Evaluation of Methadone Treatment in Malaysia: Findings from the Malaysian Methadone Treatment Outcome Study (MyTOS)

Abstract

There were 3254 respondents (93.6% response rate); of these 17.5% (n = 570) transferred to another treatment center, 8.6% (n = 280) died, 29.2% (n = 950) defaulted, and 7.6% (n = 247) were terminated for various reasons. Hence, 1233 (37%) respondents' baseline and follow-up data were further analyzed. Respondents had a mean age of 39.2 years old and were mainly male, Malay, Muslim, married (51.1%, n = 617), and currently employed. Few showed viral seroconversion after they started MMT (HIV: 0.5%, n = 6; Hepatitis B: 0.3%, n = 4; Hepatitis C: 2.7%, n = 29). There were significant reductions in opioid use, HIV risk-taking score (p < 0.01), social functioning (p < 0.01), crime (p < 0.01), and health (p < 0.01). However, there were significant improvements in quality of life in the physical, psychological, social, and environmental domains. Factors associated with change were being married, employed, consuming alcohol, and high criminality at baseline. Lower methadone dosage was significantly associated with improvements in the physical, psychological, and environmental domains. Conclusion/Importance: The MMT program was found to be successful; hence, it should be expanded.

Contemporary Asian Drug Policy: Insights and Opportunities for Change

“…Thailand has allowed access to methadone treatment since 1979 and buprenorphine since 2007 (Reid, Sharma, and Higgs, 2014). Other countries have begun to employ some form of medication treatment: China and Myanmar have had limited access to MT since 2004, Malaysia started offering methadone in 2005, and Indonesia has offered methadone and buprenorphine since 2001 and 2003, respectively (Shen et al, 2016;Reid, Sharma, and Higgs, 2014;Ali et al, 2018).…”

Sexual Inactivity in Methadone Maintenance Treatment Patients

“…Inclusion criteria were that participants were male, aged at least 18 years old, and had been on methadone treatment for at least six months. Based on Ali et al [2], the Malaysian female population on MMT was less than 1%. Given females represent a very small percentage of the MMT population, we did not include females in the present study.…”

“…Primary healthcare is the main center for MMT in Malaysia. The distribution of patients taking MMT in primary healthcare is 77% [2]. All MMT patients attending these clinics were invited to participate in the study.…”

“…Its long duration of action, reserve for tolerance effect [1], and its ability to control illicit opioid use [2], makes it favorable as a replacement therapy. Methadone is indicated for opioid use disorder to manage opioid addiction and has been proven to reduce harmful drug-seeking behavior [2]. In Malaysia, the methadone maintenance treatment (MMT) program was introduced back in 2005 as part of the harm reduction program for people who inject drugs (PWID) [3,4].…”

Medication-Assisted Treatment (MAT) for Opioid Addiction: Introduction to the Special Issue

“…Two papers report on MAT in Malaysia. Ali et al (2018) describe methadone maintenance provision and cultural barriers to it in Malaysia. The authors' main focus is on several health and social outcomes between baseline and three-month follow-up for largely male patients enrolled in MAT.…”