From the comfort of your home you can connect with the greater Aftercare community via our private online social network site. As an alumnus of our alcohol recovery program, you can also participate in our refresher weekend getaways. As part of the Smart Recovery community we run an Aftercare program that hosts virtual meetings all across Canada, England, the USA and Australia.
Certain opioid medications such as methadone and more recently buprenorphine (In America, "Subutex" and "Suboxone") are widely used to treat addiction and dependence on other opioids such as heroin, morphine or oxycodone. Methadone and buprenorphine are maintenance therapies intended to reduce cravings for opiates, thereby reducing illegal drug use, and the risks associated with it, such as disease, arrest, incarceration, and death, in line with the philosophy of harm reduction. Both drugs may be used as maintenance medications (taken for an indefinite period of time), or used as detoxification aids.[9] All available studies collected in the 2005 Australian National Evaluation of Pharmacotherapies for Opioid Dependence suggest that maintenance treatment is preferable,[9] with very high rates (79–100%)[9] of relapse within three months of detoxification from LAAM, buprenorphine, and methadone.[9][10]
Challenge and change your thoughts. When experiencing a craving, many people have a tendency to remember only the positive effects of the drug and forget the negative consequences. Therefore, you may find it helpful to remind yourself that you really won’t feel better if you use and that you stand to lose a lot. Sometimes it is helpful to have these consequences listed on a small card that you keep with you. What is Alcohol Withdrawal Like? Alcohol Withdrawal Symptoms Explained
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The gap between men and women affected by alcohol abuse and addiction has closed too. In 2016, an analysis of sixty-eight studies from around the world with a combined sample size of over four million people was carried out. The results showed that in the early 1900s, men were 2.2 times more likely to drink alcohol than women. They were also three times more likely so experience problem alcohol use and 3.6 times more likely to experience harm from their alcohol use. Megan's Battle With Alcohol Addiction | True Stories of Addiction | Detox to Rehab
Some people hold the misconception that patients in drug rehab treatment are forced to stay. However, this is untrue. Patients in rehab centers are free to leave anytime they choose to. One reason for this is that drug rehab can only be truly effective when the patient has a desire to be there and to change his or her addictive habits. That being said, in instances where individuals are compelled to go to rehab—such as via a court order—the rehab process can still be effective, even if they were initially reluctant to go.
Most severe alcohol withdrawal symptoms occur in the first three to four days after stopping drinking. Detoxification involves taking a short course of medication to help reduce or prevent withdrawal symptoms. Medications such as Valium (diazepam), Librium (chlordiazepoxide), or Ativan (lorazepam), members of the benzodiazepine family, are usually used for detox.

Medicaid is utilized all throughout the United States and helps provide basic health coverage to those in need. It is a program that has been changed over the years, and each state modifies and changes its enrollment requirements, but people who fall into the different categories can receive Medicaid coverage. Having basic health coverage does certainly help increase the well-being of an individual, and for many Americans, Medicaid does help and provides the basic services needed.
Marijuana has become one of the most widely used — and abused — drugs in the United States. The Journal of the American Medical Association notes that while the prevalence of marijuana use in the US hasn’t changed much since the 1990s, the prevalence of cannabis abuse and addiction has greatly increased. The 2012 Monitoring the Future survey, which tracks drug use among American teens, showed that marijuana use has increased among high school students in recent years, while disapproval of cannabis among teens has declined. At one time, marijuana was not considered to be addictive, but recent studies have shown that this drug can cause symptoms of dependence and addiction, including cravings, insomnia, anxiety, depression, and agitation. 12 Steps of Recovery
We are active in supporting research into improving the lives of those struggling with addiction. Searidge Foundation and our sister rehab Sobriety Home located in Godmanchester, Quebec are highly regarded as the leading alcohol and drug rehab facilities in Canada. We support Florida State University (FSU) in their research into addiction and anxiety disorder. We are also involved with Dr. Brunet, of McGill University, and his leading scientific research on PTSD and addiction memory. Everything you think you know about addiction is wrong | Johann Hari
Gateway Foundation is a national provider that has 17 convenient drug treatment centers in Illinois, Delaware and California to serve our patients in the places and communities they call home. We put our patients at the center of their substance abuse treatment—life-saving treatment that stays with them throughout their lives. Through individualized treatment, we’re able to help them discover what will work best for them in their journey to overcome drug and alcohol addiction. Brene Brown Knows! Toxic Shame & Trauma in Addiction Treatment w/ Gerald Loren Fishkin

Commitment and follow-through are key. Recovering from alcohol addiction or heavy drinking is not a quick and easy process. In general, the longer and more intense the alcohol use, the longer and more intense the treatment you’ll need. But regardless of the treatment program’s length in weeks or months, long-term follow-up care is crucial to your recovery.
Nicole Lee works as a paid consultant in the alcohol and other drug sector. She has previously been awarded grants by state and federal governments, NHMRC and other public funding bodies for alcohol and other drug research. She is a member and past President of the Australian Association for Cognitive and Behaviour Therapy. She is a registered Psychologist who has previously worked in private practice.
The first step toward recovery is admitting that the problem exists. We understand that this is often the most difficult step. If you suffer from alcohol addiction, coming to terms with the fact that alcohol has become a destructive force in your life is tough. Still, we urge you to face up to the reality as soon as possible. The sooner you do, the sooner you can begin your journey to a clean, healthy, and sober life. We encourage you to do it sooner rather than later. Drug Rehab Viola AR - What Happens In Rehab? | Drug Rehabilitation Near Me
In addition, take the time to find out whether the rehab program offers services that encompass a broad spectrum of needs, including psychological, medical, vocational and social. It is also important to find out whether the program employs a variety of strategies, including linkage to aftercare services, to help increase the chances of long-term success.
Drug abuse also plays a role in many major social problems, such as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms unborn babies and destroys families. There are different types of treatment for drug abuse. But the best is to prevent drug abuse in the first place.

UKAT treatment centres view addiction treatment as a way of giving you the best chances of long-term recovery from alcoholism. As such, treatments are individually designed with that goal in mind. Your addiction treatment will meet you where you are. Your treatment plan will be geared toward your unique circumstances, and it will lead you through the recovery journey and on to a healthier, happier life. Addiction Rehabilitation Centers Proven Not To Work - Get Real Help For Addiction


Addiction is a complex but treatable condition. It is characterized by compulsive drug craving, seeking, and use that persists even if the user is aware of severe adverse consequences. For some people, addiction becomes chronic, with periodic relapses even after long periods of abstinence. As a chronic, relapsing disease, addiction may require continued treatments to increase the intervals between relapses and diminish their intensity. While some with substance issues recover and lead fulfilling lives, others require ongoing additional support. The ultimate goal of addiction treatment is to enable an individual to manage their substance misuse; for some this may mean abstinence. Immediate goals are often to reduce substance abuse, improve the patient's ability to function, and minimize the medical and social complications of substance abuse and their addiction; this is called "harm reduction". Drug Rehab Near Me
The length of time an addict will remain as an inpatient in rehab will vary from individual to individual, and different facilities will offer programs of different durations. A typical stay will last around a month, although some shorter-term programs – one or two weeks – are available, in many addicts choose to stay longer than a month if they feel their recovery will be helped by an extended stay.
There are several differences between inpatient and outpatient care. Inpatient care is a more intense level of care than outpatient care, which is often a step down from inpatient care. Unlike inpatient care, outpatient treatment does not require clients to stay overnight. Clients can come to the facility regularly (daily, weekly, etc.) for a set number of hours a week, and go home after their session. This allows them to maintain their work schedule and tend to any other off-site responsibilities. Care is less intensive than the inpatient level, as clients typically no longer require round-the-clock care. Alcohol Rehab Florida
Insurance: Many types of insurance cover the cost of addiction treatment and rehab; in particular, the Affordable Care Act requires that insurance policies issued under the state health exchanges and through Medicaid programs under the ACA expansion must provide coverage for addiction treatment. It’s important to note that insurance coverage often still requires that the individual provide a co-insurance payment, and some require a deductible be paid before treatment will be free. Specific plans may have different coverage levels, so it’s a good idea to check the specific policy or talk to the insurance provider.
Outpatient treatment is the most flexible level of care. Recovery services are provided in a day center, clinic, rehab facility, or other location, while the patient lives at home. Outpatient clients can participate in counseling, therapy, 12-step programming, and other recovery services without giving up their self-determination. This level of care is recommended for patients who have completed an inpatient program, or for medically stable individuals who have a high level of motivation to reach sobriety.
A longitudinal study of drug-dependent individuals who participated in a six-month aftercare program showed that participants were less likely to relapse into drug or alcohol use. This study, published in Addictive Behaviors, indicates that the support, information, and coping strategies gained from aftercare play a big part in the success of a recovery program.
This is an ongoing debate in the medical community, but it is generally agreed that there is no one cause for the development of addiction. According to the National Institute on Drug Abuse, contributing factors may include a genetic predisposition to develop addictive tendencies, an environment that is permissive of drug abuse, access to illicit substances, and certain developmental issues. The existence of a Dual Diagnosis is one of the biggest risk factors for the development of addiction. My Story - Jackie's Incredible Journey with Opioid Addiction (Full Story)
Set in the heart of Essex, the facility is close to London and very accessible from the rest of the UK and wider world. Trust your loved ones with us – we will change their lives. The clinic was founded and is operated by people in long-term recovery, and our treatments, facilities and ethos make it the best possible drug & alcohol rehab for you or your loved ones. Drug Rehab Nc | You Won't Believe | Drug Rehabilitation Centers Near Me

For many people struggling with addiction, the toughest step toward recovery is the very first one: recognizing that you have a problem and deciding to make a change. It’s normal to feel uncertain about whether you’re ready to make a change, or if you have what it takes to quit. If you’re addicted to a prescription drug, you may be concerned about how you’re going to find an alternate way to treat a medical condition. It’s okay to feel torn. Committing to sobriety involves changing many things, including:
An influential cognitive-behavioral approach to addiction recovery and therapy has been Alan Marlatt's (1985) Relapse Prevention approach.[40] Marlatt describes four psycho-social processes relevant to the addiction and relapse processes: self-efficacy, outcome expectancy, attributions of causality, and decision-making processes. Self-efficacy refers to one's ability to deal competently and effectively with high-risk, relapse-provoking situations. Outcome expectancy refer to an individual's expectations about the psychoactive effects of an addictive substance. Attributions of causality refer to an individual's pattern of beliefs that relapse to drug use is a result of internal, or rather external, transient causes (e.g., allowing oneself to make exceptions when faced with what are judged to be unusual circumstances). Finally, decision-making processes are implicated in the relapse process as well. Substance use is the result of multiple decisions whose collective effects result in a consumption of the intoxicant. Furthermore, Marlatt stresses some decisions—referred to as apparently irrelevant decisions—may seem inconsequential to relapse, but may actually have downstream implications that place the user in a high-risk situation.[41]
Alcohol is known for lowering inhibitions, but when alcohol is combined with risky activities, such as driving/operating machinery or taking drugs (either prescription or recreational), this may be an indication that alcohol is being taken in at abusive levels. The National Institute on Alcohol Abuse and Alcoholism warns that mixing alcohol with medication can cause internal bleeding and heart problems, as well as cause liver damage and make the medications toxic to the body.
However, other elements – for example the type of therapies available – may lie completely beyond your understanding and experience. With this in mind, it is always advisable to speak with an addiction specialist who will almost certainly be able to think of things which may not occur to you but which could be very important. By leveraging the vast experience of an addiction specialist you can be sure that issues of great importance will not go unaddressed. First 24 Hours in Drug Rehab Treatment - 866-577-6868 - Ambrosia Drug Rehab Treatment Centers

You may be wondering how much rehab costs and is it worth the price? Inpatient treatment is generally more expensive than outpatient treatment. Depending on the severity of your addiction, it may take some time to recover. The more time you spend in alcohol rehab, the more it will cost. Many people transition from detox to inpatient treatment, to continued outpatient treatment, and then to a sober living environment.
  Great experience. Everything I needed. A safe place, calm and tranquil. Very spacious and and comfortable, lots of areas to relax, read or meditate. The groups of men and women with years of sobriety, AA and NA meetings helped me to open my eyes, find myself and spirituality... I'm back! Ready to truly live and enjoy life. Thank you to everyone at the center and groups. Thank to my sponsor. I'm so grateful.
Before entering a rehab facility, patients may have to undergo detox treatment. Detox is the process in which a patient rids his or her body of the addictive substance. From start to finish, this process varies in length, but often takes about a week. As part of a medical detox program, recovering patients will be monitored by doctors and nurses and given medications to manage withdrawal, when appropriate. Once a patient completes detox, he or she is ready for rehab. 

As important as evidence-based psychotherapy is for our addiction treatment program, it can’t be the only activity at Searidge Foundation. We schedule a wide variety of alternative therapies that help reinforce the more clinical drug rehab treatments and keep each day spent with us interesting and rewarding. This program includes Yoga, meditation, mindfulness meditation, acupuncture, Tai Chi, relaxation therapy, creative art therapy and Native healing rituals. These activities help renew the body, the mind, and the soul. And while these practices cannot cure you of a drug addiction, they can empower you with a healthy and entirely individual strength and spirit that will help you cope with life’s daily stresses and anxieties in a helpful constructive manner, rather than self medicating with drugs or alcohol.
Gateway Foundation is a national provider that has 17 convenient drug treatment centers in Illinois, Delaware and California to serve our patients in the places and communities they call home. We put our patients at the center of their substance abuse treatment—life-saving treatment that stays with them throughout their lives. Through individualized treatment, we’re able to help them discover what will work best for them in their journey to overcome drug and alcohol addiction. Brene Brown Knows! Toxic Shame & Trauma in Addiction Treatment w/ Gerald Loren Fishkin
Are you seeking an inpatient rehab center near you? There are hundreds of residential rehabilitation centers (inpatient rehab facilities) all over the country. The Recovery Village has various outpatient and inpatient treatment centers locations throughout the U.S. To find an inpatient facility near you, refer to the following Local Rehab Resources page, which allows you to narrow your search by city and state.
In his influential book, Client-Centered Therapy, in which he presented the client-centered approach to therapeutic change, psychologist Carl Rogers proposed there are three necessary and sufficient conditions for personal change: unconditional positive regard, accurate empathy, and genuineness. Rogers believed the presence of these three items, in the therapeutic relationship, could help an individual overcome any troublesome issue, including but not limited to alcohol abuse. To this end, a 1957 study[36] compared the relative effectiveness of three different psychotherapies in treating alcoholics who had been committed to a state hospital for sixty days: a therapy based on two-factor learning theory, client-centered therapy, and psychoanalytic therapy. Though the authors expected the two-factor theory to be the most effective, it actually proved to be deleterious in the outcome. Surprisingly, client-centered therapy proved most effective. It has been argued, however, these findings may be attributable to the profound difference in therapist outlook between the two-factor and client-centered approaches, rather than to client-centered techniques.[37] The authors note two-factor theory involves stark disapproval of the clients' "irrational behavior" (p. 350); this notably negative outlook could explain the results.
Traditional alcohol treatment programs rely on evidence-based strategies such as psychotherapy, behavioral modification therapy, peer group counseling, nutritional counseling and 12-step programs. Rehabilitation begins with detox, a cleansing process that allows the patient to withdraw safely and comfortably from alcohol. After detox, the patient participates in a structured series of therapies that are designed to help him or her modify destructive behaviors and create a sober life. R3hab & Headhunterz - Won't Stop Rocking (Official Music Video)
More good news is that drug use and addiction are preventable. Results from NIDA-funded research have shown that prevention programs involving families, schools, communities, and the media are effective for preventing or reducing drug use and addiction. Although personal events and cultural factors affect drug use trends, when young people view drug use as harmful, they tend to decrease their drug taking. Therefore, education and outreach are key in helping people understand the possible risks of drug use. Teachers, parents, and health care providers have crucial roles in educating young people and preventing drug use and addiction.
Drug abuse statistics can be alarming, but the numbers also show a potential for help and healing. The Substance Abuse and MEntal Health Services Administration’s (SAMHSA) National Survey on Substance Abuse and Health states that while 21 million Americans aged 12 and over needed drug or alcohol treatment in 2016, only 3.8 million received the help they needed at a specialized treatment facility. Other research sources on drug addiction show that: Drug Rehab Near Me

According to NIDA, genetic factors are responsible for 40 to 60 percent of a person’s vulnerability to drug addiction. Studies show that a person’s predisposition to drug addiction positively correlates to their degree of genetic similarity to a relative who has a history of drug dependence or addiction. Mental disorders and medical conditions are also risk factors.
Inpatient drug rehab can help anyone who has successfully completed medical detox, but still needs round-the-clock care for substance abuse and any potential co-occurring disorders. Perhaps your addiction went on for years before you sought treatment. Or perhaps you were dependent on a particular substance for months and you are struggling with cravings. Ultimately, anyone who wants a greater chance at success and a reduced risk of relapse can benefit from inpatient drug rehab. However, it’s important to keep in mind that inpatient rehab centers require a full-time commitment.
At Hazelden Betty Ford, inpatient treatment for substance abuse begins with our clinicians getting a good understanding of your specific situation. Our treatment team will evaluate your medical health, mental health and chemical use history in order to design an individualized drug and alcohol rehab plan for you. With your permission, our rehab staff may also talk with your family members and other professionals you might already be working with to address your needs and challenges.
Our priority is to offer individual support and attention to residents in a welcoming and comfortable environment in which they are not overwhelmed by a large crowd of people. This allows residents to engage with therapy more easily and get to know us and each other better. In a larger centre, a group therapy session can mean 25 or 30 people listening to a speaker, which essentially makes you a member of an audience. At Searidge a group session is much more of an interactive discussion. This enables residents to better express themselves and have their concerns and opinions be heard. A more open and deeper engagement with group therapy results.
1. First, assessment – Upon entering alcohol rehabilitation, medical staff will screen you to assess your personal situation and create a program that is unique to you. This will likely include a physical exam, a urinalysis drug test, a psychological screening and an assessment of personal circumstances. The aim here is to understand the extent of alcohol abuse and to create a program that will allow you to succeed.
At Michael’s House, we offer a holistic alcohol rehab experience designed to meet the individual needs of each patient on a personal level. An alcohol rehab center should be a place for healing, healthier living, and emotional and therapeutic support. The treatment programs that have enjoyed the most success in helping their patients heal after alcohol addiction are those that contain a variety of evidence-based strategies to enrich the mind, body and soul of the individual.1

Drugs affect the way a person thinks, feels, behaves and how they look. But substance use disorders are often accompanied by co-occuring mental health disorders like anxiety or depression. Some people may use drugs as a form of self-medication for these issues, while other people may develop a mental health disorder after taking substances. Either way, it’s important to look out for psychological and behavioral changes in friends or loved ones who might be struggling with addiction:
Group therapy tends to involve a licensed professional and multiple patients. Although group therapy sessions can occur at inpatient facilities, they are more likely to happen in the other rehabilitation programs. Group therapy sessions can last up to an hour. These sessions tend to be particularly useful because they help confront one of the primary issues of addiction.
Upon exiting treatment, a patient may be prescribed a drug like disulfiram, which prevents the body from chemically processing alcohol, causing an unpleasant reaction if the patient relapses or attempts to relapse. Because of disulfiram’s toxicity, it has to be taken under the supervision of a doctor, as unregulated usage can cause strong, even fatal reactions. Powerful Talk on Overcoming Addiction
In the 2014 National Survey on Drug Use and Health (NSDUH), 20.2 million American adults reported a past-year substance use disorder, and out of this group 7.9 million (39.1 percent) also suffered from a co-occurring mental health disorder. The range of co-occurring disorders known to coincide with drug addiction is broad and includes virtually every type of mental illness recognized by the American Psychiatric Association.
Some people hold the misconception that patients in drug rehab treatment are forced to stay. However, this is untrue. Patients in rehab centers are free to leave anytime they choose to. One reason for this is that drug rehab can only be truly effective when the patient has a desire to be there and to change his or her addictive habits. That being said, in instances where individuals are compelled to go to rehab—such as via a court order—the rehab process can still be effective, even if they were initially reluctant to go.
This kind of treatment is known as Cognitive Behavioral Therapy (CBT), because it introduces the patient to new and healthier ways of thinking (“cognitive”) and acting (“behavioral”). The National Institute on Alcohol Abuse and Alcoholism says that the success of alcohol treatment depends on “changing a person’s behaviors and expectations about alcohol.”

Residential Treatment Centers are available for all patients—men, women or adolescents. With 24/7 support, patients can fully immerse in the recovery process with few distractions for the best outcomes. Length of stay varies based on individual need. After graduating from one of our therapeutic communities, treatment continues at an Outpatient facility best suited to each patient.


As for programme length, residential rehab usually lasts between four and twelve weeks. Many experts believe that shorter programmes do not give patients enough time to recover while longer programmes run the risk of institutionalising patients and making them fearful of returning home. The one exception for longer stays is dual diagnosis. People recovering from a dual diagnosis circumstance may require longer stays.

In 2001, David Sinclair, Ph.D., a researcher in Finland claimed an 80 percent cure rate for alcohol dependence when anti-alcohol drugs Revia or Vivitrol are prescribed according to his Sinclair Method. Dr. Sinclair's research has been published in the peer-reviewed journals Alcohol and Alcoholism and the Journal of Clinical Psychopharmacology. The Sinclair Method is the standard treatment protocol for alcohol dependence in Finland, the method is also used in the U.K., but the method has yet to catch on in the United States. 
It is important to recognise that without expert support, your alcohol addiction has the potential to become increasingly worse over time, resulting in a detrimental impact on all areas of your life including your ability to function, your relationships with others, your performance at work, and your general health and wellbeing. Untreated alcohol addiction may also lead to the development of drug addictions and other behavioural addictions. This why seeking expert help is crucial in order to overcome your alcohol addiction and resume the healthy, fulfilling, addiction-free life that you deserve. Best Drug Rehabilitation Programs Backed By Research. Find Out Why.
Once a person is addicted to alcohol, to stop it may take hospitalizations, rehabilitations, and re-rehabilitations all of which hemorrhage expenses — not to mention destroy relationships and property. The estimated cost to the system of this specialized addiction care is $24.6 billion. Since addiction is a disease that rewires the brain, the individual is unlikely to quit through “willpower” alone, and it often takes something dramatic (or “hitting rock bottom”) before they will make changes. There are costs associated with these dramatic scenarios. In the case of car accidents caused by driving drunk, costs include not just hospitalization, but the cost to insurance companies, car owners, municipal employees responding to the accident, and a continued chain reaction of costs that could ultimately include vehicular homicides and funeral expenses.
Finding a drug rehab facility that has all of these features may seem difficult, but here at Axis, we provide everything on the list above and more. Our goal is to offer your loved one everything he or she needs to break free from drug and alcohol dependence and to go home with a plan that will help to continue to grow in recovery and remain true to his or her principles of sobriety. Starting with an evaluation and diagnostic process at intake, we create a treatment plan designed just for your loved one, complete with an intensive therapeutic schedule that comes with cutting-edge treatment options as well as traditional care and support.
The length of a rehab program can vary greatly, and largely depends on the needs of each individual. For some, a weekly outpatient program may suffice, while others may participate in inpatient care that lasts on average 30–40 days. You may ask yourself, “How does rehab work?” Like many things in life, long-term recovery is usually achieved with time and dedication. For some, this may include long-term inpatient drug rehab that involves staying on-site for an extended period of time. This can help some clients better regulate their recovery needs for sustained sobriety. These types of programs may also include sober living housing, which provides patients with a stable place to live while transitioning back into normal life.
We also have a heated swimming pool so you can enjoy the outdoors and the benefits of aqua fitness that extends the summer months. Our activities will also organise crafting workshops, computer skills training, and much more so you can get back or reignite that creative spark that was put on hold all during drug addiction. The grounds of Searidge Drug Rehab feature a large outside space full of green pastures and a stone’s throw of the ocean that will help you enjoy nature’s beauty that is conducive to rest, relaxation and recovery. SASH! vs Olly James - Ecuador (Official Music Video)

This kind of treatment is known as Cognitive Behavioral Therapy (CBT), because it introduces the patient to new and healthier ways of thinking (“cognitive”) and acting (“behavioral”). The National Institute on Alcohol Abuse and Alcoholism says that the success of alcohol treatment depends on “changing a person’s behaviors and expectations about alcohol.” Mom Left Job and Fell Into Alcoholism
One of the brain areas still maturing during adolescence is the prefrontal cortex—the part of the brain that allows people to assess situations, make sound decisions, and keep emotions and desires under control. The fact that this critical part of a teen's brain is still a work in progress puts them at increased risk for making poor decisions, such as trying drugs or continuing to take them. Introducing drugs during this period of development may cause brain changes that have profound and long-lasting consequences. Transformations Drug & Alcohol Treatment Centers
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