Harm Reduction Program, including:
(a) Methadone Replacement Therapy
(b) Program of syringe exchange
Today we will be focusing more on Methadone Replacement Therapy. This program started since 2008 and it is run by one FMS, one MO one AMO and one staff nurse. It is a cooperative program with Agensi Anti Dadah Kebangsaan (ADK).The objective of this program is to prevent transmission of HIV to other people. It is not a program for rehabilitation.
Below is the carta alir pemilihan perserta metadon. First of all, patient will go to ADK to report themselves as drug addicts. The ADK will then refer them to Klinik Kesihatan for screening (Liver Function Test) to be done. Those with a normal LFT results will be reviewed by medical officer for the dosage of methadone required. New patient will be sent to intoxication room for 3 – 4 hours to observe if there is any side effects.
Total number of registered patient is 112 people, inclusing 78 active cases and 34 defaulted cases(patient enter prison or unable to contact patient). the youngest patient is only 16 years old while the oldest patient is 68 years old.
On the other hand, the first 2 times of LFT should be done half year once. if the results are all normal, LFT should be done one year once. LFT should be done immediately if the patient complaints of any withdrawal symptoms.
Patients with unstable condition are required to come back to KKISP everyday for their methadone replacement. First of all, they have to write their names in one record book which will help the staff to ensure that all the patients go to the pharmacy to take the methadone.
For patients with stable condition, they are allowed to take the methadone back home and drink by themselves. The number of patient under DOT is 53 and the remainders are under stable condition.
The major problem face by this program is the difficulty to handle patients. Most of them are not cooperative and some of them even have aggresive behavior. As an example, some patients used other people’s urine for urine test in order to get a negative result. Some patients bring back methadone and sell it for RM30.