for this it should be all right and we think that it is OK. And then we’re surprised when it turns out that folks get very, very ill.
CHETRY: Right. And you know deaths caused by overdosing on prescription painkillers, drugs like oxycodone or methadone, fentanyl, they jumped more than 90 percent just between the years of 1999 to 2002. This is according to stats cited by “The Washington Post.” Why are we seeing this jump?
WAINWRIGHT: Well, a couple of reasons. I think the big reason we’re going to put our finger on it is in 1996, when OxyContin first hit the market, we saw drug companies actively marketing their drugs, both the doctors and the consumers. And I think that big marketing push or big advertising campaign nationally told people to buy these drugs, to ask their doctors for them and gave doctor’s permission to prescribe them in larger numbers to more people for more different types of syndromes. Therefore, the use escalated.
CHETRY: And the question is, you talk about how it’s easy to get your hands on it. Doctor shopping in some cases, the ease at which you can get one of these prescriptions for painkillers or anxiety conditions. And when you truly have pain and you truly have anxiety, it’s understandable that you would want to be able to take something for that.
But why does it seem that it’s easier to get your hands on medications like this when you don’t necessarily have a condition that warrants it?
WAINWRIGHT: Well, one of the things we can point to is this. It’s that with the rising managed care at the end of the ’80s, at the end of the ’90s, we step away from everyone having a primary doctor who had a long history with an individual, also have understood what they’ve been through, where they’re going, and how to treat them.
As we became sort of individually taking orders (INAUDIBLE) for the medical records, moving through the ’90s and to the 2000s, we’re seeing more rise of people going to more different doctors for more different things and the doctors with less time and less capability to follow up and to know where those patients are coming from and what they’re being treated for. Doctor shopping, the ease with which people are able to visit multiple doctors for the same ostensible real condition…
CHETRY: Right.
WAINWRIGHT: … and get medicines from all of those different doctors.
CHETRY: Do you think that a national registry could make possibly make a difference where you have to report all the stuff and every doctor would have access to it? Is that something that is in the works any time soon?
WAINWRIGHT: Well, the Bush administration talked about it. The Obama administration certainly talked about it. And it’s something we’d love to see. The unfortunate piece is it’s many years down the road to get everybody onboard so in effect you’re walking around with a piece of paper or a chip, electronic record to tell you exactly who you are, what type of blood type you have, all of the things that you need and all the things that you’re taking.
So in terms of short term, it’s not something we’re going to see anytime soon. So I think we need to look at more immediate short-term solutions to the problem that’s in front of us.
CHETRY: All right. Well, it’s certainly is a growing problem. And so we need to try to find those answers.
Andrew Wainwright, president and CEO of Assistance in Recovery. You also wrote the book “It’s Not Okay to Be a Cannibal” joining us from Minneapolis, MN this morning. Thanks so much.
WAINWRIGHT: Thank you.
_______
Trascript taken from CNN.com
Tags: american morning, andrew wainwright, assistance in recovery, cnn, michael jackson drug abuse, prescription drug abuse
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The face of substance abuse today
Friday, July 3rd, 2009
As posted July 3, 2009 on CNN’s American Morning
From my desk on the front lines of addiction treatment, the view is staggering. Prescription drugs are prevalent, proliferating and have introduced a new generation to the wonderful world of drug addiction.
These are people who otherwise might never have experienced addiction. The previous barriers to entry of stigma and circumstance were too high. Dangerous neighborhoods and unsavory characters, untrustworthy chemicals to be taken in unspecific amounts and the fear of becoming addicted kept most amateurs on the sidelines. But in 1996 that all changed.
In January of 1996, Purdue Pharma, a privately-held pharmaceutical company, launched the marketing campaign for their new pain relief product OxyContin. OxyContin was supposed to be nonabusable thanks to a special time-release ingredient. Unfortunately, this proved not to be true.
This might not have been such a big deal had Purdue not launched a multi-million dollar national advertising campaign, targeting both doctors and consumers alike. This campaign had a two-pronged approach. First Purdue incented doctors to prescribe their products then they encouraged consumers to request them by promising legitimacy, safety and lack of consequences.
From a purely business standpoint it was the right thing to do ““ if you can drive demand you can sell more product. From a “What are the long term effects on our society?” standpoint ““ it was devastating.
Today, three percent of our population is abusing prescription drugs. Prescription drug abuse accounts for forty percent of all treatment center admissions. Prescription drug abuse is growing fastest among teenagers and young adults.
These are the worst stats we could hope for.
Now, 13 years later, we are beginning to understand what happened. The question that haunts us all is “What are we going to do about it?”
Long-term solutions are indeed challenging, but here are three ideas you can adopt right now that will foster immediate positive change.
1. Restrict readily available supply. One of the easiest ways prescription drugs get diverted to the street or abused is through unmanaged access or theft from American homes. If you have leftover, unused portions of prescription pain medication in the medicine cabinet at home ““ get rid of them.
2. Talk to your doctor. The more information you give your health care professional(s) about medications you are on and the more questions you ask about medications the better for both of you. Avoid becoming an “accidental addict” due to lack of communication.
3. Don’t accept the status quo. Just because someone tells you, “it’s okay, I’ve got a prescription,” doesn’t necessarily make it okay. Trust your gut. Be willing to take risks to keep others safe. Be willing to be the bad guy. Be willing to be wrong.
4. Make help available to those that are struggling. If someone you know is struggling with an addiction to prescription drugs get him or her help as soon as possible. Treatment works.
Substance abuse is one of our nation’s largest health issues and prescription drug abuse is its face today. There are no easy solutions but there are solutions if we are all willing to do the work.
I also found this blog on addictiontomorrow.blogspot.com’s in-depth look into the federal advisory panel’s decisions to recommend a ban on Percocet and Vicodin because of their effects on the liver. Addiction Tomorrow talks about the growing concern about over prescribing, long-term effects, and information from the Office of National Drug Control Policy.
The opinions expressed in this commentary are solely those of Andrew Wainwright.
________
Andrew T. Wainwright is a national expert on addictions and intervention. He is co-author of the book “It’s Not Okay to Be a Cannibal ““ How to Stop Addiction from Eating Your Family Alive” and CEO for AiR, which provides behavioral health case management services that are a beneficial addition to the treatment of chemical dependency, mental health and eating disorders.
Tags: air, american morning, andrew wainwright, assistance in recovery, chemical dependency, cnn, eating disorders, mental health, substance abuse, Treatment
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Tune in to CNN Friday, July 3rd at 7:10am EST
Thursday, July 2nd, 2009
AiR’s Andrew Wainwright scheduled for American Morning on CNN
Founder and CEO, Andrew Wainwright, will be on CNN’s American Morning to talk about prescription drug abuse. AiR feels that the more exposure and information about addiction provided to the public, the more people can receive help and be saved.
Check local listings.
Tags: air, american morning, andrew wainwright, assistance in recovery, cnn, prescription drug abuse
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