Displaying publications 41 - 60 of 241 in total

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  1. Salina, M., Rusdi, A.R., Zahari, M.M., Sharmilla, K., Yee, A.
    MyJurnal
    Background: The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) developed by the World Health Organization is designed to identify individuals at risk for alcohol use problems and provide brief intervention.
    Objectives: To evaluate the validity and reliability of the ASSIST in Malaysia’s official language, the Bahasa Malay, among a group of alcohol users. The study also aimed to assess the impact of alcohol on the quality of life of patients.
    Methods: The final version of ASSIST-M was administered to 51 patients who were identified as alcohol users and attended the outpatient psychiatric clinic during a three-month period from September to November of 2012. Patients completed ASSIST, ASSIST-M, Mini-International Neuropsychiatric Interview (M.I.N.I.), Malay version of The Alcohol Use Disorders Identification Test (AUDIT-M), CAGE Assessment for Alcohol Abuse (CAGE), and the World Health Organization Quality of Life Scale-Brief-Malay version (WHOQoL-Brief-M). Statistical procedures were performed to assess the reliability and validity of the ASSIST-M.
    Results: Factor analysis of ASSIST-M yielded one factor similar to the factor structure of the English version. The Cronbach’s α coefficient of ASSIST-M was 0.80. The parallel reliability of the ASSIST-M was high with the intra-class correlation (ICC) of 0.96 (P< 0.01). The test–retest reliability of the ASSIST-M after the 1-week interval was high with the ICC of 0.94(P< 0.01). The ASSIST-M was positively correlated with the AUDIT-M (r =0.67, p <0 .01) and the CAGE (r=0. 57, p < 0.01). ASSIST-M score showed a negative and statistically significant relationships with the physical (r= -0 .28, p < 0.01) and social relationship (r= -0.37, p<0.01) subscales of the WHOQoL-Brief-M. The optimal cutoff point for ASSIST-M for alcohol use disorder was more than 14 with the with a sensitivity of 84.21 %, specificity of 84.38 %, positive predictive value (PPV) of 76.19% and negative predictive value (NPV) of 90%.
    Conclusions/Importance: The ASSIST-M displayed a fair psychometric performance in assessing alcohol use disorder in Malaysia.
    Keywords: Alcohol Dependence, ASSIST, ASSIST-M, M.I.N.I., CAGE, WHOQoL
    Study site: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Substance-Related Disorders*
  2. Bae K, Kwon NJ, Han E
    Forensic Sci Int, 2018 Nov;292:45-49.
    PMID: 30273913 DOI: 10.1016/j.forsciint.2018.09.008
    Abuse of new psychoactive substances (NPSs) among youths is increasing at an unprecedented rate all over the world. In Asia, abuse of synthetic cannabinoids (SCs), kratom, and poppers has been reported, but up to date information related to abuse of these three NPSs is lacking. This literature review focuses on the recent abuse of these three NPS among Asian youth. Many studies have been conducted to investigate the abuse statuses of SCs in Asian youth in Turkey, Japan, and Korea, and many cases of kratom abuse have been reported in Malaysia and Thailand. In addition, concerns have been expressed about the use of kratom in combination with other substances by teenagers. Popper abuse has been reported among many young people in Asia, including Korea and China, and many studies on popper abuse have focused on men who have sex with men in China and Malaysia. Since NPS abuse can have severe adverse effects and create social problems, there is a continuing need to investigate NPS abuse status continuously among young people.
    Matched MeSH terms: Substance-Related Disorders/epidemiology*
  3. Suhaimi FW, Zul Aznal AN, Mohamad Nor Hazalin NA, Teh LK, Hassan Z, Salleh MZ
    Behav Brain Res, 2023 May 28;446:114411.
    PMID: 36997094 DOI: 10.1016/j.bbr.2023.114411
    Kratom (M. speciosa Korth) is an herbal plant native to Southeast Asia. The leaves have been widely used to alleviate pain and opioid withdrawal symptoms. However, the increasing trend of recreational use of kratom among youth is concerning because substance abuse may render the adolescent brain more susceptible to neuropathological processes, causing dramatic consequences that persist into adulthood. Therefore, the present study aimed to investigate the long-term effects of mitragynine, the main alkaloid and lyophilized kratom decoction (LKD) exposure during adolescence on cognitive behaviours and brain metabolite profiles in adult rats. Adolescent male Sprague-Dawley rats were given mitragynine (3, 10 or 30 mg/kg) or LKD orally for 15 consecutive days during postnatal days 31-45 (PND31-45). Behavioural testing was performed during adulthood (PND70-84) and the brains were subjected to metabolomic analysis. The results show that a high dose of mitragynine impaired long-term object recognition memory. Social behaviour and spatial learning were not affected, but both mitragynine and LKD impaired reference memory. Brain metabolomic study revealed several altered metabolic pathways that may be involved in the cognitive behavioural effects of LKD and mitragynine exposure. These pathways include arachidonic acid, taurine and hypotaurine, pantothenate and CoA biosynthesis, and tryptophan metabolism, while the N-isovalerylglycine was identified as the potential biomarker. In summary, adolescent kratom exposure can cause long-lasting cognitive behavioural deficits and alter brain metabolite profiles that are still evident in adulthood. This finding also indicates that the adolescent brain is vulnerable to the impact of early kratom use.
    Matched MeSH terms: Substance-Related Disorders*
  4. Bazazi AR, Crawford F, Zelenev A, Heimer R, Kamarulzaman A, Altice FL
    AIDS Behav, 2015 Dec;19(12):2347-57.
    PMID: 26358544 DOI: 10.1007/s10461-015-1191-y
    The HIV epidemic in Malaysia is concentrated among people who inject drugs (PWID). Accurate estimates of HIV prevalence are critical for developing appropriate treatment and prevention interventions for PWID in Malaysia. In 2010, 461 PWID were recruited using respondent-driven sampling in Greater Kuala Lumpur, Malaysia. Participants completed rapid HIV testing and behavioral assessments. Estimates of HIV prevalence were computed for each of the three recruitment sites and the overall sample. HIV prevalence was 15.8 % (95 % CI 12.5-19.2 %) overall but varied widely by location: 37.0 % (28.6-45.4 %) in Kampung Baru, 10.3 % (5.0-15.6 %) in Kajang, and 6.3 % (3.0-9.5 %) in Shah Alam. Recruitment extended to locations far from initial interview sites but was concentrated around discrete geographic regions. We document the high prevalence of HIV among PWID in Greater Kuala Lumpur. Sustained support for community surveillance and HIV prevention interventions is needed to stem the HIV epidemic among PWID in Malaysia.
    Matched MeSH terms: Substance-Related Disorders*
  5. Müller CP, Yang Y, Singh D, Lenz B, Müller E
    Nervenarzt, 2024 Sep;95(9):824-829.
    PMID: 39085520 DOI: 10.1007/s00115-024-01721-6
    BACKGROUND: Kratom/ketum is a psychoactive herbal preparation that has been used for a long time as a remedy and performance-enhancing substance in Southeast Asia. The advancement of globalization is making kratom increasingly more available in the western world, where it is becoming increasingly more used.

    OBJECTIVE: The current research on kratom and its ingredients is presented.

    MATERIAL AND METHODS: An overview of the use and effects of kratom is exemplary given on the basis of reports. The instrumentalization of the drug and its consequences up to the development of addiction are discussed.

    RESULTS: Consumption is accompanied by several instrumentalizeable effects so that kratom is used as a therapeutic substance in the self-management of pain, anxiety and depression as well as other substance addictions. Another benefit comes from the performance-enhancing effects on physical work and in a social context. Consumption is usually well controlled, rarely escalates and has few and mostly mild aversive side effects. The danger arises from consumption particularly when there is an escalation of the dose and from mixed consumption with other psychoactive substances. The main alkaloid mitragynine and the more potent 7‑hydroxy-mitragynine are considered mainly responsible for the effect. Both have a complex pharmacology that involves partial µ‑opioid receptor agonism.

    DISCUSSION: Epidemiological, clinical and neurochemical studies have shown that kratom only has a limited addictive drug profile, which might suggest a medical use as a remedy or substitute in addiction treatment.

    Matched MeSH terms: Substance-Related Disorders*
  6. Sajadi SF, Hajjari Z, Zargar Y, Mehrabizade Honarmand M, Arshadi N
    Int J High Risk Behav Addict, 2014 Dec;3(4):e20995.
    PMID: 25741480 DOI: 10.5812/ijhrba.20995
    BACKGROUND: There is a great deal of medical literature suggesting that substance use disorder is a serious clinical concern, affecting general population and associated with considerable economic, societal, and personal costs.

    OBJECTIVES: This study sought to clarify the relationship between early trauma, dissociative experience, and suicide ideation as predictive factors of active and passive addiction potential (A/PAP) in high-school students.

    PATIENTS AND METHODS: Three hundred students with the mean age of 15.72 y were selected via multistage random sampling. All participants were asked to complete Iranian addiction potential scale, early trauma inventory, dissociative experiences scale, and Beck's suicide ideation scale. Analyzing data was done using canonical correlation.

    RESULTS: Structural coefficients showed that the pattern of high scores in A/PAP correlates with the pattern of high scores in early trauma, dissociative experience and suicide ideation. The findings of the study showed that the combination of low A/PAP can probably decrease the likelihood of early trauma, dissociative experience and suicide ideation.

    CONCLUSIONS: Early trauma, dissociative experience, and suicide ideation can predict A/PAP and explain the considerable variance of survival index.

    Matched MeSH terms: Substance-Related Disorders
  7. Singh D, Müller CP, Vicknasingam BK
    Drug Alcohol Depend, 2014 Jun 1;139:132-7.
    PMID: 24698080 DOI: 10.1016/j.drugalcdep.2014.03.017
    BACKGROUND: Kratom (Mitragyna speciosa) preparations have been traditionally used in Southeast Asia for its medicinal properties. Lately, Kratom use has spread to Europe and the US, where abuse potential and health hazards increasingly emerge. This study is the first to measure systematically Kratom dependence, withdrawal symptoms, and drug craving in regular Kratom users in Malaysia.
    METHODS: A cross-sectional survey of 293 regular Kratom users was conducted in the community across three northern peninsular states of Malaysia. The Leeds Dependence Questionnaire, Marijuana Withdrawal Checklist, and Marijuana Craving Questionnaire-Short Form were used to measure Kratom dependence, withdrawal and craving.
    RESULTS: More than half of the regular users (>6 month of use) developed severe Kratom dependence problems, while 45% showed a moderate Kratom dependence. Physical withdrawal symptoms commonly experienced include muscle spasms and pain, sleeping difficulty, watery eyes/nose, hot flashes, fever, decreased appetite, and diarrhoea. Psychological withdrawal symptoms commonly reported were restlessness, tension, anger, sadness, and nervousness. The average amount of the psychoactive compound, mitragynine, in a single dose of a Kratom drink was 79mg, suggesting an average daily intake of 276.5mg. Regular users who consumed ≥3 glasses Kratom per day, had higher odds of developing severe Kratom dependence, withdrawal symptoms, and inability to control Kratom craving.
    CONCLUSIONS: The findings from this study show that regular Kratom use is associated with drug dependency, development of withdrawal symptoms, and craving. These symptoms become more severe with prolonged use and suggest a stronger control of the drug.
    Matched MeSH terms: Substance-Related Disorders/diagnosis; Substance-Related Disorders/epidemiology*; Substance-Related Disorders/psychology
  8. Haerian BS
    Pharmacogenomics, 2013 Dec;14(16):2055-65.
    PMID: 24279859 DOI: 10.2217/pgs.13.217
    A majority of studies have shown a link between the common functional rs6265 polymorphism of the BDNF gene and susceptibility to drug dependence. However, the pattern of results is inconsistent. To precisely evaluate this association, a systematic review and meta-analysis of previous case-control reports was conducted. Data from 20 studies containing 9419 participants (4665 cases and 4754 controls) conducted between 2004 and 2013 restricted to alcohol, nicotine, heroin, substance and methamphetamine dependency were meta-analyzed. Following quality control of the results, a significant association between C allele and methamphetamine dependence remained in south Asian subjects (p = 0.004). Similar results were detected in south Asian subjects for methamphetamine dependence and in Chinese subjects for heroin dependence under an autosomal codominant genotype model (TT vs CC, p = 0.005 and p = 0.0004, respectively). In conclusion, the rs6265 polymorphism may be a risk factor for methamphetamine dependence in south Asian subjects or for heroin dependence in Chinese subjects.
    Matched MeSH terms: Substance-Related Disorders/genetics*; Substance-Related Disorders/metabolism; Substance-Related Disorders/pathology
  9. Isa AR, Sivakumaran S
    Med J Malaysia, 1993 Jun;48(2):124-8.
    PMID: 8350786
    The prevalence of sexually transmitted diseases (STD) among female drug abusers was determined by screening 130 new inmates of a rehabilitation centre. The majority of the subjects (77.7%) were self-confessed sex workers. A high prevalence of syphilis (50.8%), hepatitis B (52.2%), moniliasis (23.8%) and trichomoniasis (19.2%) were noted. Gonorrhoea vaginitis was seen in 8.5%, which was low compared to previous studies. Six subjects were seropositive for human immunodeficiency virus (HIV), with 5 of them admitting to needle sharing and working as prostitutes. More than half of them harboured 2 or more STD. A rich reservoir of STD was seen among the drug abusers. With more evidence now available concerning the ease of HIV transmission associated with ulcerative STD, a stage could be set for greater heterosexual HIV transmission. As part of the rehabilitation process, female drug abusers need a thorough screening for STD followed by aggressive treatment regimens.
    Matched MeSH terms: Substance-Related Disorders/complications*; Substance-Related Disorders/ethnology; Substance-Related Disorders/rehabilitation
  10. Low WY, Zulkifli SN, Yusof K, Batumalail S, Aye KW
    Drug Alcohol Depend, 1996 Oct;42(2):105-15.
    PMID: 8889409
    A survey was carried out to gather information on knowledge, attitudes and perception of parents and their children in relation to drug abuse matters. Significantly more teenagers knew more of the cause of drug addiction, as well as places for treatment and rehabilitation. Both teenagers and parents were also aware of reasons why drug addicts find it difficult to change their habits, mainly lacking motivation to stop taking drugs and that drug addicts do not have the power to control themselves. Teenagers were significantly more aware of effects of negative parental attitudes contributing to drug abuse, apart from school factors. Personal experiences before abusing drugs such as knowledge of pleasurable effects of drugs and where to obtain them has also a role to play in leading to drug abuse. There was also agreement that unfulfilled needs such as 'not being respected recognised for ones capabilities' and 'not being loved or treated fairly by parents', were causes of drug abuse. Significantly more teenagers knew of the ways of abusing drugs, mainly by injection, smoking and sniffing, and also sources of information via the mass media, social clubs, rehabilitation centres and schools. However, both the parents and teenagers were relatively ignorant of the long term effects of abusing drugs.
    Matched MeSH terms: Substance-Related Disorders/epidemiology; Substance-Related Disorders/psychology*; Substance-Related Disorders/rehabilitation
  11. Scorzelli JF
    J Subst Abuse Treat, 1992;9(2):171-6.
    PMID: 1324990
    It is a common belief that a massive effort in law enforcement, preventive education and rehabilitation will result in the elimination of a country's drug problem. Based on this premise. Malaysia in 1983 implemented such a multifaceted anti-drug strategy, and the results of a 1987 study by the author suggested that Malaysia's effort had begun to contribute to a steady decrease in the number of identified drug abusers. Although the number of drug-addicted individuals declined, the country's recidivism rates were still high. Because of this high relapse rate, Malaysia expanded their rehabilitation effort and developed a community transition program. In order to determine the impact of these changes on the country's battle against drug abuse, a follow-up study was conducted in 1990. The results of this study did not clearly demonstrate that the Malaysian effort had been successful in eliminating the problem of drug abuse, and raised some questions concerning the effectiveness of the country's drug treatment programs.
    Matched MeSH terms: Substance-Related Disorders/epidemiology; Substance-Related Disorders/prevention & control*; Substance-Related Disorders/rehabilitation
  12. Mohd Alif Jasni, Siti Hajar Abu Bakar Ah, Jal Zabdi Mohd Yusoff, Khairiyah Md Shahid, Noralina Omar, Zaiton Azman
    MyJurnal
    The return of ex-prisoners who were released from prison into an environment filled with fellow
    friends could lead to negative influences such as drug addiction and crime repetition among former
    prisoners. This paper has been derived from a doctorate study studying the repeatition of crimes that
    occurred among former prisoners in Malaysia. The findings of the study have found that former
    prisoners often return to their fellow members due to family absence. This study has been used
    qualitative methods by interviewing 16 ex-prisoners identified through the technique of snowball
    sampling. The finding revealed that all these former prisoners from different state were concentrated
    around the Chow Kit road. Addiction, as a result of invitation process by friends. This situation are
    make the study to proven relationship between the influence of friends and drug abused among the
    former prisoners.
    Matched MeSH terms: Substance-Related Disorders
  13. Ho CC, Pezhman H, Praveen S, Goh EH, Lee BC, Zulkifli MZ, et al.
    Malays J Med Sci, 2010 Apr;17(2):61-5.
    PMID: 22135540 MyJurnal
    Ketamine can be abused as a recreational drug, and there has been a recent surge in its usage. The effects of ketamine on the urinary system were unknown until the recent publication of a few case reports. Many doctors are still unaware of this new clinical entity, termed ketamine-associated ulcerative cystitis. We report a case that we encountered and discuss the diagnosis and disease management in addition to a review of the literature.
    Matched MeSH terms: Substance-Related Disorders
  14. Manan MM, Ali SM, Khan MA, Jafarian S, Hameed MA
    Pak J Pharm Sci, 2013 Jul;26(4):841-6.
    PMID: 23811468
    This study is an observational cross-sectional study aimed to examine the possible demographic and social characteristics of patients enrolled at the Methadone Maintenance Therapy Adherence Clinic (MMTAC) in Malaysia. Medical records from year 2009 - 2011 were Reviewed. Demographic, social characteristics and laboratory examinations such as age, gender, race, clinic attendances and urine analysis were recorded. Subjects were selected by means of convenient sampling but based on the specified inclusion and exclusion criteria. Data were analyzed by either Chi-square test, Fisher's exact test Mann-Whitney U-test, with the limit of significance was set at p < 0.05. Demographically, this study found that the ratio of Malays, Chinese and Indian enrolled to the MMTAC program is similar to the distribution of races in Malaysia. Their starting age for drug use was between 14-35 years and the age to enrolment between 30-58 years. Socially, many are unemployed, lowly educated and married. Most are drug users with a high percentage of HCV accompanied with impaired liver function. Retention rate was 87% but illicit drug use was at 57.50%. However, percentage of employment increased significantly after therapy. The study managed to identify several demographical and social distributions of patients attending the MMTAC. Although attendance rate was high, many were on illicit drug use. Nevertheless, employment rate improved significantly.
    Study site: government methadone clinic in Klang, Selangor, Malaysia
    Matched MeSH terms: Substance-Related Disorders/complications; Substance-Related Disorders/drug therapy*
  15. Fu JJ, Bazazi AR, Altice FL, Mohamed MN, Kamarulzaman A
    PLoS One, 2012;7(9):e44249.
    PMID: 23028508 DOI: 10.1371/journal.pone.0044249
    Throughout Asia, people who use drugs are confined in facilities referred to as compulsory drug detention and rehabilitation centers. The limited transparency and accessibility of these centers has posed a significant challenge to evaluating detainees and detention conditions directly. Despite HIV being highly prevalent in this type of confined setting, direct evaluation of detainees with HIV and their access to medical care has yet to be reported in the literature.
    Matched MeSH terms: Substance-Related Disorders/complications*; Substance-Related Disorders/epidemiology*
  16. Ghani WM, Razak IA, Yang YH, Talib NA, Ikeda N, Axell T, et al.
    BMC Public Health, 2011;11:82.
    PMID: 21294919 DOI: 10.1186/1471-2458-11-82
    Betel quid chewing is a common habit widely practiced in Southern Asian populations. However, variations are seen in the content of a betel quid across the different countries. Factors associated with commencement and cessation of this habit has been numerously studied. Unfortunately, data on Malaysian population is non-existent. This study aims to determine the factors associated with the inception and also cessation of betel quid chewing behaviour among Malaysian adults.
    Matched MeSH terms: Substance-Related Disorders/ethnology; Substance-Related Disorders/epidemiology*
  17. Adlina S, Suthahar A, Ramli M, Edariah AB, Soe SA, Mohd Ariff F, et al.
    Med J Malaysia, 2007 Aug;62(3):218-22.
    PMID: 18246911 MyJurnal
    A cross sectional descriptive study of 2048 subjects was conducted to determine the prevalence of depression and factors influencing depression among students in secondary school from urban and rural areas in the state of Selangor, Malaysia. The children's depression inventory (CDI) developed by Maria Kovacs was used in this study. Students who participated in this study come from two urban schools and three rural schools. It was found that in the yield for scores for five factors were 9.2% have negative mood, 5% have interpersonal problems, 8.3% have ineffectiveness, 9.8% have anhedonia and 10.6% have negative self esteem. Following the interpretive guidelines for the T-scores, it was found that 10.3% of the students were much above average in the depression scale. This study also found that: 1% of students were smoking, 1.6% of students were gum sniffling, 0.9% took drugs, 4.1% took alcohol and 9.9% took things from other people. Females were more depressed than males. The Chinese students were more depressed compared to Indian students. Students whose parents had no formal education or had only primary education were more depressed than students whose parents had secondary, college or university education. Depression increased with increasing number of siblings. Depression contributed to the habit of drug abuse, gum sniffing and stealing but not to smoking and alcohol abuse. Suicidal tendencies were more likely among the depressed students. It is imperative that not only caregivers but also teachers have to be equipped with the knowledge, attitude and skills to assist secondary school children cope with their emotions, handle conflicts and manage stress early so that a more productive society will develop in the future.
    Matched MeSH terms: Substance-Related Disorders/etiology; Substance-Related Disorders/epidemiology
  18. Tanguay P, Kamarulzaman A, Aramrattana A, Wodak A, Thomson N, Ali R, et al.
    Harm Reduct J, 2015 Oct 16;12:31.
    PMID: 26470779 DOI: 10.1186/s12954-015-0071-0
    Evidence indicates that detention of people who use drugs in compulsory centers in the name of treatment is common in Cambodia, China, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Thailand, and Vietnam. The expansion of such practices has been costly, has not generated positive health outcomes, and has not reduced supply or demand for illicit drugs. United Nations agencies have convened several consultations with government and civil society stakeholders in order to facilitate a transition to voluntary evidence- and community-based drug dependence treatment and support services. In an effort to support such efforts, an informal group of experts proposes a three-step process to initiate and accelerate national-level transitions. Specifically, the working group recommends the establishment of a national multisectoral decision-making committee to oversee the development of national transition plans, drug policy reform to eliminate barriers to community-based drug dependence treatment and support services, and the integration of community-based drug dependence treatment in existing national health and social service systems.In parallel, the working group recommends that national-level transitions should be guided by overarching principles, including ethics, human rights, meaningful involvement of affected communities, and client safety, as well as good governance, transparency, and accountability. The transition also represents an opportunity to review the roles and responsibilities of various agencies across the public health and public security sectors in order to balance the workload and ensure positive results. The need to accelerate national-level transitions to voluntary community-based drug dependence treatment and support services is compelling--on economic, medical, sustainable community development, and ethical grounds--as extensively documented in the literature. In this context, the expert working group fully endorses initiation of a transition towards voluntary evidence- and community-based drug dependence treatment and support services across the region, as well as the steady scale-down of compulsory centers for drug users.Components of voluntary community-based drug dependence treatment and support services are being implemented in Cambodia, China, Indonesia, Malaysia, and Thailand. However, significant technical and financial support will be required to be allocated from national budgets and by international development agencies in order to complete the transition and reduce the reliance on detention of people who use drugs in Asia.
    Matched MeSH terms: Substance-Related Disorders/epidemiology*; Substance-Related Disorders/therapy*
  19. Rahman F, Lall P, Iqbal S, Vicknasingam B
    Harm Reduct J, 2015 Nov 05;12:52.
    PMID: 26542117 DOI: 10.1186/s12954-015-0086-6
    BACKGROUND: Out of 20,887 persons who use drugs that came into contact with the National Anti-Drugs Agency (NADA) officials in the year 2013, 3.2% were women. Because women who use drugs (WWUD) are often a hidden population, this may be an underestimate. International literature shows that women who use drugs face increased risk of HIV, intimate partner violence, and mental health issues. Similar literature in Malaysia is lacking, and thus, the objective of our study was exploratory in nature.

    METHODS: Thirty-eight women who use drugs were interviewed using a semi-structured topic guide in Kelantan, Penang, Johor, Kuala Lumpur, and Selangor. Locations were chosen purposively. Nineteen women were interviewed individually and the remaining 19 were in focus group discussions (FGDs). All interviews were transcribed verbatim, translated to English, and analyzed with NVivo.

    RESULTS: Median age of respondents was 35.5 years old, 89.5% ethnic Malays, majority having married below the age of 20, and were of low socioeconomic backgrounds. Youngest age of initiation into drug use was 9 years old. Most reported is inhalation of amphetamine-type substances. Seven reported ever injecting. Three themes emerged: (a) repeating patterns of fluid family structures and instability; (b) "pain" and "difficulty" as features of home life; and (c) seeking marriage as a source of stabilization and practices of power within those marriages. Respondents often came from very fluid family environments and married to find stability, only to be drawn into a similar cycle. None of the women who had been separated from their children either institutionally, by family members, or by third parties, had accessed legal recourse for the loss of their parental rights.

    CONCLUSION: Unstable familial relationships or environments contributed to earlier initiation of drug use which raised questions about support services for WWUD and children who use drugs. Respondents were drawn into unstable and/or abusive relationships, perpetuating social inequalities that marked their own familial environments during childhood. These findings support the need for additional services to support the unique needs of WWUD, including domestic violence services, financial and life skills, parental rights assistance, and empowerment programs.

    Matched MeSH terms: Substance-Related Disorders/complications; Substance-Related Disorders/psychology*
  20. Hser YI, Liang D, Lan YC, Vicknasingam BK, Chakrabarti A
    J Neuroimmune Pharmacol, 2016 09;11(3):383-93.
    PMID: 27000123 DOI: 10.1007/s11481-016-9665-x
    Drug abuse and co-occurring infections are associated with significant morbidity and mortality. Asian countries are particularly vulnerable to the deleterious consequences of these risks/problems, as they have some of the highest rates of these diseases. This review describes drug abuse, HIV, and hepatitis C (HCV) in Asian countries. The most commonly used illicit drugs include opioids, amphetamine-type stimulants (ATS), cannabis, and ketamine. Among people who inject drugs, HIV rates range from 6.3 % in China to 19 % in Malaysia, and HCV ranges from 41 % in India and Taiwan to 74 % in Vietnam. In the face of the HIV epidemics, drug policies in these countries are slowly changing from the traditional punitive approach (e.g., incarcerating drug users or requiring registration as a drug user) to embrace public health approaches, including, for example, community-based treatment options as well as harm reduction approaches to reduce needle sharing and thus HIV transmission. HIV and HCV molecular epidemiology indicates limited geographic diffusion. While the HIV prevalence is declining in all five countries, use of new drugs (e.g., ATS, ketamine) continues to increase, as well as high-risk sexual behaviors associated with drug use-increasing the risk of sexual transmission of HIV, particularly among men who have sex with men. Screening, early intervention, and continued scaling up of therapeutic options (drug treatment and recovery support, ART, long-term HIV and HCV care for drug users) are critical for effective control or continued reduction of drug abuse and co-infections.
    Matched MeSH terms: Substance-Related Disorders/epidemiology*; Substance-Related Disorders/therapy
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