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Thread: Will TRAMADOL show up as an opiate in a urine or blood test?

  1. Default Tramadol Detection in Urine Screens

    This is a response to an old thread re: whether or not Tramadol (Ultram) shows up on urine drug screens. I own an accredited drug testing clinic and have direct experience with this and wanted to add to that thread.

    While Tramadol is not tested on a "standard" drug screen--we test for it routinely for therapists, caseworkers and others who are monitoring donors for abusive patterns of this drug. Tramadol is in the class of drugs called synthetic opioids. It is not an opiate (opiates include heroine, codeine and morphine). Standard tests include opiates but opioids--it will not show up on a standard test.

    If you are concerned with Tramadol showing up on a pre-employment test, it will depend on a couple of things. Drug testing laws vary by state and by profession. If you in a state that gives employers the freedom to test for whatever they want--and they have chosen to include Tramadol in their test, it will be detected. The same holds true for employers in the healthcare profession--where the "standard" drug test includes many drugs above and beyond what most employers would test for. This is because those types of employees have greater access to controlled drugs. On those tests we routinely look for Tramadol, Benzodiazepines, Barbiturates, Oxy, Vicodin, Fentanyl, Sufentanyl, Propoxyphene and even Propofol.

    The bottom line is that it will show up in a test if it is included in the order. It will NOT show up as an opiate. It will show up as a synthetic opiate, A.K.A. "opioid" and sometimes called "alternate" opiate.

    I hope this helps!
    Helpful Kris, veri Rated helpful


  2. Exclamation Tramodol does not show up on drug tests!!!!!

    For all you people with confusion regarding this medication......

    Tramodol is a "NSAID" that "mimicks" the release of opioid receptors in your body. It does NOT show up in urine/blood work. I am 1,000,000% POSITIVE on this BECAUSE of 3 reasons:

    1. I am a healthcare provider, and COMPLETED PHARMACOLOGY SUCCESSFULLY.
    2. I am PRESCRIBED THIS MEDICINE for my fibromyalgia pains.
    3. I was hospitalized the VERY SAME DAY I took Tramodols for a seizure (which I never had before in my life!) And they took blood work/urine to make sure I wasn't taking a designer drug or any drugs I shouldn't have been taking.. and THE RESULTS WERE NEGATIVE!!!!!

    I am NOT SURE why people said they failed a drug test from this, because as I said, it's an NSAID that mimicks the opoid receptors in your body. Maybe these people were taking other recreational drugs - I don't know, NOR AM I INSINUATING THEY DID. I am just informing you on MY knowledge and the known fact I was tested in the hospital January 2012....

    I hope I helped! :-)


    Regards,
    -A Legit Healthcare Professional :-)
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    Tramadol....if they made it a schedule 3 (which perhaps they aught to do as it is seriously addictive and habit forming and makes me question the intellect of MD's who rx it like candy) If they made it a schedule 3 I think it might gain allot more respect. It gives you a nice opiate buzz, and a mood lift (for me) due to its "other" properties. I have some of my best days on trams yet I never want to get addicted to that junk again the withdrawal had me feeling sooo odd/ bad like nothing else so I am resigned to once a week and it helps keep me stocked well on my conventional opiates. what a frigan bizarre medication tramadol is....

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    Quote Originally Posted by alumni View Post
    No, it won't. The only way tramadol will show up on any urinalysis is by the use of a separate "panel" that tests specifically for it. It's in the same synthetic category as methadone or fentanyl.
    I work with a number of pain management practices and I've never seen or heard of them doing a specific test for tramadol.
    Of course, that doesn't mean that it's never tested for but I don't think it is very high up on the typical pain clinic's radar.
    Thanks for the info @alumni , I know this is an old thread but still a relevant one. So you say tramadol will not show up for standard urinalysis. Seems to be the consensus. I was wondering If I could get your opinions on low to moderate opiate use (say oxycodone) and benzodiazipines (low-moderate) for testing in a pain management clinic setting. I really value your insight since you have worked with these facilities.

  5. @xo_unknown ...Umm, no offense; but I don't know what type of "medical professional" position you hold or not? But... tramadol is absolutely not a NSAID (like ibuprofen or naproxen- i.e., NSAIDs inhibit COX enzymes. THIS MECHANISM OF ACTION IS WHAT DEFINES NON-STEROIDAL-INFLAMMATORY DRUGS). The pain relieving effects of tramadol are derived from its activity at mu-opioid receptors, the same receptors which drugs like diacetylmorphine (heroin), morphine, & oxycodone agonize (or "activate"). Although tramadol also has antidepressive effects which can relieve some types of pain. (and NSAIDs don't "mimic" endorphin release whatsoever, this is what OPIATES/OPIOIDS do) - and "receptors" aren't "released" as you claimed.... NEUROTRANSMITTERS are released which plug into receptors. There is no physiological way you can "release receptors".. your post doesn't make much sense! I'm not trying rag on ya, but, its self-contradictory!

    To the OPer- the only drugs tested for on the standard 5-panel test are drugs metabolized into morphine (those being: codeine, heroin, & morphine itself)--b/c UAs test for actual drug metabolites, its easier to look for common metabolites. The extended tests usually include oxycodone (OxyContin) & hydrocodone (Vicodin).. it is most certainly possible to test for tramadol via urine analysis, but it wont be tested for unless its use is specifically suspected (which is unlikely, unless the tester KNOWS the testee has used/abused/etc tramadol in the past).
    Last edited by MusiciansMallet; 08-20-2012 at 01:33 PM.
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  6. #66
    Quote Originally Posted by dingleberry View Post
    I was wondering If I could get your opinions on low to moderate opiate use (say oxycodone) and benzodiazipines (low-moderate) for testing in a pain management clinic setting. I really value your insight since you have worked with these facilities.
    Are you asking if pain management practices test for these substances? The typical answer would be yes but it all depends on specifically what the doctors are looking for.
    A few are satisfied with the standard 5 panel "dip" drug tox screen which is primarily testing for illegal substances like heroin, THC, cocaine, PCP, etc.
    More likely are additional screens for semi-synthetic opioids (oxycodone, hydrocodone, etc.) and benzodiazepines. These multi-screen tests are basically "qualitative" in only determining the presence of a drug's metabolites. Some clinics stop there. Further lab testing using GC-MS analysis might be employed and it is geared to eliminating false positives/negatives and measuring the actual amount (quantitative) of the drug in the urine sample.
    Regarding "low to moderate" use of meds, that would depend on the metabolite levels that are specified for the tests. They can be set very low and thus will be much more sensitive and accurate in identifying a substance.
    As some patients try to get more knowledgeable about how to maneuver around these tests, the more sophisticated physician practices are getting smarter about how to avoid openly disclosing too many of the details about exactly how these tests are structured.
    PS: @MusiciansMallet Good catch on the misinformed "Legit Healthcare Professional." Hopefully, this poster remains unknown to actual patients given the lack of very basic knowledge about NSAID's and opioid receptors. Scary.
    Last edited by alumni; 08-20-2012 at 01:59 PM.
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  7. ^^ @alumni ..Yes, the typical 5-panel test is for: THC, "opiates" (which are morphine drugs: codeine, morphine, & heroin), barbiturates, cocaine & amphetamines (can't remember which one off hand), and (god knows why?) PCP. Although, most will do extended tests for benzodiazepines, specifically methamphetamine, and other opioids, particularly oxycodone & hydrocodone (and sometimes methadone as well).

    And yes, Alumni is correct- a lot of places will test for means/methods that may adulterate your drugs- such as your creatine levels & pH levels, then they'll compare this to previous tests (if its largely off, it may induce an "inclusive" result, & a lot of times this is interpreted as a "positive" or an "adulterated" UA. The best case scenario they'll retest you; if its for a job or something, they probably wont bother w/ it & hire someone else)

    @dingleberry ..If you're trying to avoid a positive test for these drugs, (i would recommend getting off them in the first place if possible, if you're taking them illicitly?).. but, if that isn't an option, I would recommend transitioning to a less often tested for substance 3-10 days before the UA (i.e., replacing benzodiazepines w/ carisoprodol--err, soma--for example. And replacing opioids like oxycodone/hydrocodone w/ tramadol, or even methadone--since its less tested for--if available. Or perhaps even propoxyphene? Brand name being "Darvocet"/"Darvon".. although tramadol is the only non-scheduled drug currently available, in the US at least)
    Last edited by MusiciansMallet; 08-20-2012 at 02:19 PM.

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    Default I concur

    Quote Originally Posted by alumni View Post
    Are you asking if pain management practices test for these substances? The typical answer would be yes but it all depends on specifically what the doctors are looking for.
    A few are satisfied with the standard 5 panel "dip" drug tox screen which is primarily testing for illegal substances like heroin, THC, cocaine, PCP, etc.
    More likely are additional screens for semi-synthetic opioids (oxycodone, hydrocodone, etc.) and benzodiazepines. These multi-screen tests are basically "qualitative" in only determining the presence of a drug's metabolites. Some clinics stop there. Further lab testing using GC-MS analysis might be employed and it is geared to eliminating false positives/negatives and measuring the actual amount (quantitative) of the drug in the urine sample.
    Regarding "low to moderate" use of meds, that would depend on the metabolite levels that are specified for the tests. They can be set very low and thus will be much more sensitive and accurate in identifying a substance.
    As some patients try to get more knowledgeable about how to maneuver around these tests, the more sophisticated physician practices are getting smarter about how to avoid openly disclosing too many of the details about exactly how these tests are structured.
    PS: @MusiciansMallet Good catch on the misinformed "Legit Healthcare Professional." Hopefully, this poster remains unknown to actual patients given the lack of very basic knowledge about NSAID's and opioid receptors. Scary.
    Yeah, thats pretty bad saying tramadol has anything to do with an NSAID. AS we all know, well most of us somewhat well researched members on the board, it is a synthetical opiate with SSRI like components to it. Lets hope he meant to say that, SSRI, but mixed it up with NSAID. Still a bit of a blunder if you ask me. EDIT: Upon further review even if he meant SSRI his post would still be frighteningly incorrect.
    [/B]
    *This post was auto-merged. The following text was added 19 minutes after the last post:*

    Quote Originally Posted by MusiciansMallet View Post
    ^^ @alumni ..Yes, the typical 5-panel test is for: THC, "opiates" (which are morphine drugs: codeine, morphine, & heroin), barbiturates, cocaine & amphetamines (can't remember which one off hand), and (god knows why?) PCP. Although, most will do extended tests for benzodiazepines, specifically methamphetamine, and other opioids, particularly oxycodone & hydrocodone (and sometimes methadone as well).

    And yes, Alumni is correct- a lot of places will test for means/methods that may adulterate your drugs- such as your creatine levels & pH levels, then they'll compare this to previous tests (if its largely off, it may induce an "inclusive" result, & a lot of times this is interpreted as a "positive" or an "adulterated" UA. The best case scenario they'll retest you; if its for a job or something, they probably wont bother w/ it & hire someone else)

    @dingleberry ..If you're trying to avoid a positive test for these drugs, (i would recommend getting off them in the first place if possible, if you're taking them illicitly?).. but, if that isn't an option, I would recommend transitioning to a less often tested for substance 3-10 days before the UA (i.e., replacing benzodiazepines w/ carisoprodol--err, soma--for example. And replacing opioids like oxycodone/hydrocodone w/ tramadol, or even methadone--since its less tested for--if available. Or perhaps even propoxyphene? Brand name being "Darvocet"/"Darvon".. although tramadol is the only non-scheduled drug currently available, in the US at least)
    Yeah I concur with most of your advise. Basically I am rx'd both opiates (hydrocodone) and benzodiazipines (Klonopin, upon my own request)
    It was just hard for me to decide between xanax or klonopin the only two benzos I can tollerate, besides valium which I find weak. Ativan I can't take.

    Anyway. I still have somewhat of an affinity to xanax but only on occasion, I don't like using it everyday, hence why I switched to klonopin. But I still would like to be able to take it once in a blue moon (it gives me a nice relaxed feeling and takes away any anxiety FAST, it also has a nice muscle relaxer effect for me and goes well with my opiate medication in moderation), however I don't want to mess with benzos because of the horror stories I have read about people taking one xanax and it showing up three weeks later. Benzos are very unpredictable from the info I have gathered and take far more time generally speaking to exit ones system than other drugs such as opiates. So, If I must take a xanax, since I am too scared it will be stuck in my system for a long time, I will do it after my next urine test because it will not be another 3 months at the minimum if they ever get around to testing me again. I have taken only one with them so far and that was over six months ago so who knows when they will test me again if they ever do end up getting around to it.....

    I get nearly the PERFECT amount of hydro per month, 120 10/325's. But I find some months when my pain spikes I come up just a little short and would like to have another opiate to supplement but my doctor at the moment seems to not be interested in rx'ing any additional pain medicines, he believes in keeping it at that level for me at this point. Hence why I take an occasional other opiate to help supplement my regular legal prescription. I use tramadol for the most part, occasionally, when my pain levels are not soo high, and just those few days of using tramadol allows me more than enough of my regular medication for the month, heck even I have a fair amount left over sometimes depending. The amount I need to take fluctuates greatly as does my pain levels. I also use oxycodone as I have easy access to it on occasion for the same purposes of supplementation. I use very few, perhaps 30mg of oxycodone twice a week max for the first two weeks, then stop completely to allow my system to clear.

    To me this seems like a safe plan as I am not an abuser or over-user of either alternative pain medicines I have access to, so I doubt there could be that much in my system to have clean out before an appointment. But I feel it is always best to play it safe, and thats why I give myself the two weeks break I feel this allows me to be definitely on the "safe side"

    As you suggested, tramadol is definitely my go to if for some reason the hydro is just not enough or not cutting it on its own; interestingly, I find the synergy when conventional opiates are taken along with a tramadol tablet to be very effective for pain. I don't know if anyone else has the same experience but they both seem to amplify one another when taken together.
    Last edited by dingleberry; 08-20-2012 at 09:42 PM.

  9. @dingleberry
    Yeah I concur with most of your advise. Basically I am rx'd both opiates (hydrocodone) and benzodiazipines (Klonopin, upon my own request)
    It was just hard for me to decide between xanax or klonopin the only two benzos I can tollerate, besides valium which I find weak. Ativan I can't take.

    Anyway. I still have somewhat of an affinity to xanax but only on occasion, I don't like using it everyday, hence why I switched to klonopin. But I still would like to be able to take it once in a blue moon (it gives me a nice relaxed feeling and takes away any anxiety FAST, it also has a nice muscle relaxer effect for me and goes well with my opiate medication in moderation), however I don't want to mess with benzos because of the horror stories I have read about people taking one xanax and it showing up three weeks later. Benzos are very unpredictable from the info I have gathered and take far more time generally speaking to exit ones system than other drugs such as opiates. So, If I must take a xanax, since I am too scared it will be stuck in my system for a long time, I will do it after my next urine test because it will not be another 3 months at the minimum if they ever get around to testing me again. I have taken only one with them so far and that was over six months ago so who knows when they will test me again if they ever do end up getting around to it.....

    I get nearly the PERFECT amount of hydro per month, 120 10/325's. But I find some months when my pain spikes I come up just a little short and would like to have another opiate to supplement but my doctor at the moment seems to not be interested in rx'ing any additional pain medicines, he believes in keeping it at that level for me at this point. Hence why I take an occasional other opiate to help supplement my regular legal prescription. I use tramadol for the most part, occasionally, when my pain levels are not soo high, and just those few days of using tramadol allows me more than enough of my regular medication for the month, heck even I have a fair amount left over sometimes depending. The amount I need to take fluctuates greatly as does my pain levels. I also use oxycodone as I have easy access to it on occasion for the same purposes of supplementation. I use very few, perhaps 30mg of oxycodone twice a week max for the first two weeks, then stop completely to allow my system to clear.

    To me this seems like a safe plan as I am not an abuser or over-user of either alternative pain medicines I have access to, so I doubt there could be that much in my system to have clean out before an appointment. But I feel it is always best to play it safe, and thats why I give myself the two weeks break I feel this allows me to be definitely on the "safe side"

    As you suggested, tramadol is definitely my go to if for some reason the hydro is just not enough or not cutting it on its own; interestingly, I find the synergy when conventional opiates are taken along with a tramadol tablet to be very effective for pain. I don't know if anyone else has the same experience but they both seem to amplify one another when taken together.
    Well for one- the differing detection time in UAs between different BZPs is b/c many of them have MANY shorter or longer half-lives (and remember, UAs test for metabolites, not the drug itself; only blood tests & hair tests actually detect the drug itself). I don't understood WHY the medical community doesn't define BZPs as "ultra-short"; "short"; "intermediate"; "long"; and "ultra-long" as they did w/ barbiturates!? It would make it a hell of a lot easier for patients!

    And its odd you get a muscle relaxant effect from alprazolam (Xanax)--since diazepam (Valium) is renown for having muscle-relaxing properties. Then again, everyone's body chemistry is slightly different... especially when it comes to CYP liver enzymes (which metabolize drugs when taken orally, this can have major impacts on the effects of the drug-in-question)
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    Quote Originally Posted by MusiciansMallet View Post
    @dingleberry


    Well for one- the differing detection time in UAs between different BZPs is b/c many of them have MANY shorter or longer half-lives (and remember, UAs test for metabolites, not the drug itself; only blood tests & hair tests actually detect the drug itself). I don't understood WHY the medical community doesn't define BZPs as "ultra-short"; "short"; "intermediate"; "long"; and "ultra-long" as they did w/ barbiturates!? It would make it a hell of a lot easier for patients!

    And its odd you get a muscle relaxant effect from alprazolam (Xanax)--since diazepam (Valium) is renown for having muscle-relaxing properties. Then again, everyone's body chemistry is slightly different... especially when it comes to CYP liver enzymes (which metabolize drugs when taken orally, this can have major impacts on the effects of the drug-in-question)
    Yes I know valium is probably the best for that but they all have the muscle relax efffect to some extent, I just find I have to take too many valium to equal a dose of either of the other three most commonly rx'd "BZP"'s.

  11. #71
    Just gonna throw in my 2 cents.


    I've taken tramadol for a few years.
    I've taken 3 drug tests for two different jobs.

    I passed both.
    Helpful dingleberry Rated helpful

  12. Quote Originally Posted by lobabe View Post
    Just gonna throw in my 2 cents.


    I've taken tramadol for a few years.
    I've taken 3 drug tests for two different jobs.

    I passed both.
    Yes... as I previously stated, typical 5-panel tests will check for drugs that create morphine as a metabolite for their "opiate" test, including: heroin, codeine, morphine itself (& other unique metabolites of codeine & morphine-like substances you'll really only find in opium- they'll actually HAVE to be metabolized into morphine by the liver for them to be show up as a positive result).

    Even extended tests really check for oxycodone & hydrocodone (since they have different metabolites, a different test must be used).. sometimes methadone & propoxyphene will be checked on extended tests too.

    Tramadol will only really be tested for if its use is suspected by the individual being subjected to a UA, & this is usually only if he/she is known to have used and/or abused tramadol in the past. Other than that, you'll be safe.
    Last edited by MusiciansMallet; 08-20-2012 at 10:35 PM.
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    Sorry if this is a stupid question, but I just read through this thread and was curious because posters seem to have grouped together the opiates when talking about the tests. Do the tests not differentiate between opiates? Codeine is OTC here so they'd have to, right?

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    It all sounds like Greek to me, but yeah, you can get a false positive to opium by eating poppyseed muffins, ala Seinfeld.

  15. uggh, lol- urine tests test for METABOLITES... most opiates & opioids have different metabolites (a metabolite is what the body turns the drug into, and it remains in the body longer, & therefore it is easier to test for). In the US (I can't speak for other countries) the common "opiate" test on the standard 5-panel test for opiates is for drugs that metabolize (or "turn into") morphine- that being: codeine, heroin, morphine-itself, and as I said, some other alkaloids found in opium.

    And yes.. technically poppy PIES (not so much bagels, unless you eat one immediately prior to a drug test) can cause a positive; but this will only last for about 24 hours maximum.... unless you you have a poppy-pie addiction & ate a whole pie or something.. then I guess a positive result come up beyond 24 hours?
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    Quote Originally Posted by lobabe View Post
    Just gonna throw in my 2 cents.


    I've taken tramadol for a few years.
    I've taken 3 drug tests for two different jobs.

    I passed both.


    I too have passed all my drug tests. Used tramadol for 4 years.
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  17. Im on a methodone Clinnic and get a 12 panel urine drug test and on Sunday I took 4 ultrams/tramadol and when I showed up Monday morning to get dosed I had to give a urine that get sent to a lab so the test is pretty good and I did nothing to try and get over on the test and I'm not getting ultrams/tramadolfrom a doctor so I would get in trouble for taken them but when the urine came back it was clean so they have to specialy test for them

  18. Quote Originally Posted by QATFY View Post
    I think I am scheduled for a drug test - urine and possibly blood at my pain clinic on Apr. 11. Due to severe pain (included an ER visit b/c I couldn't move for days), I have ran out of my Oxycodone. I do not want them to test me and not find it in my system and think I am selling it nor do I want to tell them I had to take several more pills per day just to get out of the bed and function. I like my doctors at the pain clinic but I just could not help having to take a few extra pills. My husband has Tramadol for his shoulder injury and I am taking that. Will it show up as an opiate? Or will it simply show up as TRAMADOL? Please don't be disrespectful, I am respect all of you, please respect me and answer with TACT.

    Thank you!
    ~QATFY~
    I see that you have had many different responses. I worked in a drug detox center and am a nurse. I have seen many people's urine drug screen show positive when they say they were not on anything for several days. I have seen just as many urine drug screens show up negative when the patient said they had drugs that day. Now, whether or not this is due to the lab making a mistake or not, I don't know. I think that to make that many mistakes that often would be imposable. I think that the urine just showed up one way or the other, that those tests are false at times. Most drugs are out of your system in three days. This would however depend on your digestion and your kidneys and liver function. If all of the drugs are in your blood and none left in the bowel, you should be clean in three days. As for the person that said that it stays in your system for weeks, I think that it takes about ten days to two weeks to feel normal again after stopping Ultram. I will say this thoug; Ultram is a great pain killer. It is easier to go without than Oxycodone but works just as good on mild pain. Now, if you have moderate to severe pain, it won't work at all. It is the only pain medication that I know of that is like an Opiate that becomes as tame as Tylenol when you are in real pain. Otherwise it is a Godsend to us veterans who have broken our backs and suffer from chronic pain. I am a nurse and I would be less attentive and less of a nurse in pain than I am on Ultram. It does not make you high if you only take a couple. Just try not to take more than four per day or five at most. One at bedtime. Also wait until you need it. If you take it scheduled you will make it less affective. I hope this helps. I have a test in the morning and I don't care if I come up positive or not. I just wanted to make sure if It did or not. If it is not suppose to but does, then the hospital will think I am lying about what I am taking. I don't have a script for anything but the Ultram. good luck.

  19. #79
    Tramadol is NOT an NSAID drug.
    Im suprized that a Health Care provider and someone who is prescribed it would not only misspell the drugs name, but also misidentify completely which group of drugs it is in and then give disinformation based on their incorrect beliefs. Please try not to give advice and share knowledge in an authoritative manner on subjects in which you are not competently 'au fait. No offense intended (seriously). Tramadol is a synthetic narcotic opioid which is not considered a controlled drug in UK or the US but does legally require a prescription. It can test positive on drug test according to if the urine test tests for opioid's and/or specific drugs within those categories. It would test positive in the UK on a standard urine test, I am not sure if it would test positive in the tests the US uses, I would be careful though.

  20. #80
    @SNOOP I have a lot of experience with U/A tox screens in the US and have not seen tramadol show positive on an accurately administered standard 5 panel test.
    It can obviously be identified on a U/A testing specifically for it. Since its metabolites are not those typically identified as an "opiate", it requires a more sophisticated screening.
    I'm not familiar with the protocols used in the UK, however.


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