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Most doctors shun methadone therapy
Date: 28 July 2009
Many doctors have stopped helping heroin addicts get rid of their habit by giving them milder replacement drugs because they are getting a bad name.
Although the treatment -- Methadone Drug Substitution Therapy (MDST) -- was approved by the government in 2003, many of these doctors are perceived as supporting the problem rather than helping the addicts.
As a result, only two from the first batch of 52 doctors trained in using methadone in 2003, are still employing the therapy.
The treatment, which suppresses the craving for the "high" found in heroin, also helps to control the spread of HIV/AIDS, hepatitis and other diseases through needle sharing.
Most of the doctors had backed out because they were afraid of being labelled negatively by people, said Professor Dr Mohamad Hussain Habil, University Malaya Medical Centre psychological medicine department addiction specialist.
"Doctors give addicts methadone so they can function like normal people and maintain their jobs.
"The doctors strictly follow rules set by the government. This is a chronic medical condition that has to be treated," he said at a press conference.
Dr Hussain, who is also a consultant psychiatrist, said the police, politicians and members of the public needed to know that drug users were like any other patients seeking treatment for a medical condition.
"People complain when they see drug addicts taking medicine from clinics. Eventually police raid these clinics due to public pressure."
Hussain said only 10 per cent of the 1,000 doctors he had trained on MDST were using the therapy.
He said evidence showed that MDST reduced the number of relapses, halved the number of admissions into rehabilitation centres and helped recovering addicts join society as useful people.
Dr Musa Jantan, a doctor who has used MDST for seven years, said doctors were facing many problems with the public and the authorities.
"Society has looked down on addicts for more than 30 years. And those who help them are looked down, too."
Dr Musa said people would complain to politicians that a certain clinic was dispensing drugs to addicts without knowing why, and the politicians in turn would put pressure on police to take action.
Because of this, clinics are raided and doctors get demoralised.
"Methadone is a medication. It is not like heroin. I have treated about 100 heavy users and 95 of them have recovered and are leading normal lives. Only five percent went back to their old habit, yet people choose to see only that."
What needs to be done, said Universiti Sains Malaysia director of research in molecular medicine Professor Dr Rusdi Ismail, was for doctors to be reassured that they could practise MDST without the negative perception.
He said the public must be informed that MDST could help rid society of addicts.
"Addicts will be on methadone for years. These are hardcore drug abusers and they cannot be cured in a day or a week.
"It is like diabetes. If the sugar level goes up, doctors increase the dosage and it continues for years. It is not like treating someone for fever and flu," he said.
This article was first published in www.nst.com.my on 20 July 2009.
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