Support the call to use
substitution therapy for drug addicts to arrest the exponential
increase of HIV/AIDS cases in Malaysia
by Ronnie Liu Tian Khiew
Both University of Malaya (UM) and the
Malaysian Medical Association have recommended that government-run
rehabilitation centres and hospitals use drug substitution therapy (DST) to
treat heroin addicts in a workshop yesterday.
The psychological research centre of
UM has found in an eight-month study that DST can yield benefits such as
reducing overdose and suicide rates among addicts and cutting down
involvement in illegal activities.
UM head of psychology Prof Dr Mohamad
Hussain Habil said the current methods of weaning addicts off drugs usually
resulted in relapse. He testifies that using medication for harm reduction
and substitution treatment rather than detoxification, there is more success
rate in getting patients off drugs for good. He also disclosed that the
proposal has been submitted to the Ministry of Health last Wednesday.
Prof Dr Adeeba Kamarulzaman, the Head
of Infectious Diseases Unit, Department of Medicine of UM has also advocated
for harm reduction model including the exchange of needles and using
Methadone to help heroin users when she participated in the live Debat
Perdana held on March 6, 2005.
Methadone ( Meh-thah-don) is the drug
most commonly used and researched for DST. It reduces the craving for
addictive substances and is effective in reducing withdrawal symptoms. High
doses of methadone can block the effects of opiates (drugs derived from
opium, like morphine and heroin) so that addicts will not get "high" when
they take drugs.
We were convinced that the risk of
contracting the HIV virus through needle-sharing among heroin addicts is
also lessened with methadone maintenance therapy (MMT), which is one form of
DST, as it comes in the form of a pill.
We disagree with the Pemadam chief,
Datuk Zainal Abidin Zin, who was skeptical about the use of Methadone. He
should study the proposal forwarded by the UM experts and other NGOs
carefully instead of urging the Government to have a second thought about
DST (as reported in the press today).
Does he know that in Australia, where
MMT was practiced, new drug addiction cases and consequently the spread of
AIDS had reached a plateau while in Asia and Africa, the growth of
HIV-positive people had been exponential in the past decade. Australia and
Malaysia have about the same population. The total number of reported HIV
cases in Australia is around 17,000, which is much lower than the Malaysian
figure, which is well above 70,000.
The government must not take the
warning issued by another expert Dr George Fernandez lightly. He said a
recent study has shown that if the use of Methadone or other form of DST
were not adopted widely by the Malaysian authority as soon as possible, the
number of HIV/AIDS cases could shoot up to 1.3 million by 2015.
MMA president Datuk Dr N. Arumugam
said methadone helped drug addicts behave and function normally, allowing
them to gradually ease back into the workforce and be responsible family
members. He also said that drug users on MMT can practice it from their own
homes without having to go to a rehabilitation centre. Such approach has
been proven more effective all over the world as drug users need not leave
the schools or resign from their work places.
This is not the first time such
proposals were submitted to the government. In the backdrop of more than a
million drug addicts in the country (with 300,000 detected cases by 2004 and
the increase of another 55 new cases every day according to the National
Drugs Agency,ADK), the government must quickly discard its old methods and
attitude in curbing drug abuse and to proceed with the new harm reduction
approach without further delay. We urge the government to legalize the use
of Methadone, needle-exchange programs and adopt other harm reduction
approaches immediately to arrest the exponential increase of HIV/AIDS cases
* Ronnie Liu Tian Khiew,
DAP International Secretary and NGO bureau chief