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How did the youth in the Indian state of Punjab get addicted to drugs and alcohol? Is this only the case of Punjab or other states as well?

India is sandwiched between the Golden Crescent and Golden Triangle [euphemisms for the drug originating regions] - with neighbors on both sides leading the production and export of drugs in the world. You can see the major drug routes of the world.Thus, both corners of India are a victim of a massive drug export. While Punjab on the northwestern corner has a massive problem, we ignore the huge drug problems happening the North East. Look at the chart here. Mizoram leads the country in drugs seized [partly because recently the community stepped up in a huge way].India on a 'high' with 7 drug addiction related suicides every dayHowever, the neighbors are not the only problem. In other drug affected regions in India, there is a massive community effort to fight the problem. [See: Behind Mizoram’s recent drug busts, a remarkable community effort] In Punjab such a community response is fairly weak due to insipid political leadership that has more of their personal quibbles in mind than fighting a social problem.Other issues affecting Punjab:High stress jobs: Punjabis tend to take on high stress jobs [army, truck driving and entrepreneurship] and many take alcohol & recreational drugs to manage the stress. As a country, India is failing to provide adequate support in managing stress. The machismo culture would also prevent men from asking for help as they always have to show their stronger side.The unraveling of the economy: Punjab went on a high with green revolution. It became the India’s richest state in 70s & 80s. That lulled the government a bit and they never continued on an industrial revolution or a service sector revolution. Thus, Punjab missed the boat when India opened up in 1991 and is no longer the high in its economy. Drugs provide the high now, for some who have fallen from their heights of their economic progress. To make it a double whammy, the falling water tables from a reckless abuse of ground water has added to massive agricultural stress. Agriculture in Punjab under stress: ExpertKhalistan movement: From 1970s to 90s the state went through a massive terrorism episode and like terrorists elsewhere in the world they used drugs to fund their activities. As India broke apart the terrorism, people needed even more drugs to heal the wounds of seeing families broken apart.Government makes money off addiction: Alcohol is a huge source of Punjab government’s revenues. Like the Tamil Nadu government, they have become experts at selling alcohol [as a Tamil dialogue goes: Utopia is where the government provides education and the private sector sells alcohol. Dystopia is where the government masters in selling alcohol and private masters in selling education]. Why would the government fight addiction when they have money to profit? At some point alcohol addiction turns into drug addiction and the government officers benefit from that too [some police officers double up as drug lords].Also see: Pushing poppies in Punjab

Is COVID-19 likely to be at pandemic proportions for two years?

There is a possible cure for Covid-19 that is getting only limited attention, possibly because the government does not want to raise false hopes. I attached a chart that was published 4 days ago by a prestigious set of medical scientists in the prestigious International journal of Antimicrobial Agents.This chart shows the results of a controlled test of medications hydroxychloroquine and azithromycin. The bottom curve (green) is the most exciting one. When these medicines were used together, 8 seriously infected patients showed no presence of the coronavirus after 5 days. The upper curve is the controlled group.The entire paper can be found at this link: cover19 treatment paperEven better, these medicines have been in common and extensive use for other illnesses, particularly malaria, and thus have only known and well-established side effects.Anthony Fauci is currently trying to determine whether to approve use of these medications for coronavirus. Trump seems to be pushing him to do that. It requires FDA approval. Right now, if you have covid-19, your local physician can prescribe these drugs, but doing so is “off label”, that is, they are FDA approved drugs but not for this purpose. I think (I’m not sure) that this leaves the medical doctor open to being sued.Fauci expressed in his morning briefing that more tests are necessary. From a statistics point of view, that is not true. Eight people were cured in 5 days, while only one person in the control group spontaneously cured. The likelihood of that happening by chance are less than 1%. Larger groups are not needed to demonstrate this efficacy. “Small numbers” can be a valid criticism for marginal results, but these results are not marginal. The positron was discovered with 1 event; only 1 positron was seen, but it was enough. Anderson got the Nobel Prize for his one event. If you have one positron, that is good enough to show it exists. Small numbers do not necessarily imply weak statistics. I hope that Dr. Fauci understand that.Part of the holdback, I suspect, is the terrible experience of the early release of a medicine called thalidomide in the 1950s that caused horrible congenital malformations in babies. Ever since this happened, the medical community has exercised enormous caution before approving a new drug. But the disruption to the world livelihood is so severe, that I believe the thalidomide cautions are not called for. Extreme caution may be inappropriate when the alternative consequences are extreme disruption.Anthony Fauci certainly knows an enormous amount about biomedicine that I don’t know. But I worry that he doesn’t understand statistics as well as I do. The published paper shows extremely significant statistics, despite the small numbers tested.I concur with the conclusions published in the cover19 treatment paper, in which the authors state:“We therefore recommend that COVID-19 patients be treated with hydroxychloroquine and azithromycin to cure their infection and to limit the transmission of the virus to other people in order to curb the spread of COVID-19 in the world.”I am optimistic by nature, perhaps by choice, so take what I say with some degree of caution. I see a path in which we can be largely rid of the coronavirus scourge in weeks rather than in months or years.

What’s something about being a pharmacist that’s not always talked about?

I suppose for me it would be that we have studied for our jobs, we have …like…. actual degrees!! Masters even …and yes.. PhDs(!)People have been stunned when i tell them this. Especially when I get the “there it is right behind you, don't waste your time slapping on a label” comment. I've had these a few times.No we are not glorified sales assistants we are actual Professionals. Not everyone thinks this but the small minority who do irritate me so much.A few notable incidences I have had over 13 years working in community pharmacy have been …Request for minor surgery from a chap who had recently moved over from eastern Europe. I think he didn't realise that the NHS was free. When i managed to get that across he was elated.Dealing with crowds of people when a patient is suffering from a seizure, twice so far. I know people can be curious but unless you are helping in some way stay away and give the person some space. There's nothing much you can do apart from making sure they don't injure themselves whilst they are having the seizure. Thankfully the seizures didnt last long.Helping someone read her pregnancy test. She was pregnant, luckily that was what she wanted it to be!Helping out a woman whose sister was having a hypoglycaemic attack in the shop next door, checking she was ok afterward.Supplying an epipen to a lady who had left home without hers to administer to her son who was having a reaction. I didn't think twice she asked for it and I handed it over. It was a combination of pharmacist and mummy in that scenario i think.Also just wanted to say…We are amateur counsellors. We see our patients so regularly you develop a bond. Especially patients you will see on a daily occurrence. One such patient opened up about their grief and depression to me once about losing their mother. I was grateful and honoured to be able to offer some comfort.We work in many different sectors from the pharmaceutical industry, to hospital, community and doctors surgeries.A pharmacist working in community pharmacy in the UK will more than likely have done some kind of management role or more than likely be the manager of a pharmacy. We are utilised in so many ways at work. Sometimes pushed to the limit.We are valued mentors to students, dispensers, accuracy checking technicians, healthcare staff.We have the ears of an elephant. We may be checking a prescription out back. But when Sheila recommends the wrong painkiller to Mr Herbert who forgets he is asthmatic we will be out like a shot.When we check prescriptions we are checking they are legally valid, clinically sound and appropriate for the patient and checking dosages in our magic BNFs. If a prescription has a multitude of drugs you can agree that the 20 or 30 minute waiting time is worth it to save your life in case anything has been missed. Which has happened in my experience.We carry out medicines use reviews both in the pharmacy and at care homes and some patients homes too. All are within different roles and scopes. In hospital we are constantly checking your drug charts on the wards supplying medications and valuable advice to doctors about specific dosages of drugs to give a patient due to its narrow therapeutic index. And are involved in making chemotherapy drugs in highly controlled aseptic units. Amongst many other things. BIG massive mention to all the technicians and dispensers who work within the pharmacy teams who are invaluable.Cholesterol testing, blood pressure monitoring, flu jabs, malaria prophylaxis advice, Macmillan pharmacist, dementia friends, diabetes checking, hair loss clinics, emergency hormonal contraception, smoking cessation. All the different directives pharmacists in the community can be involved in. (As well as sticking labels on boxes).I could go on and on, but it's almost 1 am and baby is about to wake up for his early morning feed!

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