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Ambien Withdrawal, Symptoms, Guidelines for Success

This entry was posted in Sedative and tagged on by .
Medically Reviewed Fact Checked

Last Updated on October 16, 2023 by Diane Ridaeus

Alternative to Meds Editorial Team
Medically Reviewed by Dr Michael Loes MD


Ambien withdrawal and Ambien addiction recovery entail more than just getting off the drug … it’s being able to sleep afterward. Ambien side effects can worsen over time so dramatically that physicians are strongly cautioned not to prescribe Ambien© for more than a few weeks, at most.

Drug-based sleep aids like Ambien can create more than just “an addiction.” Finding sleep relief without them is obviously a large concern.

Do Your Symptoms
Require Ambien?

successful ambien withdrawal
Alternative to Meds has been navigating sedative withdrawal for more than 17 years. We have published evidence regarding our success. Some people can eliminate Ambien dependence fairly easily with proper holistic support. The more complicated cases are typically neurotoxic, which can impair a person’s neurology. We specialize in holistic repair and cleaning up that toxic burden so that the neurochemistry can normalize once again, and resolve problems such as insomnia. The success of this approach is far more sustainable without the complicating side effects of drugging the problem.
You probably are already aware of the downward spiral this drug can cause. Drug-induced sleep at night is not really sleep, and the zombie-like depersonalization that often comes with drugs for insomnia is unbearable.
The video here about neurochemistry was designed for a benzodiazepine conversation, but much of the material applies to Ambien as well. Feel free to call us to get hope about your situation.

Ambien Addiction, Dependence, and Abuse Potential

Quite recently, Ambien addiction and abuse have been reported as a growing concern according to a 2021 multiple-case review out of Italy.24

Previously, the “Z” drugs, including zolpidem, were considered to present zero risk for dependence or abuse, but research has now demonstrated this is not the case. Problems associated with Ambien and Ambien withdrawal are best handled in a clinical setting where behavioral disturbances or other erratic withdrawal symptoms can be closely monitored for safety.25

Multiple studies out of France showed that Ambien dependence and abuse potential were higher than previously considered.29,30

Ambien Withdrawal

ambien withdrawal symptomsAmbien is a drug that may require inpatient care for proper recovery and safe tapering.

Ambien (zolpidem) has been shown in clinical studies published in the British Journal of Clinical Pharmacology and elsewhere to be prone to developing issues of dependence, and abuse.12,15,21,29,30

Full monitoring of someone who is experiencing Ambien withdrawal phenomena is highly recommended and may require 24/7 observation. Ambien Withdrawal should be managed carefully and slowly, especially after long-term use.15

Ambien Withdrawal Symptoms can Include:
  • Withdrawal delirium, hallucinations, irrelevant speech, agitated behavior 11,15
  • Seizure 31
  • Nightmares, insomnia 12
  • Anxiety, apprehension, sadness, restlessness, irritability 15
  • Panic attacks, nervousness 16
  • Rebound insomnia* 15,18
  • Dysphoria, uncontrolled crying spells 16
  • Heart palpitations 15
  • Stomach and muscle cramps 16
  • Vomiting/nausea 15,16
  • Shaking, tremors, convulsions 16
  • Fatigue 16
  • Lightheadedness 16
  • Fever, flushing, sweating 16
  • Drug cravings 15,21

*According to sleepadvisor.org,  rebound insomnia occurs when sleep problems worsen when coming off sleeping pills. An important part of recovery after Ambien use is the recovery of quality sleep.

Ambien Withdrawal and Improved Sleep

Clinical studies show that after Ambien withdrawal and from long-term use of insomnia drugs in general, the majority of participants who stopped the drug experienced better sleep quality and less anxiety compared to non-withdrawers at 6 months post-withdrawal follow-up.8

The Elderly and Improved Sleep After the Pandemic

Recent studies out of South Korea showed that of all populations, it was the elderly who suffered most from the onset of sleep problems. Younger persons also suffered a dramatic rise in sleep disruption, but their numbers decreased as the pandemic retreated. However, in the elderly, sleep disruption continued to rise even after the pandemic was over. Ambien withdrawal may improve sleep quality for anyone, regardless of age, who began using medication during such stressful periods.33 

Infants and Ambien Withdrawal

The FDA reported on clinical trials showing that Infants born to mothers taking Ambien may experience postnatal withdrawal symptoms.16

Ambien Drug Class

Ambien (zolpidem) is a powerful non-benzodiazepine hypnotic sedative.6 Though it is not classed as a benzodiazepine, Ambien is thought to share something of a similar mechanism of action that modulates the release of GABA and targets one specific benzodiazepine receptor.13 Withdrawal after prolonged use should not be abrupt according to the bulk of medical research found, including a study published in the Journal of Neuropsychiatry and Clinical Neurosciences.15 The FDA also recommends gradual dose reduction after as little as one or two weeks of use.16 Ambien withdrawal may require milder sedatives to avoid heart palpitations and other possible health complications due to the rebound effects.15 More information on the rebound phenomena associated with Ambien withdrawal recovery can be found below.

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Intolerable Ambien Side Effects

A person may take Ambien as a solution to an inability to sleep. However, in short order, the adverse effects may lead to wanting to discontinue the drug. Ambien and Ambien CR act swiftly on the central nervous system to induce sleep by way of its “knockout” effect that induces unconsciousness. Some of the reactions to the drug can result in sleep disturbances, physical discomfort, mental distress, and in some instances bizarre and unpredictable reactions. The “knockout” effect diminishes over time, which can result in a prolongation of sleep deprivation and other negative consequences.1,16

Ambien, and many other drugs, cross the placental barrier and should not be used by nursing mothers.5,16

When using Ambien, all other CNS depressants including alcohol, opioids, antianxiety meds, antipsychotics and similar should be avoided due to their cumulative effects, particularly psychomotor impairments and risk of coma or death.3,13

When Ambien dependence has developed, the simultaneous use of other CNS depressants may create a heightened health risk, due to their cumulative effects if these are combined.

Recommended prescription doses have been lowered, due to new findings concerning the intense and sometimes bizarre side effects of Ambien, such as sleep-walking, sleep-driving, etc., especially for women and the elderly. Drugmakers put additional black box warnings on the packaging, concerning the risks associated with taking Ambien.1,2,7,16

Interestingly, if one compares the drug’s adverse effects and Ambien withdrawal symptoms, you will see that a great number of these overlap. 

Some of Ambien’s side effects from the FDA drug label 1,16 and elsewhere as indicated:
  • Suicidal ideation, suicide attempts — note, the FDA recommends prescribing the least amount possible to prevent intentional suicide.
  • Severe anaphylactic reactions, anaphylactic shock, rash, allergy
  • Abnormal thinking and behaviors
  • Next morning impairment, FDA expresses caution for driving or other activities requiring alertness the next day. 7,13,16
  • Rebound Insomnia:  Patients get prescribed Ambien most often as a fast-acting sleep aid. After a short time, however, there is a lessening of the “knockout” effect, where the patient may awaken after an hour or two and be unable to fall back asleep.
  • Vertigo, increased frequency of falls, injuries, and accidents:  Dizziness, a sensation where the room is spinning, a common side effect of Ambien, that can produce an uncomfortable transition to a sleep state. Vertigo can also induce a disturbing waking sensation, which can occur at random times, especially for the extended-release version, which may cause these effects during one’s next workday or while driving or operating machinery.14
  • Ataxia, feeling intoxicated, drugged feeling:  A condition resembling drunkenness caused by a toxic reaction to medications like Ambien, presents as slurred speech, inability to control voluntary muscles, or an inability to walk without stumbling, difficulty holding or controlling objects in the hand, such as eating utensils, unable to control the body (see DATE RAPE information).
  • Tachycardia:  Racing heart even though at rest, also heart palpitations, or increased blood pressure.
  • Urticaria:  Hives, raised itchy welts, and rashes, can impact the airway which can also present as breathing difficulty. If the throat closes the patient must be sent immediately to ER.13
  • Headache
  • Abdominal disturbances:  These are common on Ambien including loss of appetite, diarrhea, flatulence, abdominal pain, nausea, vomiting, constipation, hiccups, acid reflux, and heartburn.
  • Urinary tract infections
  • Dryness of the vaginal walls is a common side effect for women taking Ambien.
  • Flu-like symptoms:  These can include sinusitis, throat infections, sore throat, chest pain, respiratory infection, fever, confusion, tinnitus, and fatigue.
  • Asthenia:  A sudden loss of physical strength or sudden sensation of overall weakness.
  • Amnesia:  Chunks of time may be missing entirely, or memories may be scrambled and partially obscured for a period of time.
  • Drug-Induced sleepwalking, somnambulism:  The phenomenon of combined wakefulness and sleep which presents as sleepwalking, sleep-driving, sleep-shopping, sleep-cooking, and so on, which the person will typically have no recollection of.9
  • Depression or worsened depression 13
  • Anxiety
  • Mood swings
  • Body aches:  Especially of the neck, back, arthralgia (aching joints), and myalgia (aching muscle or groups of muscles).
  • Nightmares
  • Respiratory depression
  • Hepatic impairment

Is Ambien Withdrawal the Same as Opioid Withdrawal?

Opioids and Ambien may share some characteristics, however, Ambien withdrawal differs from coming off an opioid. While some characteristics of Ambien withdrawal may overlap with those of opioids, the mechanism of action of these drugs differ. 

Ambien also shares some similarities with benzodiazepines though these are different classes of drugs. Ambien is classified as a hypnotic, or sedative, sometimes referred to as a non-benzodiazepine receptor modulator, or one of the “Z” drugs, in reference to its generic name, zolpidem.13

What Is Ambien Used For?

Ambien is most frequently used in a therapeutic context for the short-term treatment of insomnia. Sleep deprivation can cause many health problems, including neurocognitive consequences.

Ambien as a Date Rape Drug

Quite apart from the intended medical or therapeutic uses, Ambien has been used in drug-facilitated sexual assault, robberies, and other crimes, because of its fast onset and profound memory-obfuscating characteristics. Ambien is also hard to detect on a blood or urine drug test due to its rapid elimination. A hair sample may yield results for up to 4 weeks or more. The drug easily dissolves in alcohol, making it easy to slip into another’s drink unnoticed. The unsuspecting victim may not remember much, if any of what has happened, making a court conviction against the rapist or other perpetrator much harder to obtain.19,32

Ambien High

Taken in higher than therapeutic doses, the drug can produce euphoric effects that have been described as an Ambien high. Clinical studies have found this phenomenon more often in persons with a prior history of moderate to extensive pleasure-seeking through drug-taking. Another factor related to the potential for complications from abuse is that the effects of Ambien decline over time, which may generate the need for increasing doses to get the same effects, whether in therapeutic use for sleep or to achieve the same intensity of an Ambien high.26

Ambien Withdrawal Due to Dementia Concerns

Research has demonstrated that persons taking Ambien are more likely to develop dementia. A 2016 case study involving over 16,000 elderly persons taking Ambien showed an increased risk for dementia compared to the general population. Another study with nearly 7,000 participants showed long-term use of Ambien was associated with significantly higher rates of Alzheimer’s Disease than non-Ambien users.27,28

Natural Alternatives to Prescription Sleeping Pills After Ambien Withdrawal?

Simply stopping Ambien will not typically fix sleep dysfunction. Lack of sleep is ruinous. Sleep deprivation has been used as a method of torture in prison camps. Drugged sleep is more akin to unconsciousness than “rest,” most notably observed in the Cameron deep sleep programs of the 60s. Nestled between these 2 extremes, many natural and non-addictive sleep aids and strategies can gently improve one’s quality and duration of sleep. Using natural methods instead of prescription drugs is of great benefit after Ambien withdrawal. Examples include:

  • Correct the diet — cut the sugar, refined carbs, junk food, alcohol, and caffeine. Consume adequate proteins, vegetables, and fruits. Include foods high in magnesium and amino acids, and avoid heavy foods close to bedtime.
  • Test for and resolve vitamin/mineral deficiencies.
  • Test for and remove neurotoxin accumulations in the body.
  • Herbal and natural remedies such as a warm glass of milk (amino-rich), supplement the diet with magnesium, melatonin, glycine, GABA, tryptophan (precursor to melatonin and serotonin), and soothing teas such as chamomile, lavender, magnolia, passionflower, lemon balm, and valerian root. These can be used to help reduce discomfort during Ambien withdrawal. 
  • Remove toxins and molds that may be contaminating the work or living space.
  • Opt for toxic-chemical-free products for personal hygiene and cleaning products.
  • Electronics:  Avoid blue light, WiFi, TV and computer screens, and other electronics, before retiring.
  • Chiropractors advise upgrading your pillows and mattress. Opt for pillowcases and sheets made from soft, natural fibers that wick moisture away. In colder temperatures, choose a high thread count (400+) and a lower thread count (200) for hotter seasons to keep the body comfortable.
  • Upgrade the bedroom:  black-out curtains in the sleeping area, blue-light blockers, wear a comfortable sleep mask for eyes, white noise, soothing sounds, comfortable earplugs for noise reduction, and open a window or 2 for ventilation.
  • Take care of your gut. Add fermented foods (sauerkraut, kimchi, yogurt) to the daily diet. Supplement as needed with probiotics.
  • Breathing and relaxation exercises before retiring.
  • Set and keep a regular sleep schedule as best you can, aiming for 7-8 hours a night.

Ambien Alternative Names and Slang

Ambien®, Edluar®, Intermezzo®, Stilnox® and Zolpimist® are some of the trade names for the generic drug zolpidem tartrate. Ambien CR and zolpidem ER are the time-release versions of this medication. Ambien is sometimes referred to as a “Z” drug, along with other drugs used in the treatment of insomnia including zopiclone, eszopiclone, and zaleplon.20

Ambien withdrawal symptoms are similar to those of other “Z” drugs. 

Ambien FAQs

There is much to learn about a drug that is as unpredictable and powerful as Ambien. Some of the most common questions about Ambien and Ambien withdrawal are covered briefly below. We can provide more information by request on any of these or other important topics.

Are There Safety Concerns with Ambien? How Long Does Ambien Last?

Do not take Ambien if you are not able to stay at rest for at least seven or eight hours after taking the drug, as the sedating effects will last at least that long, and can sometimes linger beyond that time frame, into the next day. And, there are similar concerns if Ambien withdrawal symptoms occur when the drug is stopped. 

In addition to the potential “knock-out” effect, sleepwalking, sleep-driving, and other manifestations of somnambulism that may occur after taking Ambien also pose a serious safety concern.9

Ambien has a very short half-life of only one to two hours. The active ingredient in Ambien, zolpidem, will reach peak blood levels, after an exceptionally short time, approximately thirty minutes. It is strongly recommended to take Ambien only immediately prior to retiring.

Ambien is unlikely to show up on a drug test after a few days. A urine test may read positive if done within one or two days; however, testing done on a hair sample could be a more reliable method. Hair tests have shown a positive reading for 4-8 weeks according to a large research project in France published in the Journal of Forensic Science International in 2005.3.

Is Ambien a Benzodiazepine?

No. Ambien is classified as a non-benzodiazepine hypnotic sedative. Benzodiazepines have a sedating effect. They do share some but not all of the same side effects. Both Ambien and Benzos are associated with a risk for abuse and dependence because of their euphoric and muscle-relaxing effects. Clinical trials published in the British Journal of Clinical Pharmacology showed that baboons demonstrated similar “drug-liking” effects for benzodiazepines and zolpidem.21

Benzodiazepine drugs are also sometimes prescribed for insomnia, but these two types of drugs act on the central nervous system and brain in different ways. There are certain GABA receptors that Ambien acts on such as the alpha-1 subclass, where benzodiazepines act upon subunits of the GABA alpha-1, alpha-2, alpha-3, and other classes. The fine wiring of the brain is a complex matter. Drug testing will show Ambien distinctly different than benzodiazepines, cannabis, or other drugs that are not in the same class.22 We can observe that Ambien and benzodiazepines are similar, but not entirely the same in the effects produced. For instance, both benzodiazepines and Ambien affect sleep, but the benzodiazepine class additionally produces anti-anxiety effects.2

Treatment for Ambien Withdrawal and Recovery at Alternative to Meds Center

ambien withdrawal side effectsOne of the most concerning Ambien withdrawal effects is rebound insomnia. Lack of sleep can become a problematic, repeating loop, especially without proper protocols in place during and after Ambien withdrawal.

However, Alternative to Meds Center offers a holistic, medically monitored model for safe Ambien withdrawal. The program provides a wealth of services to support true recovery. At Alternative to Meds Center, we are committed to safely discontinuing medications. However, equally important is finding and resolving the root of the problems that led to prescribing a sleeping pill in the first place. On our services overview page, you will find much information to offer about the wide variety of treatments given in our retreat-style program for recovering from insomnia, and from the negative effects that were caused or aggravated by dependence on sleeping aids.

You may want to find out more about safe tapering protocols, therapeutic massage therapies, personal counseling in many genres, neurotoxin removal protocols, tailored nutritional guidance, and a host of other therapeutic services offered to our clients, geared toward authentic health recovery.

A healthy vibrant state includes being able to sleep soundly and restfully, which provides adequate energy for one’s successful day-to-day living. Alternative to Meds Center can provide Ambien alternatives and the means to help you overcome the challenges that may have impacted your life negatively. There is hope for a safe recovery, restored health, and optimal living. Alternative to Meds Center offers holistic Ambien withdrawal and recovery so life can be lived well and improved quality of sleep without further dependence on drugs.


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12. Victorri-Vigneau C, Dailly E, Veyrac G, Jolliet P. Evidence of zolpidem abuse and dependence: results of the French Centre for Evaluation and Information on Pharmacodependence (CEIP) network survey. Br J Clin Pharmacol. 2007 Aug;64(2):198-209. doi: 10.1111/j.1365-2125.2007.02861.x. Epub 2007 Feb 23. PMID: 17324242; PMCID: PMC2000636. [cited 2022 Mar 29]

13. Bouchette D, Akhondi H, Quick J. Zolpidem. [Updated 2021 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442008/ [cited 2022 Mar 29]

14. Joester J, Vogler CM, Chang K, Hilmer SN. Hypnosedative use and predictors of successful withdrawal in new patients attending a falls clinic: a retrospective, cohort study. Drugs Aging. 2010 Nov 1;27(11):915-24. doi: 10.2165/11584480-000000000-00000. PMID: 20964465. [cited 2022 Mar 29]

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17. Sharan P, Bharadwaj R, Grover S, Padhy SK, Kumar V, Singh J. Dependence syndrome and intoxication delirium associated with zolpidem. Natl Med J India. 2007 Jul-Aug;20(4):180-1. PMID: 18085123. [cited 2022 Mar 29]

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19. Anilanmert B, Çavuş F, Narin I, Cengiz S, Sertler Ş, Özdemir AA, Açikkol M. Simultaneous analysis method for GHB, ketamine, norketamine, phenobarbital, thiopental, zolpidem, zopiclone and phenytoin in urine, using C18 poroshell column. J Chromatogr B Analyt Technol Biomed Life Sci. 2016 Jun 1;1022:230-241. doi: 10.1016/j.jchromb.2016.03.040. Epub 2016 Apr 9. PMID: 27107852. [cited 2022 Mar 29]

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21. Victorri-Vigneau C, Dailly E, Veyrac G, Jolliet P. Evidence of zolpidem abuse and dependence: results of the French Centre for Evaluation and Information on Pharmacodependence (CEIP) network surveyBr J Clin Pharmacol. 2007;64(2):198-209. doi:10.1111/j.1365-2125.2007.02861.x [cited 2022 Mar 29]

22. Piergies AA, Sainati S, Roth-Schechter B. Lack of cross-reactivity of Ambien (zolpidem) with drugs in standard urine drug screens. Arch Pathol Lab Med. 1997 Apr;121(4):392-4. PMID: 9140309. [cited 2022 Aug 24]

23. Chèze M, Duffort G, Deveaux M, Pépin G. Hair analysis by liquid chromatography-tandem mass spectrometry in toxicological investigation of drug-facilitated crimes: report of 128 cases over the period June 2003-May 2004 in metropolitan Paris. Forensic Sci Int. 2005 Oct 4;153(1):3-10. doi: 10.1016/j.forsciint.2005.04.021. PMID: 15922526. [cited 2022 Aug 24]

24. Orsolini L, Chiappini S, Grandinetti P, Bruschi A, Testa R, Provenzano A, Berardis D, Volpe U. ‘Z-trip’? A Comprehensive Overview and a Case-series of Zolpidem Misuse. Clin Psychopharmacol Neurosci. 2021 May 31;19(2):367-387. doi: 10.9758/cpn.2021.19.2.367. PMID: 33888666; PMCID: PMC8077048. [cited 2022 Aug 24]

25. Hajak G, Müller WE, Wittchen HU, Pittrow D, Kirch W. Abuse and dependence potential for the non-benzodiazepine hypnotics zolpidem and zopiclone: a review of case reports and epidemiological data. Addiction. 2003 Oct;98(10):1371-8. doi: 10.1046/j.1360-0443.2003.00491.x. PMID: 14519173. [cited 2022 Aug 24]

26. Licata SC, Mashhoon Y, Maclean RR, Lukas SE. Modest abuse-related subjective effects of zolpidem in drug-naive volunteers. Behav Pharmacol. 2011;22(2):160-166. doi:10.1097/FBP.0b013e328343d78a [cited 2022 Aug 24]

27. Shih HI, Lin CC, Tu YF, Chang CM, Hsu HC, Chi CH, Kao CH. An increased risk of reversible dementia may occur after zolpidem derivative use in the elderly population: a population-based case-control study. Medicine (Baltimore). 2015 May;94(17):e809. doi: 10.1097/MD.0000000000000809. Erratum in: Medicine (Baltimore). 2016 Jun 19;94(24):1. PMID: 25929937; PMCID: PMC4603066. [cited 2022 Aug 24]

28. Cheng HT, Lin FJ, Erickson SR, Hong JL, Wu CH. The Association Between the Use of Zolpidem and the Risk of Alzheimer’s Disease Among Older People. J Am Geriatr Soc. 2017 Nov;65(11):2488-2495. doi: 10.1111/jgs.15018. Epub 2017 Sep 7. PMID: 28884784. [cited 2022 Aug 24]

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30. Victorri-Vigneau C, Dailly E, Veyrac G, Jolliet P. Evidence of zolpidem abuse and dependence: results of the French Centre for Evaluation and Information on Pharmacodependence (CEIP) network survey. Br J Clin Pharmacol. 2007 Aug;64(2):198-209. doi: 10.1111/j.1365-2125.2007.02861.x. Epub 2007 Feb 23. PMID: 17324242; PMCID: PMC2000636. [citred 2022 Aug 24]

31. Sethi PK, Khandelwal DC. Zolpidem at supratherapeutic doses can cause drug abuse, dependence and withdrawal seizure. J Assoc Physicians India. 2005 Feb;53:139-40. PMID: 15847035. [cited 2022 Aug 24]

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33.  Cha EJ, Jeon HJ. The effect of COVID-19 pandemic on sleep-related problems in adults and elderly citizens: An infodemiology study using relative search volume data. PLoS One. 2022 Jul 12;17(7):e0271059. doi: 10.1371/journal.pone.0271059. PMID: 35819941; PMCID: PMC9275680. [cited 2023 May 17]


Originally Published Oct 2, 2018 by Lyle Murphy, Founder


This content has been reviewed and approved by a licensed physician.

Dr. Michael Loes, M.D.

 

Dr. Michael Loes is board-certified in Internal Medicine, Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr. Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally, he is a well-published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response, and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.

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