Managing Substance Abuse And HIV In Malaysia

Main Category: Alcohol / Addiction / Illegal Drugs
Also Included In: HIV / AIDS
Article Date: 14 May 2007 - 12:00 PDT

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In a significant change of policy, the Malaysian government now has authority for providing medical treatment for heroin dependence and related health conditions. Evidence shows that treating addiction and drug abuse with such medications as naltrexone, buprenorphine, and methadone could help decrease the unusually high prevalence of HIV in Malaysia.

Background: Despite consistent economic development and a respected primary health care system, Malaysia has the second highest HIV prevalence among adults in the Western Pacific region and the highest proportion of HIV cases resulting from injection drug abuse. By the end of 2004, as many as 234,000 heroin abusers had been registered in the official Malaysian government registry, but there may be as many as 500,000 heroin abusers there. Drug abuse and related disorders, such as HIV, exert a heavy burden on the country's health care and legal systems. Historically, Malaysian drug offenders were rehabilitated involuntarily in correctional, rather than health care, facilities. This approach had limited effectiveness, which led to the recent introduction of medical treatments for addiction.

Study Design: The scientists reviewed the literature to determine the scope of heroin and other drug abuse in Malaysia; treatment for heroin addiction and abuse of amphetamine-type stimulants; and the scope of HIV.

What They Found: In Malaysia, more than 30,000 opiate-dependent patients are currently treated with such medications as naltrexone, buprenorphine, and methadone. Despite the high prevalence of HIV and other infectious diseases among addicted people, few HIV prevention efforts have targeted Malaysian drug abusers, who represent only a minority of patients receiving antiretroviral therapy.

Comments From The Authors: Malaysia has until recently lagged behind in the treatment of drug addiction and related disorders, despite experiencing severe drug problems. Now, however, the Ministry of Health has authority for providing medical treatment for heroin dependence. This shift signals a remarkable change in Malaysian policies and approaches to addiction and an important opportunity to develop, implement, and disseminate effective treatments. Drug treatment may provide a unique opportunity to educate drug abusers about the risks of HIV infection and transmission. The emergence of HIV and AIDS may also lead to a resurgence of tuberculosis, especially in prison populations.

What's Next: The country's health practitioners and policymakers continue to improve treatment for heroin dependence. But efforts need to be increased to deal with escalating problems associated with amphetamine-type stimulants.

Publication: Dr. Mahmud Mazlan of the Substance Abuse Center in Muar, Malaysia, and his colleagues published their findings in the September 2006 issue of Drug and Alcohol Review.

The National Institute on Drug Abuse (NIDA) is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug abuse and addiction. The Institute carries out a large variety of programs to ensure the rapid dissemination of research information and its implementation in policy and practice. Fact sheets on the health effects of drugs of abuse and other topics are available in English and Spanish.

These fact sheets and further information on NIDA research and other activities can be found on the NIDA home page at www.drugabuse.gov.