Support the call to use substitution therapy for drug addicts to arrest the exponential increase of HIV/AIDS cases in Malaysia

Media Statement
by Ronnie Liu Tian Khiew

(Petaling Jaya,  Monday): 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 in Malaysia.


* Ronnie Liu Tian Khiew, DAP International Secretary and NGO bureau chief