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A randomized controlled trial of brief cognitive–behavioral interventions for cannabis use disorder
Open accessAbstract
The increasing demand for treatment for cannabis dependence in Australia and internationally has led to the identification of significant gaps in knowledge of effective interventions. A randomized controlled trial of brief cognitive-behavioral interventions (CBT) for cannabis dependence was undertaken to address this issue. A total of 229 participants were assessed and randomly assigned to either a six-session CBT program (6CBT), a single-session CBT intervention (1CBT), or a delayed-treatment control (DTC) group. Participants were assisted in acquiring skills to promote cannabis cessation and maintenance of abstinence. Participants were followed-up a median of 237 days after last attendance. Participants in the treatment groups reported better treatment outcomes than the DTC group. They were more likely to report abstinence, were significantly less concerned about their control over cannabis use, and reported significantly fewer cannabis-related problems than those in the DTC group. Those in the 6CBT group also reported more significantly reduced levels of cannabis consumption than the DTC group. While the therapist variable had no effect on any outcome, a secondary analysis of the 6CBT and 1CBT groups showed that treatment compliance was significantly associated with decreased dependence and cannabis-related problems. This study supports the attractiveness and effectiveness of individual CBT interventions for cannabis use disorders and the need for multisite replication trials.
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“Best-practice evidence suggests that the most effective treatment response for cannabis-dependent users is a 'brief intervention' involving six sessions of cognitive behavioural therapy, yet this is not currently provided in Portugal (see, e.g.Copeland et al. 2001).”
From What Can We Learn From The Portuguese Decriminalization of Illicit Drugs? (2010) · cites this paper as Copeland et al. 2001
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Some studies have failed to report follow-up data (Stephens et al., 2002), but those that have report abstinence rates between 0% and 30% at 3-month follow-up (e.g., Budney et al., 2000;Stephens et al., 2000) and about half that or less at 9-to 12-month follow-up (e.g., Budney et al., 2000;Copeland et al., 2001;Stephens et al., 1994Stephens et al., , 2000)).”
From A preliminary investigation of acceptance and commitment therapy as a treatment for Marijuana dependence in adults (2007) · cites this paper as Copeland et al., 2001
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“Treatment options include relapse prevention (Stephens et al., 1994(Stephens et al., , 2000)), motivational enhancement procedures (Budney et al., 2000;Stephens et al., 2002), cognitive behavior therapy and coping skills training (Budney et al.;Copeland et al., 2001;Stephens et al., 2002), and voucher-based motivational incentives (Budney et al.).”
From A preliminary investigation of acceptance and commitment therapy as a treatment for Marijuana dependence in adults (2007) · cites this paper as Copeland et al., 2001
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“Early randomized studies of brief intervention for drug use among adults found statistically significant effects for at least one of the primary outcomes (Baker et al., 2005; Bernstein et al., 2005; Copeland et al., 2001; Davis, Baer, Saxon, & Kivlahan, 2003; Humeniuk et al., 2012; McCambridge & Strang, 2004; Stephens, Roffman, & Curtin, 2000; Zahradnik et al., 2009)”
From A randomized study of the use of screening, brief intervention, and referral to treatment (SBIRT) for drug and alcohol use with jail inmates (2017) · cites this paper as Copeland et al., 2001
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Self-citationMarijuana Dependence and Its Treatment
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Self-citationMarijuana Withdrawal in Humans: Effects of Oral THC or Divalproex
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“Cognitive–behavioural therapy (CBT) has been shown to be effective for problems associated with alcohol (Shand et al, 2003), cannabis (Copeland et al, 2001) and amphetamine use (Baker et al, 2005a), for improving psychotic symptomatology (Haddock et al, 2003) and in related service contexts (Graham…”
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BackgroundEffectiveness of a self-guided web-based cannabis treatment program: randomized controlled trial
Rooke, S., Copeland, J., Norberg, M., Hine, D., & McCambridge, J. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2256 · Cited by 141
“45, as this was obtained for cannabis use frequency in the face-to-face treatment on which the intervention was based [17].”
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“Some studies have failed to report follow-up data (Stephens et al., 2002), but those that have report abstinence rates between 0% and 30% at 3-month follow-up (e.g., Budney et al., 2000; Stephens et al., 2000) and about half that or less at 9- to 12-month follow-up (e.g., Budney et al., 2000; Copeland et al., 2001; St…”
BackgroundInfluentialNabilone Decreases Marijuana Withdrawal and a Laboratory Measure of Marijuana Relapse
Haney, M., Cooper, Z. D., Bedi, G., Vosburg, S. K., Comer, S. D., & Foltin, R. W. (2013) · Neuropsychopharmacology · doi:10.1038/npp.2013.54 · Cited by 134
“Yet, the vast majority of patients in marijuana treatment relapse; few are able to achieve sustained abstinence (Stephens et al, 2000; Copeland et al, 2001; MTPRG, 2004; Budney et al, 2006; Kadden et al, 2007; Carroll et al, 2012).”
BackgroundThe adolescent cannabis check-up: Randomized trial of a brief intervention for young cannabis users
Martin, G., & Copeland, J. (2007) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2007.07.004 · Cited by 132
Self-citationObesity and Its Relationship to Addictions: Is Overeating a Form of Addictive Behavior?
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“The most common treatment condition component was ME, used in nine studies (Carroll et al., 2006; Copeland et al., 2001; Gates et al., 2012; Hoch et al., 2012; Kadden et al., 2007; Martin & Copeland, 2008; Rooke et al., 2013; Stephens et al., 2000; The MTPRG, 2004).”
BackgroundMethodResultThe marijuana withdrawal syndrome: Diagnosis and treatment
Haney, M. (2005) · Current Psychiatry Reports · doi:10.1007/s11920-005-0036-1 · Cited by 112
“Both active treatments were reportedly better than the control condition, but rates of continuous abstinence were low (4% to 15%) at 6month follow-up compared with 0% abstinence in the control group [ 35 ].”
BackgroundDRUG MISUSE: PSYCHOSOCIAL INTERVENTIONS
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Neurochemical basis of cannabis addiction
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“However, complete abstinence is not absolutely necessary to achieve clinically relevant improvement and a marked reduction in cannabis-related problems (Marijuana Treatment Project Research Group, 2004; Copeland et al., 2001).”
BackgroundBarriers and facilitators to cannabis treatment.
Gates, P., Copeland, J., Swift, W., & Martin, G. (2012) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2011.00313.x · Cited by 113
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“opioids, cocaine, nicotine), adults and adolescents seeking treatment for cannabis-related disorders have great difficulty achieving and sustaining periods of abstinence: the majority relapsing to use following therapeutic interventions.([12-21]) Thus, there exists a clear need for the development and dissemination of…”
BackgroundPsychotherapeutic interventions for cannabis abuse and/or dependence in outpatient settings
Denis, C., Lavie, E., Fatseas, M., & Auriacombe, M. (2006) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005336.pub2 · Cited by 108
RetractedRoche, D. J. O., Bujarski, S., Green, R., Hartwell, E. E., Leventhal, A. M., & Ray, L. A. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.02.035 · Cited by 106
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“…employ cognitive behavioural techniques derived from alcohol interventions which are modified to meet the needs of cannabis dependent patients (Copeland et al., 2001b); however the efficacy of long-term treatment programs is unclear, and the impact of complex diagnoses on these outcomes is…”
BackgroundMethodA controlled trial of an Internet-based intervention program for cannabis users
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“efficacy in primary care but does not establish definitive answers (Bashir et al., 1994; Cormack et al., 1994; Stephens et al., 2000; Copeland et al., 2001; Babor, 2004; McCambridge and Strang, 2004, 2005; Baker et al., 2005; Denis et al., 2006; Carroll et al., 2006; Voshaar et al., 2006; Ball et al., 2007).”
BackgroundRandomized controlled trial of a novel cannabis use intervention delivered by telephone
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Self-citationThe Cannabis Problems Questionnaire: Factor structure, reliability, and validity
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“The Web-based self-help intervention, Can Reduce, was based on classical CBT approaches for treating cannabis dependence [17], MI approaches [13], and BSM [18].”
InfluentialRelapse in outpatient treatment for marijuana dependence
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“There is accumulating evidence suggesting that BIs may be effective in reducing the non-medical use of psychoactive substances, such as cannabis [17-21], ecstasy [22], cocaine [18,23,24], benzodiazepines [25] and opioids [6,13,23] among both youths and adults.”
BackgroundYoung, M. M., Stevens, A., Galipeau, J., Pirie, T., Garritty, C., Singh, K., Yazdi, F., Golfam, M., Pratt, M., Turner, L., et al. (2014) · Systematic Reviews · doi:10.1186/2046-4053-3-50 · Cited by 83
“There is also accumulating evidence suggesting that BIs may be effective in reducing the nonmedical use of psychoactive substances, such as cannabis [11-15], ecstasy [16], cocaine [12,17,18], benzodiazepines [19], and opioids [3,17,20] among both youth and adults.”
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Hoch, E., Bühringer, G., Pixa, A., Dittmer, K., Henker, J., Seifert, A., & Wittchen, H. U. (2014) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.09.028 · Cited by 79
Williams, P. P., Jordaan, E., Mathews, C., Lombard, C. J., & Parry, C. D. H. (2014) · Advances in Preventive Medicine · doi:10.1155/2014/871427 · Cited by 87
“There is, however, growing evidence of the effectiveness of brief interventions for other substances such as opiates [34], amphetamines [35], benzodiazepines [36], and cannabis [37].”
BackgroundThe Marijuana Check‐up: reaching users who are ambivalent about change
Stephens, R. S., Roffman, R. A., Fearer, S. A., Williams, C. D., Picciano, J. F., & Burke, R. S. (2004) · Addiction · doi:10.1111/j.1360-0443.2004.00832.x · Cited by 78
Self-citationEffects of baclofen and mirtazapine on a laboratory model of marijuana withdrawal and relapse
Haney, M., Hart, C. L., Vosburg, S. K., Comer, S. D., Collins, S. L., Cooper, Z. D., & Foltin, R. W. (2010) · Psychopharmacology · doi:10.1007/s00213-010-1888-6 · Cited by 79
“In fact, relapse rates for marijuana smokers are comparable to those found for other drugs of abuse (Copeland et al. 2001; Stephens et al. 1994, 2000; Moore and Budney 2003).”
Patnode, C. D., Perdue, L. A., Rushkin, M., Dana, T., Blazina, I., Bougatsos, C., Grusing, S., O’Connor, E. A., Fu, R., & Chou, R. (2020) · JAMA · doi:10.1001/jama.2019.21381 · Cited by 73
Development and Consequences of Cannabis Dependence
Budney, A. J., & Moore, B. A. (2002) · The Journal of Clinical Pharmacology · doi:10.1002/j.1552-4604.2002.tb06000.x · Cited by 75
Loflin, M., Kiluk, B. D., Huestis, M. A., Aklin, W. M., Budney, A. J., Carroll, K. M., D’Souza, D. C., Dworkin, R. H., Gray, K. M., Hasin, D. S., et al. (2020) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2020.107993 · Cited by 75
“Concordance between biological assessments and self-report measures of abstinence are fairly high (kappa range: 0.6 – 0.9; Barrowclough et al., 2014; Copeland et al., 2001; Dennis et al., 2004; Hoch et al., 2014).”
BackgroundInfluentialCollege Student Drug Prevention: A Review of Individually-Oriented Prevention Strategies
Larimer, M. E., Kilmer, J. R., & Lee, C. M. (2005) · Journal of Drug Issues · doi:10.1177/002204260503500210 · Cited by 74
Mdege, N. D., & Lang, J. (2011) · Addictive Behaviors · doi:10.1016/j.addbeh.2011.07.007 · Cited by 71
Pharmacological Treatment of Cannabis Dependence
Weinstein, A. M., & Gorelick, D. A. (2011) · Current Pharmaceutical Design · doi:10.2174/138161211796150846 · Cited by 72
“Relapse rates for cannabis users in treatment are comparable to those found for other drugs of abuse [7–11].”
ResultTime is of the essence: A selective review of the fall and rise of brief therapy research
Shapiro, D. A., Barkham, M., Stiles, W. B., Hardy, G. E., Rees, A., Reynolds, S. A., & Startup, M. (2003) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608303322362460 · Cited by 69
The Adolescent Cannabis Check-Up: Feasibility of a brief intervention for young cannabis users
Martin, G., Copeland, J., & Swift, W. (2005) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2005.06.005 · Cited by 67
Self-citationGelberg, L., Andersen, R., Afifi, A. A., LEAKE, B. D., Arangua, L., Vahidi, M., Singleton, K., Yacenda, J., SHOPTAW, S. J., Fleming, M. F., et al. (2015) · Addiction · doi:10.1111/add.12993 · Cited by 69
Tailoring cannabis dependence treatment for a diverse population
Steinberg, K. L., Roffman, R. A., Carroll, K. M., Kabela, E., Kadden, R., Miller, M., Duresky, D., & The Marijuana Treatment Project Research Group (2002) · Addiction · doi:10.1046/j.1360-0443.97.s01.5.x · Cited by 64
Self-citationCooper, Z. D., Foltin, R. W., Hart, C. L., Vosburg, S. K., Comer, S. D., & Haney, M. (2012) · Addiction Biology · doi:10.1111/j.1369-1600.2012.00461.x · Cited by 62
“Although these therapies have shown some promise for decreasing marijuana use, maintaining abstinence proves to be a challenge (Stephens, Roffman & Simpson 1994; Copeland et al. 2001; Carroll et al. 2006; Stanger et al. 2009; Ramchand et al. 2011).”
BackgroundCooper, K. L., Chatters, R., Kaltenthaler, E., & Wong, R. (2015) · Health Technology Assessment · doi:10.3310/hta19560 · Cited by 63
Efficacy of a targeted cognitive–behavioral treatment program for cannabis use disorders (CANDIS*)
Hoch, E., Noack, R., Henker, J., Pixa, A., Höfler, M., Behrendt, S., Bühringer, G., & Wïttchen, H. (2011) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2011.07.014 · Cited by 60
“Based on our needs assessment, we adapted modules from the few existing treatment programs with empirical validation (Budney et al., 2000; Copeland, 2004; Copeland et al., 2001; Denis et al., 2006; Litt et al., 2008; McRae et al., 2003; Stephens et al., 1994, 2000, 2002; The Marijuana Treatment Project Research Group,…”
Marijuana Neurobiology and Treatment
Elkashef, A. M., Vocci, F. J., Huestis, M. A., Haney, M., Budney, A. J., Gruber, A. J., & el‐Guebaly, N. (2008) · Substance Abuse · doi:10.1080/08897070802218166 · Cited by 60
“Other studies confirmed these findings ( 23 , 24 , 25 ).”
Comorbidity: Cannabis and Complexity
Raphael, B., Wooding, S., & Stevens, G. J. (2005) · Journal of Psychiatric Practice · doi:10.1097/00131746-200505000-00004 · Cited by 58
Motivational interviewing for substance use reduction
Schwenker, R., Dietrich, C. E., Hirpa, S., Nothacker, M., Smedslund, G., Frese, T., & Unverzagt, S. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008063.pub3 · Cited by 56
Weinstein, A. M., Miller, H., Bluvstein, I., Rapoport, E., Schreiber, S., Bar-Hamburger, R., & Bloch, M. (2014) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952990.2013.819362 · Cited by 53
Lithium carbonate in the management of cannabis withdrawal in humans: an open-label study
WINSTOCK, A. R., Lea, T., & Copeland, J. (2008) · Journal of Psychopharmacology · doi:10.1177/0269881108089584 · Cited by 52
Self-citationThe epidemiology of cannabis use and cannabis‐related harm in Australia 1993–2007
Roxburgh, A., Hall, W., Degenhardt, L. J., McLaren, J., Black, E., Copeland, J., & Mattick, R. P. (2010) · Addiction · doi:10.1111/j.1360-0443.2010.02903.x · Cited by 48
Self-citationLee, D. C., Schlienz, N. J., Peters, E. N., Dworkin, R. H., Turk, D. C., Strain, E. C., & Vandrey, R. G. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.10.020 · Cited by 49
Role of endocannabinoid system in mental diseases
Manzanares, J., Urigüen, L., Rubio, G., & Palomo, T. (2004) · Neurotoxicity Research · doi:10.1007/bf03033223 · Cited by 49
“One group of 198 self-defined problem cannabis users (Copeland et al., 2001b) were typically (70”
BackgroundResultInfluentialIntellectual Disability among Dutch Homeless People: Prevalence and Related Psychosocial Problems
van Straaten, B., Schrijvers, C. T. M., van der Laan, J., Boersma, S. N., Rodenburg, G., Wolf, J., & van de Mheen, D. (2014) · PLoS ONE · doi:10.1371/journal.pone.0086112 · Cited by 49
“Nevertheless, in the general population self-report measures have shown reasonable levels of reliability and validity when measuring alcohol consumption [35] and cannabis consumption [36].”
BackgroundReward-related Brain Response and Craving Correlates of Marijuana Cue Exposure
Goldman, M., Szucs-Reed, R. P., Jagannathan, K., Ehrman, R. N., Wang, Z., Li, Y., Suh, J. J., Kampman, K. M., O’Brien, C. P., Childress, A. R., et al. (2012) · Journal of Addiction Medicine · doi:10.1097/adm.0b013e318273863a · Cited by 45
“A variety of psychosocial and pharmacological treatments have been investigated for MJ dependence with underwhelming results (Copeland et al., 2001; Tirado et al., 2008; Copyright © 2013 American Society of Addiction Medicine.”
BackgroundThe influence of client behavior during motivational interviewing on marijuana treatment outcome
Walker, D. D., Stephens, R. S., Rowland, J. A., & Roffman, R. A. (2011) · Addictive Behaviors · doi:10.1016/j.addbeh.2011.01.009 · Cited by 45
Self-citationFeasibility and impact of brief interventions for frequent cannabis users in Canada
Fischer, B., Dawe, M., McGuire, F., Shuper, P. A., Capler, R., Bilsker, D., Jones, W. R., Taylor, B., Rudzinski, K., & Rehm, J. T. (2012) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2012.03.006 · Cited by 51
Delay and probability discounting by drug-dependent cocaine and marijuana users
Cruz, D. M., Green, L., Myerson, J., Chainé, S. M., & Nieto, J. (2016) · Psychopharmacology · doi:10.1007/s00213-016-4316-8 · Cited by 51
Pharmacotherapy and psychotherapy in cannabis withdrawal and dependence
Benyamina, A., Lecacheux, M., Blecha, L., Reynaud, M., & Lukasiewcz, M. (2008) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.8.3.479 · Cited by 45
Prendergast, M. L., McCollister, K., & Warda, U. (2017) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2016.12.011 · Cited by 42
“Early randomized studies of brief intervention for drug use among adults found statistically significant effects for at least one of the primary outcomes (Baker et al., 2005; Bernstein et al., 2005; Copeland et al., 2001; Davis, Baer, Saxon, & Kivlahan, 2003; Humeniuk et al., 2012; McCambridge & Strang, 2004; Stephens…”
BackgroundResultMarijuana discontinuation, anxiety symptoms, and relapse to marijuana
Bonn‐Miller, M. O., & Moos, R. H. (2009) · Addictive Behaviors · doi:10.1016/j.addbeh.2009.04.009 · Cited by 42
“This withdrawal profile tends to appear relatively quickly during thecourseofaddictiveuse(Budney,Higgins,Radonovich,N Copeland, Swift, Roffman, & Stephens, 2001; Stephens, Babor, Kadden, Miller,&theMarijuanaTreatmentProjectGroup,2002)andmaypredict relapse (Budney, Novy, & Hughes,1999).”
Urbanoski, K. A., Strike, C. J., & Rush, B. R. (2005) · European Addiction Research · doi:10.1159/000085546 · Cited by 41
Treating drug misuse problems : evidence of effectiveness.
Gossop, M. (2006) · Europe PMC (PubMed Central) · Cited by 41
Metadata
- Authors
- Copeland, J., Swift, W., Roffman, R., & Stephens, R.
- Affiliations
- UNSW Sydney (AU)
- University of Washington (US)
- Virginia Tech (US)
- Corresponding author
- Copeland, Jan
- ORCID
- Copeland, Jan
- Venue
- Journal of Substance Abuse Treatment
- Publisher
- Elsevier BV
- Published
- 2001-09
- Volume
- 21
- Issue
- 2
- Pages
- 55-64
- ISSN
- 0740-5472 (ISSN-L)
- OpenAlex
- W2017872800
- Cited by
- 322
- References
- 32
- Citations by year
- 2026: 7 · 2025: 4 · 2024: 12 · 2023: 8 · 2022: 10 · 2021: 4 · 2020: 8 · 2019: 8 · 2018: 17 · 2017: 13 · 2016: 15 · 2015: 16 · 2014: 17 · 2013: 14 · 2012: 16
- FWCI
- 5.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Substance Abuse Treatment (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Keywords
- cannabis use disorder, cognitive behavioral therapy, brief intervention, single-session intervention, abstinence maintenance, cannabis cessation, medication adherence, cannabis-related problems, therapist effects
- MeSH terms
- Adult, Australia, Marijuana Abuse, Female, Humans, Male, Patient Compliance, Self-Assessment, Time Factors, Cognitive Behavioral Therapy, Treatment Outcome
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