Research paper
Malaysia and harm reduction: The challenges and responses

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Abstract

In Malaysia the response to illicit drug use has been largely punitive with the current goal of the Malaysian government being to achieve a drug-free society by 2015. This paper outlines the results of a desk-based situation assessment conducted over a 3-week period in 2004. Additional events, examined in 2005, were also included to describe more recent policy developments and examine how these came about. Despite punitive drug policy there has been a substantial rise in the number of drug users in the country. Over two-thirds of HIV/AIDS cases are among injecting drug users (IDUs) and there has been an exponential rise in the number of cases reported. Further, data suggest high risk drug use practices are widespread. Harm reduction initiatives have only recently been introduced in Malaysia. The successful piloting of substitution therapies, in particular methadone and buprenorphine, is cause for genuine hope for the rapid development of such interventions. In 2005 the government announced it will allow methadone maintenance programmes to operate beyond the pilot phase and needle and syringe exchange programmes will be established to serve the needs of IDUs.

Section snippets

Background

Malaysia is not a major producer of illicit drugs, but close geographical proximity to the Golden Triangle (Myanmar, Laos and Thailand) and other Southeast Asian countries that produce heroin, amphetamine type substances (ATS) and other drugs, has resulted in rising domestic drug use (United Nations Office on Drugs and Crime (UNODC), 2003; United States Department of State Bureau for International Narcotics and Law Enforcement Affairs (US Department of State), 2004). In Malaysia, illicit drug

Methods

This project consisted of a 3-week desk-based data collection and analysis exercise involving three researchers. Over 100 journal articles, reports, drug user profiles, abstracts, documents, conference presentations and books were collected and reviewed. A review of drug-related issues in the media for the period 2001–2004 resulted in a further 120 reports. Key informant interviews with respondents from various government and non-government sectors dealing with drug use and HIV/AIDS were also

Trafficking, drug taking practices and risk factors

The trafficking of heroin into Malaysia remains a concern as reflected by the number of drug seizures, but also because heroin was the drug of misuse for most drug treatment admissions and drug-related arrests (United Nations Office on Drugs and Crime (UNODC), 2004). In 2003, 128 kg of heroin were seized (Polis Malaysia, 2004) and whilst ATS were becoming increasingly popular and available, heroin (followed by cannabis) was the most common illicit drug for which people received treatment (United

Discussion

In Malaysia the HIV epidemic has for the last 15 years primarily affected IDUs. A similar situation has been reported in other Asian countries. In July 2004, at the Second Asia-Pacific Ministerial meeting on HIV/AIDS in Thailand, the Joint Ministerial statement reported its alarm at the rapid spread of HIV among IDUs. They noted a commitment to expand prevention efforts, recognising the special needs of IDUs (Ministerial Meeting on HIV/AIDS, 2004). Yet whilst Malaysia has long recognised that

Acknowledgement

This research was supported by CIPRA Grant R03 AI 56379-01, Department of Health and Human Services, National Institute of Allergy and Infectious Diseases, National Institutes of Health, USA.

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    1

    These authors contributed equally to this work.

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