Substitution treatment in Malaysia

Noordin, Noorliza Mohamad; Merican, Mohd Ismail; Rahman, Hasan Abdul; Lee, Shui Shan; Ramly, Rushidi

doi:10.1016/s0140-6736(08)61479-8

Cited by 13 publications

(10 citation statements)

References 3 publications

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“…OAT utilization, however, was low and did not differ between injectors and non-injectors. OAT like methadone is one of the most effective evidence-based treatments for opioid dependence, which has been available in Malaysia since 2006 as part of a comprehensive national HIV prevention strategy (30) and has been deployed in several community-based settings and selected prisons (32, 33). While methadone has been introduced in some of the men’s prisons (32), Malaysia has unfortunately not initiated it in women’s prisons.…”

Section: Discussionmentioning

confidence: 99%

“…Although drug use remains a serious problem in Malaysia, the increased availability of opioid agonist maintenance treatment (OAT) for opioid dependence has been a major priority for the Malaysian government since 2006 when the Malaysian Ministry of Health introduced government-funded free methadone maintenance treatment for Malaysians at select government clinics (30). For a temporary period, methadone was provided within at least one mosque as an effort to bridge the divide between the government’s advocacy for OAT and skepticism from religious leaders (31).…”

Section: Introductionmentioning

confidence: 99%

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Patterns of substance use and correlates of lifetime and active injection drug use among women in Malaysia

Wickersham

Loeliger

Marcus

et al. 2015

The American Journal of Drug and Alcohol Abuse

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Background While drug use is associated with HIV risk in Southeast Asia, little is known about substance use behaviors among women, including drug injection. Objectives To describe patterns of substance use among women using alcohol and drugs in Malaysia and identify correlates of lifetime and active drug injection, a risk factor for HIV transmission. Methods A survey of 103 women who used drugs in the last 12 months assessed drug use history and frequency, including drug injection and drug use during pregnancy, self-reported HIV-status, childhood and adulthood physical and sexual abuse, and access to and utilization of harm reduction services, including needle-syringe exchange programs (NSEP) and opioid agonist maintenance therapy (OAT). Principal component analyses (PCA) were conducted to assess drug use grouping. Results Amphetamine-type substances (ATS; 82.5%), alcohol (75.7%) and heroin (71.8%) were the most commonly used drugs across the lifetime. Drug injection was reported by 32.0% (n=33) of participants with 21.4% (n=22) having injected in the last 30 days. PCA identified two groups of drug users: opioids/benzodiazepines and club drugs. Lifetime drug injection was significantly associated with lower education, homelessness, prior criminal justice involvement, opioid use, polysubstance use, childhood physical and sexual abuse, and being HIV-infected, but not with prior OAT. Conclusion Women who use drugs in Malaysia report high levels of polysubstance use and injection-related risk behaviors, including sharing of injection equipment and being injected by others. Low OAT utilization suggests the need for improved access to OAT services and other harm reduction measures that prioritize women.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patterns of substance use and correlates of lifetime and active injection drug use among women in Malaysia

Wickersham

Loeliger

Marcus

et al. 2015

The American Journal of Drug and Alcohol Abuse

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“…12 Malaysia's initial experience with the implementation of needle and syringe exchange programmes and MMT programmes has been described elsewhere. 13,14 The MMT programme was rolled out in three phases. In Phase I, MMT was introduced in specialty clinics for people with drug dependence, and in Phase II it was expanded to primary care settings.…”

Section: Setting and Approachmentioning

confidence: 99%

Implementing methadone maintenance treatment in prisons in Malaysia

Wickersham

Marcus

Kamarulzaman

et al. 2013

Bull. World Health Organ.

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“…D. Bruce, Govindasamy, Sylla, Kamarulzaman, & Altice, 2009; Vicknasingam, Mazlan, Schottenfeld, & Chawarski, 2010). Methadone maintenance therapy (MMT) was introduced in 2006 (Noordin, Merican, Rahman, Lee, & Ramly, 2008; Razali, 2008), with a three-phase MMT expansion to addiction specialty clinics, primary care settings and then prisons (Sharifa Ezat, Noor Azimah, Rushidi, Raminder, & Ruhani, 2009; Wickersham, Marcus, Kamarulzaman, Zahari, & Altice, 2013a). Despite global recognition of the effectiveness of OMT for treating opioid dependence and preventing transmission of blood-borne infections, access to OMT in low- and middle-income countries like Malaysia is limited, and barriers to implementation persist (L.…”

Section: Introductionmentioning

confidence: 99%

Treatment Readiness, Attitudes Toward, and Experiences with Methadone and Buprenorphine Maintenance Therapy Among People Who Inject Drugs in Malaysia

Vijay

Bazazi

Yee

et al. 2015

Journal of Substance Abuse Treatment

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Background Little is known about attitudes toward and experiences with opioid maintenance therapy (OMT) among people who inject drugs in Malaysia, a country where people who inject drugs comprise 1.3% of the adult population. Methods In 2010, 460 people who inject drugs in Greater Kuala Lumpur, Malaysia were surveyed to evaluate attitudes toward and experience with OMT and treatment readiness. Attitudes towards OMT with both methadone and buprenorphine were assessed using an opinions scale. Multivariable linear regression was used to assess correlates of treatment readiness, measured with the 19-item Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Results All 460 participants used opioids and nearly all (99.1%) met criteria for opioid dependence. Few had had previous experience with methadone (9.3%) or buprenorphine (12.6%) maintenance therapy, yet many had used methadone (55.2%) or buprenorphine (51.7%) outside of treatment settings. Fifteen percent had injected buprenorphine in the past month, and of the few that were currently receiving buprenorphine maintenance therapy, almost all were injecting it. The majority of subjects exhibited a moderate level of treatment readiness and a preference for methadone over buprenorphine. Those with low treatment readiness scores were more likely to have previous experience with compulsory drug detention centers (p<0.01), needle/syringe exchange programs (p<0.005), or be of Indian ethnicity (p<0.001). Past use of methadone (p<0.01), older age (p<0.001), stress symptom severity (p<0.001), and sharing of needles or syringes (p<0.05) were associated with higher treatment readiness scores. Conclusion There are suboptimal levels of OMT experience among people who inject drugs that may be improved by addressing factors that influence patient attitudes. Those individuals with moderate treatment readiness may be targeted by brief motivational and cognitive interventions in primary care, prisons or OMT clinics aimed at improving entry into and retention in treatment.

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Substitution treatment in Malaysia

Cited by 13 publications

References 3 publications

Patterns of substance use and correlates of lifetime and active injection drug use among women in Malaysia

Patterns of substance use and correlates of lifetime and active injection drug use among women in Malaysia

Implementing methadone maintenance treatment in prisons in Malaysia

Treatment Readiness, Attitudes Toward, and Experiences with Methadone and Buprenorphine Maintenance Therapy Among People Who Inject Drugs in Malaysia

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