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If Doctors Would Diagnose Addiction

by James Heller 5. September 2012 14:10
If you consider that there are an estimated 22 million Americans with a drug or alcohol problem, you might assume that doctors regularly diagnose and treat them.  Reality is, though, that most doctors have never been trained to in addiction treatment, and usually treat only the symptoms of the disease.  Fortunately, some new treatments involving medications may change this sad situation.
 
 
One big problem with alcoholism and drug addiction is that so many medical problems result from them.  Substance abuse negatively affects different parts of the body, depending on the drug being used.  Alcohol abuse, without exaggeration, harms every cell in the body.  To the untrained in addiction medicine, the symptoms of these abuses might appear as primary problems, only requiring common treatments.  For example, a doctor may prescribe specialized medication for a bleeding ulcer and schedule a follow-up visit.

Another problem with addiction is that alcoholics and drug addicts are not quick to admit their problems.  Even if a doctor asks about drinking and drug use habits, these patients will minimize or deny it.  Short of the patient arriving at 9:00am and smelling of alcohol, or having injection track marks up and down their arms, untrained doctors will not see a reason to investigate.  The answer is often accepted as true and the doctor looks to heal the symptom.  

The result is that alcoholics and drug addicts get temporary relief from negative symptoms of their disease, but don’t receive, at the very least, guidance from their doctors on how to prevent them in the future.  The worst result is that people die every day from the negative effects of alcoholism and drug addiction.  Most of them could have been saved had they been given early treatment for the primary disease of addiction.

According to this article, there is possible good news on the horizon.  There is an effort to attract doctors to the addiction treatment field, and to promote addiction medicine as a recognized subspecialty.  Medical treatment and new prescription drugs are proving to be effective means of helping addicts to recover.  Counseling for the psycho-social aspects of the disease is still important, but detox and craving reduction medications, like Vivitrol, have become very beneficial in the early days of recovery.

Tarzana Treatment Centers provides Vivitrol treatment for alcohol and opiate craving reduction, for example.  This follows medical detoxification, which is important to avoid the severe effects of withdrawals.  We have seen some great success stories from patients who previously struggled with relapse after their first Vivitrol injection.  

Imagine if doctors could diagnose addiction from the symptoms they normally treat.  They could make a referral to a detox facility, followed with Vivitrol for eligible patients, and maybe residential or outpatient treatment.  Patients tend to listen to doctors more than they would even to their most beloved family members.  Hopefully, the effort mentioned above can spread so more of those who suffer can get the treatment they need.

Tarzana Treatment Centers in Los Angeles provides a full array of health care services including adult and youth alcohol and drug treatment.  We specialize in treatment for mental health and substance use disorders, and have two primary medical care clinics in the San Fernando Valley and Antelope Valley and specialized services for HIV/AIDS care.  If you or a loved one needs help with alcohol dependencedrug addiction, or co-occurring mental health disorders or from other services we offer, please call us now at 888-777-8565 or contact us using our secure contact form.

Telemedicine services are also available with online medical care, online mental health treatment, and online alcohol and drug treatment.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.

Vivitrol for Women in Alcohol and Drug Treatment

by James Heller 29. August 2012 14:05
The various aspects of alcoholism and opiate addiction happen faster for women.  Because of this, extra factors need to be considered when providing treatment for women, especially when children are involved.  Many of these factors can be minimized by including Vivitrol in alcohol and drug treatment for women.
 
 
The female human body processes alcohol and opiates differently than the male counterpart.  It takes lower quantities and less time for intoxication to occur, withdrawals appear faster and stronger, and dependence and “hitting bottom” appear sooner to the first use.  Social factors, coupled with alcohol or opiate cravings, can also make resisting relapse much more difficult.

Alcohol and opiate cravings are major relapse triggers for both men and women suffering addiction.  But women commonly face social situations that involve peer pressure, predators, and even violence that invite relapse.  While these situations and other forms of stress may be difficult to avoid, craving reduction can reduce the chance that a relapse will occur.

Tarzana Treatment Centers provides Vivitrol for alcohol and opiate craving reduction.  Alcoholics, heroin, and prescription painkiller addicts relapse in large part due to cravings.  By removing this trigger, women can better focus on core issues that keep them drinking or using drugs.  It also takes away the added pressure to drink or use in social situations.

Tarzana Treatment Centers in Los Angeles provides a full array of health care services including adult and youth alcohol and drug treatment.  We specialize in treatment for mental health and substance use disorders, and have two primary medical care clinics in the San Fernando Valley and Antelope Valley and specialized services for HIV/AIDS care.  If you or a loved one needs help with alcohol dependencedrug addiction, or co-occurring mental health disorders or from other services we offer, please call us now at 888-777-8565 or contact us using our secure contact form.

Telemedicine services are also available with online medical care, online mental health treatment, and online alcohol and drug treatment.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.

Prescription drug relapse

by James Heller 28. August 2012 08:07
Prescription painkiller addiction can often be difficult to treat because the addict believes a drug is medically necessary.  Addiction counselors must help addicts get passed this notion or relapses will surely occur.  One obstacle to counseling is that opiate cravings also plague addicts, and they reinforce the feeling of need.  Those cravings can be reduced with Vivitrol, allowing for more effective counseling.
 
 

Tarzana Treatment Centers provides Vivitrol treatment.  Our services are covered by Medicare and Medi-Cal, along with other health care contracts.  This monthly injection of Naltrexone can improve your chances at long-term recovery.

When prescription opiate addiction begins as a result of pain management, having been legally prescribed for treatment, some individuals will become addicted.  It can start with mild or strong pain killers, prescribed for varying durations of time, and the addiction can take hold.  As long as they can convince a medical professional to prescribe the medication, they will justify the need for it to themselves and others.

This creates a challenge in drug treatment because the great majority of prescription drug addicts will not suffer real physical pain if they stop using.   Medical detoxification is recommended, and they may feel minor pangs from nerves coming back to life.  But the biggest fear they have is that they will begin to feel emotions again.  Counselors need to help addicts to understand this, and then they can dig down to core issues.

Opiate cravings are at their peak in early recovery.  They are a major trigger for relapse, and very distracting.  Vivitrol treatment reduces the cravings, providing a less stressful environment for treatment.  It clears the road for recovering prescription drug addicts to understand that they don’t have physical pain, and to learn how to deal with their emotions.

Tarzana Treatment Centers in Los Angeles provides a full array of health care services including adult and youth alcohol and drug treatment.  We specialize in treatment for mental health and substance use disorders, and have two primary medical care clinics in the San Fernando Valley and Antelope Valley and specialized services for HIV/AIDS care.  If you or a loved one needs help with alcohol dependencedrug addiction, or co-occurring mental health disorders or from other services we offer, please call us now at 888-777-8565 or contact us using our secure contact form.

Telemedicine services are also available with online medical care, online mental health treatment, and online alcohol and drug treatment.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.

Medi-Cal Covers Vivitrol Treatment

by James Heller 20. August 2012 08:30
At Tarzana Treatment Centers, our goal is to provide healthcare to anyone in need.  One of the services we are known for is alcohol and drug treatment, which includes Vivitrol treatment.  This monthly Naltrexone injection reduces alcohol and opiate cravings and is covered by Medi-Cal.  Many who once felt hopeless are now in recovery and improving their lives.

We take pride in the fact that we help thousands of individuals, from all walks of life, every year.  Far too many have lost jobs and family, and have no health care coverage other than Medi-Cal.  Alcohol or drugs have dragged them into a world of despair.  A number of them will suffer multiple relapses because, even if they enjoy being sober, cravings lead them back to alcohol, heroin, or prescription pain killers.
 
 
The road back to treatment gets longer every time an alcoholic or a drug addict relapses.  When finances, legal issues, or relationships are a problem, the addicted mind will make them think that alcohol and drugs are the only answer.  So when they complete treatment, any craving for alcohol or their drug of choice threatens sobriety.  Constant relapses eat away at confidence, and convince them that there is no use in trying to improve their lives.

Medi-Cal has approved coverage for Vivitrol treatment at Tarzana Treatment Centers to help this group of individuals, among others.  Vivitrol takes cravings out of the picture during treatment, allowing patients to focus on core issues that keep them drinking and using drugs.  Once they get past the false belief that they don’t deserve better, it is more likely that they will want to take better care of themselves.  This gives them a better chance at long-term recovery and an improved life.

Tarzana Treatment Centers in Los Angeles provides a full array of health care services including adult and youth alcohol and drug treatment.  We specialize in treatment for mental health and substance use disorders, and have two primary medical care clinics in the San Fernando Valley and Antelope Valley and specialized services for HIV/AIDS care.  If you or a loved one needs help with alcohol dependencedrug addiction, or co-occurring mental health disorders or from other services we offer, please call us now at 888-777-8565 or contact us using our secure contact form.

Telemedicine services are also available with online medical care, online mental health treatment, and online alcohol and drug treatment.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.

Vivitrol with Medicare and Medi-Cal Coverage

by James Heller 17. August 2012 08:24
For those eligible for Medicare and Medi-Cal most healthcare expenses are fully covered.  This can be very good news for those who suffer from alcoholism or prescription pain killer addiction.  At Tarzana Treatment Centers, we provide Vivitrol treatment services so they can begin the process of recovery without cravings that can lead to relapse.

Vivitrol is Naltrexone, administered monthly by injection.  After medical detoxification for alcohol or opiates, if necessary, Vivitrol reduces cravings for these drugs.  Alcohol and opiate cravings are major triggers for relapse during the early months of recovery.  Craving reduction removes distractions, which improves chances at long-term sobriety.

Medicare is the Federal program that covers seniors and seriously disabled individuals.  Medi-Cal is the California state Medicaid program for people who meet low-income and asset requirements for eligibility.  Those who qualify for both are known as “Medi-Medi” or “dual eligible”.  Medicare is the primary coverage, and Medi-Cal provides secondary coverage.  The combined coverage is important for many who might not otherwise be able to afford necessary treatment.

A growing number of seniors suffer from substance use disorders and many of them live on fixed incomes.  Whether alcohol or drug abuse is the problem, their retirement years can be an emotional torture.  Medi-Medi coverage for Vivitrol gives them the chance to enjoy the senior years without being bound by addiction.  

An accident may cause a person to become disabled, for another example.  If painkillers were prescribed for severe pain, this person will likely form an opiate dependence.  No matter how innocent the circumstances, they are now a prescription drug addict.  When the pain is gone, the addiction needs to be treated at some point.  Vivitrol treatment at Tarzana Treatment Centers will aid in the recovery process, and allow for better focus on therapies for the original disability.

Please don’t hesitate to contact Tarzana Treatment Centers is you are Medi-Medi eligible and have a substance use disorder.

Tarzana Treatment Centers in Los Angeles provides a full array of health care services including adult and youth alcohol and drug treatment.  We specialize in treatment for mental health and substance use disorders, and have two primary medical care clinics in the San Fernando Valley and Antelope Valley and specialized services for HIV/AIDS care.  If you or a loved one needs help with alcohol dependencedrug addiction, or co-occurring mental health disorders or from other services we offer, please call us now at 888-777-8565 or contact us using our secure contact form.

Telemedicine services are also available with online medical care, online mental health treatment, and online alcohol and drug treatment.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.

Medication and Technology in Alcohol and Drug Treatment

by James Heller 1. August 2012 15:13
Alcoholism and drug addiction haven’t changed over time, and treatment still requires a certain level of patient motivation for recovery.  That motivation is the key to cultivating the deep-seeded desire to quit using alcohol or other drugs.  Forward thinking facilities, like Tarzana Treatment Centers, are using medications and technology to encourage patients to stay motivated.

When individuals make the decision to enter alcohol and drug treatment, motivation is at its highest level.  Whether the reason is legal, financial, or relationship, doesn’t matter.  It is only important to validate the motivation and encourage treatment.  From the moment of the decision, the addicted mind will begin to chip away at the motivation for recovery.

One way to slow the demotivation is to offer solutions to concerns that are often stated during the treatment admission process.  Previously failed attempts at recovery can cause pessimistic feelings.  Heavy work schedules and family needs can be a barrier to aftercare discussions.  Medication Assisted Treatments (MAT) can bring optimism, and telehealth can break down barriers.

Alcohol and opiate cravings are major causes of relapse.  Tarzana Treatment Centers is a Vivitrol treatment provider.  Vivitrol reduces alcohol and opiate cravings, taking away the distraction that can hinder or put a halt to treatment.  Methadone Maintenance is also available for qualified opioid addicts who have struggled with multiple relapses.  MAT offers hope to individuals who are motivated for recovery, and have a simultaneous “what’s the use?” feeling.

Sometimes the timing of recovery motivation conflicts with work or family obligations, or transportation may be an issue.  Instead of labeling this as an “excuse”, Tarzana Treatment Centers offers telehealth services. Using secure video conference technology, you can attend counseling sessions from your home or office.   Telehealth is proving to be just as effective as face-to-face outpatient treatment.

When your loved one tells you they need help, don’t delay.  Please call us immediately, and we will help.

Tarzana Treatment Centers in Los Angeles provides a full array of health care services including adult and youth alcohol and drug treatment.  We specialize in treatment for mental health and substance use disorders, and have two primary medical care clinics in the San Fernando Valley and Antelope Valley and specialized services for HIV/AIDS care.  If you or a loved one needs help with alcohol dependencedrug addiction, or co-occurring mental health disorders or from other services we offer, please call us now at 888-777-8565 or contact us using our secure contact form.

Telemedicine services are also available with online medical care, online mental health treatment, and online alcohol and drug treatment.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.

Opioid Withdrawal Treatment

by James Heller 31. July 2012 09:45
Since the sap of the opium poppy was first used to craft a remedy for pain and discomfort, it has been observed as being both helpful and harmful.  Opioids can get patients through the worst of serious physical maladies, and then turn them into struggling addicts.  Withdrawal symptoms from opioids can be severe, so this often drives addicts to continue using the drugs long after they are medically necessary.

Tarzana Treatment Centers provides Medication Assisted Treatment (MAT) options for individuals suffering from opioid addiction.  Medical detoxification works with the body to slowly taper off of opioids until it is cleansed.  Methadone Maintenance is meant for individuals who have suffered multiple relapse, and helps to reduce opioid cravings.  Both opioid withdrawal treatment methods are meant to help you achieve long-term abstinence.

Patients are regularly prescribed opioid medications like Vicodin, Oxycodone, and Morphine to manage pain ranging from headaches to broken bones.  These medications are very effective and highly addictive, so they are meant to be used for a short period of time.  The addiction can set in so rapidly, though, that the brain will trick the body into thinking the medication is still needed for “pain relief”.  With further use, the body becomes opioid dependent.

Opioids have been manufactured legally and illegally, for medicinal and recreational use, for over a century.  Heroin is notorious for being extremely addictive.  Once provided as a legal medication, it is now one of the most damaging drugs sold illegally on the street.  The opioid withdrawal symptoms from heroin are so intense that, some say, you can become addicted with one use.  Heroin is once again gaining popularity among teens and young adults, and is reaching across all social and financial circles.

A very small percentage of opioid addicts can “kick” the drug without medical assistance.  Successful opioid withdrawal treatment requires MAT to minimize the risk of relapse.  The goal must be complete abstinence.  Treating the withdrawal symptoms is only a part of the battle, though.  Quality treatment, like at Tarzana Treatment Centers, also includes counseling and an option for Vivitrol in aftercare treatment.

Tarzana Treatment Centers in Los Angeles provides a full array of health care services including adult and youth alcohol and drug treatment.  We specialize in treatment for mental health and substance use disorders, and have two primary medical care clinics in the San Fernando Valley and Antelope Valley and specialized services for HIV/AIDS care.  If you or a loved one needs help with alcohol dependencedrug addiction, or co-occurring mental health disorders or from other services we offer, please call us now at 888-777-8565 or contact us using our secure contact form.

Telemedicine services are also available with online medical care, online mental health treatment, and online alcohol and drug treatment.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.

Tarzana Treatment Centers Telehealth Program

by James Heller 11. July 2012 12:39
Connecting patients face-to-face with health care providers can be a challenge at times.  This is especially true when the patient suffers from mental health or substance use disorders.  Telehealth is a great solution whether the individual is already in treatment or is delaying the start of treatment.

Telehealth is a broad term for health care that is provided via email, phone, data transfer, or video conference.  The main benefit for patients is that they can be anywhere for treatment, as long as they have a computer with internet access or a phone available.  Tarzana Treatment Centers is currently using several telehealth delivery methods, and we plan to take advantage of more as they become available to us.

Tarzana Treatment Centers’ Telehealth Program makes it possible for patients in residential alcohol and drug treatment to visit with offsite providers without leaving the building.  Each patient has a secure account on the LiveVisit video conference application, and can meet with clinic physicians or licensed mental health professionals.  We also use telehealth video conferencing for outpatient clients.

Sufferers postpone getting treatment for mental health and substance use disorders more often than you might think.  When they finally do go to that first treatment session, almost all of them realize that the delay was unnecessary.  Tarzana Treatment Centers’ Valley Tele-Treatment Program (VTP) makes that first session more convenient.  Individuals can receive treatment via VTP for up to 90 days, or they may choose to start face-to-face sessions after that first one.  
For more information, please call 818-654-3821 or email vtp@tarzanatc.org today.

Tarzana Treatment Centers in Los Angeles provides a full array of health care services including adult and youth alcohol and drug treatment.  We specialize in treatment for mental health and substance use disorders, and have two primary medical care clinics in the San Fernando Valley and Antelope Valley and specialized services for HIV/AIDS care.  If you or a loved one needs help with alcohol dependencedrug addiction, or co-occurring mental health disorders or from other services we offer, please call us now at 888-777-8565 or contact us using our secure contact form.

Telemedicine services are also available with online medical care, online mental health treatment, and online alcohol and drug treatment.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.

Medicare and Medicare Advantage Services

by James Heller 6. July 2012 08:23
Tarzana Treatment Centers accepts Medicare and Medicare Advantage for a variety of healthcare services.  Primary medical care is certainly a priority for seniors to maintain good health.  We also cover medically necessary treatment for drug addiction and mental illness

The senior years can be very enjoyable.  This time of life also comes with many changes, both personal and environmental.  The environmental changes include relocation, loss of friends and family, financial concerns, and even the amount of medical care you need.  What this means is that you need to take care of yourself and remain aware of how environmental changes are affecting you.  We aim to help you through these issues so they don’t become the focal point of your senior years.

Mental health concerns arise for seniors because of the changes they face.  Obviously, when a long-time spouse or friend passes on there is grief to deal with.  Depression can accompany the grief even for the strongest of characters.  When the spouse who handled the finances and other concerns passes, it can leave the surviving spouse with great anxiety.  Sadly, too many seniors suffer loneliness due to infrequent visits from family members.

Drug addiction can seemingly come out of nowhere for seniors.  Individuals who rarely had a cocktail may be prescribed a painkiller for chronic pain.  Initially, this is fine and the pain is relieved.  But when they feel another type of relief, like an escape from the feeling of loneliness, they may continue to use the drug in increasing amounts and become addicted.  If their doctor refuses to continue filling the prescription, they may even resort to using illegal drugs.

For seniors suffering mental health or drug addiction disorders, or co-occurring disorders, physical health can quickly become a casualty.  It is important that you be treated for these problems right away so you don’t suffer needless medical problems.  

We staff quality mental health professionals who will handle your case with sensitivity in a confidential setting.  Our variety of treatment methods for drug addiction, including medical detoxification, counseling, and Medication Assisted Treatment (MAT), provides for a tailored treatment plan that will help you get back into life.

Click this link to see our Medicare services brochure:

Tarzana Treatment Centers in Los Angeles provides a full array of health care services including adult and youth alcohol and drug treatment.  We specialize in treatment for mental health and substance use disorders, and have two primary medical care clinics in the San Fernando Valley and Antelope Valley.  If you or a loved one needs help with alcohol dependencedrug addiction, or co-occurring mental health disorders, please call us now at 888-777-8565 or contact us using our secure contact form.

Telemedicine services are also available with online medical care, online mental health treatment, and online alcohol and drug treatment.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.

Convenient Vivitrol Treatment

by James Heller 2. July 2012 15:03
Motivation for recovery can change in an instant for alcoholics and opiate addicts.  They’ll say they want Vivitrol treatment to reduce cravings and help them focus on treatment.  The addict brain then does everything it can to change that decision.  Because of this, Tarzana Treatment Centers makes every effort to speed the process from decision to Vivitrol injection.

According to the California Department of Alcohol and Drug Programs (ADP) in the excerpt below, a collaboration of effort is required to treat a patient successfully with Vivitrol:

-- Begin External Content --

“Collaboration between substance abuse treatment providers and primary care physicians and clinicians on behalf of alcohol-dependent individuals is key to obtaining the best treatment outcomes for this chronic, relapsing disease.”

-- Source: http://wwwtest.adp.ca.gov/Pressroom/News/Focus/June2012/INDEX.html#feat1 --
<Read the entire article for details about Medication Assisted Treatment (MAT) when you finish this>

Patients must be assessed for Vivitrol treatment by qualified medical personnel.  Tarzana Treatment Centers’ alcohol and drug treatment program has licensed medical professionals on staff daily.  This minimizes the time between decision and assessment.  Every step like this toward getting the actual injection helps a patient to resist thoughts suggesting to not go through with the decision.

Vivitrol is available by prescription only, which is the next step toward injection.  Our daily staff of medical personnel includes licensed prescribers.  This minimizes another possible waiting period, and may even eliminate it if the assessor and prescriber is the same person.  The only step left is to receive the Vivitrol injection, and we keep a stock ready for new patients.  

Collaboration between providers is easy at Tarzana Treatment Centers because they all work in the same facility and use the same software to track patient care.  Nobody can promise that you will get a Vivitrol injection the same day you make the decision, but we make it possible.

Tarzana Treatment Centers in Los Angeles provides a full array of health care services including adult and youth alcohol and drug treatment.  We specialize in treatment for mental health and substance use disorders, and have two primary medical care clinics in the San Fernando Valley and Antelope Valley.  If you or a loved one needs help with alcohol dependencedrug addiction, or co-occurring mental health disorders, please call us now at 888-777-8565 or contact us using our secure contact form.

Telemedicine services are also available with online medical care, online mental health treatment, and online alcohol and drug treatment.

Southern California Locations for Alcohol and Drug Treatment
Tarzana Treatment Centers has locations all over Southern California in Los Angeles County. Other than our central location in Tarzana, we have facilities in Lancaster in the Antelope Valley, Long Beach, and in Northridge and Reseda in the San Fernando Valley.