Illicit Drug use in the Asia Pacific Region - Burnet Institute

Situational analysis of illicit drug issues and responses in the Asia–Pacific region
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Treatment In the Government’s primary detoxification unit in-patient
treatment usually lasts 14 days, in which clonidine and
buprenorphine therapies are provided . NGOs follow the
traditional ‘spiritual’ detoxification model of massage,
hot baths and prayer .
Voluntary or self-referral Yes
Compulsory No (although if convicted of drug use, drug users can be
sent to a prison where a special unit has been established) .
Methadone for
No
detoxification
Substitution therapy Limited to HIV-positive drug users
Most common type
of treatment provided
Primary prevention Yes
School-based education Yes
Community education Yes
2 .7 .7 Australia’s involvement — NA
2 .7 .8 International involvement — NA
Traditional detoxification, often with medication
in government facilities but often no medication in
NGO system . Post-treatment rehabilitation provided .
2 .8 Malaysia
Population: 23,522,482
2 .8 .1 Overview of
recent drug trends
Although amphetamine-type substances
(ATS) (mainly in the form of crystalline
methamphetamine) are increasingly popular
and appearing to be more accessible in
2003, heroin followed by cannabis are the
most common illicit drugs for which people
sought and received treatment . Ecstasy use is
established but widespread use is unclear .
2 .8 .2 Prevalence of drug use
There are varying estimates of the number of
illicit drug users in Malaysia, none particularly
methodologically sound; the current
literature suggests an increasing number
of people using illicit drugs . In 2002, the
National Drug Agency estimated more than
350,000 drug users in the country, with the
media in 2004 citing government sources
reporting figures ranging from 400,000
to 500,000 . In 2003, there were 36,996
registered drug users . From January to March
2004 there were 1931 new cases of drug
users registered per month . In 2004, the UN
Reference Group on drug injecting issues
suggested 150,000 to 240,000 injecting
drug users (IDUs) with a middle-range figure
of 195,000 .
2 .8 .3 Drug supply
Malaysia is not a major producer of illicit
drugs . However, its close geographical
proximity to the Golden Triangle and other
Southeast Asian countries that produce
heroin and ATS has ensured that the supply
of illicit drugs entering the nation is substantial
. Drug trafficking through Malaysia
most often stems from Golden Triangle
countries, with trafficking overland across
the long border that Malaysia shares with
Thailand, or through various and extensive
sea routes between the two countries .
2 .8 .4 Drug-taking practices,
risk factors and trends
On average, drug users progressed from
smoking and ‘chasing’ to injecting over a
period of two to five years . Generally the
timeframe had shortened . When the quality of
heroin decreases, the trend in Kuala Lumpur is
to ‘chase’ and to mix the heroin with methamphetamine
. There is widespread sharing of
needles and syringes, often 60 per cent and
greater, as well as of other injecting paraphernalia
. Most drug users are aware of the
dangers of being identified by law enforcement
officers and are reluctant to be caught
in possession of injecting equipment, or
purchasing such equipment from a pharmacy .
Drug users are frequently sexually active and
at risk . One study found, among nearly 2000
respondents in 16 rehabilitation centres,
64 per cent were sexually active, of whom
90 per cent did not use condoms; 20 per cent
of the respondents were HIV infected and,
of these, 81 per cent shared needles and
28 per cent reported being sexually active .
The HIV epidemic in Malaysia has for over
15 years primarily affected IDUs; from 1986
to 2002, 76 per cent of all HIV/AIDS cases
were found among IDUs . Of the 6756 HIV
infections reported in 2003, 75 per cent were
among IDUs .
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Country summaries: Malaysia