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Alcohol and Mental Health

The Relationship Between Social Anxiety and Alcohol Misuse

Published:
September 14, 2023
·
21 min read
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Written by
Reframe Content Team
A team of researchers and psychologists who specialize in behavioral health and neuroscience. This group collaborates to produce insightful and evidence-based content.
September 14, 2023
·
21 min read
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Certified recovery coach specialized in helping everyone redefine their relationship with alcohol. His approach in coaching focuses on habit formation and addressing the stress in our lives.
September 14, 2023
·
21 min read
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Recognized by Fortune and Fast Company as a top innovator shaping the future of health and known for his pivotal role in helping individuals change their relationship with alcohol.
September 14, 2023
·
21 min read
Reframe App LogoReframe App Logo
Reframe Content Team
September 14, 2023
·
21 min read

Imagine that you’re about to attend a social event where you won’t know many people. You’ve been nervous about it all week, but now that it’s tonight, your anxiety is building. You pour yourself a glass of wine to help you relax. You gulp it down and experience a sense of relief. But is this really the best way to handle your social anxiety? Is it possible you’re actually making your anxiety worse in the long run? 

In this post, we’ll explore the relationship between social anxiety and alcohol misuse. We’ll also offer self-help tips for managing social anxiety. Let’s get started!

What Is Social Anxiety? 

Contrary to popular belief, social anxiety is more than just being shy: it’s an intense, persistent fear of being watched, judged, or rejected by others in social situations. 

People with social anxiety often have anxiety or fear in social situations, such as meeting new people, performing in front of people, taking or making phone calls, answering a question in front of people, asking for help in a public place, or participating in an interview. 

Symptoms range from mild to severe and vary in intensity from person to person. They also vary by situation. For instance, someone with social anxiety might be afraid when they get into a social situation with people they don’t know, such as at a spouse’s company holiday party or a friend’s bridal shower. Others might get anxious simply thinking about an upcoming social gathering — otherwise known as anticipatory anxiety. For instance, if we receive a wedding invite in the mail, we might start to get anxious in anticipation of it. 

Some of the more common physical and physiological symptoms of social anxiety include blushing, sweating, shaking or feeling our heart race in social situations. People with social anxiety tend to be very self-conscious, embarrassed, or awkward in front of others. They might feel like their mind goes blank when talking to people.

Overall, social anxiety is a relatively common condition, with 12% of adults in the U.S. experiencing it at some point in their lives — mathematically speaking, in a group of 25 people, 3 people have struggled with social anxiety! In fact, it’s the third most common mental health condition behind substance use disorder and depression. If this is something you experience, just know that you’re not alone. 

How Alcohol Affects Social Anxiety 

Living with social anxiety can be debilitating, and it’s not uncommon for people with the condition to turn to alcohol for relief. This makes sense given that alcohol is a depressant with sedative effects, helping calm our central nervous system. As a result, it can help “take the edge off” and provide a temporary respite from anxiety. 

The problem, however, is that alcohol can actually worsen our anxiety in the long run. How so? It all comes down to how alcohol interacts with neurotransmitters — important chemicals — in our brain. We often don’t realize it, but our brain depends on a delicate balance of chemicals to keep us functioning well. As a toxin, alcohol does significant damage and disrupts this balance.

Here’s how it works: whenever we consume alcohol, our brain is flooded with neurotransmitters such as dopamine and serotonin — both of which make us feel good. Alcohol also temporarily increases levels of neuromodulators gamma-aminobutyric acid (GABA), glycine, and adenosine, decreasing anxiety. 

However, once the temporary effects of alcohol wear off, production of all these neurotransmitters is impaired. As a result, we’re often left feeling more anxious. This also explains why we might experience a crash or “down in the dumps” feeling after a night of drinking. Even moderate amounts of alcohol can lead to an increase in anxiety, irritability, or depression a few hours later or the next day. 

The Relationship Between Social Anxiety and Alcohol

While alcohol might feel like a solution to our social anxiety, it can quickly lead to problems. After all, the relationship between social anxiety and alcohol is a bit like the chicken and egg: anxiety can lead us to drink for temporary relief, but drinking can make us anxious. This can create a vicious cycle that can spiral into physical and mental dependence on alcohol.

In fact, social anxiety and alcohol misuse often go hand-in-hand. Research shows that a person with an anxiety disorder is three times more likely to develop an alcohol use disorder compared to someone who has never been diagnosed with anxiety. 

Furthermore, one study estimates that about 1 in 5 people with social anxiety disorder (SAD) also struggle with alcohol abuse or dependence. Many more fall into gray area drinking and would like to drink less than they do on social occasions. 

In a nutshell, drinking to cope with social anxiety can quickly become a harmful habit. If we’re continually using alcohol to feel more relaxed or at ease in social situations, we might eventually avoid any social situation where we wouldn’t be able to drink. Furthermore, depending on the degree of our social anxiety, we might feel the need to have a drink before a social event — in addition to consuming alcohol during it. 

Some people with social anxiety may drink excessive amounts because they strongly associate alcohol with relief. Over time, long-term alcohol use often leads to increased tolerance, in which we need to consume more alcohol to get the desired effect. For example, we might have started feeling more relaxed after just one glass of wine. As time goes on, however, we might find ourselves needing two, three, or more glasses to get the same relief. 

Treating Social Anxiety and Alcohol Misuse 

Given the close connection between social anxiety and alcohol misuse, it’s perhaps not surprising that treating one condition typically requires adequately addressing the other. 

Research suggests that a combination of cognitive-behavioral therapy (CBT) and motivational enhancement therapy (MET) may successfully treat co-occurring social anxiety disorder and alcohol misuse. Let’s take a closer look at these therapies: 

  • Cognitive Behavioral Therapy: CBT is a goal-oriented therapy that focuses on our thoughts, feelings, and behaviors. The core belief of CBT is that identifying and adjusting harmful thought patterns can help influence our feelings and actions. Essentially, CBT helps us rewire our thoughts and the ways we respond to them. In the context of social anxiety and alcohol use, a therapist might help us identify harmful thoughts related to our social anxiety, which triggers us to drink. They would then work with us on changing our thought patterns and developing healthier coping mechanisms. Overall, CBT has proven to be a highly effective approach in helping people manage social anxiety and overcome alcohol misuse. 
  • Motivational Enhancement Therapy: MET is a therapeutic approach aimed at helping us resolve ambivalent feelings, set direct goals for self-improvement, and stay motivated to achieve them. Otherwise referred to as “motivational interviewing,” MET can encourage us to examine the negative consequences of alcohol use and address any resistance to change that might be holding us back. This has been shown to be a particularly powerful technique for treating alcohol misuse since many people feel powerless against addiction and can benefit from increased motivation to take action against it. 

Depending on the severity of our social anxiety and alcohol misuse, we may also benefit from anti-anxiety medication or medications for reducing alcohol cravings. It’s important to consult a medical professional who can help us develop a personalized treatment plan. They can also recommend licensed counselors or therapists who offer cognitive behavioral therapy or motivational enhancement therapy. 

Tips for Managing Social Anxiety

Apart from seeking professional help, we can also develop new habits and coping skills to help us manage our social anxiety. Here are 6 techniques to try: 

1. Challenge negative thinking

Many people with social anxiety feel bad when they misinterpret other people’s comments or facial expressions. For instance, sometimes we assume we know what other people are thinking about us or we assume that others’ behavior is related to us. Often these thoughts are so automatic that we don’t even realize we’re having them. Learning to challenge them can be incredibly helpful. 

The first thing we should do is try to pay attention to automatic negative thoughts that we have before, during, or after social situations. We can then work on challenging them with alternative thoughts. For instance, if our automatic thought was, “She just yawned, she must find me boring,” try asking yourself whether there’s a different explanation. Could it be that she was just tired and that yawn had nothing to do with you? 

2. Start small

It’s easy to get overwhelmed when thinking about making your way through major social events or situations, like weddings or parties. But try to start small, by picking realistic goals and taking baby steps. For instance, if you’re considering joining a club, sit in on a meeting first. If you’d like to volunteer at a local organization, take a friend or family member with you the first time. Try pursuing social opportunities with like-minded individuals, since engaging with people with similar interests makes us less likely to feel anxious. Over time, as you take small steps and survive things that make you nervous, you’ll build the confidence to tackle bigger social situations.

3. Take time to celebrate your wins

It’s important to acknowledge our effort and celebrate our wins, no matter how small. For instance, perhaps you finally inquired about signing up for that cooking class — that’s a win! You might consider rewarding yourself with a special treat, like your frothy coffee drink or a meal at your favorite restaurant. Every time you have a “win,” consider writing it down in a journal so you can track your progress. When you need a little boost, revisit your journal to see how far you’ve come!

Keep in mind, however, that we might not always succeed. Perhaps we wanted to go to a dinner we were invited to, but our anxiety just really flared up beforehand. Don’t beat yourself up! Practice self-compassion and give yourself some grace, recognizing that progress is not always linear. 

4. Cultivate self-esteem 

Cultivating self-esteem can help us manage social anxiety and lead to more positive interactions with others. If we feel confident, we’re less likely to be worried about what someone thinks about us. Try making a list of your strengths, admirable traits, or things you like about yourself. For instance, maybe you’re a really good listener and people come to you for advice. It can also be helpful to keep a journal of accomplishments. For instance, maybe you won an award at work or were among the finishers at a local sporting event. 

Positive affirmations are another great way to cultivate self-esteem. They might feel awkward at first, but the more you practice and stick with them the easier and more natural it becomes. Focus on “I am” statements, such as “I am a strong person” or “I am working hard and making progress.”

5. Practice deep breathing exercises

Social anxiety causes physiological changes. One way to reduce tension and anxiety is by bringing our body back to a relaxed state. When our body is relaxed, our breathing is slow and natural, making it easier to be around others. 

Try focusing on your breathing and slowing it down. We can do this by inhaling through our nose and exhaling through our mouth. Try using your diaphragm rather than your chest. Inhale for 3 seconds and exhale for 3 seconds. As you exhale, imagine the tension and anxiety leaving your body. Do this as often as necessary throughout the day. Over time, it will likely become automatic and help you relax.

6. Don’t avoid social situations!

For people with social anxiety, It can be tempting to avoid social situations. But doing so isn’t doing anything to help lessen our anxiety. Plus, it’s not healthy to isolate ourselves. Gradual exposure to social situations coupled with relaxation techniques can help us reduce our anxiety. 

To overcome avoidance, try making a list of situations that you might avoid. For instance, maybe you’re afraid of being the center of attention. Then, come up with a list of steps you can take to confront this fear. For instance, maybe you can tell a funny story about yourself to a group of people that you know well, like your friends. With practice, you might then make it a goal to tell a funny story about yourself to a group of strangers. We know: this might be uncomfortable at first. But anxiety tends to go away when we start doing things that make us anxious. It can also give us a nice confidence and self-esteem boost.

Just remember: avoiding situations that make us anxious may seem like a solution, but it will only make things more challenging in the long run. 

The Bottom Line

Social anxiety can make life difficult. While consuming alcohol might help calm our nerves in the moment, it will gradually only worsen our symptoms. It can also increase our risk of developing alcohol misuse, causing us to depend on alcohol for any social situation. For people struggling with both social anxiety and alcohol misuse, it’s important to reach out to a healthcare provider who can help treat both conditions simultaneously. We can also practice our own self-help strategies for social anxiety, such as deep breathing exercises and challenging our negative thinking. 

If you want to stop using alcohol to cope with social anxiety, consider trying Reframe. We’re a neuroscience-backed app that has helped millions of people reduce their alcohol consumption and develop healthier coping mechanisms. 

Imagine that you’re about to attend a social event where you won’t know many people. You’ve been nervous about it all week, but now that it’s tonight, your anxiety is building. You pour yourself a glass of wine to help you relax. You gulp it down and experience a sense of relief. But is this really the best way to handle your social anxiety? Is it possible you’re actually making your anxiety worse in the long run? 

In this post, we’ll explore the relationship between social anxiety and alcohol misuse. We’ll also offer self-help tips for managing social anxiety. Let’s get started!

What Is Social Anxiety? 

Contrary to popular belief, social anxiety is more than just being shy: it’s an intense, persistent fear of being watched, judged, or rejected by others in social situations. 

People with social anxiety often have anxiety or fear in social situations, such as meeting new people, performing in front of people, taking or making phone calls, answering a question in front of people, asking for help in a public place, or participating in an interview. 

Symptoms range from mild to severe and vary in intensity from person to person. They also vary by situation. For instance, someone with social anxiety might be afraid when they get into a social situation with people they don’t know, such as at a spouse’s company holiday party or a friend’s bridal shower. Others might get anxious simply thinking about an upcoming social gathering — otherwise known as anticipatory anxiety. For instance, if we receive a wedding invite in the mail, we might start to get anxious in anticipation of it. 

Some of the more common physical and physiological symptoms of social anxiety include blushing, sweating, shaking or feeling our heart race in social situations. People with social anxiety tend to be very self-conscious, embarrassed, or awkward in front of others. They might feel like their mind goes blank when talking to people.

Overall, social anxiety is a relatively common condition, with 12% of adults in the U.S. experiencing it at some point in their lives — mathematically speaking, in a group of 25 people, 3 people have struggled with social anxiety! In fact, it’s the third most common mental health condition behind substance use disorder and depression. If this is something you experience, just know that you’re not alone. 

How Alcohol Affects Social Anxiety 

Living with social anxiety can be debilitating, and it’s not uncommon for people with the condition to turn to alcohol for relief. This makes sense given that alcohol is a depressant with sedative effects, helping calm our central nervous system. As a result, it can help “take the edge off” and provide a temporary respite from anxiety. 

The problem, however, is that alcohol can actually worsen our anxiety in the long run. How so? It all comes down to how alcohol interacts with neurotransmitters — important chemicals — in our brain. We often don’t realize it, but our brain depends on a delicate balance of chemicals to keep us functioning well. As a toxin, alcohol does significant damage and disrupts this balance.

Here’s how it works: whenever we consume alcohol, our brain is flooded with neurotransmitters such as dopamine and serotonin — both of which make us feel good. Alcohol also temporarily increases levels of neuromodulators gamma-aminobutyric acid (GABA), glycine, and adenosine, decreasing anxiety. 

However, once the temporary effects of alcohol wear off, production of all these neurotransmitters is impaired. As a result, we’re often left feeling more anxious. This also explains why we might experience a crash or “down in the dumps” feeling after a night of drinking. Even moderate amounts of alcohol can lead to an increase in anxiety, irritability, or depression a few hours later or the next day. 

The Relationship Between Social Anxiety and Alcohol

While alcohol might feel like a solution to our social anxiety, it can quickly lead to problems. After all, the relationship between social anxiety and alcohol is a bit like the chicken and egg: anxiety can lead us to drink for temporary relief, but drinking can make us anxious. This can create a vicious cycle that can spiral into physical and mental dependence on alcohol.

In fact, social anxiety and alcohol misuse often go hand-in-hand. Research shows that a person with an anxiety disorder is three times more likely to develop an alcohol use disorder compared to someone who has never been diagnosed with anxiety. 

Furthermore, one study estimates that about 1 in 5 people with social anxiety disorder (SAD) also struggle with alcohol abuse or dependence. Many more fall into gray area drinking and would like to drink less than they do on social occasions. 

In a nutshell, drinking to cope with social anxiety can quickly become a harmful habit. If we’re continually using alcohol to feel more relaxed or at ease in social situations, we might eventually avoid any social situation where we wouldn’t be able to drink. Furthermore, depending on the degree of our social anxiety, we might feel the need to have a drink before a social event — in addition to consuming alcohol during it. 

Some people with social anxiety may drink excessive amounts because they strongly associate alcohol with relief. Over time, long-term alcohol use often leads to increased tolerance, in which we need to consume more alcohol to get the desired effect. For example, we might have started feeling more relaxed after just one glass of wine. As time goes on, however, we might find ourselves needing two, three, or more glasses to get the same relief. 

Treating Social Anxiety and Alcohol Misuse 

Given the close connection between social anxiety and alcohol misuse, it’s perhaps not surprising that treating one condition typically requires adequately addressing the other. 

Research suggests that a combination of cognitive-behavioral therapy (CBT) and motivational enhancement therapy (MET) may successfully treat co-occurring social anxiety disorder and alcohol misuse. Let’s take a closer look at these therapies: 

  • Cognitive Behavioral Therapy: CBT is a goal-oriented therapy that focuses on our thoughts, feelings, and behaviors. The core belief of CBT is that identifying and adjusting harmful thought patterns can help influence our feelings and actions. Essentially, CBT helps us rewire our thoughts and the ways we respond to them. In the context of social anxiety and alcohol use, a therapist might help us identify harmful thoughts related to our social anxiety, which triggers us to drink. They would then work with us on changing our thought patterns and developing healthier coping mechanisms. Overall, CBT has proven to be a highly effective approach in helping people manage social anxiety and overcome alcohol misuse. 
  • Motivational Enhancement Therapy: MET is a therapeutic approach aimed at helping us resolve ambivalent feelings, set direct goals for self-improvement, and stay motivated to achieve them. Otherwise referred to as “motivational interviewing,” MET can encourage us to examine the negative consequences of alcohol use and address any resistance to change that might be holding us back. This has been shown to be a particularly powerful technique for treating alcohol misuse since many people feel powerless against addiction and can benefit from increased motivation to take action against it. 

Depending on the severity of our social anxiety and alcohol misuse, we may also benefit from anti-anxiety medication or medications for reducing alcohol cravings. It’s important to consult a medical professional who can help us develop a personalized treatment plan. They can also recommend licensed counselors or therapists who offer cognitive behavioral therapy or motivational enhancement therapy. 

Tips for Managing Social Anxiety

Apart from seeking professional help, we can also develop new habits and coping skills to help us manage our social anxiety. Here are 6 techniques to try: 

1. Challenge negative thinking

Many people with social anxiety feel bad when they misinterpret other people’s comments or facial expressions. For instance, sometimes we assume we know what other people are thinking about us or we assume that others’ behavior is related to us. Often these thoughts are so automatic that we don’t even realize we’re having them. Learning to challenge them can be incredibly helpful. 

The first thing we should do is try to pay attention to automatic negative thoughts that we have before, during, or after social situations. We can then work on challenging them with alternative thoughts. For instance, if our automatic thought was, “She just yawned, she must find me boring,” try asking yourself whether there’s a different explanation. Could it be that she was just tired and that yawn had nothing to do with you? 

2. Start small

It’s easy to get overwhelmed when thinking about making your way through major social events or situations, like weddings or parties. But try to start small, by picking realistic goals and taking baby steps. For instance, if you’re considering joining a club, sit in on a meeting first. If you’d like to volunteer at a local organization, take a friend or family member with you the first time. Try pursuing social opportunities with like-minded individuals, since engaging with people with similar interests makes us less likely to feel anxious. Over time, as you take small steps and survive things that make you nervous, you’ll build the confidence to tackle bigger social situations.

3. Take time to celebrate your wins

It’s important to acknowledge our effort and celebrate our wins, no matter how small. For instance, perhaps you finally inquired about signing up for that cooking class — that’s a win! You might consider rewarding yourself with a special treat, like your frothy coffee drink or a meal at your favorite restaurant. Every time you have a “win,” consider writing it down in a journal so you can track your progress. When you need a little boost, revisit your journal to see how far you’ve come!

Keep in mind, however, that we might not always succeed. Perhaps we wanted to go to a dinner we were invited to, but our anxiety just really flared up beforehand. Don’t beat yourself up! Practice self-compassion and give yourself some grace, recognizing that progress is not always linear. 

4. Cultivate self-esteem 

Cultivating self-esteem can help us manage social anxiety and lead to more positive interactions with others. If we feel confident, we’re less likely to be worried about what someone thinks about us. Try making a list of your strengths, admirable traits, or things you like about yourself. For instance, maybe you’re a really good listener and people come to you for advice. It can also be helpful to keep a journal of accomplishments. For instance, maybe you won an award at work or were among the finishers at a local sporting event. 

Positive affirmations are another great way to cultivate self-esteem. They might feel awkward at first, but the more you practice and stick with them the easier and more natural it becomes. Focus on “I am” statements, such as “I am a strong person” or “I am working hard and making progress.”

5. Practice deep breathing exercises

Social anxiety causes physiological changes. One way to reduce tension and anxiety is by bringing our body back to a relaxed state. When our body is relaxed, our breathing is slow and natural, making it easier to be around others. 

Try focusing on your breathing and slowing it down. We can do this by inhaling through our nose and exhaling through our mouth. Try using your diaphragm rather than your chest. Inhale for 3 seconds and exhale for 3 seconds. As you exhale, imagine the tension and anxiety leaving your body. Do this as often as necessary throughout the day. Over time, it will likely become automatic and help you relax.

6. Don’t avoid social situations!

For people with social anxiety, It can be tempting to avoid social situations. But doing so isn’t doing anything to help lessen our anxiety. Plus, it’s not healthy to isolate ourselves. Gradual exposure to social situations coupled with relaxation techniques can help us reduce our anxiety. 

To overcome avoidance, try making a list of situations that you might avoid. For instance, maybe you’re afraid of being the center of attention. Then, come up with a list of steps you can take to confront this fear. For instance, maybe you can tell a funny story about yourself to a group of people that you know well, like your friends. With practice, you might then make it a goal to tell a funny story about yourself to a group of strangers. We know: this might be uncomfortable at first. But anxiety tends to go away when we start doing things that make us anxious. It can also give us a nice confidence and self-esteem boost.

Just remember: avoiding situations that make us anxious may seem like a solution, but it will only make things more challenging in the long run. 

The Bottom Line

Social anxiety can make life difficult. While consuming alcohol might help calm our nerves in the moment, it will gradually only worsen our symptoms. It can also increase our risk of developing alcohol misuse, causing us to depend on alcohol for any social situation. For people struggling with both social anxiety and alcohol misuse, it’s important to reach out to a healthcare provider who can help treat both conditions simultaneously. We can also practice our own self-help strategies for social anxiety, such as deep breathing exercises and challenging our negative thinking. 

If you want to stop using alcohol to cope with social anxiety, consider trying Reframe. We’re a neuroscience-backed app that has helped millions of people reduce their alcohol consumption and develop healthier coping mechanisms. 

Summary FAQs

1. What is social anxiety? 

Social anxiety is an intense, persistent fear of being watched and judged by others in social situations, including meeting new people, making phone calls, answering questions in front of people, or asking for help in a public place. 

2. How does alcohol affect social anxiety?

Although alcohol can temporarily calm our nerves in the moment, mixing anxiety and alcohol can actually worsen symptoms in the long run and create a vicious cycle.

3. What is the relationship between social anxiety and alcohol misuse? 

Social anxiety and alcohol misuse often go hand-in-hand. Research suggests that about 1 in 5 people with social anxiety disorder (SAD) also struggle with alcohol abuse or dependence.

4. How is social anxiety and alcohol misuse treated? 

Given that social anxiety and alcohol misuse often co-occur, it’s important to treat both conditions simultaneously. A combination of medication and therapy are often effective. 

5. What are some tips for managing social anxiety? 

We can help manage our social anxiety by challenging negative thinking, practicing breathing exercises, and slowly confronting our social fears through practice. 

Reduce Your Anxiety and Drinking With Reframe

Although it isn’t a treatment for alcohol use disorder (AUD), the Reframe app can help you cut back on drinking gradually, with the science-backed knowledge to empower you 100% of the way. Our proven program has helped millions of people around the world drink less and live more. And we want to help you get there, too!

The Reframe app equips you with the knowledge and skills you need to not only survive drinking less, but to thrive while you navigate the journey. Our daily research-backed readings teach you the neuroscience of alcohol, and our in-app Toolkit provides the resources and activities you need to navigate each challenge.

You’ll meet millions of fellow Reframers in our 24/7 Forum chat and daily Zoom check-in meetings. Receive encouragement from people worldwide who know exactly what you’re going through! You’ll also have the opportunity to connect with our licensed Reframe coaches for more personalized guidance.

Plus, we’re always introducing new features to optimize your in-app experience. We recently launched our in-app chatbot, Melody, powered by the world’s most powerful AI technology. Melody is here to help as you adjust to a life with less (or no) alcohol.

And that’s not all! Every month, we launch fun challenges, like Dry/Damp January, Mental Health May, and Outdoorsy June. You won’t want to miss out on the chance to participate alongside fellow Reframers (or solo if that’s more your thing!).

The Reframe app is free for 7 days, so you don’t have anything to lose by trying it. Are you ready to feel empowered and discover life beyond alcohol? Then download our app through the App Store or Google Play today!

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