Helping Addicts

Hospital of Malaya Centre of Addiction Sciences (UMCAS) support Methadone therapy for drug addicts.

Help addicts with Methadone 

By Ravichandran D.J Paul

KUALA LUMPUR, April 21 (Bernama) - Drug addiction is a serious problem in Malaysia with an average of 16 new addicts and 18 repeat addicts recorded per day during the last year.Another noteworthy fact in the 2008 statistics released by the National Drug Information System Unit (Nadi) is 6,413 (51.92 percent) of 12.352 drug addicts who are repeat offenders are identified.

Based on the number of repeat offenders, Tan Sri Lee Lam Thye, former chairman of the Malaysian Drug Prevention Association (Fighting), to conclude that the program carried out during this recovery failed to meet its objectives.Lee said this during the Addiction Medicine Association Malaysia (AMAM) here on the theme 'Looking Into the Window of Opportunities for Drug Dependence Treatment.Another significant fact about the scenario of the recovery process in this country comes from the Assoc. James F. Scorelli who mentioned in his journal the International Journal of Psychosocial Rehabilitation "that the drug rehabilitation program in Malaysia is less effective, given the recurring billing rate exceeds 50 percent.

TREAT ADDICTS IS USELESS? 
Hundreds of millions of dollars spent over the years in recovering addicts continue to increase their number in addition to their criminal activity that threatens the community.Malaysians will recall the numerous open a rehabilitation center, now known as Puspen (Narcotic Addiction Rehabilitation Center), and rehabilitation centers across the country that has always been a concern for rioting inmates.

Drug addiction is a behavior and biology are complex but can be treated as described by Dr Sivakumar Thurairajasingam, consultant psychiatrist and lecturer at the School of Medicine and Health Sciences, Monash University campus in Malaysia. 
 
 However, the treatment goal today is no longer abstinence from drugs which in reality can only be achieved by a small group of addicts, but a more realistic approach known as 'harm reduction' could help more addicts.

Thus, as in most developed countries, Malaysia has also adopted the Drug Substitution Therapy (DST) since 2002 which is a more potent option in helping addicts to recover. Basically, the addicts are substitute drugs that are safer and at the same time they undergo rehabilitation. However, there are some issues that need attention DST better results are encouraging. 



REGIMENTED TREATMENT 
Lee and Dr Sivakumar pointed out that the main treatment approach now is to use a strict discipline in which addicts are incarcerated in correctional facilities. This is not an ideal approach, especially since no single treatment will suffice for the different stages of addiction - a new drug, normal and hardcore. The treatment success rate of up to 20 per cent recorded in government run institutions clearly indicate weaknesses in its recovery program.Lee felt that such regimented treatment only creates fear and prevent others to seek treatment voluntarily.

"Treatment for drug addiction should be voluntary and drug addicts should not be arrested or harassed. Best way to do this is to give them the confidence to seek treatment," added Lee.Another important thing is based on Lee's observation that parental and community support is needed, but both groups have chosen to exclude drug addicts.

 


DST IS THE BEST CHOICE 
Although the DST using Buprenophine introduced here in 2002 and well received, it stalled in 2004 after reports of abuse. However, in 2005 the DST (MDST) was introduced by the national government.Although the MDST also criticized, a study conducted by Universiti Malaya (UM) through a pilot project in 2005 recorded MDST retention rates came for treatment on a voluntary basis up to 90 percent within a year.

MDST is basically a treatment in the office scene with addicts coming in to take a dose of methadone during the induction period and taking drugs at home during the term `the maintenance. Employees who handle this drug will also monitor the progress of treatment.

This therapy directly address the psychological processes behind drug addiction and hunger. The study also showed that HIV positive addicts on MDST exhibit better decisions on antiretroviral (ARV) with an equal success rate as compared to HIV positive cases is not related to drug addicts. 
 
 With the success recorded by MDST in other countries and in meet the Millennium Development Goals United Nations Organisation, Malaysia has embarked on methadone up scaling.

ISSUES RELATING TO MDST
Currently, there are concerted efforts in making MDST more easily by recovering addicts who want to volunteer.AMAM president Dr Steven Chow who chaired the round table noted that since 2001 at least 600 private medical practitioners have volunteered for the MDST scheme.However, it is not an easy task given the challenges faced by private practitioners and the addicts in the MDST.The first, Dr Chow said, addiction is a stubborn disease that often involves stubborn patients and thus it is not easy to convince addicts to come forward and seek treatment voluntarily.Second, there is no financial support or resources from government to private practitioners involved in the MDST.Third, doctors have to deal with issues related to law enforcement as drug addicts and their treatment under police arrest and cause the treatment process is interrupted. 

BETTER UNDERSTANDING 
The third scenario is attested by Datuk Dr Lim Boon Sho, vice president of AMAM, the two patients were arrested recently when both were under suboxone, a substitute drug allowed under the Poisons Act 1952.

"A patient of mine who was brought by his father for DST was arrested outside the clinic after he received the first treatment. Another patient who is an employee of the Province Council following the DST with the last two years, and showed signs of recovery good, also was arrested after receiving treatment from me. This really confuses me and addicts' family concern.

"I find that there is a serious miscommunication on this substitute drug," he said. 
 
 philanthropic doctor who has been treating drug addicts in the Province starting with opium addicts over 30 years ago, and he derives great satisfaction from seeing the addicts recover and return to live usual, to their families and communities. 
 
 Based on his own experience, Dr Lim said the private practitioners carry out DST has seen success up to 75 percent in recovering addicts. The roundtable was also felt that there could be some misunderstanding of the law that caused the arrest of drug addicts under DST but a representative of the police pointed out that they may be arrested for other crimes.

ENCOURAGING RESULTS FROM 
 MDST 
Whatever the shortcomings, DST using methadone is seen as a potential method for recovering addicts. On 8 April, University of milestone in MDST with the opening of the UM Center for Addiction Sciences and Methadone Research Clinic (UMCAS) in Jalan Universiti.

Center's chief coordinator Dr Rusdi Abdul Rashid said the center was the result of a pilot project launched in 2005 MSDT psychology clinic University Medical Center (UMMC).After several weeks of starting treatment, most were able to return to work and enjoy a better life. The clinic is expected to see between 200-400 patients per month with at least 200 of them from the psychological clinic's waiting list.

Dr Rusdi believes that the clinic is set to play a major role in achieving the government's objective to restore up to 60 per cent of heroin addicts predicted 72.000 by 2015.MDST is probably the best currently in drug treatment and rehabilitation centers adopting the program. However, the number of addicts is increasing every year is still worrying that the burden to rehabilitate them.

Sources: http://umcas.um.edu.my