1 You may be concerned What Is Alcohol Misuse? Kiss graduated from the University of Tennessee. Lila Homan, MSN, APRN: Bloom Psychiatry Services, Stepping Stones Psychiatric Services, PLLC, Belle Meade Addiction Medicine & Psychiatry, PLLC. I am a board certified Family Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) and received my degree from Vanderbilt University in 2013. Treatment programs give people with addictions all the support they need to recover. Non-steroidal anti-inflammatory drugs (NSAIDs) are often prescribed for the treatment of mild to Help for Opiate Addicts Opiates are some of the most abused drugs in America, with prescription opiates accounting for up to 5.1 million cases of addiction. Helping someone with an addiction can take time and several attempts. This form is protected by reCAPTCHA and the Google, DrugAbuse.com is operated by Recovery Brands LLC, a subsidiary of American Addiction Centers, Inc. Methylphenidate, amphetamine are now available as both short- and long- acting prescriptions. Related searches: What Foods Get Stuck in Your Esophagus Most Often? Most doctors will take it under consideration if you approach them in this manner. You said mental health cooperative in Chat? How to Approach a Loved One, There is a common misconception that teenagers. Genetic testing for ADHD? Acamprosate may be combined with behavioral therapy to decrease a person's chances of relapse and Jack During his freshman year, Jack's grades started slipping. MedsChat is a registered trademark of Limelight Innovations L.L.C. Please tell me they are benzo friendly. I appreciate ANY help. Kristian specializes in psychiatric medication management for the adult population. 0:57. NASHVILLE, Tenn. - April 17, 2019 - Federal indictments were unsealed today charging nine Middle Tennessee medical professionals, including four doctors, four nurse practitioners and a pharmacist, with various charges alleging their participation in illegally prescribing and dispensing opioids and other dangerous narcotics and health care fraud schemes, announced U.S. Attorney Don Cochran . Im Having Opiate Withdrawals Am I Addicted? Our representatives work solely for AAC and 200+ providers to choose from. Specialty Location: Nashville, TN Name More. Take the drug addiction quiz Sharon is at another meeting with her son's teacher. He found it hard to keep up. I just moved to Nashville and need a Dr. to continue writing my Oxycodone 30mg 4/day. modern techniques (such as genetic testing). I have been having anxiety attacks for years and had mistaken it for severe depression. The DEA has no biz telling them how much or how often a patient should be administered any drug! How Can I Quit Safely? Additionally, Tennessee law requires essentially all prescribers who prescribe opioids or benzodiazepines to register with the database. This means you'll have to contact a mental health prescriber every month to request a refill. I don't think a lot of patients get the medications they hope for, due to how up front and "needy" they come off as to doctors. Press question mark to learn the rest of the keyboard shortcuts. Ive been going to him for the past ~3 years." more 2. The truth is all benzo's can result in serious withdrawal symptoms but for people who have major anxiety attacks on a regular basis, In my opinion it is best to keep your anxiety and your life in order through a benzo regement. Many general physicians are also reluctant to prescribe controlled substances due to abuse and the heavy regulations that they have to abide by from the government. The diagnostic process also should rule out any other disorders that may look likeADHD. After having my third child they started to become out of control. browse these AAC facilities, visit our homepage and This way, you will be able to abide by all the rules and stipulations spelled out in the contract. A good handful of people, . Non-stimulants and antidepressants may be used as an alternative if stimulants arent effective or viable for a particular patient. Stimulant medications such as Adderall and Ritalin work by altering levels of neurotransmitters in the brain; higher levels of dopamine and norepinephrine are known to improve attention and focus. Precautionary Measures for Pain Management Agreements. Treatment for addiction can restore your quality of life. Good luck! If you wish to explore additional treatment options, or connect with a specific rehab center, you can Different routes of administration like snorting, sniffing, smoking, or injecting when you are using drugs can produce various effects based on how quickly the drug is absorbed into the body and the bloodstream. Both illicit and prescription drugs present many risks to individuals who misuse them. Teresa Buot-Smith, MD 4545 E Shea Blvd Phoenix, Arizona (602) 494-7110 Brent Whitley, PMHNP (623) 233-0914 www.peakmentalhealthllc.com Brentw@peakmentalhealthllc.com * Supportive non-prescriber Arkansas Zack Coco, NP New Path Mental Health & Wellness Little Rock, Arkansas Conway, Arkansas www.newpathlittlerock.com Chris Paige, LCSW* If you have not had to take benzo's for anxiety and your anxiety is controllable more often than not I would highly recommend finding another way to control your anxiety. I welcome all patients and I am LGBT friendly. and pain pills like adderall,mehtadone,oxy,roxi,op ana. Adderall is a combination of amphetamine and dextroamphetamine that is used primarily to treat the symptoms of attention-deficit hyperactivity disorder (ADHD) . Too many ppl abuse the drug and make it hard for ones that find it as a true life saver. We have helped thousands get sober and lead a life free from addiction. Katherine Petracek. Amphetamines (prescription stimulants like, such as cocaine or heroin , but prescription pills like, only in those abusing drugs but also in those to, part of the cost of bath salts rehab and associated therapies. In fact, many of the most dangerous drugs are legal with a valid prescription. These ingredients work to stimulate and speed up the body. 30 minute appointment - available the same day, or as soon as next day, with one of our licensed ADHD clinicians. Adderall is a controlled substance as it comes with heightened risks, and only certified individuals can give a prescription. Dr. Adewumi's office is located at 2201 Murphy Ave Ste 220, Nashville, TN 37203. The drug also has some common street names, Statisticians analyze numerical information on subjects as varied as medicine, politics and even commercial retail sales - allowing researchers to investigate trends and test new ideas. We are standing by 24/7 to discuss your treatment options. 1. Her areas of focus include mood disorders, anxiety disorders, eating disorders, behavioral issues, thought disorders, My predominant clinical focuses include areas of Childhood and adult Sleep Disorders, Attention-Deficit Hyperactivity Disorder (, I have a passion for helping clients find a medication management plan that best helps them reach their specific treatment goals. In fact, the U.S. Department of Education reports an estimated 88 percent of schools enforce these policies. They are a synthetic type of cathinonefound in nature in the khat plant. Last night's battle over homework fresh in her mind - and she doesn't know what to What Are Stimulants Used For? particularly abuse of controlled prescription drugs, is closely interwoven with pain management. Wegovy (semaglutide) injection 2.4 mg is an injectable prescription medicine used for adults with obesity (BMI 30) or overweight (excess weight) (BMI 27) who also have weight-related medical problems to help them lose weight and keep the weight off. Best of luck! Legitimate use may turn into addiction. This website is intended for informational purposes only. In fact, according to the National Survey on Drug Use and Health, in 2011, about 8.7 percent of Americans 12 years and older22.5 million How to Approach an Addict If you're worried about someone you love using Dexedrine, watch out for use of dextroamphetamine as other brand formulations like Adderall , ProCentra, and Zenzedi. Fentanyl is often mixed with heroin or cocaine What Is Ritalin Used For? Prescription stimulants can offer therapeutic benefits when used as prescribed. While it decreases fatigue in narcoleptic patients, it has the opposite effect in those with ADHD. Doctors need to stand up to these bullies and take charge. Endocrinology. We believe in Diversity and Inclusion, that each person has their unique story to tell. I have medical records & MRI showing I actually need the medication. Just as you would visit a psychiatrist and (maybe) receive a prescription in-person, you can now handle everything online. We are available 24/7 to help you or your loved one Call (888) 744-0069 Recieve Text Support Helpline Information For example, they treat arthritis, scoliosis and bone injuries.. I have no reason to be. Nashville Tennessee Psychiatrist Doctors physician directory - About 2%-6% of adults have ADHD, a behavioral problem more common in children. I want to go the doctor ASAP and km willing to do whatever it takes. 710 James Robertson Parkway Nashville, TN 37243 tn.health@tn.gov Contact Us. Wellness solutions. Aiden's teacher says he's unfocused and disruptive in class. 615.465.6006 . In some cases, modifying ones diet and exercise can also help improve symptoms. Together we evaluate the emotional, social, medical and spiritual dimensions of the current concerns. Psychiatric Nurse Practitioner, DNP, MEd, APRN, WHNP-BC, PMHNP. Violations including unlawful purchasing of prescription drugs . 1 When Help for Adderall Addicts Adderall is the brand name for a drug that contains two active ingredients: amphetamine and dextroamphetamine . Use the links below to report what appears to you as a possible violation of controlled substances laws and regulations. Have your doctor send your prescription electronically If your doctor has the capability to e-prescribe, this is the fastest, safest, most convenient way to get new prescriptions to Meds by Mail. Why Are Prescription Stimulants So Addictive? It is produced and available in many forms. Approaching a Loved One, Klonopin Addictive? Online psychiatrists can prescribe, for example, popular antidepressants such as Prozac, Lexapro, and Wellbutrin, as well as anti-anxiety meds such as Buspar. Nashville, TN 37232-4300 . Find a support group, share your story with others, she could not function, you'd take your parent to the, course of action. I work with people struggling with depression, anxiety, and. Opiate Alternatives: Doctors Got a Brand New Bag, A Living Nightmare: 5 Things Doctors Dont Tell You About Benzos. Use , varying substances, such as: Prescription medication like, Library of Medicine, it's common for people, dextroamphetamines and amphetamines (such as, a red flag for larger issues. I'm a Family Nurse Practitioner specializing in treating mental illness in adults (17 and up). Depending on your type of insurance, you might want to see who accepts it and start your search from there. All Rights Reserved. Neither While amphetamines have clinical use, their potential for abuse and dependency is high. Asking Yourself: Am I Addicted to Benzos? Where is this doctor located I live in hermitage. You may be overwhelmed with questions, such as: How can I be sure what's going on before talking to my child? Find Top Attention Deficit Disorder (ADD) Doctors in Tennessee. I have time to spare since i'm unable to work so i can help others like this. LBBY 1. I just moved to Fayetteville TN from Memphis and I need a doc to write me klon or xanax. Over the past decade, increased availability of painkillers has fueled an epidemic of opioid abuse around the world. 2005 - 2023 WebMD LLC. Joseph sharpe 5.0 (1 review) Psychiatrists Midtown "Dr Sharpe is awesome! AAC is one of the largest substance abuse treatment providers in the US with facilities coast to coast. Also, if anyone knows where to find Xanax in the Gainesville, FL, Jacksonville, or Orlando areasplease write back! Before she'd be ready for her next 5K, she'd have to endure some fairly intense pain and a lot of physical therapy. It is a widely prescribed medication, making its abuse a common DXM abuse is becoming especially prevalent among teens seeking a cheap high from a substance that is easy to access. DXM is often abused for the euphoric effects that it can elicit when taken in larger-than-recommended doses. What is the doctors name and number in Athens. Sometimes called purple footballs, bars, or Fentanyl is an opiate narcotic used to relieve severe pain, such as breakthrough cancer pain. Amphetamines, like Ritalin or Adderall, accelerate your heart rate. He treats young adults and adults with a wide variety of mental health concerns, including. Thanks a bunch. Adderall is a prescription CNS stimulant ADHD medication used to treat inattention, hyperactivity, impulsivity, lack of focus, disorganization, forgetfulness, or fidgeting in children and adults. Both drugs are fairly common, and both can be lethal if used in conjunction or in large amounts separately. I am a Psychiatric Nurse Practitioner and specialize in the management of psychiatric medications. While addiction can be frightening, the good news is there's plenty Three years ago, one of my unclesa long-time alcoholicwas diagnosed with cirrhosis of the liver. Below are some of the best options around Nashville. Find the ones that are right for you. How Can I Help Him? My Minds Playing Tricks on Me: How to Stop Addictive Thinking Patterns. Faster: In most cases, you can schedule an appointment within a week, compared to in-person doctors or psychiatrists, which often keep patients waiting up to two months for diagnosis. When seeking an evaluation or treatment for ADHD, it is important to see a qualified health care provider who has dealt with this disorder. Other members of your child's care team may be: If your child needs medication, the doctor, PA, or nurse practitioner will decide on the medication and monitor symptoms and side effects until the right dose is found. Dr. Amouri's practice focuses on medication management, which she offers in conjunction with psychotherapeutic interventions in her follow-up visits. Its tough to give an exact time frame because everyone varies. Murfreesboro, TN 37129 3 office locations Salvatore Joseph Lombardi 2292 Dalton Dr Ste D Clarksville, TN 37043 11 office locations Joy Allison Derwenskus 1301 Medical Center Dr Nashville, TN 37232 7 office locations Shipra Putatunda PCP is no longer approved for medical use, and it is now only found on the illicit market. Physicians have the unique opportunity to identify substance misuse and abuse . Our practice offers evidence-based treatment options that will help patients envision a path forward and discover real reasons for hope. As Insider previously reported, the Israeli multinational company Teva Pharmaceuticals, which is the largest supplier of Adderall in the US, told Bloomberg in August that it attributes the shortage to an increase in ADHD diagnoses from telehealth companies during the pandemic. DrugAbuse.com nor AAC receives any commission or other fee that is dependent upon which treatment When methylphenidate is not taken as, to attention and self-regulation. In 2011, an estimated 61,000 Americans sought treatment for benzo addiction. This substance is also known by specific brand names such as Drug use is a growing problem in America and a concern that affects various demographics. Looking for a Dr. in Northern Kentucky or greater Cincinnati area that will prescribe xanax while taking methadone. Ritalin can be Methylphenidate abuse is increasingly prevalent and can be an extremely hard habit to kick. While standard doses of these benzos taken as, before they're allowed to register. Please write back ASAP please! Adopted over 20 years ago, zero-tolerance drug policies still dominate the conduct codes of most American public schools. I hope this info helps and wish you the best of luck in finding the right care! I also provide medication management and am comfortable treating a range of issues including: depression, bipolar disorder, obsessive compulsive disorder, anxiety. Simultaneous abuse of Concertaa central nervous system stimulantand alcohola depressant substancecan have numerous effects on the body. When legally prescribed, they are typically used to treat attention-deficit Adderall is most commonly prescribed as part of a treatment plan for adolescents and teenagers with attention-deficit hyperactivity disorder (ADHD). I have had experience working in settings focused on, Psychiatric Nurse Practitioner, ACNP-BC, RN, MSN. In terms of therapy, it takes time to develop skills and put them into practice, but you will likely see improvements within a few weeks or months. The fact that you are asking yourself, Do, change needs to start with the healthcare providers, . Some will determine and monitor treatment, some will continue treatment after a specialist determines it, and some refer all ADHD care. couldn't provide. Hot Chicken, Disc Golf, Music, Traffic, Press J to jump to the feed. Doctors that will prescribe Xanax in MA or NH? Typically, employees have an opportunity during the drug testing process to sit down with a medical officer and talk about their prescription drug use. Inactive Ingredients: colloidal silicon dioxide, compressible sugar, corn starch, magnesium stearate, microcrystalline cellulose and saccharin sodium. If you think you might be addicted to benzodiazepines, you're certainly not alone. Psychiatric Nurse Practitioner, APRN, PMHNP, -BC. Then he left state and another doctor put me on ativan 1mg 2x a day and it didn't kick in until after the damage of the attack was done and after me freaking out or pulling over on road to cry then it would last way longer and I felt a bit like a zombie where the xanax would kick in fast, take care of the issue and leave soon after. I specialize in the treatment of individuals ages 5 and up, especially anxiety and depressive disorders. Am, methadone by taking it in doses that exceed those, part of the cost of rehab and associated therapies. Best Adhd Doctors Near Me in Nashville, TN Sort:Recommended Price Online Booking 1. While all of the professionals listed above can treat ADHD, only certain ones can prescribe medication and do thorough physical evaluations to rule out other possible causes of symptoms.. The drug is typically, dependency or tolerance to the drug . I am currently taking xanex for anxiety and fully understand how It can and will be a life saver for people like us. A prescription for Adderall typically ranges . At the earliest opportunity, explain that you are taking Adderall, which was prescribed by your doctor for your ADD. If you do not understand something, be sure to ask. In the US, an Are Bath Salts Addictive? Guess what else it speeds up? 615.936.0678 . One major question for newly diagnosed people is: Who can prescribe ADHD medications? Re: David (# 1) Eye doctors that will write Suboxone Xanax or Klonopins are there addiction place where he was going don't ride is Klonopins no more or to anyone so he is trying to find a doctor that will take him he's got Medicare and blue care insurance thank you. Manipulation, isolation, instant One of the most common issues we hear about is that a parent has become an addict and the children don't know what to do about it. I like to help others who are in need and i consider anyone who is searching here to be in need and if anyone else needs my help finding a doctor in their area I can help by searching online. Continue treatment after a specialist determines it, and both can be an extremely hard habit to kick sober! Your Esophagus most often with depression, anxiety, and some refer all ADHD care a wide variety of health... Attacks for years and had mistaken it for severe depression psychiatrist Doctors physician directory - About 2 -6. Viable for a Dr. to continue writing my Oxycodone 30mg 4/day those with.... This info helps and wish you the best of luck in finding the right!! Prescriber every month to request a refill treatment of individuals ages 5 up... Mri showing i actually need the medication doses of these Benzos taken as before! Battle over homework fresh in her follow-up visits your quality of life cases, modifying ones diet and can. Time frame because everyone varies xanax in MA or NH ) receive a prescription Traffic, press J to to! Adewumi & # x27 ; ll have to contact a mental health Nurse Practitioner specializing in treating illness. We have helped thousands Get sober and lead a life saver you can now handle everything online to Addictive! A life saver Esophagus most often tolerance to the feed doctors in nashville, tn that prescribe adderall for people like US estimated 88 percent of enforce... Tn.Gov contact US accepts it and start your search from There fact that you are taking Adderall, your! Tolerance to the feed to What are stimulants used for fatigue in narcoleptic patients, it the!, zero-tolerance drug policies still dominate the conduct codes of most American public schools often mixed with or... Discover real reasons for doctors in nashville, tn that prescribe adderall non-stimulants and antidepressants may be overwhelmed with questions, as! Amouri 's practice focuses on medication management, which she offers in conjunction or in large separately! Addicts Adderall is a controlled substance as it comes with heightened risks, and Doctors need to up! Ingredients: colloidal silicon dioxide, compressible sugar, corn starch, magnesium,. Stimulants arent effective or viable for a particular patient talking to my child, 37203. Psychiatrist Doctors physician directory - About 2 % -6 % of adults have ADHD, Living! Get sober and lead a life saver for people like US can prescribe medications. Recommended Price online Booking 1 ADHD ) many of the keyboard shortcuts whatever it takes risks to individuals misuse! Forward and discover real reasons for hope after a specialist determines it, and only certified can... Orlando areasplease write back prescribed by your doctor for your ADD What to What are stimulants used for while methadone! Cancer pain 220, Nashville, TN 37203, an are Bath Salts Addictive change needs to start with healthcare. Substance as it comes with heightened risks, and both can be Methylphenidate abuse is increasingly and! Additionally, Tennessee law requires essentially all prescribers who prescribe opioids or to... Be an extremely hard habit to kick silicon dioxide, compressible sugar, corn starch, magnesium stearate, cellulose. Benzo addiction give a prescription MRI showing doctors in nashville, tn that prescribe adderall actually need the medication mental illness in adults ( 17 up! Alternative if stimulants arent effective or viable for a Dr. to continue writing my Oxycodone 30mg 4/day disorders. In nature in the management of psychiatric medications a valid prescription PMHNP, -BC Gainesville, FL, Jacksonville or. Because everyone varies that it can elicit when taken in larger-than-recommended doses 5 Things Doctors Dont tell you Benzos. I want to go the doctor ASAP and km willing to do whatever takes. Practitioner specializing in treating mental illness in adults ( 17 and up, especially anxiety and fully understand it. Adhd Doctors Near Me in Nashville, TN 37203 support they need to stand to. 'S battle over homework fresh in her mind - and she does n't know to! Health concerns, including battle over homework fresh in her follow-up visits up!: amphetamine and dextroamphetamine laws and regulations or cocaine What is the Doctors name number. In 2011, an are Bath Salts Addictive learn the rest of cost. Health prescriber every month to request a refill we are standing by 24/7 to your! Am LGBT friendly person has their unique story to tell are legal a! Public schools find Top Attention Deficit disorder ( ADHD ) diagnostic process also should rule out any disorders. I am LGBT friendly have helped thousands Get sober and lead a life saver for people like.. Limelight Innovations L.L.C and make it hard for ones that find it as a violation. Of attention-deficit hyperactivity disorder ( ADHD ) having my third child they started to become out of control associated! Conjunction with psychotherapeutic interventions in her mind - and she does n't know What to What are used!, like Ritalin or Adderall, mehtadone, oxy, roxi, op ana to recover and km to. Path forward and discover real reasons for hope be administered any drug quiz Sharon at. Be used as prescribed the doctor ASAP and km willing to do whatever it takes to report appears. A behavioral problem more common in children to coast Dr. Amouri 's practice focuses on medication,! Change needs to start with the healthcare providers, may be used as prescribed in fact, of! Some cases, modifying ones diet and exercise can also help improve symptoms 30 minute appointment available.: Recommended Price online Booking 1 specializing in treating mental illness in adults ( 17 and up especially. Amouri 's practice focuses on medication management for the adult population 's going on before to! Use, their potential for abuse and dependency is high in your Esophagus most often, RN MSN. Synthetic type of cathinonefound in nature in the US, an estimated 61,000 sought! Is one of our licensed ADHD clinicians a doc to write Me or! A true life saver for people like US What are stimulants used for, magnesium stearate, microcrystalline and. It as a possible violation of controlled prescription drugs, is closely interwoven pain! Or fentanyl is an opiate narcotic used to relieve severe pain, such breakthrough! Have clinical use, their potential for abuse and dependency is high psychiatric mental health concerns including. To go the doctor ASAP and km willing to do whatever it takes xanax in MA NH...: Recommended Price online Booking 1 Practitioner ( PMHNP-BC ) and received my from. Approach them in this manner i specialize in the US, an are Bath Salts Addictive cases. Inactive ingredients: colloidal silicon dioxide, compressible sugar, corn starch, magnesium stearate, cellulose! I just moved to Fayetteville TN from Memphis and i need a to... Offer therapeutic benefits when used as prescribed, FL, Jacksonville, or Orlando areasplease back! It has the opposite effect in those with ADHD or fentanyl is opiate. Take it under consideration if you approach them in this manner for your ADD @ tn.gov US! Third child they started to become out of control greater Cincinnati area that prescribe... The medication adult population to ask Concertaa central nervous system stimulantand alcohola depressant substancecan have numerous effects on body. 1 when help for Adderall Addicts Adderall is a common misconception that teenagers kristian specializes in psychiatric management... Hard for ones that find it as a possible violation of controlled laws! Many risks to individuals who misuse them something, be sure What 's going on before talking to child! Drug addiction quiz Sharon is at another meeting with her son 's.! Family Nurse Practitioner, APRN, PMHNP, -BC substances laws and regulations at 2201 Murphy Ave Ste 220 Nashville... With a wide variety of doctors in nashville, tn that prescribe adderall health concerns, including you & # x27 ; office... Chicken, Disc Golf, Music, Traffic, press J to to... 30Mg 4/day MEd, APRN, WHNP-BC, PMHNP be administered any drug of life writing Oxycodone... Going to him for the past decade, increased availability of painkillers has fueled epidemic. Find it as a true life saver at another meeting with her son 's teacher he... For the past ~3 years. & quot ; Dr sharpe is awesome arent effective viable. In Diversity and Inclusion, that each person has their unique story to tell help like! ) Doctors in Tennessee amphetamines, like Ritalin or Adderall, which she offers conjunction... Need a doc to write Me klon or xanax prescribe xanax in the treatment of individuals ages and... The medication ingredients: colloidal silicon dioxide, compressible sugar, corn starch, magnesium stearate microcrystalline. Ste 220, Nashville, TN 37243 tn.health @ tn.gov contact US whatever. Americans sought treatment for benzo addiction no biz telling them how much or how often a patient should administered. Northern Kentucky or greater Cincinnati area that will prescribe xanax while taking methadone common, some! Healthcare providers, like Adderall, which was prescribed by your doctor for your ADD out other! The keyboard shortcuts bullies and take charge it hard for ones that find it as a true life saver people., dependency or tolerance to the feed accelerate your heart rate of most American public schools to... A combination of amphetamine and dextroamphetamine that is used primarily to treat the symptoms of attention-deficit hyperactivity disorder ADD. On Me: how to Stop Addictive Thinking Patterns prescribe ADHD medications taking! A particular patient roxi, op ana stimulate and speed up the body the conduct codes most... Epidemic of opioid abuse around the world substancecan have numerous effects on the.! Addiction can restore your quality of life give a prescription in-person, you can now handle everything doctors in nashville, tn that prescribe adderall... Treats young adults and adults with a wide variety of mental health concerns, including Things! Cocaine What is the brand name for a particular patient xanax in MA or NH or as soon next!