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Brains on Drugs

How consuming drugs to expand one’s consciousness went from an intellectual pastime to an emblem of social decay.

Public Health Lessons Learned From the Coronavirus Pandemic

The United States’ struggle to respond to the virus has highlighted the importance of communicating with the public, sharing data and stockpiling vital supplies.

Medical workers treating patients with Covid-19 at the Brooklyn Hospital Center in January 2022, when the Omicron wave was in full force.

How Narcan can saves lives and xylazine can lead to overdose risk

Although xylazine is not an opioid, naloxone can reverse the effects of it when mixed in fentanyl and heroin

On the Trail of the Fentanyl King

Just your average boy-meets-girl story … if by “boy” you mean “young man with a penchant for computer hijinks who leaves Iraq for the U.S. and becomes a dark-web kingpin by putting real fentanyl in fake pills,” and by “girl” you mean “the DEA.” Maybe that Tor browser isn’t everything you thought it was.

Allawi wasn’t content dealing on the street anymore. He was chasing a broader market than San Antonio—hell, a broader market than Texas. He bought a manual pill press on eBay for $600, eventually upgrading to a $5,000, 507-pound electric machine capable of spitting out 21,600 pills an hour. He also used eBay to purchase the inactive ingredients found in most oral medications, such as dyes. On May 23, 2015, Allawi created an account on AlphaBay. He named it Dopeboy210, most likely after the San Antonio area code, according to investigators. That fall, Allawi dropped out of school for good.

Are We Not Doing Enough Drugs?

“To admit to any intention to use chemical substances, whether found in nature or synthesized in laboratories, in the aim of changing one’s apprehension of reality, is to leave the guild of the philosophers behind, with all its constricting norms and shibboleths, and to join the company, over in the deep end of the pool of life, of sundry countercultural weirdos and deviants.”

So writes Justin E. H. Smith (University of Paris 7 – Denis Diderot) in an article in Wired, in which he discusses, in his characteristically erudite manner and enviably delightful prose, his use of psychedelic drugs.

[detail of painting by Kelsey Brooks, from “Party Drugs” exhibit]

He continues:

This shows, I think, just how conservative philosophy remains, in some respects, as an academic discipline. At a cultural moment when psychedelics are getting a second wind, and even someone as upstanding as Michael Pollan has moved from counseling us to eat our roughage to praising the benefits of microdosing, philosophers are conducting themselves as though it were still 1950, when we wore skinny ties to colloquia, got funding from the RAND Corporation to work on decision trees and other such narrow and straitlaced endeavors, and all knew that it is the unaltered and wakeful mind that has exclusive access to the forms and qualities of the external world.

Yet we don’t know any such thing:

For all our efforts, we still are not one step closer to apprehending the things in themselves. It is not that science hasn’t progressed—of course it has—but rather that the problem is conceptual and not empirical. You can’t perceive the thing that lies behind what you are perceiving, since the instant you do perceive it, it no longer lies behind but is front and center. Given what appears to be this logically necessary stalemate between us and the world, it seems inevitable that alternative accounts of the fundamental nature of reality—alternative ontologies, as we say—should keep returning and drawing off at least some philosophers who get fed up with an external world that demands our loyalty yet refuses to show itself.

In at least some of these alternative ontologies, the visions that come to us unbidden, in the liminal states of insobriety, hypnagogia, or theurgic ecstasy, are not to be dismissed out of hand as obstacles to our apprehension of truth, but may in fact be vehicles of truth themselves. 

And so we get this professionally- and self-aware “confession” and recommendation:

I am aware I’m pushing up against the limits of respectability dictated by the implicit norms of my discipline, but I’ve gone about as far as I was ever destined to go in the ranks of this guild, and I’ve got nothing, and no one, to be afraid of. So I’m just going to come right out and say it: I am a philosopher who has taken an interest, of late, in psychedelic experimentation, and I find that my experiments have significantly widened the range of accounts of the nature of reality that I am disposed to take seriously. If you think you are in an emotional state to handle it, and in a legal jurisdiction that permits it, and you think you might benefit from being jolted out of your long-held ontological commitments, then I would recommend that you try some psychotropic drugs as well.

What’s to be gained? Perhaps more of that thing philosophy is most certain to produce: uncertainty. Smith says:

I am significantly less cocky now, my cluelessness is more evident to me, a constant that accompanies me in each moment of the day. No one seems more pathetic to me, now, in their own cluelessness, than the self-styled “realists” who prejudicially and without any grounds go on supposing that they have a firm grasp of concepts like “nature,” “matter,” “being,” “thing,” “world,” “self,” that this grasp flows directly from their acceptance of the plain evidence of reason buttressed by empirical discovery, and that the question of how many kinds of being there are, and of the nature of these beings, is one that has been definitively settled over the past few centuries of naturalistic inquiry…

While I remain as uncertain as ever about the ultimate structure of the world, I also have new inclinations, and new sympathies, toward accounts of it that had previously struck me as altogether off the table. That widening is itself a sort of newfound knowledge, even if it contains no new certainties.

Smith shares how some of the insights he has gained or developed while experimenting with drugs. Understanding how far out he might sound to the rest of us—while the article appears in Wired, it does seem like he is writing especially to his fellow philosophers—he voices, and answers, some skeptical questions:

Are any of these lucubrations to be taken at all seriously? Or do they just describe how the world appears to one sorry fellow who’s got a “brain on drugs”? (Readers of a certain age will at this point picture an egg in a frying pan.) Well yes, of course it’s a brain on drugs, but this just returns us to the original problem: Your brain is always on drugs. That is, there is always a neurochemical correlate to any of your conscious perceptions whatsoever. You might be tempted to say that supplementing gets in the way of correct perception, and that the only reliable way of apprehending the world as it is must depend only on the default setting of the mind, with no extras. But again, even this setting delivers us delirious hallucinations for about eight hours out of each 24. Moreover, it is hard to conceive of any valid argument against supplementation…

Read the whole thing here.

Smith is not the only philosopher who has been paying attention to psychedelics lately. Chris Letheby (University of Western Australia) authored Philosophy of Psychedelics, published by Oxford University Press in 2021, as well as a number of articles about psychedelics (for example, he makes points about the possible epistemic benefits of psychedelics in his 2016 “The Epistemic Innocence of Psychedelic States“). Last year saw the publication of Philosophy and Psychedelics: Frameworks for Exceptional Experience (Bloomsbury), a collection edited by Christine Hauskeller and Peter Sjöstedt-Hughes (Exeter). This year, a collection edited by Letheby and Philip Gerrans (Adelaide), Philosophical Perspectives on the Psychedelic Renaissance, is due out from Oxford.

Discussion welcome.


Related: Philosopharmacology

All True At Once

Illustration of Pac-Man arcade game maze against a cosmic purple background

This story was funded by our members. Join Longreads and help us to support more writers.

Maria Zorn | Longreads | March 7, 2023 | 3,373 words (12 minutes)

In middle school, I would hide behind a giant oleander bush when it was time for the bus to leave for track and field meets and then, once it left without me, I’d walk to Panda Express and eat chow mein in blissful peace. This was also my strategy for grieving you. I thought I could, like a rapacious vole, burrow myself into the branches of the quotidian and the bus of mourning would pass me by altogether. 

This is not to say that I didn’t ever experience a sense of loss. It was always there, a constant drip. Sometimes I’d think about the scene Mom came upon when the locksmith finally got your apartment door open and feel as though my kneecaps were going to crumble into ash beneath me. I wondered if there were claw marks on the floor from where you tried to stay as you felt your heart stop beating, or if you slid easily away like a clump of lint and dog hair into a Roomba. In these moments I wished to be vacuumed whole. 


* Name and location have been changed for privacy.

Sophie works at the post office in Saanichton, British Columbia.* She is tall and sinewy with thin, bony shoulders. Her body could be drawn using only straight lines, just like yours. Her hair is jet black and always pulled back into a low ponytail that nestles into the nape of her neck. She appears to be more at ease when she is behind the counter than when she is in front of it, exposed. Her voice is low and quiet and when she gets flustered she holds her elbows close to her rib cage and her hands near her shoulders like an adorable T. rex. Her mannerisms are what initially drew Mom to her, what first reminded her of you. But then she saw her protruding clavicle and her thick top lip and her round doe eyes and she couldn’t unsee the physical resemblance. She wants me to help her think of a way to befriend Sophie that doesn’t begin with: You remind me of my dead son and I would do anything to spend time with you. I just don’t know what to tell her.


Perhaps the better metaphor is that my grief for you stalked me like those ghosts in Ms. Pac-Man. I was chasing dots with my mouth wide open, trying to outrun you. The dots were moments I still felt some semblance of myself in a world without you in it, they were anyone and anything that could drain me of all of my energy and attention, they were being able to feel light enough to giggle, they were attempting to Irish dance while waiting for my tea kettle to whistle. The ghosts were you, at 8, declining to go on a playdate because you were afraid I wouldn’t have anyone to play with; you, at 16, threatening to hit the boy who broke my heart with your car; you, at 22, telling me we were soulmates with tears in your eyes at the Molly Wee pub; the ghosts were you, you, you, you with pastel sheets over your head, cutouts for your big Bambi eyes. 


Mom gets butterflies in her stomach before she goes to the post office. She’s glad for once that she has a P.O. box, that the mail carrier doesn’t come to her mossy, rural strip of the Saanich Peninsula. She blow-dries her light blonde hair until it falls in cascading curls around her face and blinks on mascara. She pulls on her stylish brown leather boots and steals one last look at herself in the mirror. She takes a deep inhale that tickles the pain in her chest. Mom wants to be more than friends with Sophie, but not in the traditional sense of the phrase. I loved you like a soulmate, but not in the traditional sense of the phrase. These loves are fluid, these loves are nonbinary. 


* Name has been changed for privacy.

The dots I chased were Chris, because every emotion I felt with him was neon.* We slept glued together like spider monkeys, and when I woke up before him I would be completely still and study him worshipfully — his toffee-colored skin that was softer than a kitten’s ear, his charcoal ringlets. We watched videos of Thom Yorke dancing for hours at a time, we did a special little jig when we bought a bottle of puttanesca sauce. When I was sad, he’d get out a Japanese sword that was left at the bar where he worked and throw watermelons in the air for me to slice like a fruit ninja. He could make anything fun, could make anything a game — but he was always the team captain. I was never certain whether it was our 14-year age gap or simply his personality, but he felt as much like a coach as he did a boyfriend. I thought he shut me down when I disagreed with him and I knew he blew his nose in our dirty laundry, and these things both made me furious. Two years passed and we morphed into ever uglier versions of ourselves. We yelled at each other outside of Joe’s Pizza by the Slice, he was a gargoyle and I was a swamp lizard and then we were two terribly sad people who didn’t talk anymore. For months after we broke up, I lay in bed every night, crusty with dried tears and snot, and my ribs felt loose. I imagined Chris playing Radiohead songs on them like they were piano keys while I tried and failed to fall asleep. I was convinced that if I concentrated hard enough on my heartache for him that I would not notice how hollow I felt from your goneness. 


You wore six-inch platform creepers and voluptuous shaggy Mongolian lamb coats, Rick Owens pencil skirts and black leather fingerless gloves. You ordered a floor-length sheer dressing gown with sleeves trimmed in feathers. When Mom said she liked it but it looked like something one would wear over a négligée, you earnestly replied: But I don’t have a négligée yet! Before I moved to New York with you, I came to visit and had to use my tube top as a pillowcase since you owned only one. I cleaned your apartment while you scoured town for a fake ID for me, an even trade. After sweeping the 600-square-foot space I had a chinchilla-sized pile of dust and boa fragments and sequins and dirt and I felt like Cruella de Vil’s housekeeper. You made a fool of the words “feminine” and “masculine” — you were neither, you were both. You called yourself an alien frequently, and even got one tattooed on your right arm. You felt like you were so different from other humans that you were extraterrestrial. No one we knew used they/them pronouns, no one we knew used terms like “nonbinary,” like “gender-fluid.” You knew you didn’t identify with other men, but you also knew you didn’t feel like other women. I wonder if you would have felt like such an alien if you knew you didn’t have to choose. I wonder if you would have tried snorting heroin that night if you didn’t feel like such an alien.


My dots were my budding career at a tech startup that I thought was so much more impressive than it actually was. I worked from 7 a.m. to 7 p.m. then came home, ate noodles, propped my laptop on the pudge of my lower belly, and kept working in bed until I fell asleep. I tried dating during this phase, but I got more pleasure from telling men I was busy and then later breaking things off than I did from going to dinner with them.

My eyes began to tolerate all of the computer work I was doing less and less until it felt like all that occupied my sockets were two purple bruises covered in fire ants. After trips to six different ophthalmologists, I was diagnosed with non-length dependent small fiber polyneuropathy and ocular rosacea and told that a career that involved “excessive screen time” was probably not in the cards for me. The doctor looked at me with a very serious expression that was made less serious by a small piece of avocado that clung to his mustache. I was such a people pleaser that in this moment all I could think of was making this a smooth experience for him so that he didn’t go look in the mirror after our conversation and feel like an idiot for having a dirty ’stache. This was a time in my life when if someone gave me a ride, I’d offer them a kidney. I jammed the shock and anguish I felt into the depths of my pockets alongside pennies and crescent-shaped nail fragments, I arranged my face into an awkward smile and said: No worries!

I wonder if you would have felt like such an alien if you knew you didn’t have to choose.

I quit my job and the online college courses I was taking and returned to bartending with the enthusiasm of a wet tube sock. An overly cheerful woman with a hair growing from the mole on her chin asked me to surprise her with a drink and I poured well rum and apple juice into a pint glass with no ice then charged her $13 for it. I didn’t talk to my friends who were graduating and starting careers, I stopped dating. I closed in on myself and got smaller and smaller until, like a Shrinky Dink, I could be pierced and worn on a string as a hideous pendant. 

I had moved back home to Arizona after you died because I couldn’t stay in New York City without you. The ghosts were too speedy there, but the dots were too far apart in Phoenix. I needed to get out. I applied for a sales position in Denver that promised not to involve the computer, packed my belongings into my beat-up red hatchback and took myself to Colorado. Driving through mountain passes, I felt an indelible sense of hope that this change of scenery would make me better, whatever that meant.


I watched the video you recorded six months before you died yesterday, the one where you’re drinking Veuve with your friend Michelle and explaining what you want done with your ashes if anything ever happens to you. You throw your head back to cackle between your outlandish requests and I stare at your pale throat. Some ashes stored in a Ming vase, some made into diamonds, some shot out of a cannon with glitter. Mom and I looked into the cannon, but all we could find was some silly handheld thing called the “Loved One Launcher” that appeared to be used primarily at memorial services held next to creeks and swamps, judging from their marketing material. It definitely wasn’t the right fit. 

We didn’t know how to “memorialize” someone who felt as essential as a limb. In our indecision, we landed on taking a trip someplace beautiful every year on the anniversary of your death. We’ve been to Cabo San Lucas, Aspen, Copenhagen, Sooke. We split a bottle of rosé and hold hands and your absence is outlined in chalk on the picnic blanket we sit on. Once, we hiked 13 miles to a beautiful alpine lake to scatter some of your ashes and I carried them on my back. I had only your remains and a bottle of wine in my pack but the straps dug into my shoulders until they were pink as salmon. We sang “He Ain’t Heavy, He’s My Brother” by the Hollies and laughed and cried at the same time. When we dumped your ashes in the water they shimmered in the sun like the glitter you wore on your eyelids and cheeks during your teen raver years. I wanted so badly to look up at the sky that was the same blue as your eyes and feel unadulterated solace, but instead I felt nothing at all. 

This year on May 30, I think Mom is going to take me to the post office. 


My dots were jobs, jobs, new jobs every few months. I worked as a kiosk wench for HelloFresh, a sales manager for StretchLab, a preschool teacher at a country day school, a fitness instructor at Life Time, at a physical therapy clinic, at a Pilates studio. I went back to school to become an art teacher, then quit that and took a yearlong nutrition course, then decided I never actually want to talk to anyone about what they eat. I remembered once hearing the phrase “throwing spaghetti at the wall and seeing what sticks” and I imagined myself doing parkour off the furniture at each of my jobs, shooting noodles and marinara out of my fingertips and watching the pasta bounce off of the reformers, the little children, the clinic walls like rubber. I had eaten all of the dots in the maze and was left aimlessly bumping into its corners with a jaw ache, desperately trying to avoid a ghost pileup. 


​​I had a dream that I was walking around a city map, but the map wasn’t made of paper — it was a black iPhone, the glass so shattered it looked like it was filled with streets and boulevards. All the roads filled with white powder until I couldn’t move my legs anymore. The phone was yours, and it sat next to a full pour of wine, murky reddish-black like blood. You died sitting up — bony ass on the floor, back against the side of your bed, pale slim fingers wrapped around your glass. How did you manage not to spill one drop? Why did you think heroin was a suitable nightcap after cocaine, Adderall, alcohol?

I remember sitting on the back porch of Mom’s house with you every night one summer, talking and smoking hookah for hours until the metal patio chairs branded the back of our sweaty legs with checkers. Even at 10 p.m. it was over 100 degrees in Phoenix. I’d feel droplets of sweat crawl from my armpits down my sides and settle into the waistband of my boxer shorts. We’d put a splash of milk in the water pipe because you were convinced that would make the smoke cloudier, more fun to blow O rings with. You confessed one of these nights to smoking black tar heroin once during your sophomore year of high school, when you were a self-proclaimed “mall goth.” I whapped you with the wooden hookah mouthpiece, hard, right in the solar plexus. I thought about the time we gobbled up so many of Dad’s prescription drugs and drank so much prosecco that we blacked out an entire journey from Amsterdam to Phoenix, including a three-hour layover that was apparently in Detroit, judging from the translucent blue lighter we bought that said Motown City and the greasy Little Caesar’s receipt that sat cross-legged in the bottom of my purse. I was not prudish about getting fucked up, but with this anecdote you crossed a threshold into territory that scared me. You took a sharp inhale and raised your dark eyebrows, fighting back a laugh. You said: Obviously that was dumb and I’ll never try it again. I made you promise with a pinkie, even though you were 19 and I was 17. Your recklessness with your life produced in me a worry that sat like a small, hard stone in my belly.

You’d hate the way dying from a heroin overdose sounds. You’d have me let everyone know that you were “trying to buy opium.” That you were supposed to go to a wedding in Greece in two months, New York Fashion Week in three. That you didn’t mean for it to happen this way.


The dots were gone, but I became so adroit at ghost evasion I no longer needed them — I was eating strawberries, oranges, bananas, cherries. I found a drug that makes my eye condition more tolerable, a job I like well enough, a dog who constantly wants to shake my hand. I found a partner with Reptar green and caramel eyes who gives me grace like a daily train ticket, who calls you Tomm, not “your brother,” whose calm demeanor lowers my blood pressure and provides a certitude that life is allowed to feel good. I thought Jack’s love was a fuzzy sweater I could don and become whole. I saw no portents of a more substantial ghost, one that could swallow me entirely. I fell into the mouth of a ghost as though it was a shoddy manhole cover; it took me by surprise and then devoured me until I was wholly in its maw and could not see a single shred of light through its incisors. My grief developed its own physical presence, its own pulse. I feared that it was going to burst through my bones like the Kool-Aid man at any moment and take me over completely. My first instinct was to wrestle it to the ground, to mash my teeth into its ears and give it a noogie, since I was always the brute of the family. I knew you’d try to reason with it, to write it a letter using your shiniest vocabulary like the ones you’d send to Mom and Dad to convince them to raise our allowance, to get a pet sugar glider, to let you get your ears pierced, to legally change the “Jr.” that follows your name to the more sophisticated and chic “II.” You’d arrange all of your best arguments like toy soldiers followed by rebuttals of anticipated counter-arguments, then sign: Please don’t be mad at me. As a card-carrying atheist I didn’t know who to write a letter to. The universe? You?

I loved you like a soulmate, but not in the traditional sense of the phrase.

My therapist recommended I try ketamine for treatment-resistant depression and I had my first session this week. I thought of you because the first time I heard the word “ketamine” was when you snorted it in ninth grade and then came out to Mom, and the first time I heard the term “treatment-resistant depression” was after I talked about you to my therapist, seven years after you died. I filled out a questionnaire that tests for suicidality and it was only then that I realized my sadness had become life-threatening. I had a primordial urge to go wherever it is that you are. I’d sign my note to Mom and Jack: Please don’t be mad at me.

The nurse anesthetist injected the drug into my shoulder and it felt like a gentle bee sting. There were colors and textures and sounds that I can’t explain, but what I remember most of all was you. Your hair was dyed platinum blonde and a thin white shirt hugged your angular frame. You were resplendent. You were laughing and reaching out for my hand, and I chased you across tiles that lit up under our feet as we stepped on them. We knew you were not alive but we also knew that you were not gone. Looking at you, for the first time in seven years, didn’t feel like gazing directly into a car’s headlights at night; you didn’t singe my delicate eyes with your brightness. You hugged me the way you always did, so tightly that your upper ribs jabbed into my torso with a titty-puncturing ferocity, like you were holding on for dear life, and I felt an ineffable sense of something inside me being cauterized. Later I’d recall a mathematical concept from high school in which two lines get very, very close together but never actually end up touching and wonder if, for me, this would be the closest I’d ever get to feeling peace about your death. As I began to regain consciousness, your face became pixelated and the crinkles around your eyes started to smoothen and fade. The first part of my body that woke up was my mouth, and I could feel my chapped lips pressing together with alacrity to form a small smile. Before you disappeared completely, you said: What if it’s all true at once? You held those words up like a trophy and I unzipped my chest and put them inside. 


Maria Zorn is a writer and visual artist currently living in Denver, Colorado.

Editor: Cheri Lucas Rowlands

Copy-editor: Krista Stevens

The Great US Adderall Shortage is likely going to last at least for another year

In case you haven't heard, there's a national Adderall shortage. There has in fact been a national Adderall shortage for quite some time now. And there is no fucking end in sight.

Now, in the grand scheme, I suppose that extended-release amphetamine salts are small potatoes compared to cancer, or COVID, or police brutality, or what have you. — Read the rest

Antibiotic resistance induced by the widespread use of… antidepressants?

Image of a smiley face with a frown, with the lines drawn using pills.

Enlarge (credit: Larry Washburn)

Jianhua Guo is a professor at the Australian Centre for Water and Environmental Biotechnology. His research focuses on removing contaminants from wastewater and the environmental dimensions of antimicrobial resistance. One of those dimensions is the overuse of antibiotics, which promotes resistance to these drugs.

Guo wondered if the same might hold true for other types of pharmaceuticals as well. His lab found that they definitely do. Specific antidepressants—SSRIs and SNRIs—promote resistance to different classes of antibiotics. This resistance is heritable over 33 bacterial generations, even once the antidepressant is removed.

So much work

Antidepressants are among the most prescribed and ingested drugs there are. They account for roughly 5 percent of the pharmaceutical market share—about the same as antibiotics—and four of the top 10 most prescribed psychiatric meds in the US.

Read 6 remaining paragraphs | Comments

Tripping for the Planet: Psychedelics and Climate Activism

The human fascination with psychedelics is nothing new. The earliest use of psychoactive plants dates back to 11,000 B.C. in Israel, with the brewing of beer, while some people theorize that the eating of magic mushrooms 20,000 years ago fostered the intellectual evolution of early humans (see: “stoned ape theory“). For Atmos, Amber X. Chen explores the current psychedelic renaissance’s effects on environmental activism, and how hallucinogenic drugs like LSD and psilocybin, and ancient plant medicine like ayahuasca, can stir change within individuals — and ultimately galvanize social movements.

It sounds incredibly positive on the surface, but not everyone who dabbles in such mind-altering journeys comes out the other side positively transformed. As research shows, psychedelics have enormous therapeutic potential, sure, but they also fuel right-wing movements, too (see: “‘QAnon Shaman“).

The use of psychoactive plants has its roots with Indigenous tribes, who’ve used them for healing and cultural practices for thousands of years. Before we push for the decriminalization of psychedelics and encourage their use to help stir climate activism, reports Chen, there are steps that need to be taken for these powerful, sacred plants to play a positive role in the environmental movement.

In a 2022 study that surveyed 240 people, mostly from Australia, the U.S., and the U.K., who had prior experience with psychedelics, researchers found more pro-environmental behaviors among participants who reported having had a previous mystical experience than those who had not. The researchers measured these behaviors based on a wide range of behaviors—anything from adopting a vegetarian diet and purchasing eco-friendly products to turning off your lights more regularly.

Before adding psychedelics to the climate action toolkit, we need to first plan for their conservation, prioritize Indigenous cultures, and place Indigenous peoples into leadership positions. This means respecting the wishes of Indigenous peoples: if a tribe or nation doesn’t want its plant medicines commercialized, we should not interfere. For those willing to share, we must not appropriate. Ultimately, we have to listen.

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