Is needle exchange programme still relevant in the advent of Methadone maintanence Therapy?
Aims: This study aims to determine the prevalence of relapse in those receiving MMT and study the harmful practices done during the relapses with their perceived causes. Background: Substance abuse is both a social and public health problem with a substantial burden to society. Opioid dependence,...
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| Main Authors: | , , |
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| Format: | Conference or Workshop Item |
| Language: | English English |
| Published: |
2018
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| Subjects: | |
| Online Access: | http://eprints.unisza.edu.my/1282/1/FH03-FP-19-23773.pdf http://eprints.unisza.edu.my/1282/2/FH03-FP-19-23774.pdf http://eprints.unisza.edu.my/1282/ |
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| Summary: | Aims: This study aims to determine the prevalence of relapse in those receiving MMT and study
the harmful practices done during the relapses with their perceived causes.
Background: Substance abuse is both a social and public health problem with a substantial
burden to society. Opioid dependence, with an estimated prevalence of 16.5 million worldwide,
carries a high cost to society by resulting in unemployment, crimes and family disruption; not to
mention transmission of diseases such as HIV and Hepatitis C. In Malaysia, there is an estimated
234 000 heroine abusers.Harm reduction practices, namely Methadone Maintenance Therapy
(MMT) and needle exchange programme has been in Malaysia since 2005. For MMT, relapse
during treatment remains an issue that hinders successful outcome of reducing transmission of
blood-borne infections.
Methods: This is a mixed-method cross-sectional study done from June-July 2016. All MMT
clients in primary care therapy centres in Kuala Nerus district, Terengganu, Malaysia who
fulfilled the inclusion and exclusion criteria and consented were included. A semi-structured
questionnaire was filled via face-to-face interview and reference to the case records was done.
122 questionnaires were assessed. Ethical clearance was obtained from National Medical
Research Ethics Committee (Ref 5-2307-27817).
Results: Response rate was 90.2%. All respondents were males of Malay race. Mean age was
36.2. Mean duration in MMT was 1.4 years. Current relapse, defined as any episode of intake of
heroine for the past one month after a period of abstinence was 34.4%. Of those relapsed,
majority (78.6%) had Hepatitis C, 19.0% had HIV. Majority (97.6%) deny sharing needles during
relapse. All attributed this due to ease of accessibility of needle exchange programme, and ability
to withstand the urge for injection until getting a clean needle due to taking methadone. 50.8% still shared needle-washing containers despite non-sharing needles, all unaware that this may
spread infections. Those who shared needles had both HIV and hepatitis C, could not get any
needle despite exchange programme nearby.
Conclusion: Relapse in opioid addiction remains high in those receiving MMT. Education to
avoid harmful injecting practices is important even in this group. To achieve aim of harm
reduction, MMT and needle exchange programme need to go hand to minimize the transmission
of blood-borne diseases during opioid re-injecting behaviour. |
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