A Fifty-Year Challenge in Managing Drug Addiction in Malaysia

The history of substance abuse in Malaysia can be divided into pre- and post-independent era. In preindependence, the main drug of abuse was opium which was initially consumed by immigrants from China who were introduced by the British colonialist to work in Malaya. The post-independence era began in the 1960s when young adults were influenced by the “Hippy” subculture. At this time, consumption patterns changed where more Malays were involved in drug abuse compared to other ethnic groups (1, 2). By the early 1980s, the prevalence of drug addiction increased and this increasing trend made the Malaysian government consider heroin addiction as a national threat. The national anti-drug task force was formed to control trafficking and to rehabilitate addicts who were involved in heroin addiction (3). Legislation was introduced where mandatory death sentence was implemented for those who smuggled more than 15 grams of heroin. Drug addicts found to be positive for heroin were forced to undergo compulsory rehabilitation for two years (4). Nationwide, up to 28 government drug rehabilitation centers were established, and at any particular period, each center accommodated up to 500 inmates. Approximately RM50 million a year was spent to run these centers (5). The centers were initially managed on a total abstinence philosophy; however this approach produced poor results. The latest survey showed that 85% of drug addicts relapsed after completing their rehabilitation at these centers (4, 6). In view of the poor results, substitute treatment with methadone was introduced recently to these centers (7). One of the visions of the Malaysian government was to create a drug addiction free nation by the year 2015. However, the increasing number of drug addicts has caused a surge in demand for rehabilitation centers, resulting in the inability of these centers to cope. For example, the number of drug addicts increased by 1% from year 2001 to 2002, but the number of drug addicts detected in year 2003 was 36,996, a 16% jump from the previous year (31,893). Furthermore, the National Drug Agency reported that 45% of the cases were repeat addicts. As for distribution of new cases, by ethnic group the Malays constituted 71%, Chinese 10.6% and Indian 8.2%. The majority (70%) were in the socially and economically most productive age group (20-39 years) and almost 98% of the addicts who occupied these rehabilitation centers were male. Currently, the number of drug users in the country is estimated to be 250,000 but the number is predicted to reach half a million by year 2015 (3, 8-10). The resulting economic, human resource and social loss is not quantifiable as the vacuum left by these people in various employment sectors are currently being filled by migrant workers. Thus, it is evident that the increasing trend in drug addiction poses a threat to the future of the nation (1, 6, 9).