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Alcohol and Health

Why Does Drinking Too Much Alcohol Make You Shake?

Published:
October 30, 2023
·
18 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.
October 30, 2023
·
18 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.
October 30, 2023
·
18 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.
October 30, 2023
·
18 min read
Reframe App LogoReframe App Logo
Reframe Content Team
October 30, 2023
·
18 min read

What's the first symptom you think of when it comes to overindulgence in alcohol? For many, the dreaded hangover might be the immediate response. But have you ever noticed a slight tremble in your hand after a night of one too many drinks? The "alcohol shakes" — sometimes flippantly referred to as the "booze jitters" — aren't just an expression: they're a genuine physiological response rooted in the relationship between alcohol and our central nervous system. 

Let’s dig deeper and learn more about what’s behind this frustrating symptom and what we can do to prevent it!

The Central Nervous System and Alcohol

The central nervous system (CNS), consisting of our brain and spinal cord, is the main hub of activity in our bodies in charge of orchestrating our movements and regulating our emotions. Ingesting alcohol leads to a cascade of reactions that manifest as the familiar symptoms of intoxication. The CNS is the primary area affected:

  • Alcohol is a depressant. As a CNS depressant, alcohol slows brain function and neural activity. When we drink, our inhibitions lower, our reaction times slow down, our judgment becomes impaired, and we might feel relaxed. These effects occur because alcohol interferes with the brain's communication pathways.
  • The CNS adapts over time. When we drink regularly and in large amounts, the CNS sees the addition of alcohol as the new normal and starts to adapt. To keep things running smoothly, the CNS tweaks its activity (more on that later on), leading to increased tolerance. The result? Over time, we need more booze to achieve the same effects.
  • The rebound effect. Now, here's where things get messy. If we develop a dependence on alcohol and suddenly stop drinking, our CNS is still in the "hyperactive" mode. Without alcohol’s depressant effects to balance out the adjustment, we end up with withdrawal symptoms, including tremors, anxiety, and seizures. This phenomenon is referred to as the "rebound effect."
  • Neurotransmitters in the mix. The CNS communicates through chemicals called neurotransmitters, and alcohol affects their balance . For example, it can increase the effects of GABA, a neurotransmitter that slows down brain activity, leading to sedation. On the other hand, it decreases the effects of glutamate, an excitatory neurotransmitter. The imbalance contributes to the CNS's altered state during alcohol consumption and withdrawal.
  • The brain's reward system. Beyond just slowing things down, alcohol also taps into the brain's reward system. Dopamine, a neurotransmitter associated with pleasure and reward, surges when we drink, causing that familiar brief euphoria after a few sips. Consistent activation of this reward pathway can lead to increased cravings and a drive to consume more, contributing to the cycle of dependence.
The Tremor Timeline

As we can now see, tremors are the result of the brain’s adaptive response that ensures that the system maintains its functions despite the consistent presence of alcohol. When the alcohol is suddenly reduced or removed, the CNS finds itself in a state of hyperactivity, which takes some time to re-tune. Here’s a general timeline of alcohol-induced shakes:

  • Initial alcohol consumption (within hours of drinking). Alcohol depresses the central nervous system (CNS). The more alcohol consumed, the more suppressed the CNS becomes.
  • Early withdrawal (6-12 hours after last drink). As blood alcohol levels decrease, the CNS goes into overdrive, leading to initial symptoms such as hand tremors, anxiety, and sweating. The shakes can range from mild hand tremors to more generalized, severe shaking. 
  • Peak withdrawal symptoms (24-72 hours post-drinking). Tremors peak during this period, especially if we’ve been drinking heavily and regularly, and they might persist for hours or even days. Other withdrawal symptoms such as seizures, hallucinations, and high blood pressure might emerge.

Delirium Tremens: A Severe Form

While tremors can be a nuisance on their own, in some cases, they can also be a precursor to a more severe withdrawal syndrome called delirium tremens (DTs). DTs is characterized by severe confusion, agitation, fever, hallucinations, and seizures. DTs are considered a medical emergency — so seek medical help! 

Beyond Tremors: The Bigger Picture

While tremors or "the shakes" are undoubtedly one of the more visible manifestations of alcohol withdrawal, they’re just the tip of the iceberg. The body's response to alcohol withdrawal includes a range of physical and psychological symptoms: 

  • Sweating and elevated heart rate. The sudden change in alcohol levels can cause the body as well as the brain to go into overdrive. This hyperactivity can manifest as excessive sweating and an increased heart rate. 
  • Nausea and vomiting. Gastrointestinal disturbances are another common symptom of alcohol withdrawal. Chronic drinking can disrupt normal functioning of the digestive system, and its sudden cessation can result in nausea and vomiting.
  • Anxiety and mood disturbances. On the psychological front, anxiety is a prevalent symptom of alcohol withdrawal. This heightened state of worry and unease can trigger mood swings, irritability, and depression. The brain's chemistry, thrown off by the absence of alcohol, struggles to find its equilibrium, leading to these emotional disturbances.
  • Sleep disruptions. Sleep disturbances, including insomnia and nightmares, are common complaints during alcohol withdrawal. Alcohol affects the sleep-wake cycle, and abruptly quitting can lead to difficulties in both falling and staying asleep.
  • Hallucinations. In more severe cases, people undergoing alcohol withdrawal might experience hallucinations. These can be auditory, visual, or tactile, and they usually occur within the first 48 hours of the last drink.
  • Seizures. One of the more severe and concerning symptoms of alcohol withdrawal is the risk of seizures. These typically occur within the first 24 hours to 48 hours of the last drink. They can be life-threatening, especially if not treated promptly — so please get medical attention if someone you know is experiencing this!
  • Cognitive impairments. Memory problems, difficulty concentrating, and confusion are cognitive symptoms associated with alcohol withdrawal. The brain, trying to adapt without the alcohol it’s become accustomed to, struggles to keep up. 
  • Delirium Tremens. As previously mentioned, delirium tremens (DTs) is a severe form of alcohol withdrawal that combines many of these symptoms. It's characterized by profound confusion, hallucinations, high blood pressure, fever, and heavy sweating. DTs is a medical emergency and requires immediate attention.
Diagram about body’s responses to alcohol withdrawal

Stopping Alcohol-Related Tremors: A Guide to Safe and Effective Strategies

While alcohol-related tremors can be distressing, for many of us, they can be a wake-up call to address our relationship with booze. However, it's crucial to proceed carefully! Let's explore some methods to effectively manage and halt the shakes.

  • Medical supervision. The most critical recommendation is always to seek medical advice before making any drastic changes to alcohol consumption habits. Abruptly stopping alcohol after prolonged and heavy use can be dangerous! A healthcare professional can assess the situation and guide us through a detoxification process, providing necessary medical interventions.
  • Gradual reduction. While the ultimate goal for some might be to quit entirely, for many, a gradual reduction in alcohol consumption is safer than going cold turkey. This unhurried approach helps to minimize severe withdrawal symptoms and allows the body to adjust more comfortably to decreasing alcohol levels.
  • Medications. FDA-approved medications can help alleviate the symptoms of alcohol withdrawal, including tremors. Some common ones include benzodiazepines, which help reduce the risk of seizures and ease other withdrawal symptoms. Others, such as anticonvulsants and beta-blockers, can also be prescribed based on individual needs.
  • Hydration. Alcohol can be dehydrating, and many people experiencing withdrawal symptoms — including tremors — might be dehydrated. Drinking enough water can speed recovery.
  • Correcting vitamin deficiencies.  Chronic alcohol consumption can lead to deficiencies in vital vitamins and minerals, notably thiamine (vitamin B1), folic acid, vitamin B6, and magnesium. These deficiencies can contribute to withdrawal symptoms, including tremors, so vitamin-rich foods — such as peas, nuts, bananas, and oranges — can help.
  • Balanced meals. A diet with balanced meals rich in lean proteins, whole grains, and plenty of fruits and vegetables can provide the body with the nutrients it needs for recovery. Nutrient-rich foods help stabilize blood sugar levels and reduce the severity of tremors. Omega-3 fatty acids, found in foods like fish, flaxseed, and walnuts, support brain health. Incorporating these into the diet can bolster cognitive functions during the recovery process.
  • Sugar intake. Reducing sugar intake is crucial! While we might get cravings for sweets post-alcohol (sugar can mimic the dopamine release alcohol provides), excessive sweets lead to blood sugar spikes and crashes, intensifying tremors.
  • Supplementation. In some cases, doctors might recommend supplements to address nutritional deficiencies caused by prolonged alcohol use. Always consult with a healthcare professional before starting any new supplements.
  • Emotional support. Emotional and psychological support during this period can be invaluable. Consider joining community-based groups (or online communities such as Reframe!) where people share their experiences and coping mechanisms for motivation and comfort.
  • Cognitive behavioral therapy (CBT). CBT can work wonders for those wanting to change their drinking habits. This form of therapy helps people recognize patterns and triggers, and it provides strategies to cope and make lasting changes.
  • Stay active. Engaging in regular physical activity can help reduce tremors and other withdrawal symptoms. Exercise releases endorphins — natural mood elevators — and can also act as a distraction from cravings and discomfort.

Alternative Therapies for Stopping the Shakes 

While more research is needed, some people find relief from tremors through alternative therapies such as acupuncture, meditation, or yoga. These methods can also provide stress relief, which can be beneficial during the withdrawal process. Let’s take a closer look:

  • Acupuncture. Acupuncture, an ancient Chinese medicinal practice, involves inserting thin needles into specific points on the body. While the exact mechanisms remain under study, some believe acupuncture can help regulate neurotransmitter levels and stabilize the nervous system, potentially offering relief from tremors.
  • Herbal remedies. Certain herbs, like passionflower or valerian root, have been historically used to soothe nervous system disturbances. They might provide a calming effect, potentially reducing the severity of tremors. However, always consult with a healthcare professional before incorporating any herbs into your regimen, as they can interact with other medications or conditions.
  • Mindfulness and meditation. Regular meditation practices can help manage stress and anxiety, common triggers for tremors during alcohol withdrawal. Mindfulness exercises can teach people to remain present, recognize their body's signals, and respond to tremors with a calm mindset.
  • Yoga and tai chi. Both yoga and tai chi emphasize controlled movements, breathing, and mindfulness. These practices promote physical strength, balance, and relaxation, potentially offering relief from tremors.
  • Biofeedback. Biofeedback makes us aware of specific physiological functions (like muscle activity) with the help of instruments that provide information on their activity. With biofeedback, we can learn to control or change physiological responses, potentially managing tremors more effectively.
  • Aromatherapy. Certain essential oils, like lavender or chamomile, have calming properties. While more research is needed, aromatherapy creates a soothing environment, which may help in the overall management of withdrawal symptoms, including shakes.
  • Massage therapy. Massage can promote relaxation, improve circulation, and reduce muscle tension. For some, regular massage sessions during withdrawal can provide comfort and temporarily reduce tremors.

Shaking Up Our Habits

"The shakes" might be a pop-culture symbol of heavy drinking, but they’re rooted in our body's actual response to alcohol. While they can be alarming, they’re manageable with the right strategies and support. Always prioritize safety, seek professional guidance, and lean on supportive networks along the way.

Recognizing and understanding why alcohol-related shakes happen can also be the first step towards making healthier choices. Remember, every person’s journey is unique. Whether you're exploring ways to cut back or quit altogether, there's a path for you! 

What's the first symptom you think of when it comes to overindulgence in alcohol? For many, the dreaded hangover might be the immediate response. But have you ever noticed a slight tremble in your hand after a night of one too many drinks? The "alcohol shakes" — sometimes flippantly referred to as the "booze jitters" — aren't just an expression: they're a genuine physiological response rooted in the relationship between alcohol and our central nervous system. 

Let’s dig deeper and learn more about what’s behind this frustrating symptom and what we can do to prevent it!

The Central Nervous System and Alcohol

The central nervous system (CNS), consisting of our brain and spinal cord, is the main hub of activity in our bodies in charge of orchestrating our movements and regulating our emotions. Ingesting alcohol leads to a cascade of reactions that manifest as the familiar symptoms of intoxication. The CNS is the primary area affected:

  • Alcohol is a depressant. As a CNS depressant, alcohol slows brain function and neural activity. When we drink, our inhibitions lower, our reaction times slow down, our judgment becomes impaired, and we might feel relaxed. These effects occur because alcohol interferes with the brain's communication pathways.
  • The CNS adapts over time. When we drink regularly and in large amounts, the CNS sees the addition of alcohol as the new normal and starts to adapt. To keep things running smoothly, the CNS tweaks its activity (more on that later on), leading to increased tolerance. The result? Over time, we need more booze to achieve the same effects.
  • The rebound effect. Now, here's where things get messy. If we develop a dependence on alcohol and suddenly stop drinking, our CNS is still in the "hyperactive" mode. Without alcohol’s depressant effects to balance out the adjustment, we end up with withdrawal symptoms, including tremors, anxiety, and seizures. This phenomenon is referred to as the "rebound effect."
  • Neurotransmitters in the mix. The CNS communicates through chemicals called neurotransmitters, and alcohol affects their balance . For example, it can increase the effects of GABA, a neurotransmitter that slows down brain activity, leading to sedation. On the other hand, it decreases the effects of glutamate, an excitatory neurotransmitter. The imbalance contributes to the CNS's altered state during alcohol consumption and withdrawal.
  • The brain's reward system. Beyond just slowing things down, alcohol also taps into the brain's reward system. Dopamine, a neurotransmitter associated with pleasure and reward, surges when we drink, causing that familiar brief euphoria after a few sips. Consistent activation of this reward pathway can lead to increased cravings and a drive to consume more, contributing to the cycle of dependence.
The Tremor Timeline

As we can now see, tremors are the result of the brain’s adaptive response that ensures that the system maintains its functions despite the consistent presence of alcohol. When the alcohol is suddenly reduced or removed, the CNS finds itself in a state of hyperactivity, which takes some time to re-tune. Here’s a general timeline of alcohol-induced shakes:

  • Initial alcohol consumption (within hours of drinking). Alcohol depresses the central nervous system (CNS). The more alcohol consumed, the more suppressed the CNS becomes.
  • Early withdrawal (6-12 hours after last drink). As blood alcohol levels decrease, the CNS goes into overdrive, leading to initial symptoms such as hand tremors, anxiety, and sweating. The shakes can range from mild hand tremors to more generalized, severe shaking. 
  • Peak withdrawal symptoms (24-72 hours post-drinking). Tremors peak during this period, especially if we’ve been drinking heavily and regularly, and they might persist for hours or even days. Other withdrawal symptoms such as seizures, hallucinations, and high blood pressure might emerge.

Delirium Tremens: A Severe Form

While tremors can be a nuisance on their own, in some cases, they can also be a precursor to a more severe withdrawal syndrome called delirium tremens (DTs). DTs is characterized by severe confusion, agitation, fever, hallucinations, and seizures. DTs are considered a medical emergency — so seek medical help! 

Beyond Tremors: The Bigger Picture

While tremors or "the shakes" are undoubtedly one of the more visible manifestations of alcohol withdrawal, they’re just the tip of the iceberg. The body's response to alcohol withdrawal includes a range of physical and psychological symptoms: 

  • Sweating and elevated heart rate. The sudden change in alcohol levels can cause the body as well as the brain to go into overdrive. This hyperactivity can manifest as excessive sweating and an increased heart rate. 
  • Nausea and vomiting. Gastrointestinal disturbances are another common symptom of alcohol withdrawal. Chronic drinking can disrupt normal functioning of the digestive system, and its sudden cessation can result in nausea and vomiting.
  • Anxiety and mood disturbances. On the psychological front, anxiety is a prevalent symptom of alcohol withdrawal. This heightened state of worry and unease can trigger mood swings, irritability, and depression. The brain's chemistry, thrown off by the absence of alcohol, struggles to find its equilibrium, leading to these emotional disturbances.
  • Sleep disruptions. Sleep disturbances, including insomnia and nightmares, are common complaints during alcohol withdrawal. Alcohol affects the sleep-wake cycle, and abruptly quitting can lead to difficulties in both falling and staying asleep.
  • Hallucinations. In more severe cases, people undergoing alcohol withdrawal might experience hallucinations. These can be auditory, visual, or tactile, and they usually occur within the first 48 hours of the last drink.
  • Seizures. One of the more severe and concerning symptoms of alcohol withdrawal is the risk of seizures. These typically occur within the first 24 hours to 48 hours of the last drink. They can be life-threatening, especially if not treated promptly — so please get medical attention if someone you know is experiencing this!
  • Cognitive impairments. Memory problems, difficulty concentrating, and confusion are cognitive symptoms associated with alcohol withdrawal. The brain, trying to adapt without the alcohol it’s become accustomed to, struggles to keep up. 
  • Delirium Tremens. As previously mentioned, delirium tremens (DTs) is a severe form of alcohol withdrawal that combines many of these symptoms. It's characterized by profound confusion, hallucinations, high blood pressure, fever, and heavy sweating. DTs is a medical emergency and requires immediate attention.
Diagram about body’s responses to alcohol withdrawal

Stopping Alcohol-Related Tremors: A Guide to Safe and Effective Strategies

While alcohol-related tremors can be distressing, for many of us, they can be a wake-up call to address our relationship with booze. However, it's crucial to proceed carefully! Let's explore some methods to effectively manage and halt the shakes.

  • Medical supervision. The most critical recommendation is always to seek medical advice before making any drastic changes to alcohol consumption habits. Abruptly stopping alcohol after prolonged and heavy use can be dangerous! A healthcare professional can assess the situation and guide us through a detoxification process, providing necessary medical interventions.
  • Gradual reduction. While the ultimate goal for some might be to quit entirely, for many, a gradual reduction in alcohol consumption is safer than going cold turkey. This unhurried approach helps to minimize severe withdrawal symptoms and allows the body to adjust more comfortably to decreasing alcohol levels.
  • Medications. FDA-approved medications can help alleviate the symptoms of alcohol withdrawal, including tremors. Some common ones include benzodiazepines, which help reduce the risk of seizures and ease other withdrawal symptoms. Others, such as anticonvulsants and beta-blockers, can also be prescribed based on individual needs.
  • Hydration. Alcohol can be dehydrating, and many people experiencing withdrawal symptoms — including tremors — might be dehydrated. Drinking enough water can speed recovery.
  • Correcting vitamin deficiencies.  Chronic alcohol consumption can lead to deficiencies in vital vitamins and minerals, notably thiamine (vitamin B1), folic acid, vitamin B6, and magnesium. These deficiencies can contribute to withdrawal symptoms, including tremors, so vitamin-rich foods — such as peas, nuts, bananas, and oranges — can help.
  • Balanced meals. A diet with balanced meals rich in lean proteins, whole grains, and plenty of fruits and vegetables can provide the body with the nutrients it needs for recovery. Nutrient-rich foods help stabilize blood sugar levels and reduce the severity of tremors. Omega-3 fatty acids, found in foods like fish, flaxseed, and walnuts, support brain health. Incorporating these into the diet can bolster cognitive functions during the recovery process.
  • Sugar intake. Reducing sugar intake is crucial! While we might get cravings for sweets post-alcohol (sugar can mimic the dopamine release alcohol provides), excessive sweets lead to blood sugar spikes and crashes, intensifying tremors.
  • Supplementation. In some cases, doctors might recommend supplements to address nutritional deficiencies caused by prolonged alcohol use. Always consult with a healthcare professional before starting any new supplements.
  • Emotional support. Emotional and psychological support during this period can be invaluable. Consider joining community-based groups (or online communities such as Reframe!) where people share their experiences and coping mechanisms for motivation and comfort.
  • Cognitive behavioral therapy (CBT). CBT can work wonders for those wanting to change their drinking habits. This form of therapy helps people recognize patterns and triggers, and it provides strategies to cope and make lasting changes.
  • Stay active. Engaging in regular physical activity can help reduce tremors and other withdrawal symptoms. Exercise releases endorphins — natural mood elevators — and can also act as a distraction from cravings and discomfort.

Alternative Therapies for Stopping the Shakes 

While more research is needed, some people find relief from tremors through alternative therapies such as acupuncture, meditation, or yoga. These methods can also provide stress relief, which can be beneficial during the withdrawal process. Let’s take a closer look:

  • Acupuncture. Acupuncture, an ancient Chinese medicinal practice, involves inserting thin needles into specific points on the body. While the exact mechanisms remain under study, some believe acupuncture can help regulate neurotransmitter levels and stabilize the nervous system, potentially offering relief from tremors.
  • Herbal remedies. Certain herbs, like passionflower or valerian root, have been historically used to soothe nervous system disturbances. They might provide a calming effect, potentially reducing the severity of tremors. However, always consult with a healthcare professional before incorporating any herbs into your regimen, as they can interact with other medications or conditions.
  • Mindfulness and meditation. Regular meditation practices can help manage stress and anxiety, common triggers for tremors during alcohol withdrawal. Mindfulness exercises can teach people to remain present, recognize their body's signals, and respond to tremors with a calm mindset.
  • Yoga and tai chi. Both yoga and tai chi emphasize controlled movements, breathing, and mindfulness. These practices promote physical strength, balance, and relaxation, potentially offering relief from tremors.
  • Biofeedback. Biofeedback makes us aware of specific physiological functions (like muscle activity) with the help of instruments that provide information on their activity. With biofeedback, we can learn to control or change physiological responses, potentially managing tremors more effectively.
  • Aromatherapy. Certain essential oils, like lavender or chamomile, have calming properties. While more research is needed, aromatherapy creates a soothing environment, which may help in the overall management of withdrawal symptoms, including shakes.
  • Massage therapy. Massage can promote relaxation, improve circulation, and reduce muscle tension. For some, regular massage sessions during withdrawal can provide comfort and temporarily reduce tremors.

Shaking Up Our Habits

"The shakes" might be a pop-culture symbol of heavy drinking, but they’re rooted in our body's actual response to alcohol. While they can be alarming, they’re manageable with the right strategies and support. Always prioritize safety, seek professional guidance, and lean on supportive networks along the way.

Recognizing and understanding why alcohol-related shakes happen can also be the first step towards making healthier choices. Remember, every person’s journey is unique. Whether you're exploring ways to cut back or quit altogether, there's a path for you! 

Summary FAQs

1. What causes alcohol-related tremors?

Tremors arise from alcohol's effect on the central nervous system. Regular and heavy alcohol consumption depresses the CNS, and when alcohol levels suddenly drop, the CNS becomes hyperactive, leading to tremors.

2. Are alcohol withdrawal tremors the same as delirium tremens (DTs)?

No. While both are associated with alcohol withdrawal, DTs is a severe condition that combines tremors with confusion, hallucinations, high blood pressure, and heavy sweating. DTs requires immediate medical attention.

3. Beyond tremors, what are other symptoms of alcohol withdrawal?

Other symptoms include sweating, elevated heart rate, nausea, vomiting, anxiety, mood disturbances, sleep disruptions, hallucinations, seizures, and cognitive impairments.

4. How should I safely stop alcohol-related tremors?

Always seek medical advice. Approaches include a medically supervised detoxification, gradual reduction of alcohol intake, medications, staying hydrated, emotional support, cognitive behavioral therapy, staying active, and exploring alternative therapies.

5. Can physical activity help reduce tremors during withdrawal?

Yes. Regular exercise releases endorphins, natural mood elevators, and can act as a distraction from cravings and discomfort.

6. Why is it vital to seek medical supervision when experiencing withdrawal symptoms?

Abruptly stopping alcohol after prolonged use can be dangerous. Medical professionals can guide you through detox safely, providing necessary interventions if severe symptoms arise.

7. Do alternative therapies like acupuncture help with tremors?

Some people find relief from tremors through alternative therapies. While more research is needed, methods like acupuncture, meditation, or yoga can offer stress relief during the withdrawal process.

Ready to Leave Alcohol Behind? Try Reframe!

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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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