Mazlan Mahmud, Schottenfeld Richard S, Chawarski Marek C
Substance Abuse Center, Muar, Malaysia.
Drug Alcohol Rev. 2006 Sep;25(5):473-8. doi: 10.1080/09595230600883354.
Until recently, Malaysia has lagged behind in the treatment of drug addiction and related disorders, despite experiencing severe drug problems. By the end of 2004, 234,000 heroin users or heroin-dependent individuals had been registered in the official government registry, but other estimates exceed 500,000 for heroin abusers in the country. Amphetamine-type stimulant abuse is also increasing and of considerable public and government concern. Among the population of drug users, HIV and other infectious diseases rates are very high. In the Western Pacific regions, Malaysia has the second highest HIV prevalence (after Vietnam) among adult populations (0.62%) and the highest proportion of HIV cases resulting from injection drug use (76.3%). Drug use and related disorders exert a heavy burden on the country's health care and legal systems. Historically, drug abusers were rehabilitated involuntarily in correctional, rather than health-care, facilities. This primarily criminal treatment approach had limited effectiveness which led to widespread public dissatisfaction and the recent introduction of medical treatments for addiction. Naltrexone was introduced in 1999; buprenorphine was introduced in 2001 and methadone in 2003. Agonist maintenance programmes were embraced rapidly by the medical community in Malaysia. Currently, over 30,000 opiate-dependent patients are treated with agonist maintenance treatments by more than 500 medical practitioners in Malaysia. Despite these recent advances, treatments for amphetamine-type stimulant abuse or dependence are underdeveloped, and diversion of agonist medications is an emerging concern.
直到最近，尽管面临严重的毒品问题，但马来西亚在药物成瘾及相关疾病的治疗方面一直滞后。截至2004年底，已有23.4万名海洛因使用者或海洛因依赖者在政府官方登记在册，但该国海洛因滥用者的其他估计数字超过50万。苯丙胺类兴奋剂的滥用情况也在增加，引起了公众和政府的极大关注。在吸毒人群中，艾滋病毒和其他传染病的感染率非常高。在西太平洋地区，马来西亚成年人中的艾滋病毒感染率在该地区位居第二（仅次于越南），为0.62%，且因注射吸毒导致的艾滋病毒病例比例最高，达76.3%。吸毒及相关疾病给该国的医疗保健和法律体系带来了沉重负担。从历史上看，吸毒者是在惩教机构而非医疗保健机构接受非自愿康复治疗的。这种主要基于刑事处罚的治疗方法效果有限，导致公众普遍不满，最近才开始引入成瘾药物治疗。纳曲酮于1999年引入；丁丙诺啡于2001年引入，美沙酮于2003年引入。激动剂维持治疗方案迅速得到了马来西亚医学界的认可。目前，马来西亚有500多名医生为3万多名阿片类药物依赖患者提供激动剂维持治疗。尽管最近取得了这些进展，但针对苯丙胺类兴奋剂滥用或依赖的治疗仍不发达，激动剂药物的滥用问题也日益引起关注。
