Online Suboxone Doctors Help - Minnesota

Never ever Stop Giving Up
Our physicians are on a mission to serve, assistance, and also boost the lives of individuals we offer through Medication- Helped Treatment (FLOOR COVERING). Floor covering is taken into consideration the most efficient treatment for opioid use problem by the CDC, SAMHSA, FDA as well as various other federal companies. We enjoy to report 95% of our clients state they have no withdrawal signs and symptoms at 5 days.


OPIOID WITHDRAWAL Minnesota
What is Opioid withdrawal?To understandopioid withdrawal, it is important to initially comprehend what taking opioids over an extended period of time does to ones body. Taking an opioid everyday for three weeks or longer causes a modification in brain chemistry which can be defined as drug tolerance. This means that gradually, even more of the drug is required to accomplish the same end result (euphoria, discomfort control, or control or anxiety/depression). Dependancy does not always suggest dependency nonetheless, which is characterized by continuously craving and also continuously preoccupying oneself with the demand to get more of the medication. If somebody who is dependent on opioids stops unexpectedly, they will likely have both physical and also psychological symptoms of withdrawal as the body is no more receiving a medication that it is dependent on. The most common withdrawal symptoms are flu- like in nature and include:
1. Runny nose

2. Muscle pains

3. Upset stomach, nausea, throwing up, diarrhea

4. Chills/sweats.

5. Fast heart beat.

6. Goosebumps on the skin.

7. Stress and anxiety.

8. Inability to rest.

9. Exhaustion.


There are 2 major methods of going into withdrawal:.

1) Instantly quiting all opioid usage without tapering down first (spontaneous withdrawal).

2) Taking an opioid villain like naloxone (included in suboxone) or naltrexone prematurely (precipitated withdrawal).





How Much Time Does Opioid Withdrawal Last?
If you ask any person that has experienced opioid withdrawal, the answer is that it is rather awkward and in some situations, life- threatening. Withdrawals can start as early as a couple of hours and generally last 3-5 days. Nonetheless, depending on the severity of addiction and the sort of drug used, signs and symptoms may last as much as 3-6 weeks (methadone). A rough guideline is a beginning of signs occur after 2 to 3 times the half-life of the taken out opioid.
Exists Anything to Make Withdrawals Easier?
While the mainstay oftreatment for opioid withdrawal, Buprenorphine/Naloxone (Suboxone), concentrates on pleasing your bodys physical dependence to opioids and decreasing yearnings, we also have additional treatment to help relieve the other unpleasant signs of withdrawal. Below is a listing of signs and symptoms with matching therapy medications:.
1) Muscle mass aches, headache- acetaminophen, advil, and also naproxen.

2) Muscular tissue spasm- cyclobenzaprine, baclofen, and methocarbamol.

3) Nausea or vomiting, vomiting- tigan, as well as ondansetron.

4) Diarrhea- loperamide, bismuth subsalicylate.

5) Stomach cramping- dicyclomine.

6) Lack of ability to rest (sleeping disorders) - diphenhydramine, hydroxyzine, melatonin, trazodone, and doxepin.

7) Anxiety, irritation, restlessness- diphenhydramine, hydroxyzine, and also clonidine.


The Family MD Concentrates On Opioid Dependency as well as Withdrawal Treatment.
We offerMedication- aided treatmentwith Buprenorphine/Naloxone (Suboxone) to help patientsovercome opioid addictionand withdrawal. Begin today by scheduling a digital check out with one of our board- accredited physicians. Whether youre at home, at the office, or on lunch break, weve obtained you covered and also are below to make recovery easy. Click on this link to arrange currently!

MEDICATION- ASSISTED TREATMENT Minnesota

 
At the Family members MD, our company believe there are multiple roads that lead from addiction to healing
What is Medicine Assisted Therapy (MAT)?

Before we begin speaking about treatment for opioid addiction, it is essential to know what is specified as opioid addiction. Opioid addiction is characterized by a solid, uncontrollable desire to eat opioid medicines, also when they are no more clinically required. Opioid dependency remains at epidemic levels in the U.S as well as the numbers are only expected to increase. Right here are some fast facts:

-More than 263,000 people died from opioid overdose from 1999 to 2020 (21 years).
-More than 75,000 people died from opioid overdose in simply this previous year finishing in April 2021.
-10.1 million individuals misused prescription opioids this previous year.
-Overdose fatalities including opioid have actually raised a minimum of 6 times given that 1999.

Its clear that opioids have a high possibility for causing addiction in people, also when they are taken as suggested. Although there are multiple roadways torecovery, only one is described as the most reliable by the CDC as well as accepted by several federal agencies (FDA, SAMHSA, as well as various other firms), and that is Medication- assisted treatment.Medication- aided treatment( MAT) involves making use of drug, together with cognitive or behavior modification, to offer an alternative strategy to treatingopioid dependency.

Here at The Household MD, we integrate cutting edge modern technology with floor covering therapy inRochesterMinnesota.
Although MAT has actually conserved countless clients from opioid relevant complications and also death, less than 20% of those dealing with opioid dependency have access to it.In enhancement to geographical constraints, there is a shortage of doctors that are learnt its application. According to SAMHSA, less than 7 percent of physicians are efficiently waivered to deal with opioid addiction. Tele- MAT solutions, like we provide atThe Household MD, is one means to improve accessibility to care for those who may not otherwise have the ability to do so because of cost, lack of accessibility to or absence of schedule of suggesting medical professionals.

The M inMATstands for specific FDA accepted medicine that is made use of to lower food cravings and physiologic dependancy on opioids. While there are several formulations and suppliers, every one of them can be summed up in 3 medications:.
1) Buprenorphine.
2) Methadone.
3) Naltrexone.
The very first 2, buprenorphine and methadone, are both partial as well as complete opioid agonists respectively, whereas naltrexone is an opioid villain. While all three are accepted for therapy of opioid dependency, maybe the very best one for most clients is buprenorphine/naloxone (Suboxone) because of its beneficial account. Given that it is only a partial agonist, it protects against the feelings of euphoria when taken, lowers yearnings at the same time, and discourages IV shot. For this reason, buprenorphine/naloxone (Suboxone) is the only FDA authorized treatment that is prescribed at The Family MD. With greater than 95% of clients withdrawal totally free at 5 days, our outcomes are a testament to our competence when taking care of opioid dependency. Arrange an appointment currently to go over further exactly how we can best aid you attain long-term soberness.


SHIFT FROM METHADONE Minnesota.


What is Methadone?

Methadone is just one of 3 medicines that is FDA approved for the treatment of opioid use.
condition, as aMedication- assisted therapy( MAT). It is the first of the MAT medicines (approved in the 1960s) as well as is the most greatly researched.Unlike the other two medicines that are used in MAT, methadoneis a full opioid agonist, which implies it carries all the dangers that any various other opioid off the street would have.These consist of bliss, danger of breathing depression, opportunity of overdose, and hallucinations among other things. Because of this, various other MAT drugs such asSuboxonehave currently end up being extra favored due to its very little side effect profile. Rochester Minnesota.



How Long Does Methadone Withdrawal Last?

If switching fromMethadoneto one more floor covering medicine, such asSuboxone, it is initially essential to.
lower the amount of methadone one is on to 30 mg daily for at the very least one week. Once steady on this dose, methadone is stopped totally and suboxone began once mild- modest withdrawal signs begin to set in, which is usually after 36 hrs however might differ depending upon addiction extent. After three to five days, withdrawal is usually total and also client is currently effectively on Suboxone.

The Family Members MD Focuses On Methadone Addiction and Withdrawal Treatment.

We offer Medication- assisted therapy with Buprenorphine/Naloxone (Suboxone) to help people.
conquered methadone addictionand withdrawal.Get started today by setting up a virtual go to with among our board- certified doctors.Whether youre in your home, at the workplace, or on lunch break, weve got you covered as well as are here to make healing easy.Click below to arrange currently.

 

  

How it functions
It is essential to first stop all methadone usage. You must wait up until you have light to moderate withdrawal symptoms (typically 12- 72 hrs) before taking your very first dose of Suboxone. If it is taken prematurely, it can force you into precipitated withdrawal, which is both extremely awkward and also may be dangerous. Continue as guided by your doctor and thats it. Generally 95% of our clients do not have any type of withdrawal signs after the first 5-7 days of beginning Suboxone. You may also ask for additional drug to help reduce withdrawal symptoms to make sure that you can proceed with your day to day tasks (work, school, etc) without missing a beat.

 

TREATMENT FOR NORCO WITHDRAWAL Rochester Minnesota 

 What is Norco?

Norco is a combination discomfort medication, consisting of both acetaminophen and hydrocodone. It is utilized to treat modest to severe discomfort. Hydrocodone, which is the addictiveopioidcontained withinNorco, is stemmed from either codeine or thebaine and it is one of the most often recommended opioid in the USA. It is generally for short term pain as well as is frequently made use of as an antitussive (coughing suppressant). When abused, it can also be crushed as well as snorted. It takes about 10 to half an hour for you to really feel the impacts ofNorcowhen taken and impacts can last approximately four to 6 hrs. Other trade names that contain both hydrocodone as well as acetaminophen are Lortab, Vicodin, Lorcet- HD, Hycodan, and also Vicoprofen.


For How Long Does Norco Withdrawal Last?

The onset ofwithdrawal symptomsroughly starts concerning six to twelve hours after last usage. Signs and symptoms normally peak around day 3 as well as are typically significantly decreased by seven to 10 days. Often it is feasible to last longer than 10 days relying on the seriousness of the addiction and also it varies on an instance by case basis.


The Household MD Concentrates On Norco Addiction as well as Withdrawal Treatment

We offerMedication- assisted treatmentwith Buprenorphine/Naloxone (Suboxone) to help people overcomeNorcoaddiction andwithdrawal. Get started today by setting up a digital visit with one of our board- certified medical professionals. Whether youre in your home, at the office, or on lunch break, weve obtained you covered and also are below to make recovery simple. Visit this site to arrange currently.





Exactly how it functions
It is very important to very first quit all Norco usage. You have to wait up until you have light to modest withdrawal signs (generally 12- 72 hrs) prior to taking your initial dose of Suboxone. If it is taken prematurely, it can force you into precipitated withdrawal, which is both extremely uncomfortable and might be dangerous. Proceed as routed by your doctor which it. Usually 95% of our individuals do not have any kind of withdrawal signs and symptoms after the first 3-5 days of startingSuboxone. You might also ask for additional medication to help relieve withdrawal signs so that you can continue with your day to day activities (work, college, and so on) without skipping a beat.

TREATMENT FOR OXYCODONE WITHDRAWAL Rochester Minnesota


What is Oxycodone?

Oxycodone is a prescription opioid medication that was initially made in 1916 from thebaine, a component of poppy plant. It is made use of for therapy of moderate to severe discomfort and is recognized for being highly habit forming. It normally starts to manage discomfort within fifteen mins as well as can for approximately 6 hours with the prompt release formulation. It is additionally marketed under the brand Roxicodone and OxyContin (which is the extended launch type), to name a few. The extended release kind is slowly released right into the body and gives around the clock discomfort control. Because of the slower start, it has less capacity for abuse contrasted tooxycodonewhich has a quicker start of activity.



How Long Does Oxycodone Withdrawal Last?

The beginning ofwithdrawal symptomsroughly starts concerning eight to twelve hours after last usage. Symptoms generally come to a head around day three and hardly ever last longer than 5 to seven days. As always, there can be a long term withdrawal phase depending upon the extent of dependency as well as depending upon private variables.

The Household MD Concentrates On Oxycodone Dependency as well as Withdrawal Treatment

We offerMedication- aided treatmentwith Buprenorphine/Naloxone (Suboxone) to assist patients overcomeoxycodone addictionandwithdrawal. Get started today by scheduling a virtual see with among our board- certified medical professionals. Whether youre in your home, at the office, or on lunch break, weve obtained you covered and are here to make recovery very easy. Click on this link to arrange now.

 

 

Exactly how it works
It is very important to initial quit all oxycodone usage. You need to wait till you have moderate to moderatewithdrawal signs( normally 12- 72 hrs) prior to taking your first dose of Suboxone. If it is taken prematurely, it can require you right into precipitated withdrawal, which is both really uncomfortable and may threaten. Continue as directed by your physician and thats it. Usually 95% of our patients do not have any withdrawal symptoms after the initial 3-5 days of starting Suboxone. You may additionally ask for extra medicine to assist relieve withdrawal symptoms to make sure that you can proceed with your everyday activities (work, college, etc) without skipping a beat.

THERAPY FOR FENTANYL WITHDRAWAL Rochester Minnesota


What is Fentanyl?

Fentanyl is an artificial opioid, which means that it is produced by pharmaceutical firms in the lab. It is a really effective opioid and also is about 50- 100 times more stronger than morphine. Due to its strength, it is mostly being utilized for pain administration therapy of cancer cells individuals. Of note, numerous individuals are unaware they are purchasingfentanyllaced products when they purchase opioids. Distributors do this since it makes drugs more affordable, enhances potency, raises addictive residential properties, and also therefore, makes thesefentanyllaced medications very dangerous also in tiny doses. Beginning to action is 3 to 5 minutes if utilized intravenously. Various other typical kinds that it is made in is as a transdermal patch (Duragesic), as a lozenge called lollipops (Aqtic), and also in an injectable kind (Sublimaze).



How Long Does Fentanyl Withdrawal Last?

The onset ofwithdrawal symptomsroughly begins about 6 to twelve hrs after last use. Signs typically peak around day 3 as well as seldom last longer than five to 7 days. Nevertheless, it might happen relying on the seriousness of addiction or instance by situation basis.

The Family MD Specializes in Fentanyl Dependency and also Withdrawal Therapy

We offerMedication- aided treatmentwith Buprenorphine/Naloxone (Suboxone) to assist individuals overcomefentanyladdiction andwithdrawal. Get going today by setting up an online visit with among our board- certified medical professionals. Whether youre in your home, at the workplace, or on lunch break, weve got you covered and are below to make recuperation easy. Click here to set up currently.





How it functions
It is necessary to initial stop all Fentanyl use. You need to wait up until you have mild to modest withdrawal signs and symptoms (usually 12- 72 hours) before taking your very first dosage ofSuboxone. If it is taken prematurely, it can compel you right into precipitated withdrawal, which is both really uncomfortable and may be dangerous. Continue as guided by your physician which it. Normally 95% of our clients do not have any kind of withdrawal symptoms after the initial 3-5 days of starting Suboxone. You may additionally ask for extra medication to help ease withdrawal symptoms to make sure that you can continue with your day to day activities (work, college, and so on) without missing a beat.

TREATMENT FOR OXYMORPHONE/OPANA WITHDRAWAL Rochester Minnesota

 

What is Oxymorphone?

Oxymorphoneis an extremely potentopioidindicated for the therapy of serious discomfort. It is a lot more generally recognized asOpanaor Numorphan. It is considerably stronger than morphine as well as is made use of to treat pain that is less competent to other opioid medications. In 2017, the FDA asked the maker of oxymorphone to remove its item from the US market and also because has been unavailable in the United States. Nonetheless, prolonged release oxymorphone formulas are still offered in the United States because of its somewhat reduced misuse possibility. The instant launch regulates pain 5-10 minutes if taking IV, and after 30 minutes if taken by mouth, and after that last 3-4 hrs. If taking the extended launch, pain control lasts 12 hours.

 

How Long Does Oxymorphone/Opana Withdrawal Last?

The onset of withdrawal symptoms roughly starts about four to forty eight hours after last use. Symptoms typically intensify at two to five days and peak during the first week.
 

The Family MD Specializes in Oxymorphone Addiction and Withdrawal Treatment

We offer Medication- assisted treatment with Buprenorphine/Naloxone (Suboxone) to help patients overcome oxymorphone addiction and withdrawal. Get started today by scheduling a virtual visit with one of our board- certified doctors. Whether you’re at home, at work, or on lunch break, we’ve got you covered and are here to make recovery easy. Click here to schedule now.  

 

 

How it works

It is necessary to initial quit all oxymorphone usage. You have to wait until you have mild to modest withdrawal symptoms (generally 12- 72 hrs) prior to taking your first dose of Suboxone. If it is taken prematurely, it can force you right into precipitated withdrawal, which is both very uncomfortable and also might be dangerous. Proceed as guided by your physician and thats it. Generally 95% of our people do not have anywithdrawalsymptoms after the very first 5-7 days of startingSuboxone. You might likewise request additional medicine to assist relieve withdrawal signs and symptoms to ensure that you can proceed with your daily tasks (work, institution, etc) without missing a beat.

TREATMENT FOR TRAMADOL WITHDRAWAL Rochester Minnesota

 

What is Tramadol?

When it was originally authorized in 1995, tramadol was ruled out an opiate despite the fact that its mechanism of action was similar. However, as a result of all the instances of misuse as well as addiction, the FDA ultimately assigned tramadol as a controlled substance in 2014. Compared to other dangerous drugs however, tramadol has less possibility for abuse. Because of this, tramadol is one of the many common treatments for osteo arthritis and various other painful conditions.


For How Long Does Tramadol Withdrawal Last?

The beginning of withdrawal signs roughly begins concerning thirty- 6 to seventy- two hours after last use. Signs commonly last 5 to 8 days. As constantly, there can be a prolonged withdrawal stage depending upon the seriousness of addiction and also depending upon specific aspects.


The Family MD Focuses On Tramadol Addiction and Withdrawal Therapy

We offer Medication- assisted treatment with Buprenorphine/Naloxone (Suboxone) to assist people get rid of tramadol dependency and also withdrawal. Begin today by scheduling a digital see with among our board- certified doctors. Whether youre in the house, at the office, or on lunch break, weve got you covered and are here to make recovery simple. Click here to schedule now.

 

 

How it works

It is important to first quit all tramadol use. You have to wait up until you have moderate to modest withdrawal signs and symptoms (generally 12- 72 hours) before taking your initial dose of Suboxone. If it is taken too early, it can compel you into precipitated withdrawal, which is both really unpleasant as well as may threaten. Proceed as routed by your doctor and thats it. Normally 95% of our clients do not have any type of withdrawal signs and symptoms after the first 3-5 days of starting Suboxone. You may also ask for extra medicine to aid reduce withdrawal symptoms to make sure that you can proceed with your day to day activities (job, school, and so on) without skipping a beat.TRAMADOL

TREATMENT FOR CODEINE WITHDRAWAL Rochester Minnesota

 

 What is Codeine?

Codeine is an opiate that is commonly found is prescription- grade cough suppressants. Tylenol 3, a popular painkiller, is codeine combined with acetaminophen. Because codeine- based cough syrups are less regulated that some other opiates considered to be more dangerous (Such as morphine and oxycodone), it is relatively easy to start getting and abusing it. Once ingested, codeine is converted into morphine in the body, thus producing similar effects but to a lesser degree.  

 

 How Long Does Codeine Withdrawal Last?

The onset of withdrawal symptoms roughly starts about four hours after last use. Symptoms typically intensify at one to three days and peak during the first week. The final phase of codeine withdrawal can last anywhere from one week after last dose and can linger for months.

The Family MD Specializes in Tramadol Addiction and Withdrawal Treatment

We offer Medication- assisted treatment with Buprenorphine/Naloxone (Suboxone) to help patients overcome tramadol addiction and withdrawal. Get started today by scheduling a virtual visit with one of our board- certified doctors. Whether you’re at home, at work, or on lunch break, we’ve got you covered and are here to make recovery easy. Click here to schedule now.  

 

 

How it works

It is important to first stop all methadone use. You must wait until you have mild to moderate withdrawal symptoms (generally 12- 72 hours) before taking your first dose of Suboxone. If it is taken too early, it can force you into precipitated withdrawal, which is both very uncomfortable and may be dangerous.  Continue as directed by your doctor and that’s it. Generally 95% of our patient’s do not have any withdrawal symptoms after the first 5-7 days of starting Suboxone. You may also request additional medication to help ease withdrawal symptoms so that you can continue with your day to day activities (work, school, etc) without skipping a beat .

TREATMENT FOR MORPHINE WITHDRAWAL Rochester Minnesota

 

 What is Morphine?

Morphine is considered the classic opioid analgesic with which other painkillers are compared. It is a non- synthetic narcotic that is derived from opium and has a high potential for abuse. Traditionally morphine was almost exclusively used by injection, but the variety of pharmaceutical forms that it is marketed as today supports its use by oral and other routes of administration.  

 

How Long Does Morphine Withdrawal Last?

The onset of withdrawal symptoms roughly starts about four hours after last use. Symptoms typically intensify at one to three days and peak during the first week.

The Family MD Specializes in Morphine Addiction and Withdrawal Treatment

We offer Medication- assisted treatment with Buprenorphine/Naloxone (Suboxone) to help patients overcome morphine addiction and withdrawal. Get started today by scheduling a virtual visit with one of our board- certified doctors. Whether you’re at home, at work, or on lunch break, we’ve got you covered and are here to make recovery easy. Click here to schedule now.  

 

 

 

How it works

It is important to first stop all morphine use. You must wait until you have mild to moderate withdrawal symptoms (generally 12- 72 hours) before taking your first dose of Suboxone. If it is taken too early, it can force you into precipitated withdrawal, which is both very uncomfortable and may be dangerous. Continue as directed by your doctor and that’s it. Generally 95% of our patient’s do not have any withdrawal symptoms after the first 5-7 days of starting Suboxone. You may also request additional medication to help ease withdrawal symptoms so that you can continue with your day to day activities (work, school, etc) without skipping a beat .

TREATMENT FOR HYDROMORPHONE WITHDRAWAL Rochester Minnesota

 
What is Hydromorphone?

Hydromorphone, also commonly known as dilaudid, is an opioid medication used to treat severe pain. It is a semi- synthetic opioid that is derived from morphine, however it is 2-8x more potent than morphine. It has higher addictive potential because of its shorter duration to onset and causes greater sedation. It is used to treat pain that is not controlled by other opiate medications.  

 

 How Long Does Hydromorphone Withdrawal Last?

The onset of withdrawal symptoms roughly starts about four to eight hours after last use. Symptoms typically intensify and peak at one to two days. After three days the symptoms should start to subside and are generally resolved after the first week.

The Family MD Specializes in Hydromorphone Addiction and Withdrawal Treatment

We offer Medication- assisted treatment with Buprenorphine/Naloxone (Suboxone) to help patients overcome hydromorphone addiction and withdrawal. Get started today by scheduling a virtual visit with one of our board- certified doctors. Whether you’re at home, at work, or on lunch break, we’ve got you covered and are here to make recovery easy. Click here to schedule now.  

 

  

How it works

It is important to first stop all hydromorphone use. You must wait until you have mild to moderate withdrawal symptoms (generally 12- 72 hours) before taking your first dose of Suboxone. If it is taken too early, it can force you into precipitated withdrawal, which is both very uncomfortable and may be dangerous. Continue as directed by your doctor and that’s it. Generally 95% of our patient’s do not have any withdrawal symptoms after the first 5-7 days of starting Suboxone. You may also request additional medication to help ease withdrawal symptoms so that you can continue with your day to day activities (work, school, etc) without skipping a beat .
 

TREATMENT FOR MEPERIDINE WITHDRAWAL Rochester Minnesota

What is Meperidine?

The trademark name version of Meperidine is called Demerol. It has a misuse prospective comparable to that of morphine, however it should not be used for treatment of chronic discomfort. Meperidine should only be used in the treatment of severe episodes of extreme pain as a result of the threat of seizures from the accumulation of meperidine metabolites, particularly normeperidine, if it is utilized long term. In addition to seizures, it can also create serotonin syndrome if utilized in mix with certain medications. It is offered in intramuscular, subcutaneous, intravenous, syrup, and also tablet kinds.



For How Long Does Meperidine Withdrawal Last?

The beginning of withdrawal symptoms approximately begins about three- twenty 4 hours after last usage. Symptoms typically peak around three days as well as start to decrease in intensity after the initial week. Some signs might exist for a long term period of time depending upon the seriousness of the addiction.

The Family Members MD Concentrates On Meperidine Addiction and also Withdrawal Therapy

We provide Medication- assisted treatment with Buprenorphine/Naloxone (Suboxone) to aid clients overcome Meperidine dependency and withdrawal. Begin today by arranging an online check out with among our board- accredited doctors. Whether youre in your home, at the office, or on lunch break, weve obtained you covered and also are below to make recovery very easy. Visit this site to set up currently.







Exactly how it functions

It is important to initial quit all Meperidine use. You need to wait until you have mild to moderate withdrawal symptoms (normally 12- 72 hrs) before taking your first dose of Suboxone. If it is taken prematurely, it can require you into precipitated withdrawal, which is both really uneasy and might be dangerous. Continue as routed by your medical professional and thats it. Generally 95% of our patients do not have any kind of withdrawal symptoms after the first 5-7 days of starting Suboxone. You may additionally request extra medication to help relieve withdrawal symptoms to make sure that you can continue with your everyday activities (work, institution, and so on) without missing a beat.