The transition to harm reduction: Understanding the role of non-governmental organisations in Malaysia

Narayanan, Suresh; Vicknasingam, Balasingam; Robson, Noorzurani

doi:10.1016/j.drugpo.2011.01.002

Cited by 26 publications

(22 citation statements)

References 14 publications

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“…While Kelantan observes strict interpretations of religious law in which drug use is denounced as forbidden and immoral (Kamarulzaman and Saifuddeen 2010;Narayanan, Vicknasingam, and Haris Robson 2011), participants did not report concerns about the implications of their own drug use within the context of conservative Islamic society. Limited economic, vocational, and recreational or social opportunities in Kelantan may also contribute to the high prevalence of problems with drug use.…”

Section: Discussionmentioning

confidence: 91%

Emerging Drug Use Trends in Kelantan, Malaysia

Desrosiers

Chooi

Zaharim

et al. 2016

Journal of Psychoactive Drugs

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The primarily rural and agrarian Kelantan province of Malaysia has high rates of drug use and is characterized by unique sociocultural factors. Combining qualitative and ethnographic methods, we investigated drug use and treatment needs of people who use drugs (PWUD) in rural areas of Kelantan. In February 2014, field visits, participant observation, and focus group discussions (FGDs) with 27 active PWUD were conducted in rural areas surrounding the capital city of Kelantan. The findings indicate a high prevalence of opiate and amphetamine type stimulants (ATS) use in these areas. FGD participants reported initiating drug use at early ages due to peer influences, to relieve boredom, to cope with problems, and a high saturation of villages with other PWUD was reported as a major contributor to their own continued drug use. They reported a trend of drug use initiation at younger ages and increased drug use among females. Participants were interested in treatment; however, their limited knowledge about treatment options and perceived limited availability of services were barriers to treatment seeking. Easy access to drugs, primarily from Thailand and facilitated by the use of mobile phones, resulted in an expanding prevalence of drug use that underscores the need to bolster education and prevention efforts and accessibility of treatment services in Kelantan.

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Section: Discussionmentioning

confidence: 91%

Emerging Drug Use Trends in Kelantan, Malaysia

Desrosiers

Chooi

Zaharim

et al. 2016

Journal of Psychoactive Drugs

Self Cite

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“…More commonly in the literature, however, the entry point for ISA across the region tends to be disease focused, for example, sexually transmitted diseases (Brewis ), HIV (Narayanan et al. ), chronic respiratory disease (Varela 2010), and malaria and dengue (van den Berg et al. ).…”

Section: Resultsmentioning

confidence: 99%

“…Politically connected champion's progressing issues are also identified (Narayanan et al. ). Individual initiative in the absence of structural supports is also seen as critical (Colombini et al.…”

Section: Resultsmentioning

confidence: 99%

Health in All Policies Approaches: Pearls from the Western Pacific Region

Friel

Harris

Simpson

et al. 2015

Asia & Pacific Policy Stud

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“…The introduction of NSEP is commendable, considering the barriers that the government and NGOs had to overcome in 2006 to implement the nationwide program [15]. However, after several years of implementation, the proportions of clients being referred to Voluntary Counseling and Testing (VCT) and MMT are low, with only approximately 10% of NSEP clients referred to VCT and about 4% referred to and entering MMT [8].…”

Section: Discussionmentioning

confidence: 99%

Substance abuse and the HIV situation in Malaysia

Singh

Chawarski

Vicknasingam

2013

Journal of Food and Drug Analysis

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Heroin continues to be the main drug used in Malaysia, while amphetamine-type stimulants (ATS) have been recently identified as a growing problem. A cumulative total of 300,241 drug users were detected between 1988 and 2006. It is also estimated that Malaysia has 170,000 injecting drug users. HIV prevalence among drug users in the country ranges from 25% to 45%. Currently, there are approximately 380 general medical practice offices that offer agonist maintenance treatments for approximately 10,000 patients. There are 27,756 active patients in 333 general medical practice offices and government-run methadone maintenance treatment (MMT) centers. The Needle Syringe Exchange Program (NSEP) reached out to 34,244 injection drug users (IDUs) in 2011. In the last 2 years (2011 and 2012) the number of detected drug addicts decreased from 11,194 to 9015. The arrests made by the police related to opiate and cannabis use increased from 41,363 to 63,466 between the years 2008 and 2010, but decreased since 2010. An almost four-fold increase in the number of ATS and ketamine users was detected from 2006 (21,653 users) 2012 (76,812). Between 2004 and 2010, the yearly seizures for heroin ranged between 156 to 270 kg. However, in 2010 and 2011, heroin seizures showed a significant increase of 445kg and 410.02 kg, respectively. There has been a seizure of between 600 to 1000kg of syabu yearly from 2009 to 2012. Similar to heroin, increased seizures for Yaba have also been observed over the last 2 years. A significant increase has also been recorded for the seizures of ecstasy pills from 2011 (47,761 pills) to 2012 (634,573 pills). The cumulative number of reported HIV infections since 1986 is 94,841. In 2011, sexual activity superseded injection drug use as the main transmission factor for the epidemic. HIV in the country mainly involves males, as they constitute 90% of cumulative HIV cases and a majority of those individuals are IDUs. However, HIV infection trends are shifting from males to females. There are 37,306 people living with HIV (PLHIV) who are eligible for treatment, and 14,002 PLHIV were receiving antiretroviral treatment (ART) in 2011. The decreasing trend of heroin users who have been detected and arrested could be due to the introduction of medical treatments and harm reduction approaches for drug users, resulting in fewer drug users being arrested. However, we are unable to say with certainty why there has been an increase in heroin seizures in the country. There has been an increasing trend in both ATS users and seizures. A new trend of co-occurring opiate dependence and ATS underscores the need to develop and implement effective treatments for ATS, co-occurring opiate and ATS, and polysubstance abuse disorders. The low numbers of NSEP clients being tested for HIV underscores our caution in interpreting the decline of HIV infections among drug users and the importance of focusing on providing education, prevention, treatment, and outreach to those who are not in treatment.

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The transition to harm reduction: Understanding the role of non-governmental organisations in Malaysia

Abstract: Given their central role in the needle-syringe exchange programme, the NGOs are well positioned to convince injecting drug users to opt for voluntary medical treatment. This can potentially reduce both the harm from drug use and the prevalence of it.

Cited by 26 publications

References 14 publications

Emerging Drug Use Trends in Kelantan, Malaysia

Emerging Drug Use Trends in Kelantan, Malaysia

Health in All Policies Approaches: Pearls from the Western Pacific Region

Substance abuse and the HIV situation in Malaysia

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