Yousuf Raza – The Deceit of Drug Rehabilitation Center

Yousuf Raza
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The speakers discuss the complex dynamics of drug addiction and the importance of mental health awareness and consistency in treatment. They emphasize the need for proper work and consistency in treatment to avoid complications and avoid mental health harm. The speakers also discuss the importance of education and negotiating with the insurance industry to convince people to get admission to a school. The speakers emphasize the need for professional help to convince students to get admission to any university and the importance of psychiatry in scientific research.

AI: Summary ©

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			Assalamu alaikum wa rahmatullahi wa barakatuhu.
		
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			Wa alaikum assalam Yusuf bhai, how are you?
		
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			I am fine Azam, how are you?
		
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			I am fine, Alhamdulillah, I am fine for
		
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			now.
		
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			You are fine for now?
		
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			Let's see what's next.
		
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			Are you ready?
		
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			Yes, Inshallah.
		
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			Deceit of Drug Rehabilitation Centers.
		
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			Yes, Dr. Yusuf, why did you name it
		
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			as Deceit?
		
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			I didn't understand it myself, why?
		
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			Okay, because according to my experience, most
		
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			of the drug rehabilitation centers are not drug
		
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			rehabilitation centers.
		
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			There is no rehabilitation, there is more deceit
		
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			and fraud.
		
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			And there is no rehabilitation.
		
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			Okay, you said most of, so is it
		
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			most of or all of them?
		
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			I mean, will there be some that will
		
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			be comparatively better?
		
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			A lot of people ask me to name
		
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			a drug rehabilitation center.
		
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			And I ask back and forth from seniors,
		
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			colleagues, and from somewhere, nobody has any trust
		
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			in any.
		
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			So if there is anyone, then it is
		
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			not in our knowledge, at least not in
		
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			my knowledge.
		
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			We know more how untrustworthy they are, rather
		
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			than how any of them can be trusted.
		
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			So the words you have used for drug
		
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			rehab centers, you are calling them deceit, untrustworthy,
		
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			fraud, you say a lot of things in
		
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			your private meetings.
		
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			Yes, I still say it.
		
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			So what is the reason for this?
		
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			After all, they also give medicines, people go
		
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			there, and a lot of people also report
		
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			that we went there and then left the
		
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			drug.
		
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			So what is the reason for all this?
		
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			See, for the large part, all the drug
		
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			rehab centers we have, there are some protocols
		
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			that they follow, some qualified personnel are on
		
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			their panel, are included in their employees, most
		
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			of the people working for them, don't have
		
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			the first idea about what drug dependence is.
		
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			All the drugs that people depend on, what
		
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			are their protocols, what are their treatment methods,
		
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			what are the dos and don'ts, none of
		
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			that is defined, none of that exists.
		
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			If there are any government recommendations, if there
		
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			are any protocols that a psychiatrist should be
		
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			in drug rehab, or a licensed clinical psychologist
		
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			should be there, then at max, more than
		
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			the paperwork, how a psychiatrist or clinical psychologist's
		
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			drug rehab center actually works, they have no
		
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			say in that.
		
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			The owners, the businessmen, they define how the
		
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			rehabilitation will be, how it won't be, what
		
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			treatment to give to the patients, what medicines
		
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			to give, how many people have to hold
		
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			them, drag them, hit them.
		
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			All of that is going to be decided
		
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			by people who have utterly no qualification in
		
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			what drug rehabilitation is supposed to be like.
		
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			Yusuf bhai, what you said, one thing that
		
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			comes to my mind, and what I remember,
		
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			is that many times, there is a psychiatrist
		
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			who is credible himself, and he doesn't malpractice
		
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			himself, but when he admits someone somewhere, admits
		
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			his patient in a rehab, then what happens
		
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			after admission, is usually not in the hands
		
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			of that psychiatrist.
		
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			And many times we have seen this, I
		
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			know some of my colleagues, who are prescribing
		
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			something else, but the drug rehab centers are
		
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			prescribing something else, the actual medicines that are
		
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			going are something else.
		
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			So what is the reason for this?
		
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			Why do rehab centers do this?
		
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			Why do they do this?
		
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			And this not only harms the patient, but
		
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			also causes a bad name in the name
		
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			of a psychiatrist.
		
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			So why are rehab centers doing this?
		
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			Why don't they listen to a psychiatrist?
		
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			Again, psychiatrist, this is most likely a very
		
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			recent intervention from the government, that to function
		
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			a rehab center, it is very important to
		
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			have a psychiatrist on board, that in their
		
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			documents, it is very important to have a
		
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			psychiatrist.
		
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			And now, the drug rehab centers, for so
		
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			many years, without any psychiatrist, and they don't
		
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			have any kind of international guidelines, they are
		
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			not following any kind of recommendations, they have
		
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			a self-managed management protocol, on which they
		
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			operate.
		
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			On the basis of that, they have some
		
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			cocktail medications with some drug companies, some cocktails
		
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			of medications, which they have prepared.
		
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			Now a psychiatrist will come and tell, that
		
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			for this disease, or for this withdrawal symptom,
		
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			they don't give 15 medications, they give one
		
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			or two, whatever it is, he will give
		
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			such recommendations.
		
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			Those cocktails that are running, which are in
		
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			their contracts with those drug companies, the drug
		
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			companies, one is their source of revenue, obviously,
		
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			those poor patients, who have to pay lakhs
		
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			of rupees, to these frauds, they are in
		
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			their place, but their source of income, from
		
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			the drug companies, it is even at times,
		
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			more profitable, than the patients themselves.
		
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			So, there are a lot of such psychiatrists,
		
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			and perhaps that deserves a show in itself,
		
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			an entire psych meeting, on what independent of
		
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			drug rehab centers, the corruption in medical practice,
		
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			the prescription malpractice, the over-prescribing, the pharmaceuticals,
		
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			the prostitution of doctors, that is, let's just
		
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			not go there for today, let's stick with
		
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			drug rehab centers.
		
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			So, for them, the psychiatrist, is a pain
		
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			in the neck, he is an obstacle.
		
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			Okay.
		
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			Dr. Yusuf, we often hear, that a patient
		
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			went to drug rehab, and he left the
		
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			initial addiction, but he got addicted to some
		
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			other medicine, or something else, so how does
		
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			this happen?
		
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			Again, the psychopathology of addiction, the way addiction
		
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			works, it's not just one type of drug,
		
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			there are multiple types of drugs, the root
		
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			cause, and every patient will have a different
		
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			cause, not every addict of heroin, has the
		
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			same psychopathology, every patient is unique, every situation
		
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			is unique, there are multiple array of factors,
		
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			which have influencing factors, when no one has
		
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			ever addressed them, forcefully, against the basic human
		
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			rights, if someone is released, from the dependence
		
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			of a particular drug, so naturally, since the
		
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			influencing factors are still there, the problems have
		
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			not been addressed, they will fall on to
		
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			some other drug, and not only that, the
		
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			drug rehab centers, they are in a very
		
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			tight nexus, the pharmaceutical companies, which are legal
		
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			drugs, prescription medications, they have illegal contracts with
		
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			them, they are in their place, the dependency
		
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			drugs, the drugs of abuse, drugs, heroin, cocaine,
		
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			you name the whole bunch, drug rehab centers,
		
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			are the supplying centers, the people who supply,
		
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			with them also, there is a tight nexus,
		
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			of the rehab centers, we get to hear
		
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			from many patients, that the best church, or
		
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			the best heroin, is from a certain rehab
		
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			center, or from there, or from here, so
		
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			for them to go from one medication, from
		
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			one addiction to another, and in another way,
		
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			one influencing factor of addiction, is a kind
		
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			of rebelliousness, that the society engenders, and when
		
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			you force someone, to go through all kinds
		
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			of physical pain, and force them to get
		
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			rid of a drug, then that rebelliousness is
		
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			not going down, it has increased, and they
		
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			have to find a chance, that wow, when
		
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			that will come around, and when that will
		
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			lead for the people, to take some drug
		
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			or the other, in
		
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			government hospitals, where I have worked, we keep
		
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			them for maximum 2-3-4 weeks, to
		
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			reduce their biological dependence, the acute issues, and
		
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			send them home, and engage them for a
		
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			long time, and we saw this practice outside,
		
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			so in these addiction centers, the initial bond
		
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			is of 2-3 months, and the initial
		
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			payment is also taken, so the financial strain
		
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			on the patient, and the way he is
		
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			kept in a room for 2 months, does
		
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			he not respect it more, that he will
		
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			come out and start again?
		
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			Definitely, not only will he come out and
		
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			start again, but he will do it with
		
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			a new passion, with a new excitement, with
		
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			a new anger, with whom, as you said,
		
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			the practice in our hospitals, we used to
		
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			go after so many protocols, and admit someone,
		
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			that we had to see their commitment, we
		
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			had to see at what stage they are,
		
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			we had to see that, when these government
		
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			resources will be applied to them, then the
		
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			possibility of a relapse, how much is it,
		
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			how much is it less, and if it
		
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			was not on the stage, that all this
		
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			effort is going to be worth it, we
		
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			did not even admit it, so we had
		
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			properly defined protocols.
		
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			Dr. Yusuf, at least in this matter, we
		
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			can safely say that, the management of government
		
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			hospitals, is better than the private businesses, of
		
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			the drug addiction centers, and is safer than
		
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			them.
		
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			Far better, far safer, there you will have
		
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			a full team, ranging from professor to consultant,
		
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			with postgraduate trainees of all levels, and house
		
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			officers, that in itself having that entire team,
		
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			from senior to junior, that in itself controls,
		
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			what type of management will be done, what
		
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			level of management, which is a completely egregious
		
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			kind of offenses, at least they get debarred,
		
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			they get precluded, we get saved a lot
		
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			from them.
		
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			This is another thing, that the same consultants,
		
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			outside in some other rehab center, in their
		
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			private clinics, follow some other guidelines, and that's
		
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			a separate story altogether, but nevertheless within that,
		
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			that institutional set up, that government set up,
		
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			it's far better, it is definitely far better.
		
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			And in the institutional set up, the support
		
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			that comes from psychologists, and social workers, in
		
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			the drug rehab centers, that is also far
		
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			better.
		
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			Absolutely.
		
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			In fact, in drug rehabs, the physical abuse,
		
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			sexual abuse, economic abuse, emotional abuse, the extent
		
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			to which it happens, that is of a
		
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			whole new level altogether.
		
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			That the mentality of the people working there,
		
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			the people running those institutions, about the drug
		
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			dependent patients, they conceive of them to be
		
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			less than human.
		
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			They think they are a little above the
		
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			animals, or even below them, they think everything
		
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			is justified on them.
		
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			Psychiatric patients are stigmatized the same way.
		
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			If someone has a psychiatric problem, the same
		
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			concept is used, that we know the story,
		
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			and we know the way the society treats
		
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			or perceives them.
		
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			But if it is an addiction, then we
		
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			will find even the most trained and experienced
		
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			people, having a great deal of difficulty, to
		
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			empathize with them.
		
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			They are seen as a burden on our
		
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			social resources, of their parents, of their family,
		
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			of the society.
		
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			They are seen as a hindrance.
		
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			And when all these labels are put on
		
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			them, then we can chemically abuse them, physically
		
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			abuse them, sexually abuse them, economically abuse them.
		
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			It just gets rationalized in their mind.
		
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			It gets justified in their mind, that it's
		
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			all a fair game now.
		
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			We are looting these parents, for something that
		
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			we know we can't provide.
		
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			Why are they justified?
		
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			They are justified because they didn't take care
		
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			of their children.
		
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			They put their children on drugs.
		
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			And the evil prevails.
		
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			Yusuf bhai, whoever has spent one or two
		
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			years in the psychiatric community of Pakistan, knows
		
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			what happens in drug rehab centers and what
		
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			doesn't.
		
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			But since the government has made a requirement,
		
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			that at least one psychiatrist is compulsory on
		
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			the panel of your rehab center, who should
		
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			come twice a week, and meet the requirements.
		
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			So we see that there are a lot
		
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			of rehab centers, which are functioning in such
		
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			a way, that the psychiatrist has only got
		
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			his name written there.
		
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			They know what's going on there, and it's
		
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			like turning a blind eye, that we don't
		
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			know what's going on there.
		
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			We are just getting our name written, and
		
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			instead of that, whatever share they get, or
		
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			whatever money they get.
		
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			So we, those psychiatrists, who are allowing these
		
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			things in their name, we can't exclude them
		
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			either.
		
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			Azam, you are a witness.
		
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			When your FCPS exam was cleared, you didn't
		
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			even get a degree yet.
		
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			What happened after that?
		
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			Exactly.
		
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			Would you like to share with people?
		
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			There are offers.
		
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			What offers did you get?
		
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			Of course, there are offers.
		
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			And whoever has done FCPS in psychiatry in
		
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			Pakistan, they can tell you.
		
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			The exam has just been cleared.
		
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			It has just been announced that you have
		
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			passed.
		
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			It's not even official yet.
		
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			That you have satisfied the board of examiners.
		
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			However you satisfied.
		
00:19:28 --> 00:19:31
			So you just give us your name, give
		
00:19:31 --> 00:19:33
			us your degree, and we will give you
		
00:19:33 --> 00:19:34
			a month's salary.
		
00:19:34 --> 00:19:36
			And whether you come or not, we don't
		
00:19:36 --> 00:19:39
			have any issue.
		
00:19:40 --> 00:19:44
			And it is very lucrative for a psychiatrist.
		
00:19:44 --> 00:19:50
			And at that time, you are getting paid
		
00:19:50 --> 00:19:52
			to take it.
		
00:19:52 --> 00:19:57
			But for a psychiatrist, that money won't be
		
00:19:57 --> 00:20:00
			more than 10, 12, 13, 15 consultations.
		
00:20:01 --> 00:20:04
			As much as the drug rehab center is
		
00:20:04 --> 00:20:04
			giving you.
		
00:20:04 --> 00:20:09
			So for the money of 15 consultations, you
		
00:20:09 --> 00:20:14
			let unethical practices happen under your name.
		
00:20:15 --> 00:20:19
			At least our own community should also think
		
00:20:19 --> 00:20:19
			about this.
		
00:20:20 --> 00:20:20
			Absolutely.
		
00:20:21 --> 00:20:23
			In fact, what you told me, that if
		
00:20:23 --> 00:20:26
			a psychiatrist insists, that no, no, I will
		
00:20:26 --> 00:20:29
			still go to the center or I will
		
00:20:29 --> 00:20:29
			go.
		
00:20:29 --> 00:20:31
			And I will see each patient.
		
00:20:31 --> 00:20:34
			And I will also give recommendations on it.
		
00:20:34 --> 00:20:35
			What happens to them?
		
00:20:40 --> 00:20:43
			What you said, if they are watching the
		
00:20:43 --> 00:20:44
			program, they must have understood.
		
00:20:45 --> 00:20:47
			You told the story.
		
00:20:47 --> 00:20:48
			Absolutely.
		
00:20:48 --> 00:20:51
			Even if you write on it, then your
		
00:20:51 --> 00:20:54
			prescription will not be followed.
		
00:20:55 --> 00:20:58
			Your paper is not more than waste for
		
00:20:58 --> 00:20:58
			them.
		
00:20:59 --> 00:21:03
			Because what you are prescribing, that prescription is
		
00:21:03 --> 00:21:04
			in the mind of thinking, that we have
		
00:21:04 --> 00:21:05
			to release them from here in 15 to
		
00:21:05 --> 00:21:05
			20 days.
		
00:21:06 --> 00:21:08
			We don't want to make them dependent on
		
00:21:08 --> 00:21:09
			new drugs.
		
00:21:09 --> 00:21:11
			So that after 15 to 20 days, they
		
00:21:11 --> 00:21:13
			go home and live with their family.
		
00:21:13 --> 00:21:15
			They get good social support there.
		
00:21:15 --> 00:21:16
			And they will live with us in the
		
00:21:16 --> 00:21:17
			plaza.
		
00:21:18 --> 00:21:21
			But the prescriptions that the drug rehab centers
		
00:21:21 --> 00:21:24
			want to run, is that they stay there
		
00:21:24 --> 00:21:25
			for at least 2 to 3 months.
		
00:21:26 --> 00:21:28
			And when they leave there, they should go
		
00:21:28 --> 00:21:30
			to such medicines that they can't live their
		
00:21:30 --> 00:21:31
			own lives.
		
00:21:32 --> 00:21:35
			And in a way, we get such patients
		
00:21:35 --> 00:21:37
			very easily.
		
00:21:38 --> 00:21:39
			The ones who went to the drug rehab
		
00:21:39 --> 00:21:44
			once, and then they were stuck in it
		
00:21:44 --> 00:21:44
			for many years.
		
00:21:44 --> 00:21:46
			That they stay for 2 months, stay outside
		
00:21:46 --> 00:21:48
			for 3 to 4 months, then they reach
		
00:21:48 --> 00:21:49
			the threshold again.
		
00:21:49 --> 00:21:51
			Then after 2 months, then after 3 to
		
00:21:51 --> 00:21:52
			4 months, this cycle continues.
		
00:21:54 --> 00:21:55
			It is exactly like this.
		
00:21:56 --> 00:21:59
			And do you remember what happens in that
		
00:21:59 --> 00:22:00
			cocktail?
		
00:22:03 --> 00:22:06
			Yes, I remember that.
		
00:22:06 --> 00:22:09
			There are at least 2 antipsychotics in it,
		
00:22:09 --> 00:22:10
			which is very famous.
		
00:22:11 --> 00:22:12
			Alloperidol and Largectal.
		
00:22:13 --> 00:22:18
			And Largectal, we usually, I don't think we
		
00:22:18 --> 00:22:20
			use it in any academic institution.
		
00:22:23 --> 00:22:26
			The medicine that was of the 80s and
		
00:22:26 --> 00:22:26
			90s.
		
00:22:28 --> 00:22:29
			Absolutely.
		
00:22:29 --> 00:22:31
			It has been out of the market for
		
00:22:31 --> 00:22:31
			a long time.
		
00:22:31 --> 00:22:35
			And let me also tell you that the
		
00:22:35 --> 00:22:36
			medicines used in drug rehab come in such
		
00:22:36 --> 00:22:39
			big jars, which are measured from Shalmi.
		
00:22:40 --> 00:22:42
			It is a jar of 500 pills, which
		
00:22:42 --> 00:22:44
			is being made on the back side of
		
00:22:44 --> 00:22:44
			the same shop.
		
00:22:47 --> 00:22:54
			And there are benzodiazepines in it.
		
00:22:54 --> 00:22:58
			One is anti-depressant, one is mood stabilizer.
		
00:22:58 --> 00:23:01
			And at hand, there are always antipsychotic injections.
		
00:23:02 --> 00:23:04
			And this is a cocktail.
		
00:23:04 --> 00:23:08
			And in every drug rehab, across the board,
		
00:23:08 --> 00:23:09
			this is the cocktail.
		
00:23:10 --> 00:23:16
			And we know that even the most severe
		
00:23:16 --> 00:23:20
			psychiatric illness, we will not give this cocktail.
		
00:23:22 --> 00:23:25
			At least, we can't describe that with a
		
00:23:25 --> 00:23:25
			good conscience.
		
00:23:25 --> 00:23:27
			And we will never give it on these
		
00:23:27 --> 00:23:27
			doses.
		
00:23:28 --> 00:23:30
			And we will never give it on these
		
00:23:30 --> 00:23:30
			doses.
		
00:23:31 --> 00:23:34
			And we also see this thing there, that
		
00:23:34 --> 00:23:38
			in psychiatry, even in the first year of
		
00:23:38 --> 00:23:40
			PGR, there is no concept that you have
		
00:23:40 --> 00:23:43
			to take the medicine up slowly, you have
		
00:23:43 --> 00:23:43
			to take it down slowly.
		
00:23:44 --> 00:23:45
			There is no such concept.
		
00:23:45 --> 00:23:47
			On the first day, the patient is numb,
		
00:23:48 --> 00:23:49
			he is like a zombie.
		
00:23:49 --> 00:23:51
			And he is numb, he is moving around,
		
00:23:51 --> 00:23:53
			he is falling in the washroom, he is
		
00:23:53 --> 00:23:53
			falling somewhere.
		
00:23:54 --> 00:23:55
			And in the same way, the patients are
		
00:23:55 --> 00:23:56
			kept there for two to two and a
		
00:23:56 --> 00:23:57
			half months.
		
00:23:59 --> 00:24:03
			And, now I am also thinking that the
		
00:24:03 --> 00:24:05
			rehabs that we get, at least in Lahore,
		
00:24:06 --> 00:24:10
			from 1500-2000 per day to 35,000
		
00:24:10 --> 00:24:12
			-40,000 per day, we get them.
		
00:24:14 --> 00:24:15
			And there is no difference?
		
00:24:15 --> 00:24:17
			Apart from logistics?
		
00:24:18 --> 00:24:18
			In medicines?
		
00:24:19 --> 00:24:22
			Absolutely, in medicines, there is no difference.
		
00:24:22 --> 00:24:23
			The only difference is that the room will
		
00:24:23 --> 00:24:24
			be good, the AC will be good, the
		
00:24:24 --> 00:24:25
			food will be good.
		
00:24:26 --> 00:24:28
			Apart from this, in the expensive rehabs, they
		
00:24:28 --> 00:24:36
			have put 8-10-12 psychologists, who will
		
00:24:36 --> 00:24:37
			do a small session every 15-20 minutes.
		
00:24:40 --> 00:24:44
			And, believe me, those sessions will not be
		
00:24:44 --> 00:24:45
			according to any guideline.
		
00:24:45 --> 00:24:48
			They will only be happening so that the
		
00:24:48 --> 00:24:50
			family and the patient feel that something is
		
00:24:50 --> 00:24:50
			happening.
		
00:24:51 --> 00:24:52
			And psychologists?
		
00:24:53 --> 00:24:57
			Typically, what will be the highest qualification of
		
00:24:57 --> 00:24:57
			these psychologists?
		
00:25:00 --> 00:25:03
			Maximum BS, MSB, even if they are there,
		
00:25:05 --> 00:25:06
			you will also get qualifications up to MS
		
00:25:06 --> 00:25:06
			MPhil.
		
00:25:08 --> 00:25:12
			But, the result of those sessions will be
		
00:25:12 --> 00:25:14
			that look at my coming and going.
		
00:25:14 --> 00:25:18
			One session is ending, another is starting, another
		
00:25:18 --> 00:25:19
			is starting, third is starting.
		
00:25:21 --> 00:25:22
			Absolutely.
		
00:25:24 --> 00:25:28
			So, that's the situation in most drug rehab
		
00:25:28 --> 00:25:30
			centers around the country.
		
00:25:32 --> 00:25:37
			Zainab is asking are all rehab centers the
		
00:25:37 --> 00:25:37
			same?
		
00:25:38 --> 00:25:41
			Are there any who have an ethical practice?
		
00:25:43 --> 00:26:13
			Yes,
		
00:26:13 --> 00:26:13
			Azam.
		
00:26:13 --> 00:26:28
			So,
		
00:26:43 --> 00:26:45
			he will also let you stay there for
		
00:26:45 --> 00:26:45
			a long time.
		
00:26:46 --> 00:26:47
			If you want to stay there.
		
00:26:47 --> 00:26:49
			this is exactly what happens.
		
00:26:50 --> 00:26:51
			There is no work to stay there.
		
00:26:52 --> 00:26:55
			The second thing is that usually the same
		
00:26:55 --> 00:27:01
			psychiatrists are there at rehab, like you and
		
00:27:01 --> 00:27:01
			me.
		
00:27:02 --> 00:27:03
			So, those who do not have their own
		
00:27:03 --> 00:27:05
			patients or do not have any other job,
		
00:27:06 --> 00:27:07
			they are doing a job there.
		
00:27:10 --> 00:27:12
			And the patients who are coming are coming
		
00:27:12 --> 00:27:12
			from rehab.
		
00:27:13 --> 00:27:16
			Or the old medical officers who are working
		
00:27:16 --> 00:27:17
			there are coming from rehab.
		
00:27:18 --> 00:27:20
			So, that psychiatrist does not have a say
		
00:27:20 --> 00:27:20
			there.
		
00:27:21 --> 00:27:24
			That psychiatrist is just a showpiece which is
		
00:27:24 --> 00:27:26
			kept in front that we have a psychiatrist.
		
00:27:28 --> 00:27:30
			Again, the same thing you said when we
		
00:27:30 --> 00:27:32
			were fresh graduates, we have just taken the
		
00:27:32 --> 00:27:35
			degree of FCPSP and we do not have
		
00:27:35 --> 00:27:36
			job opportunities.
		
00:27:37 --> 00:27:37
			Right?
		
00:27:37 --> 00:27:39
			We have done specialization.
		
00:27:39 --> 00:27:43
			It's not like there are hospitals lining up
		
00:27:43 --> 00:27:45
			to hire us.
		
00:27:45 --> 00:27:46
			There is no such thing.
		
00:27:46 --> 00:27:48
			We know how difficult it was for us.
		
00:27:48 --> 00:27:50
			What was going on in private medical colleges?
		
00:27:50 --> 00:27:51
			What was going on in public medical colleges?
		
00:27:52 --> 00:27:53
			What was going on in private hospitals?
		
00:27:54 --> 00:27:57
			You have a mental hospital in Lahore.
		
00:27:58 --> 00:28:03
			The biggest freaking institute for mental health in
		
00:28:03 --> 00:28:03
			the country.
		
00:28:04 --> 00:28:06
			And there is no psychiatrist there.
		
00:28:07 --> 00:28:08
			Now, I don't know if there is a
		
00:28:08 --> 00:28:08
			psychiatrist.
		
00:28:09 --> 00:28:09
			There is no psychiatrist.
		
00:28:12 --> 00:28:14
			Medical officers are running the show.
		
00:28:15 --> 00:28:21
			So, then a fresh graduate looking for money.
		
00:28:21 --> 00:28:22
			We used to get money in training.
		
00:28:22 --> 00:28:23
			We got the degree.
		
00:28:24 --> 00:28:25
			So, we have nowhere to go.
		
00:28:26 --> 00:28:29
			And so, when these drug rehab centers, they
		
00:28:29 --> 00:28:30
			will bring an offer in a sweet tongue
		
00:28:30 --> 00:28:32
			that Doctor, you come to us.
		
00:28:32 --> 00:28:32
			You come to us.
		
00:28:33 --> 00:28:34
			You come with us.
		
00:28:35 --> 00:28:36
			It will be as you say.
		
00:28:37 --> 00:28:38
			Serve the patients.
		
00:28:39 --> 00:28:42
			There is death in drugs.
		
00:28:42 --> 00:28:43
			There is life in treatment.
		
00:28:44 --> 00:28:45
			You come under the umbrella of this slogan
		
00:28:45 --> 00:28:48
			and see what happens.
		
00:28:49 --> 00:28:51
			Who has life in treatment?
		
00:28:52 --> 00:28:52
			And who has death?
		
00:28:53 --> 00:28:55
			That too, the writers know.
		
00:28:56 --> 00:28:58
			Everyone knows what goes on there.
		
00:28:59 --> 00:29:03
			Dr. Yusuf, my colleagues who worked like this
		
00:29:03 --> 00:29:07
			or I worked like this for a month
		
00:29:07 --> 00:29:07
			or two.
		
00:29:09 --> 00:29:11
			Our frustration when we used to sit together,
		
00:29:11 --> 00:29:13
			we used to see that we have written
		
00:29:13 --> 00:29:15
			this medicine but the next day when we
		
00:29:15 --> 00:29:16
			asked the patient if he got the medicine,
		
00:29:16 --> 00:29:17
			he said no.
		
00:29:18 --> 00:29:21
			And those who want to practice well, they
		
00:29:21 --> 00:29:22
			used to do the same with us.
		
00:29:24 --> 00:29:25
			We used to go to jail to do
		
00:29:25 --> 00:29:26
			jail duty.
		
00:29:26 --> 00:29:28
			We used to write medicines there.
		
00:29:28 --> 00:29:31
			In fact, the constable himself used to tell
		
00:29:31 --> 00:29:34
			us, whatever you write, they have to give
		
00:29:34 --> 00:29:35
			us what we have.
		
00:29:36 --> 00:29:42
			And that's another problem for another day.
		
00:29:42 --> 00:29:43
			I used to talk to my colleagues.
		
00:29:44 --> 00:29:46
			So, with those colleagues, their frustration was also
		
00:29:46 --> 00:29:47
			visible.
		
00:29:47 --> 00:29:49
			Many times we see this in the beginning.
		
00:29:49 --> 00:29:50
			Those colleagues fight.
		
00:29:51 --> 00:29:54
			The honor is that why did you do
		
00:29:54 --> 00:29:54
			this?
		
00:29:54 --> 00:29:58
			But slowly they also understand that that's the
		
00:29:58 --> 00:30:01
			way that's the way things go.
		
00:30:01 --> 00:30:03
			There is no other option.
		
00:30:03 --> 00:30:07
			Drug rehab or again, we need to know
		
00:30:07 --> 00:30:08
			this.
		
00:30:09 --> 00:30:14
			Obviously, the parents when they see that my
		
00:30:14 --> 00:30:17
			child is on drugs, they don't know what
		
00:30:17 --> 00:30:23
			is the difference between heroin and cocaine, LSD.
		
00:30:23 --> 00:30:24
			They don't know.
		
00:30:24 --> 00:30:25
			They only know it's drugs.
		
00:30:26 --> 00:30:27
			They only know it's drugs.
		
00:30:28 --> 00:30:30
			I have seen such patients who come and
		
00:30:30 --> 00:30:32
			tell that, Doctor, I used to smoke.
		
00:30:34 --> 00:30:38
			And the rehab center people told my family
		
00:30:38 --> 00:30:44
			that until he quits smoking, we don't recommend
		
00:30:44 --> 00:30:44
			him to go from here.
		
00:30:44 --> 00:30:45
			We will get him to quit smoking.
		
00:30:46 --> 00:30:49
			And no place in the world admits for
		
00:30:49 --> 00:30:50
			cigarette smoking.
		
00:30:51 --> 00:30:51
			There is no rehab for that.
		
00:30:51 --> 00:30:56
			Even Charski, we know for the majority of
		
00:30:56 --> 00:30:58
			patients, 99% of the people that we
		
00:30:58 --> 00:31:02
			deal with, they don't have physical withdrawals because
		
00:31:02 --> 00:31:03
			of Charski.
		
00:31:04 --> 00:31:08
			For 3 months, you are admitting them in
		
00:31:08 --> 00:31:09
			rehab centers.
		
00:31:13 --> 00:31:17
			So, even with them, everyone is put in
		
00:31:17 --> 00:31:21
			the same box, the same label, everyone is
		
00:31:21 --> 00:31:23
			put, it's drugs and for drugs, it's 3
		
00:31:23 --> 00:31:23
			months.
		
00:31:25 --> 00:31:28
			For the most addictive of medications, that's not
		
00:31:28 --> 00:31:28
			the protocol.
		
00:31:30 --> 00:31:30
			The money is advance.
		
00:31:31 --> 00:31:32
			The money for 3 months is advance.
		
00:31:33 --> 00:31:40
			And, I have heard that I have never
		
00:31:40 --> 00:31:42
			contacted them directly that there is such a
		
00:31:42 --> 00:31:45
			rehab center which takes advance check.
		
00:31:46 --> 00:31:49
			And when they have to cash after 3
		
00:31:49 --> 00:31:51
			months, if it is not cashed, then it
		
00:31:51 --> 00:31:54
			will be FIR against it, whose check will
		
00:31:54 --> 00:31:54
			be bounced.
		
00:31:55 --> 00:31:56
			That he has to give our money and
		
00:31:56 --> 00:31:57
			he has not given.
		
00:31:57 --> 00:32:03
			So, that's how they trap you in it.
		
00:32:05 --> 00:32:06
			Absolutely.
		
00:32:07 --> 00:32:15
			So, Azam, for the people watching, unaware what
		
00:32:15 --> 00:32:20
			to do when such things happen, how do
		
00:32:20 --> 00:32:23
			they know that they are being conned, that
		
00:32:23 --> 00:32:25
			someone is doing fraud with them or someone
		
00:32:25 --> 00:32:26
			is treating them.
		
00:32:26 --> 00:32:27
			What do we tell them?
		
00:32:29 --> 00:32:32
			Personally, first of all, I would say that
		
00:32:32 --> 00:32:34
			if there is such a thing in someone's
		
00:32:34 --> 00:32:39
			family, then prefer government institutes.
		
00:32:41 --> 00:32:44
			This is the reason that we talked about
		
00:32:44 --> 00:32:49
			that the environment and academic community is there,
		
00:32:49 --> 00:32:51
			there are less chances that such a thing
		
00:32:51 --> 00:32:51
			will happen.
		
00:32:52 --> 00:32:54
			In government institutes, the doctor has to send
		
00:32:54 --> 00:32:55
			you home in 2-3 weeks.
		
00:32:55 --> 00:32:59
			He does not have to work with you
		
00:33:00 --> 00:33:03
			Because he has no benefit of such money.
		
00:33:06 --> 00:33:10
			The second thing is that frankly, I cannot
		
00:33:10 --> 00:33:15
			recommend any private drug addiction center to you.
		
00:33:16 --> 00:33:19
			In my mind, at least in Lahore, there
		
00:33:19 --> 00:33:22
			is no such place where proper work is
		
00:33:22 --> 00:33:22
			being done.
		
00:33:22 --> 00:33:23
			Not yet.
		
00:33:25 --> 00:33:26
			Absolutely right.
		
00:33:26 --> 00:33:28
			Did you get any information about Islam?
		
00:33:28 --> 00:33:29
			Not yet.
		
00:33:31 --> 00:33:32
			Not yet.
		
00:33:33 --> 00:33:36
			Yes, many people asked me this question.
		
00:33:37 --> 00:33:38
			Many people were frustrated.
		
00:33:39 --> 00:33:43
			Obviously, when parents and family members get to
		
00:33:43 --> 00:33:46
			know, they are ready to do all kinds
		
00:33:46 --> 00:33:47
			of things.
		
00:33:48 --> 00:33:50
			And we need to be very clear on
		
00:33:50 --> 00:33:51
			this as well.
		
00:33:51 --> 00:33:56
			A drug rehab center will give you force.
		
00:33:57 --> 00:34:02
			And force is not the treatment for drug
		
00:34:02 --> 00:34:02
			dependence.
		
00:34:05 --> 00:34:09
			At best, for those 2-3 months, we
		
00:34:09 --> 00:34:12
			are talking about heroin in particular.
		
00:34:13 --> 00:34:16
			We are particularly talking about heroin dependence or
		
00:34:16 --> 00:34:20
			benzodiazepine dependence, which is not that common in
		
00:34:20 --> 00:34:21
			our country.
		
00:34:21 --> 00:34:23
			But it is still there.
		
00:34:24 --> 00:34:26
			That would require you to stay in a
		
00:34:26 --> 00:34:27
			rehab center.
		
00:34:28 --> 00:34:32
			For every drug, rehab is not the answer.
		
00:34:32 --> 00:34:34
			3 months is not the answer.
		
00:34:34 --> 00:34:36
			Drug cocktail is not the answer.
		
00:34:37 --> 00:34:40
			And most importantly, there is a prerequisite and
		
00:34:40 --> 00:34:46
			that is the patient's own motivation or commitment.
		
00:34:47 --> 00:34:51
			If that motivation or commitment is not there,
		
00:34:52 --> 00:34:59
			then certain very good psychotherapists can facilitate the
		
00:34:59 --> 00:35:01
			patients in developing that motivation.
		
00:35:03 --> 00:35:07
			Very good psychotherapists, very good psychiatrists may in
		
00:35:07 --> 00:35:11
			a series of sessions help develop that motivation.
		
00:35:11 --> 00:35:17
			And when it develops, then such steps can
		
00:35:17 --> 00:35:17
			be taken.
		
00:35:17 --> 00:35:21
			Like you said, a public hospital, a government
		
00:35:21 --> 00:35:27
			hospital is a much better option as compared
		
00:35:27 --> 00:35:31
			to any private rehab center.
		
00:35:32 --> 00:35:34
			And Dr. Yusuf, like you also talked about
		
00:35:34 --> 00:35:40
			psychologists, if any rehab center or even a
		
00:35:40 --> 00:35:45
			psychiatrist tells you that without a psychologist or
		
00:35:45 --> 00:35:49
			therapy, I will get rid of his addiction
		
00:35:49 --> 00:35:53
			forever, he will lie to you, no matter
		
00:35:53 --> 00:35:55
			how big a professor he is.
		
00:35:55 --> 00:35:56
			Exactly.
		
00:35:56 --> 00:35:58
			The one who tells you that he only
		
00:35:58 --> 00:36:02
			needs medicines and all the rest is fraud.
		
00:36:02 --> 00:36:05
			We will taper down his receptors with medicines,
		
00:36:05 --> 00:36:06
			then the addiction will end.
		
00:36:06 --> 00:36:07
			This is a lie.
		
00:36:08 --> 00:36:10
			No, he will tell you in a simpler
		
00:36:10 --> 00:36:13
			way that his brain juice has decreased.
		
00:36:14 --> 00:36:16
			This medicine will fill his juice.
		
00:36:16 --> 00:36:18
			He doesn't need anything else.
		
00:36:19 --> 00:36:19
			Exactly.
		
00:36:20 --> 00:36:24
			So whoever is saying that, no matter who
		
00:36:24 --> 00:36:27
			he is, is taking you for a ride.
		
00:36:27 --> 00:36:29
			Is taking you for a ride.
		
00:36:30 --> 00:36:31
			Azam, let's take one more question.
		
00:36:32 --> 00:36:32
			Yes.
		
00:36:34 --> 00:36:37
			Dasoji, what does the law say about regulating
		
00:36:37 --> 00:36:38
			these drug rehab centers?
		
00:36:39 --> 00:36:43
			So, as far as I know, who can
		
00:36:43 --> 00:36:44
			open these?
		
00:36:44 --> 00:36:48
			Anyone can open it, but your drug rehab,
		
00:36:48 --> 00:36:51
			means anyone can open it by investing, like
		
00:36:51 --> 00:36:52
			in a private hospital.
		
00:36:53 --> 00:36:58
			But on your panel, the law says that
		
00:36:58 --> 00:36:59
			24 hours should be covered by the medical
		
00:36:59 --> 00:37:00
			officer.
		
00:37:02 --> 00:37:06
			Emergency facilities should be covered.
		
00:37:06 --> 00:37:10
			Because a lot of our medicines have cardiac
		
00:37:10 --> 00:37:11
			block and arrhythmias.
		
00:37:13 --> 00:37:13
			Hmm.
		
00:37:14 --> 00:37:17
			And the psychiatrist should be at least on
		
00:37:17 --> 00:37:17
			the panel.
		
00:37:17 --> 00:37:21
			The government says that at least two visits
		
00:37:21 --> 00:37:21
			a week.
		
00:37:22 --> 00:37:25
			And psychiatrist means MCPS or FCPS.
		
00:37:25 --> 00:37:26
			At least MCPS.
		
00:37:28 --> 00:37:29
			Diploma won't work.
		
00:37:31 --> 00:37:32
			And the medical officer should be covered for
		
00:37:32 --> 00:37:34
			24 hours.
		
00:37:36 --> 00:37:37
			Right, right, right.
		
00:37:37 --> 00:37:40
			Because withdrawals can be so serious and some
		
00:37:40 --> 00:37:43
			prescription medications can also have such consequences, especially
		
00:37:43 --> 00:37:44
			in those cocktail doses.
		
00:37:45 --> 00:37:48
			It is necessary that you have that facility
		
00:37:48 --> 00:37:49
			available.
		
00:37:49 --> 00:37:51
			Then who's regulating all of this?
		
00:37:53 --> 00:37:58
			Punjab Punjab Health Care Commission was very active
		
00:37:58 --> 00:38:00
			until two years ago.
		
00:38:01 --> 00:38:04
			Now, I think it is not as active
		
00:38:04 --> 00:38:04
			as it used to be.
		
00:38:04 --> 00:38:07
			But at that time, at least in Lahore,
		
00:38:07 --> 00:38:10
			a lot of addiction centers were closed.
		
00:38:11 --> 00:38:15
			Then when addiction centers started hiring psychiatrists or
		
00:38:15 --> 00:38:18
			some other method which can be used very
		
00:38:18 --> 00:38:20
			easily by putting wheels under files.
		
00:38:22 --> 00:38:25
			So, then they reopened.
		
00:38:25 --> 00:38:28
			But two years ago, they were very active.
		
00:38:29 --> 00:38:36
			But again, psychiatrists are on payroll of drug
		
00:38:36 --> 00:38:37
			addiction centers.
		
00:38:38 --> 00:38:43
			So, no psychiatrist who is working there dares
		
00:38:43 --> 00:38:47
			to take a stand against those cocktail treatments.
		
00:38:48 --> 00:38:51
			Because he knows that if I do more
		
00:38:51 --> 00:38:53
			then they will fire me and hire someone
		
00:38:53 --> 00:38:53
			else.
		
00:38:57 --> 00:39:02
			Young psychiatrists their job situation their practice situation
		
00:39:02 --> 00:39:06
			So, doing any such work for someone career
		
00:39:06 --> 00:39:09
			-wise is very bad.
		
00:39:10 --> 00:39:13
			Because, obviously, he is a fresh graduate.
		
00:39:13 --> 00:39:14
			It will take at least two to three
		
00:39:14 --> 00:39:15
			years to develop a private practice.
		
00:39:15 --> 00:39:17
			It will take at least two to three
		
00:39:17 --> 00:39:18
			years to develop a private practice.
		
00:39:19 --> 00:39:21
			What you said that these rehab centers offer
		
00:39:21 --> 00:39:27
			10 to 15 consultations in the beginning.
		
00:39:28 --> 00:39:32
			To get 10 to 15 consultations per month
		
00:39:32 --> 00:39:36
			to reach that level, you have to invest
		
00:39:36 --> 00:39:39
			at least 2 to 3 years of consistent
		
00:39:39 --> 00:39:40
			private practice.
		
00:39:40 --> 00:39:41
			In the very least.
		
00:39:41 --> 00:39:44
			Then you will get 10 to 15 consultations.
		
00:39:47 --> 00:39:52
			You start developing a repute and you start
		
00:39:52 --> 00:39:57
			getting a patient population or a clientele.
		
00:39:58 --> 00:40:01
			So, until then we are talking about people
		
00:40:01 --> 00:40:06
			who have spent at least 30 years studying.
		
00:40:06 --> 00:40:06
			At least.
		
00:40:09 --> 00:40:11
			This is what they are offered and this
		
00:40:11 --> 00:40:12
			is what they have.
		
00:40:13 --> 00:40:16
			When we talk about the drug syndicate.
		
00:40:36 --> 00:40:38
			They have very established practices.
		
00:40:38 --> 00:40:41
			And they themselves send the patients to the
		
00:40:41 --> 00:40:44
			addiction center once and remove them from their
		
00:40:44 --> 00:40:44
			head.
		
00:40:45 --> 00:40:47
			They get their commission from the addiction center
		
00:40:48 --> 00:40:49
			and move ahead.
		
00:40:50 --> 00:40:54
			So, those who have established practices, we can't
		
00:40:54 --> 00:40:54
			exempt them from this crime.
		
00:40:56 --> 00:40:58
			Even those who are not established.
		
00:40:59 --> 00:41:01
			Temptation is stronger for them.
		
00:41:01 --> 00:41:03
			But what are the consequences?
		
00:41:03 --> 00:41:06
			We are not talking about 2-3 months.
		
00:41:08 --> 00:41:13
			To finance those 2-3 months, someone has
		
00:41:13 --> 00:41:16
			sold their rickshaw, someone has sold their house,
		
00:41:17 --> 00:41:21
			someone has sold all their jewelry, someone has
		
00:41:21 --> 00:41:23
			taken a loan from somewhere.
		
00:41:24 --> 00:41:27
			Literally people come on the streets to afford
		
00:41:27 --> 00:41:28
			the fraud of these rehab centers.
		
00:41:28 --> 00:41:33
			To afford the fraud of these rehab centers.
		
00:41:33 --> 00:41:35
			And that's not the extent of it.
		
00:41:35 --> 00:41:39
			If a teenager, even during your 20s and
		
00:41:39 --> 00:41:41
			30s, who tolerates emotional abuse?
		
00:41:43 --> 00:41:45
			Who doesn't care about physical abuse?
		
00:41:46 --> 00:41:49
			Is sexual abuse good for their mental health?
		
00:41:51 --> 00:41:53
			The level at which they are being treated,
		
00:41:54 --> 00:41:58
			a neem hakeem psychologist, and we need to
		
00:41:58 --> 00:42:01
			be very clear on this, those who have
		
00:42:01 --> 00:42:04
			not gone through that process, those who have
		
00:42:04 --> 00:42:07
			barely done a bachelor's degree, they are sitting
		
00:42:07 --> 00:42:12
			in front of a psychopathologist and telling him
		
00:42:12 --> 00:42:15
			stories from their perspective that you have this,
		
00:42:15 --> 00:42:16
			you have that.
		
00:42:17 --> 00:42:19
			That is nothing short of emotional abuse.
		
00:42:21 --> 00:42:24
			The damage that he has to do, now
		
00:42:24 --> 00:42:27
			that personality obviously came in with a significant
		
00:42:28 --> 00:42:31
			damage to it already, that the drugs had
		
00:42:31 --> 00:42:33
			done, that what led them to drugs had
		
00:42:33 --> 00:42:34
			done.
		
00:42:34 --> 00:42:41
			After that, this experience is going to exponentially
		
00:42:41 --> 00:42:42
			worsen the problem.
		
00:42:44 --> 00:42:47
			You first gather four people around a person
		
00:42:47 --> 00:42:51
			whose hands are ready to grasp you and
		
00:42:51 --> 00:42:53
			then if they try to defend themselves, you
		
00:42:53 --> 00:42:54
			say that it is getting aggressive.
		
00:42:54 --> 00:42:56
			It is getting aggressive.
		
00:42:56 --> 00:42:59
			As you said, neem hakeem, khatra jaan came
		
00:42:59 --> 00:43:02
			to my mind that in Lahore, at least
		
00:43:02 --> 00:43:07
			I know there are some rehabs which such
		
00:43:07 --> 00:43:09
			people are running who are not doctors.
		
00:43:10 --> 00:43:12
			And they are running single-handedly.
		
00:43:13 --> 00:43:17
			And one of them once contacted me on
		
00:43:17 --> 00:43:19
			the phone that we have to show you
		
00:43:19 --> 00:43:19
			a patient.
		
00:43:20 --> 00:43:22
			I asked him what happened to the patient.
		
00:43:22 --> 00:43:23
			He said he was an addict.
		
00:43:23 --> 00:43:25
			Now he has a little depression, a little
		
00:43:25 --> 00:43:28
			schizophrenia, and he is getting a little more
		
00:43:28 --> 00:43:28
			bipolar.
		
00:43:32 --> 00:43:34
			So a little schizophrenia and a little more
		
00:43:34 --> 00:43:35
			he was getting bipolar.
		
00:43:37 --> 00:43:39
			So this is what the patient wanted to
		
00:43:39 --> 00:43:40
			show me.
		
00:43:41 --> 00:43:42
			Oh my God.
		
00:43:43 --> 00:43:43
			Let's see.
		
00:43:44 --> 00:43:45
			What can we say?
		
00:43:45 --> 00:43:46
			It is a blessing that he has asked
		
00:43:46 --> 00:43:49
			you to contact at this level.
		
00:43:51 --> 00:43:52
			That now you help us.
		
00:43:53 --> 00:43:55
			When all this has started happening.
		
00:43:56 --> 00:43:57
			It has started happening.
		
00:43:59 --> 00:44:03
			See, what we are dealing with, the drug
		
00:44:03 --> 00:44:08
			syndicate we have, the mafia in it, it
		
00:44:08 --> 00:44:09
			is not just the drug dealers.
		
00:44:10 --> 00:44:13
			It is not just the drug dealers.
		
00:44:13 --> 00:44:17
			It is definitely not just the people who
		
00:44:17 --> 00:44:19
			have developed dependence.
		
00:44:43 --> 00:44:44
			It does not say that I will become
		
00:44:44 --> 00:44:45
			an addict when I grow up.
		
00:44:46 --> 00:44:49
			But if they have developed that habit, there
		
00:44:49 --> 00:44:54
			are significant social factors that our education system
		
00:44:54 --> 00:44:55
			is not paying attention to.
		
00:44:56 --> 00:45:00
			That our politicians have no concern for.
		
00:45:01 --> 00:45:06
			That in any political manifesto you will not
		
00:45:06 --> 00:45:10
			find this to be anywhere near their priority
		
00:45:10 --> 00:45:11
			list.
		
00:45:11 --> 00:45:17
			Mental health has been like 73 years and
		
00:45:17 --> 00:45:20
			nobody has ever even considered.
		
00:45:22 --> 00:45:25
			By the way, what you said, three years
		
00:45:25 --> 00:45:30
			ago, a resolution was approved by the Senate.
		
00:45:30 --> 00:45:34
			And that is that every college and university
		
00:45:34 --> 00:45:37
			should have a psychiatrist and a psychologist on
		
00:45:37 --> 00:45:39
			board.
		
00:45:41 --> 00:45:43
			At least in colleges and universities.
		
00:45:43 --> 00:45:45
			But that has only been done by the
		
00:45:45 --> 00:45:45
			Senate.
		
00:45:46 --> 00:45:49
			It has never been tabled in our National
		
00:45:49 --> 00:45:49
			Assembly.
		
00:45:50 --> 00:45:54
			Because the schools themselves will have to divert
		
00:45:54 --> 00:45:58
			their financial chunk somewhere else.
		
00:46:01 --> 00:46:06
			Schools have so-called counsellors who have no
		
00:46:06 --> 00:46:07
			background in counselling.
		
00:46:07 --> 00:46:11
			Who have no background in everything except counselling.
		
00:46:11 --> 00:46:15
			I have a friend who is an engineer
		
00:46:15 --> 00:46:18
			and he did a Masters in Sociology and
		
00:46:18 --> 00:46:20
			he was on the counselling seat.
		
00:46:21 --> 00:46:25
			And you see, we are talking about the
		
00:46:25 --> 00:46:27
			top elitist schools of the country.
		
00:46:28 --> 00:46:30
			Lahore is an elitist school.
		
00:46:31 --> 00:46:32
			Lahore is an elitist school.
		
00:46:32 --> 00:46:33
			Everyone...
		
00:46:33 --> 00:46:36
			So, what are their agendas?
		
00:46:37 --> 00:46:37
			What is counselling?
		
00:46:38 --> 00:46:40
			You have to convince students to get admission
		
00:46:40 --> 00:46:46
			in Ivy League, Harvard, Yale, or any American
		
00:46:46 --> 00:46:47
			university.
		
00:46:50 --> 00:46:50
			You just have to convince the students.
		
00:46:51 --> 00:46:53
			You don't have to see their situation at
		
00:46:53 --> 00:46:53
			home.
		
00:46:53 --> 00:46:59
			They are not counsellors.
		
00:46:59 --> 00:47:00
			They are convincers.
		
00:47:00 --> 00:47:00
			Why?
		
00:47:00 --> 00:47:03
			So that the school gets ratings.
		
00:47:03 --> 00:47:05
			That we have so many international admissions.
		
00:47:05 --> 00:47:06
			And that's it.
		
00:47:06 --> 00:47:07
			And they are playing with people's lives.
		
00:47:08 --> 00:47:09
			So, to expect them to be concerned with
		
00:47:09 --> 00:47:12
			the mental health of their students, it is
		
00:47:12 --> 00:47:13
			farcical.
		
00:47:13 --> 00:47:14
			It is an absolute absurdity.
		
00:47:15 --> 00:47:18
			And yet, we are expecting them to...
		
00:47:18 --> 00:47:22
			These are the people who have set the
		
00:47:22 --> 00:47:26
			bar in their education system of what it
		
00:47:26 --> 00:47:27
			means to be a good student.
		
00:47:28 --> 00:47:32
			There is absolutely no holds bar with respect
		
00:47:32 --> 00:47:36
			to bullying, parenting, what it is, what it
		
00:47:36 --> 00:47:36
			should be.
		
00:47:36 --> 00:47:37
			No idea.
		
00:47:37 --> 00:47:39
			We have a collectivist culture.
		
00:47:40 --> 00:47:42
			Individualism is on the rise.
		
00:47:42 --> 00:47:43
			How do we negotiate it?
		
00:47:44 --> 00:47:45
			We have no idea.
		
00:47:45 --> 00:47:47
			We have a traditionally religious culture.
		
00:47:48 --> 00:47:49
			How do we deal with modernity?
		
00:47:50 --> 00:47:51
			We have no idea.
		
00:47:51 --> 00:47:52
			There are financial challenges.
		
00:47:52 --> 00:47:53
			We have no idea.
		
00:47:54 --> 00:47:57
			Anti-narcotics force people say no to drugs.
		
00:47:57 --> 00:47:59
			I mean, what the...
		
00:48:00 --> 00:48:06
			I know, through my patients, who gives drugs,
		
00:48:06 --> 00:48:08
			where does it come from, where do they
		
00:48:08 --> 00:48:08
			get it from.
		
00:48:09 --> 00:48:11
			Anti-narcotics force people don't know.
		
00:48:11 --> 00:48:14
			They get roadside potteries to catch drugs.
		
00:48:15 --> 00:48:19
			And you have all of this syndicate.
		
00:48:20 --> 00:48:26
			And the target is our poor roadside potteries.
		
00:48:27 --> 00:48:29
			This thing will remain in our mind that
		
00:48:29 --> 00:48:32
			this syndicate is being financed by those people
		
00:48:32 --> 00:48:37
			or they are being forced to finance it
		
00:48:37 --> 00:48:42
			by selling their rickshaw, selling something else to
		
00:48:42 --> 00:48:43
			get their children treated.
		
00:48:44 --> 00:48:45
			Absolute nonsense.
		
00:48:46 --> 00:48:47
			Absolute nonsense.
		
00:48:47 --> 00:48:48
			And where did the judgment come from?
		
00:48:48 --> 00:48:51
			Anti-narcotics force people say no to drugs.
		
00:48:51 --> 00:48:54
			Even we will hear people of our mental
		
00:48:54 --> 00:48:56
			health profession that they are anti-social.
		
00:48:57 --> 00:48:59
			These people are anti-social.
		
00:48:59 --> 00:49:00
			Nothing can happen to them.
		
00:49:01 --> 00:49:04
			We will find these statements being passed in
		
00:49:04 --> 00:49:07
			academic rounds that why are we spending government
		
00:49:07 --> 00:49:09
			resources on druggies.
		
00:49:11 --> 00:49:16
			Even one of my acquaintances used to say
		
00:49:21 --> 00:49:24
			that there are 5 patients in the ward
		
00:49:24 --> 00:49:25
			and 2 addicts.
		
00:49:29 --> 00:49:34
			We have dehumanized them by Now you have
		
00:49:34 --> 00:49:35
			made addicts lower than patients.
		
00:49:38 --> 00:49:42
			So that's just doesn't get any better than
		
00:49:42 --> 00:49:42
			that.
		
00:49:43 --> 00:49:45
			It just does not get any worse than
		
00:49:45 --> 00:49:45
			that.
		
00:49:46 --> 00:49:48
			That's the deal with the deceit of drug
		
00:49:48 --> 00:49:49
			rehab centers.
		
00:49:50 --> 00:49:53
			This is at best what we could present
		
00:49:53 --> 00:49:57
			before our audience.
		
00:49:57 --> 00:50:00
			And we would hope that you carry this
		
00:50:00 --> 00:50:03
			message as far and wide as you possibly
		
00:50:03 --> 00:50:03
			can.
		
00:50:03 --> 00:50:04
			We are people of the field.
		
00:50:04 --> 00:50:07
			We have seen what goes around, what is
		
00:50:07 --> 00:50:09
			happening and what should not be happening.
		
00:50:09 --> 00:50:11
			And we want to use this platform to
		
00:50:11 --> 00:50:14
			get the message as far and wide as
		
00:50:14 --> 00:50:15
			possible that no rickshaw driver should have to
		
00:50:15 --> 00:50:16
			sell his rickshaw.
		
00:50:17 --> 00:50:19
			No one should have to come on the
		
00:50:19 --> 00:50:24
			road for an utterly useless rather more than
		
00:50:24 --> 00:50:29
			useless damaging greatly damaging intervention.
		
00:50:29 --> 00:50:32
			Okay, we don't deny there must have been
		
00:50:32 --> 00:50:32
			a difference between the two.
		
00:50:33 --> 00:50:36
			But exception only proves the rule.
		
00:50:37 --> 00:50:38
			Right?
		
00:50:38 --> 00:50:43
			So you can't use that to justify the
		
00:50:43 --> 00:50:43
			syndicate.
		
00:50:44 --> 00:50:47
			You cannot be atoned for all the lives
		
00:50:47 --> 00:50:48
			that have been ruined.
		
00:50:49 --> 00:50:51
			Every level of abuse is happening in drug
		
00:50:51 --> 00:50:51
			rehab centers.
		
00:50:52 --> 00:50:54
			This is like a new record.
		
00:50:55 --> 00:50:57
			You have not left any kind of abuse.
		
00:50:58 --> 00:51:00
			What is financial, what is emotional, what is
		
00:51:00 --> 00:51:02
			physical, what is sexual.
		
00:51:02 --> 00:51:04
			And yet, nobody cares.
		
00:51:05 --> 00:51:09
			So, whoever is watching, we would request for
		
00:51:09 --> 00:51:12
			you to spread this as far and wide
		
00:51:12 --> 00:51:13
			as possible.
		
00:51:13 --> 00:51:16
			And if anyone has any doubts about what
		
00:51:16 --> 00:51:20
			we're saying, we will be happy to justify
		
00:51:20 --> 00:51:22
			every single thing that we've said.
		
00:51:24 --> 00:51:24
			Okay.
		
00:51:26 --> 00:51:27
			Okay.
		
00:51:45 --> 00:51:52
			The biological paradigm of psychiatry is fetishization.
		
00:51:53 --> 00:51:57
			And explaining away everything with the juices of
		
00:51:57 --> 00:51:57
			the brain.
		
00:51:58 --> 00:51:58
			Right.
		
00:51:59 --> 00:52:00
			Okay.
		
00:52:02 --> 00:52:04
			You must have discussed this in one of
		
00:52:04 --> 00:52:04
			your dreams.
		
00:52:04 --> 00:52:07
			I don't remember that I had this discussion,
		
00:52:08 --> 00:52:10
			but okay, if this is what it is,
		
00:52:10 --> 00:52:12
			you must have discussed it with Ali.
		
00:52:13 --> 00:52:15
			But this is fair enough.
		
00:52:15 --> 00:52:17
			That's the topic for next week.
		
00:52:17 --> 00:52:18
			We have to come up with a title
		
00:52:18 --> 00:52:19
			for that.
		
00:52:19 --> 00:52:21
			We will talk about that in our field
		
00:52:21 --> 00:52:26
			of psychiatry, not just in Pakistan, but all
		
00:52:26 --> 00:52:29
			over the world, and psychiatry has developed a
		
00:52:29 --> 00:52:37
			fetish for biological causes and biological cures of
		
00:52:37 --> 00:52:39
			all mental health illnesses.
		
00:52:40 --> 00:52:43
			And the result of this is how psychology
		
00:52:43 --> 00:52:46
			has sold itself to psychiatry.
		
00:52:46 --> 00:53:16
			Absolutely.
		
00:53:16 --> 00:53:17
			We will send in their questions and we
		
00:53:17 --> 00:53:20
			would look to answer them as best as
		
00:53:20 --> 00:53:21
			possible.
		
00:53:22 --> 00:53:25
			And covering other mental health illnesses, we will
		
00:53:25 --> 00:53:27
			try to provide additional information on those as
		
00:53:27 --> 00:53:27
			well.
		
00:53:28 --> 00:53:31
			Thank you all for following, for watching.
		
00:53:32 --> 00:53:32
			Thank you.
		
00:53:33 --> 00:53:33
			Azam.
		
00:53:34 --> 00:53:35
			Thank you, Yusuf bhai.
		
00:53:36 --> 00:53:37
			You were so nice.
		
00:53:37 --> 00:53:38
			Okay, Allah Hafiz.
		
00:53:39 --> 00:53:39
			Okay, Allah Hafiz.
		
00:53:40 --> 00:53:41
			Assalamu Alaikum.