DRUG addiction is a chronic disease that requires a combination of medical and non-medical interventions.
People who struggle with drug dependency and addiction often have other health problems (comorbidities or co-occurrences), such as learning disabilities, organic causes, mental illnesses (dual diagnosis), and other conditions which require accurate diagnoses and appropriate care, says Malaysian Family Medicine Specialists' Association (FMSA) president Dr Nor Hazlin Talib.
Dr Nor Hazlin said this in response to concerns over the proposed amendments to the Drug Dependents (Treatment and Rehabilitation) Bill 2024.
FMSA views these amendments as incomplete, and lacking the involvement of multiple agencies that contribute to the comprehensive treatment of drug addiction in the country.
"We view the amendment to Section 8(3), which shifts the responsibility of confirming individuals with drug addiction for rehabilitation from medical officers to rehabilitation officers, to be an inappropriate measure," she says.
Dr Nor Hazlin, a consultant family medicine specialist and addiction medicine specialist, adds that medical officers have clinical training to conduct biological, psychological and social diagnosis and assessments, unlike rehabilitation officers.
The training and certification requirements for rehabilitation officers are also not explicitly defined. Hence, there is uncertainty regarding their capability to assume this position, she explains.
"Furthermore, the inclusion of a requirement in the legislation that necessitates the reporting of all individuals with drug dependency undergoing treatment at facilities other than the National Anti-Drugs Agency (AADK), is perceived as a measure that goes against decriminalisation efforts, infringing upon patient privacy and confidentiality, and impeding endeavours to promote voluntary treatment-seeking without any associated stigma."
Embracing decriminalisation represents a necessary shift in societal attitudes, necessitating a reevaluation of addiction as a medical condition rather than a mere behavioural issue, she points out.
"This change seems to contradict the goals of decriminalisation that are being advocated for, since it appears to be more focused on punishment rather than providing assistance and rehabilitation for individuals struggling with drug addiction in the long run."
Dr Nor Hazlin adds that in Malaysia, several entities, including the Ministry of Health, Ministry of Higher Education and non-governmental organisations have been extensively engaged in the treatment and rehabilitation of those suffering from drug addiction for an extended period.
AADK, being the principal body responsible for tackling drug addiction in Malaysia, should be more receptive to partnering with these diverse entities, she says.
Combining pharmaceutical methods with psychological and spiritual rehabilitation has been shown to be more effective and offers long term treatment for drug addiction.
Additionally, it is more economically efficient, diminishes societal discrimination against individuals with addiction and reinstates the ability of those struggling with drug addiction to contribute to society
The Ministry of Health currently provides drug rehabilitation therapy at the One Stop Centre for Addiction (OSCA), which operates in 74 health clinics around Malaysia.
This treatment is supervised by family medicine specialists and/or addiction medicine specialists.
Dr Nor Hazlin points out that since 2005, methadone therapy has effectively facilitated the recovery of chronic heroin users, enabling them to overcome addiction. Selected private facilities throughout the country also provide methadone treatment.
In hospitals which offer addiction treatment, addiction psychiatrists can also provide treatment to individuals with addiction who have complex mental health issues.