Hard News by Russell Brown

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Hard News: Cannabis reform is a serious matter – so be serious about it

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  • Dennis Frank,

    "Otago University health researchers warn cannabis risks are being downplayed in talk about changing the law but, in a New Zealand Medical Journal editorial, do support decriminalising recreational use by adults."

    "Friday's editorial in the NZMJ urging caution in how the law is changed was written by Research Associate Professor Joseph Boden, from the university's Department of Psychological Medicine, and by Emeritus Professor David Fergusson, who died in October." https://www.stuff.co.nz/national/health/109979248/nzmj-editorial-urges-caution-in-changing-cannabis-laws-warns-risks-being-downplayed

    I note that Joe has briefly commented above. I also note that he looks suspiciously similar to Frank Zappa in the early seventies! Anyway, good to see that he's willing to participate in the commentariat discussion of the issues.

    The public have moved on beyond decriminalisation. The recent poll had 60% for legalisation. So why be so cautious? Here's the rationale:

    "The Christchurch study involved 1265 people born in 1977 and studied to the age of 35. More than 75 per cent reported using cannabis, with about 15 per cent developing a pattern of heavy use and dependence at some point."

    "Data showed cannabis use was associated with educational delay, welfare dependence, increased risks of psychotic symptoms, major depression, increased risks of motor vehicle accidents, increased risks of tobacco use, increased risks of other illicit drug use, and respiratory impairment."

    The risks listed here are valid concerns, and do correspond with my lifetime experience (a half-century of mediating between users & non-users, with personal usage for some periods within that). But those vulnerable to such consequences are only a small portion of the whole - 60% of the users studied didn't become victims of the habit. Eliminating the civil rights of all to protect a small bunch of users is ethically untenable. It's analogous to removing the right to drive cars because speeding drivers keep killing people.

    New Zealand • Since Jun 2016 • 273 posts Report Reply

  • BenWilson, in reply to Dennis Frank,

    Eliminating the civil rights of all to protect a small bunch of users is ethically untenable. It’s analogous to removing the right to drive cars because speeding drivers keep killing people.

    That’s the grossest level framework that applies to this, although I tend to think the right to drive has a nuance in it. We rate the right to drive highly not just because of some arbitrary philosophical stance about the sanctity of rights balanced against harms, but also by a simple evaluation of the incredible utility of cars.

    I doubt our right to drive would justify all the death resulting from it if cars were only toys we played around with, rather than extraordinarily useful devices that have become integral to the life of any dwellers in cities with significant suburbs (you could further argue that the significant suburbs arose from the existence of all those cars, but at this point it’s not that relevant – we now have them and the people in them want to be able to use them in a way that fits their chosen lifestyles), let alone for rural people and anyone engaged in any kind of goods production or the provision of mobile services.

    I table this point for at least the 20th time – the harm reduction framework has never made more than partial sense to me because it ignores that the enjoyment people might get from recreational drugs is a good in itself. If that is not acknowledged then harm reduction leads to prohibition being taken seriously and all the arguments against it focussing on the harm of prohibition, the negative side effects of people being taken to task by law enforcement, and the engagement with criminal elements that are required for any would-be users, and the chances of being accidentally (or deliberately poisoned). It treats as irrelevant or even ridiculous the main reason that people take these drugs – that they want to, because they enjoyed doing it, and all the focus is on how to minimize the use of something inherently harmful, short of prohibition.

    To me that’s only half of the reason for legalization. In general I usually agree with the points raised on harm reduction, and I can see the cunningness of it as an incremental approach (it leverages off people who rate caution higher than fun, typically on behalf of the children), whilst still thinking that the nuances of harm reduction are NOT the source of a general public majority for legalization, they are political window dressing to the enormous number of people who have simply smoked cannabis at some time and had a good time who see THAT as an important reason why it should be legalized, too.

    Auckland • Since Nov 2006 • 10596 posts Report Reply

  • Russell Brown, in reply to Ross Bell,

    Boden FINAL.pdf

    There’s an editorial in the NZ Medical Journal today, and it’s not very good. So some questions for the researcher who wrote it (who also comments on Public Address):

    In this very thread!

    We’re talking about Joe Boden’s cannabis editorial for the New Zealand Medical Association Journal – which is being widely reported today – and at first glance I think there’s a problem there: the key research he quotes (Hasin) has very little to say about the impact of *legalisation* in the US.

    The trends the editorial observes, some of which should be of concern, aren’t attributed to recreational cannabis legalisation. Some are attributed to permissive medicinal cannabis laws, or took place under decriminalisation. And yet Joe *recommends* decriminalisation as a safer step.

    On the other hand, youth use is either stable or falling in *all legalised states*. It could be that half-pie measures like decriminalisation actually aren’t as effective as comprehensive regulation. Joe needs to demonstrate that’s not the case if he’s to recommend decriminalisation.

    So, in short, I think there are some significant unexamined assumptions in the editorial. It’s saying something intuitively appealing – decriminalisation is safer than legalisation and regulation – that may not actually be true.

    There’s also an assumption that legalisation in NZ would look like legalisation in the US. That’s not necessarily the case. Joe could have looked at the impact of, say, the cannabis social clubs of Europe. They legalise and regulate the production and sale of cannabis. Or even what Canada is doing. His assumption that legalisation means big business retail isn’t well-founded either – I can’t think of anyone in New Zealand who wants that, apart from Karl du Fresne, and he’s an unserious fool.

    It’s important to note that the editorial does propose decriminalising small-scale social supply, which is welcome, but its solution doesn’t regulate production at all. It may be easier to prevent supply to under 18 year-olds if you don’t leave production and supply to the criminal market.

    Anyway, I do genuinely appreciate that Joe has engaged here over time and is thus part of the PA community, and I’d be delighted if he wanted to discuss these criticisms.

    I also hope that no one minds too much that I’ve uploaded a PDF of the editorial at the top of this comment :-)

    Auckland • Since Nov 2006 • 22688 posts Report Reply

  • Alfie, in reply to Russell Brown,

    I also hope that no one minds too much that I’ve uploaded a PDF of the editorial at the top of this comment

    Quite the opposite, Russell. I went to the NZMA site yesterday and was disappointed to find the controversial editorial, which was being widely discussed in the media, was locked behind a subscriber-only firewall. Thanks for sharing.

    Dunedin • Since May 2014 • 1346 posts Report Reply

  • Joe Boden,

    Yeah, sorry about the paywall. I can't even read it without the library providing a password. Let me try to provide some clarity. First, Ross Bell's comments.

    "Where, in the last few years, have we heard drug law reform advocates arguing that we need to legalise cannabis because it's safe?"

    Certainly not in serious circles (including the NZDF), but in talking to a wide range of people about the issue there is still a gap in knowledge about the risks associated with cannabis, as well as a tendency to downplay those risks.

    With the half-measure of decriminalisation, are you really happy that the supply of cannabis remains in the criminal black market? If not, you editorial doesn't address the supply issue.

    You're right, it doesn't. What did appear in the editorial was a suggestion that if the "half-measure" of decriminalization showed no adverse effects (which I expect it will show), the next step would be legalization.

    You do realise that New Zealand could design a model of cannabis regulation very different from the more commercial models in some US states, and that we can learn from NZ's own mistakes on alcohol regulation?

    I'm a realist. I think the chances of _designing_ a properly-regulated model for commercial cannabis are great. For example, the NZDF plan, and the plan articulated by Chris Wilkins are both comprehensive and well-thought out.

    Having said that, I believe the chances of _implementing_ such a plan are very small indeed. We've already seen in California for example that the costs of compliance are so high that only large commercial interests will be able to afford to join in. That's how you end up with regulatory capture, and I'm not sure how to avoid this. The issue is, if we don't get it right the first time, then we will have a great deal of difficulty "walking it back" (the history of attempted alcohol reform in New Zealand is a great example of this).

    If we were able to set up a strictly regulated system, I agree that legalization would be preferable. The history of cannabis legalization thus far would suggest that this is difficult to achieve.

    On to Russell...

    We’re talking about Joe Boden’s cannabis editorial for the New Zealand Medical Association Journal – which is being widely reported today – and at first glance I think there’s a problem there: the key research he quotes (Hasin) has very little to say about the impact of *legalisation* in the US.

    The trends the editorial observes, some of which should be of concern, aren’t attributed to recreational cannabis legalisation. Some are attributed to permissive medicinal cannabis laws, or took place under decriminalisation. And yet Joe *recommends* decriminalisation as a safer step.

    Because the law changes are very recent, the data are quite sparse, but well-summarized by Hasin. But you are correct when you mention permissive medical cannabis laws. Most medical cannabis in the US is the same product that is provided for recreational use in places where that is legal.

    An important factor in recommending decriminalization were the findings in Portugal, where drug use went down across all but one age group following decriminalization. Again, as noted in my response to Ross, this is intended as a temporary measure until we can confirm that we have not increased cannabis-related harm (as a public health researcher, I tend to tread cautiously until I have data). I anticipate no real increase in harm following decriminalization, but that's an empirical question.

    It's also worth noting that some of the data from the US are difficult to interpret. For example, Colorado has shown increases in rates of driving under the influence of cannabis. However, the state also increased their drug testing capability from five mobile units to fifty, so that "uptick" is likely to be a result of increased interdiction.

    On the other hand, youth use is either stable or falling in *all legalised states*. It could be that half-pie measures like decriminalisation actually aren’t as effective as comprehensive regulation. Joe needs to demonstrate that’s not the case if he’s to recommend decriminalisation.

    Again, please see my point above about this being a cautious, stepwise approach. It's interesting to note that youth substance use rates are falling all over the world (well, in places where we can measure it). Not only that, but reported rates of early onset sexual activity are also down. This is a welcome change, but it may have little to do with kids making smarter choices.

    https://www.latrobe.edu.au/nest/generation-dry-why-young-people-are-drinking-less/

    There’s also an assumption that legalisation in NZ would look like legalisation in the US. That’s not necessarily the case. Joe could have looked at the impact of, say, the cannabis social clubs of Europe. They legalise and regulate the production and sale of cannabis. Or even what Canada is doing. His assumption that legalisation means big business retail isn’t well-founded either – I can’t think of anyone in New Zealand who wants that, apart from Karl du Fresne, and he’s an unserious fool.

    Agreed on du Fresne.

    As I noted above, I think we already have some great plans outlined that, if implemented, would provide a very-well regulated legal cannabis market that would in all likelihood reduce the overall level of cannabis-related harm. Our history of attempting to regulate alcohol does not give me a great deal of hope that those plans can be implemented. I would love to be proven wrong on this score.

    It’s important to note that the editorial does propose decriminalising small-scale social supply, which is welcome, but its solution doesn’t regulate production at all. It may be easier to prevent supply to under 18 year-olds if you don’t leave production and supply to the criminal market.

    Agreed, but again what we are proposing is intended to be more cautious. The counterfactual in this argument is a situation in which we have legalized cannabis, but have ended up with the regulatory capture we see with alcohol, with attendant increases in cannabis-related harm. It would be nigh on impossible to walk that back.

    I'd like to conclude by saying that I think we are all pulling in the same direction. We all want to reduce substance-related harm, but our approach is more incremental. I'd be happy to support a well-regulated legalization scheme, if we could achieve it, because I believe it would deliver the best results. I'm just skeptical that we will achieve it.

    Christchurch • Since Nov 2006 • 67 posts Report Reply

  • Joe Boden, in reply to BenWilson,

    I table this point for at least the 20th time – the harm reduction framework has never made more than partial sense to me because it ignores that the enjoyment people might get from recreational drugs is a good in itself. If that is not acknowledged then harm reduction leads to prohibition being taken seriously and all the arguments against it focussing on the harm of prohibition, the negative side effects of people being taken to task by law enforcement, and the engagement with criminal elements that are required for any would-be users, and the chances of being accidentally (or deliberately poisoned). It treats as irrelevant or even ridiculous the main reason that people take these drugs – that they want to, because they enjoyed doing it, and all the focus is on how to minimize the use of something inherently harmful, short of prohibition.

    One of the most influential things I've ever read was a book I found when I was just starting in graduate school over 25 years ago:

    https://www.goodreads.com/book/show/922207.Intoxication

    Siegel's argument is that humans have a drive to alter their mental states, and find this to be pleasing. Of course, there is a bit of "Thanks Captain Obvious!" about the argument, but it articulated clearly for me the psychological "good" provided by substance use. That's why harm reduction makes perfect sense to me.

    To me that’s only half of the reason for legalization. In general I usually agree with the points raised on harm reduction, and I can see the cunningness of it as an incremental approach (it leverages off people who rate caution higher than fun, typically on behalf of the children), whilst still thinking that the nuances of harm reduction are NOT the source of a general public majority for legalization, they are political window dressing to the enormous number of people who have simply smoked cannabis at some time and had a good time who see THAT as an important reason why it should be legalized, too.

    I think it's quite possible that decriminalization would be more palatable to people in certain demographics (thinking of NZF voters here) than legalization. If decriminalization results in no increase in harm, these individuals may be easier to persuade.

    A further feature in all of this is the disconcerting level of fact-resistance among some MPs. I had a "debate" at Waikato with two MPs, one National, one Labour, and the National MP refused to accept any data and evidence suggesting that the sky would indeed not fall in if we changed the laws concerning cannabis.

    Christchurch • Since Nov 2006 • 67 posts Report Reply

  • Simon Armstrong,

    Thank you Joe, your logic is much appreciated.

    I was thinking the term half-pie was intended as a slur similar to the term half-baked but your defense of decriminalization as an incremental step makes a lot of sense to me.

    New Zealand • Since Jan 2015 • 18 posts Report Reply

  • andin, in reply to Joe Boden,

    refused to accept any data and evidence

    This just blows the concept that there are two equal and opposing views in this debate to smithereens Yet these comfortably well off commentators on their media pulpits will continue to have printed their scaremongering, moralizing, fact free screeds.
    All that happens is they end up sounding like their parents, the shell shocked post war generation who created a society their children the "hippie" generation didnt want any part of when young, but ended up sucked into it because it was so prevalent. And now we have to reject it all over again, because to keep it going will cause "the sky to fall", But that is another topic.
    And we will have to endure more pointless debates, and the anti squad will benefit from more airtime, spewing their nonsense. I just hope because the opposing view is so utterly stupid, the pro campaign doesnt fracture along some imaginary line and render themselves ineffectual.
    Ben touched on the enjoyment aspect, and thats a curly one cause it intersects that boundary between the personal good vs societal safety. In a society that is becoming ever more invasive in order to protect itself, individual benefit will suffer, when it should be being protected. And society needs some boundaries erected around it to stop encroachment into personal space.
    And more research is needed into benefits, the downsides are well known if exaggerated .Such research was stopped 40 years ago as the postwar generation turned their children into criminals, and the work of people like Shulgin and McKenna was driven underground. Rick Strassman managed a research project on DMT used in ayahuasca ceremonies. The only study I know of. But there are some clever people out there like Dr Gabor Mate

    raglan • Since Mar 2007 • 1763 posts Report Reply

  • Ross Bell,

    Thanks for your responses Joe.

    Wellington, NZ • Since Nov 2006 • 167 posts Report Reply

  • Joe Boden,

    I almost forgot to reply to Dennis, sorry about that!

    I note that Joe has briefly commented above. I also note that he looks suspiciously similar to Frank Zappa in the early seventies! Anyway, good to see that he's willing to participate in the commentariat discussion of the issues.

    If only I was that good looking! :)

    The public have moved on beyond decriminalisation. The recent poll had 60% for legalisation. So why be so cautious? Here's the rationale:

    "The Christchurch study involved 1265 people born in 1977 and studied to the age of 35. More than 75 per cent reported using cannabis, with about 15 per cent developing a pattern of heavy use and dependence at some point."

    "Data showed cannabis use was associated with educational delay, welfare dependence, increased risks of psychotic symptoms, major depression, increased risks of motor vehicle accidents, increased risks of tobacco use, increased risks of other illicit drug use, and respiratory impairment."

    The risks listed here are valid concerns, and do correspond with my lifetime experience (a half-century of mediating between users & non-users, with personal usage for some periods within that). But those vulnerable to such consequences are only a small portion of the whole - 60% of the users studied didn't become victims of the habit. Eliminating the civil rights of all to protect a small bunch of users is ethically untenable. It's analogous to removing the right to drive cars because speeding drivers keep killing people.

    I couldn't agree more. In fact, we noted in another publication that a full 50% of regular users at age 35 reported none of the problems that we had found to be associated with cannabis use in earlier studies, suggesting that for most at that age, cannabis use is pretty much harmless. The incremental approach we are suggesting will, in time, restore those civil rights.

    Christchurch • Since Nov 2006 • 67 posts Report Reply

  • BenWilson, in reply to Joe Boden,

    I’d be happy to support a well-regulated legalization scheme, if we could achieve it, because I believe it would deliver the best results. I’m just skeptical that we will achieve it.

    I'm skeptical but I think it's what we should aim for.

    If we do end up getting a referendum, the support of the various political parties do not vote as blocs. NZ First voters will vote on their own recognizance, as will National Party members. It doesn't matter that Simon Bridges is a prohibitionist, there is no way the country has the high levels of support for legalization that it does without a lot of that support coming from National voters. This is hardly surprising - I know a lot of National party voters who smoke bud. They probably don't admit it freely, being illegal and the kind of thing that could end up being a workplace bludgeon, but it's simply a widely appreciated thing in NZ, and this is obscured by the mantle prohibition draws over truth.

    Auckland • Since Nov 2006 • 10596 posts Report Reply

  • simon g,

    National's position on this is not smart politics. The usual response on such issues is to say "conscience vote" and let different MPs appeal to different constituencies. So on, for example, marriage equality, the MPs (like Bridges) who opposed it did not taint the whole party. The nods and winks said "We're conservative enough" to their base, while Key and co could legitimately say they voted for it, even spoke eloquently for it.

    Giving Paula Bennett a new job title, announcing it at a press conference today ... they're basically declaring that they want the party to be seen as obstructionist. And all the National MPs who differ from their leaders will be forced to waffle and backtrack. Nuances like "conscience vote" won't cut through into public perception. Even if they are allowed one.

    Backing a losing horse, and requiring the whole team to back it too - that won't end well.

    Auckland • Since Nov 2006 • 1283 posts Report Reply

  • Joe Boden, in reply to simon g,

    National's position on this is not smart politics. The usual response on such issues is to say "conscience vote" and let different MPs appeal to different constituencies. So on, for example, marriage equality, the MPs (like Bridges) who opposed it did not taint the whole party. The nods and winks said "We're conservative enough" to their base, while Key and co could legitimately say they voted for it, even spoke eloquently for it.

    Giving Paula Bennett a new job title, announcing it at a press conference today ... they're basically declaring that they want the party to be seen as obstructionist. And all the National MPs who differ from their leaders will be forced to waffle and backtrack. Nuances like "conscience vote" won't cut through into public perception. Even if they are allowed one.

    Backing a losing horse, and requiring the whole team to back it too - that won't end well.

    I've just read the Stuff article; it's really nonsensical. Between this and my own experience with a fact-resistant National MP, I'm starting to wonder whether they are being subsidized to sing from the same hymn sheet.

    Christchurch • Since Nov 2006 • 67 posts Report Reply

  • BenWilson, in reply to simon g,

    National’s position on this is not smart politics.

    It definitely is not. I don't think it matters much. Their leadership is a sideshow to their bloc popularity - even their own supporters don't take Bridges seriously.

    Auckland • Since Nov 2006 • 10596 posts Report Reply

  • simon g,

    I'm honestly baffled by it. Sure, I understand why politicians on the constant treadmill say and do dumb things; for eleven months of the year they barely have time to think. But when you have a long summer break, time to refresh and reflect, and after all that you then make a deliberate decision to start the political year with a press conference and announcement on ... this? They might as well shout "Jacinda eats dolphins". You could come up with dozens of better issues for National in five minutes.

    Where's the motivation coming from? What strategic genius has prompted this? Just ... baffled.

    Auckland • Since Nov 2006 • 1283 posts Report Reply

  • Joe Wylie, in reply to simon g,

    Where's the motivation coming from? What strategic genius has prompted this? Just ... baffled.

    They were both ripped as a pair of chooks?

    flat earth • Since Jan 2007 • 4590 posts Report Reply

  • Neil,

    I’m for legalisation and harm reduction but one area of harm the government seems to be overlooking is the illicit use of marijuana and other drugs in acute mental health units.

    This already causes a great deal of harm. The naive and unscrupulous often traffic drugs into mental health units causing mental and physical harm through relapse of psychotic symptoms and physical aggression.

    Peoples’ recovery is set back, many people suffer physical injury from violence and some become vulnerable to the financial and sexual predation of others.

    If drugs are more widely available then the likelyhood is that this will just get worse.

    The government needs to recognise this as an issue and resource mental health units to deal with it. Should there be increased security? Should there be special authorisation of medications such as paramedics have now when dealing with aggressive people?

    Sadly some people with psychosis and mood disorders react very badly to drugs such as marijuana and meth. If the government wants to do away with seclusion and restraint then resourcing mental health units to stop illicit drug use must be a priority. Otherwise the harm reduction in the community won’t carry through to mental health units.

    Since Nov 2016 • 304 posts Report Reply

  • andin, in reply to Neil,

    psychotic symptoms and physical aggression.

    Meth will do that to you, thats why it was used by troops during recent wars.

    Marijuana can amplify paranoia, if you are that why inclined dont use it.
    Tho it does take some self knowledge to know if you are that way inclined.
    And it doesnt aid conversation probably where the caricature of the mumbling stoner comes from.

    raglan • Since Mar 2007 • 1763 posts Report Reply

  • Neil, in reply to andin,

    Marijuana can amplify paranoia, if you are that why inclined dont use it.

    If someone is already mentally unwell then they may lack the insight and judgement to make the best choice. And there will be the parasites pushing drugs at them for money.

    I haven’t seen the government address this as yet.

    There could be new penalties re supply to the vulnerable and perhaps automatic discharge and prosecution for anyone in an inpatient unit providing drugs to others.

    Since Nov 2016 • 304 posts Report Reply

  • andin, in reply to Neil,

    pushing drugs at them for money.

    If a person has an addiction they will usually seek it out themselves, and they will go to criminals if that is the only place to get it.
    Pot dealers generally arent pushers, someone selling meth often is. But I dont know every drug dealer in the country so that is a generalization on my part.
    Tho IMO corporations can turn into pushers as easily as a person.

    raglan • Since Mar 2007 • 1763 posts Report Reply

  • steven crawford, in reply to Neil,

    Attachment

    If someone is already mentally unwell then they may lack the insight and judgement to make the best choice.

    Thats why cannabis needs to be marketed thru privet enterprise, obviously.

    Wellington • Since Nov 2006 • 4082 posts Report Reply

  • andin, in reply to steven crawford,

    raglan • Since Mar 2007 • 1763 posts Report Reply

  • Neil, in reply to andin,

    If a person has an addiction they will usually seek it out themselves, and they will go to criminals if that is the only place to get it.

    I was thinking more specifically of people in acute mental health inpatient settings. People bringing drugs onto those units is a very real problem. Drugs are being supplied to the vulnerable causing mental and physical harm. It also soaks up staff resources that could be better spent on therapeutic interventions.

    It’s a form major harm to the most vulnerable which isn’t being addressed in a process that is supposed to prioritise harm reduction.

    Since Nov 2016 • 304 posts Report Reply

  • andin, in reply to Neil,

    People bringing drugs onto those units is a very real problem.

    Thats quite a specific problem. I dont think this legislation is intended to address this kind of thing. Harm reduction is something of a misnomer its very difficult to stop people doing something that is harmful to them, If you put a barrier up people will always find a way around it, especially if there are addiction and mental health issues. Coming back from that is a long difficult road, getting another fix just seems easier,and people being how we are, always prefer the easier route.

    If there are people exploiting another’s situation for their financial benefit, legislation wont stop that, just look at the business world. If they see a profit in it for them they just see anything stopping that as interference and get very shitty about it. Or watch Mike Hoskings latest bleat. He proves yet again that the best fate we can hope for is extinction.

    Ever tried to stop a junkie get their next fix? They will threaten, cajole, lie, cheat, steal anything to get that next fix. Kinda like Donald Trump on an average day.

    raglan • Since Mar 2007 • 1763 posts Report Reply

  • BenWilson, in reply to andin,

    Thats quite a specific problem.

    It sure is. I don't see it bringing a great deal to bear on the question of legalizing cannabis for the general public, that acute mental health units can't currently stop illegal drugs being brought in. Perhaps the solution to that doesn't involve taking away the rights of everyone else who isn't in an acute mental health unit, and instead involves better security in those specific places. Or something that isn't automatically everyone else in the whole country's problem.

    Auckland • Since Nov 2006 • 10596 posts Report Reply

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