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Making drug treatment work : opportunities and challenges towards an evidence and rights-based approach (English)

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. Relapse rates between the groups were compared using advanced statistical analysis. Screening occurred in 168 CDDC attendees and 113 VTC in-patients, with 89 (CDDC), and 95 (VTC) of these individuals, respectively, having a baseline interview and at least one UDT. The authors found that opioid-dependent persons that have been released from CDDCs relapse to opioid use significantly faster than those from VTC services. This suggests the services provided by CDDCs have little role in the treatment of opioid use disorders.


  • Author

    Wegman,Martin P., Altice,Frederick L., Kaur,Sangeeth, Rajandaran,Vanesa, Osornprasop,Sutayut, Wilson,David, Wilson,David P., Kamarulzaman,Adeeba

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    Working Paper

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    The World Region,

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    Making drug treatment work : opportunities and challenges towards an evidence and rights-based approach

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    men who have sex with men; substance abuse treatment; relapse rate; Drug use; Substance Use Disorders; detention center; harm reduction; drug dependence treatment; drug treatment centers; higher education level; substitution treatment; complete secondary school; world health organization; drug treatment centre; correctional health care; methadone maintenance treatment; risk of death; Sexually Transmitted Infection; illicit drug use; compulsory drug treatment; needle and syringe; absence of evidence; human rights principle; method study; hiv risk behavior; drug testing; hiv transmission; behavioral assessment; survey questionnaire; career development; survival analysis; hiv testing; Vocational Training; social commission; clinical trial; physical education; forced labor; treatment outcomes; tuberculosis screening; outpatient treatment; integrated care; job skill; drug abuse; detention facility; national drug; social outcome; policy shift; causal effect; qualitative assessment; rehabilitation centers; public health; compulsory treatment; heroin users; literature review; addictive behaviors; treatment group; alcohol use; prevention program; urban health; male prisoners; medical therapy; antiretroviral therapy; Antiretroviral therapies; rehabilitation program; open society; care service; compulsory detention; ethical dilemma; collected information; psychosocial intervention; family counseling; physical training; commercial production; marital status; social support; average age; asian countries; medical treatment; international call; administrative staff; opiate use; Urgent Care; test result; dependent persons; pilot activities; horizontal axis



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Wegman,Martin P. Altice,Frederick L. Kaur,Sangeeth Rajandaran,Vanesa Osornprasop,Sutayut Wilson,David Wilson,David P. Kamarulzaman,Adeeba

Making drug treatment work : opportunities and challenges towards an evidence and rights-based approach (English). Washington, D.C. : World Bank Group.