Publication: Relapse to Opioid Use in Opioid-Dependent Individuals Released from Compulsory Drug Detention Centres Compared with Those from Voluntary Methadone Treatment Centres in Malaysia: A Two-Arm, Prospective Observational Study
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Published
2017-02
ISSN
2214-109X
Date
2018-02-12
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Abstract
Detention of people who use drugs into compulsory drug detention centres (CDDCs) is common throughout East and Southeast Asia. Evidence-based pharmacological therapies for treating substance use disorders, such as opioid agonist treatments with methadone, are generally unavailable in these settings. We used a unique opportunity where CDDCs coexisted with voluntary drug treatment centres (VTCs) providing methadone in Malaysia to compare the timing and occurrence of opioid relapse (measured using urine drug testing) in individuals transitioning from CDDCs versus methadone maintenance in VTCs. Opioid-dependent individuals in CDDCs are significantly more likely to relapse to opioid use after release, and sooner, than those treated with evidence-based treatments such as methadone, suggesting that CDDCs have no role in the treatment of opioid-use disorders.
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Publication Making Drug Treatment Work(World Bank, Washington, DC, 2018)Compulsory drug detention centers (CDDCs) are common throughout Asia. However, medical treatments for substance use disorders, such as opioid agonist treatment (OAT), are generally unavailable in these settings. In this report, the authors compare the effectiveness of CDDCs with voluntary drug treatment centers (VTCs) offering OAT in Malaysia. Positive urine drug testing (UDT) after release confirmed opioid relapse in both groups. Specifically, the authors measure the timing of relapse, that is, the authors compare when patients that have been discharged from CDDCs and VTCs relapse to opioid. The authors conducted a study on opioid dependent individuals from Malaysian CDDCs and VTCs from August 2012 to September 2014. Baseline (at the starting point of the study) and semi-monthly behavioral assessments and UDTs were conducted for up to one year after release and discharge. 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