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The OI Foundation sponsors a biennial national conference, an interactive web site and publishes materials that can fill this need. For others it may start later quite often during pregnancy. The residents interviewed in this study felt that the dynamics in their families were so dysfunctional that they had resulted in permanently unresolved conflicts, denial, break-down of open communication and mutual caring, which then became a further trigger for substance abuse. Physicians may be certified through the American Society of Addiction Medicine.

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