Displaying all 13 publications

  1. Mostafa H, Amin AM, Teh CH, Murugaiyah VA, Arif NH, Ibrahim B
    J Subst Abuse Treat, 2017 06;77:1-5.
    PMID: 28476260 DOI: 10.1016/j.jsat.2017.02.015
    BACKGROUND: Alcohol use disorders (AUD) is a phase of alcohol misuse in which the drinker consumes excessive amount of alcohol and have a continuous urge to consume alcohol which may lead to various health complications. The current methods of alcohol use disorders diagnosis such as questionnaires and some biomarkers lack specificity and sensitivity. Metabolomics is a novel scientific field which may provide a novel method for the diagnosis of AUD by using a sensitive and specific technique such as nuclear magnetic resonance (NMR).

    METHODS: A cross sectional study was conducted on three groups: individuals with alcohol use disorders (n=30), social drinkers (n=54) and alcohol-naive controls (n=60). 1H NMR-based metabolomics was used to obtain the metabolic profiles of plasma samples. Data were processed by multivariate principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) followed by univariate and multivariate logistic regressions to produce the best fit-model for discrimination between groups.

    RESULTS: The OPLS-DA model was able to distinguish between the AUD group and the other groups with high sensitivity, specificity and accuracy of 64.29%, 98.17% and 91.24% respectively. The logistic regression model identified two biomarkers in plasma (propionic acid and acetic acid) as being significantly associated with alcohol use disorders. The reproducibility of all biomarkers was excellent (0.81-1.0).

    CONCLUSIONS: The applied plasma metabolomics technique was able to differentiate the metabolites between AUD and the other groups. These metabolites are potential novel biomarkers for diagnosis of alcohol use disorders.

  2. Marcus R, Bojko MJ, Mazhnaya A, Makarenko I, Filippovych S, Dvoriak S, et al.
    J Subst Abuse Treat, 2018 03;86:86-93.
    PMID: 29415856 DOI: 10.1016/j.jsat.2018.01.003
    Numerous individual barriers, including negative attitudes toward opioid agonist therapies (OAT), have undermined HIV prevention efforts in Ukraine where the epidemic is concentrated in people who inject drugs (PWID). The recent availability of extended-release naltrexone (XR-NTX), an opioid antagonist, provides new opportunities for treatment and prevention, but little is known about patient preferences. We conducted qualitative analysis using focus groups (FG) of PWID recruited based on OAT experience: currently, previously, and never on OAT in five Ukrainian cities. FG included 199 PWID in 25 focus groups. Focus group transcripts were coded and analyzed using a modified grounded theory approach to identify common themes and domains related to attitudes about and preferences for XR-NTX, relative to other treatments. Interest in XR-NTX was supported if supervised opioid withdrawal and psychological support were assured. Other factors supporting XR-NTX included a focus on younger PWID early in their injection career and motivated for recovery. Perceptions of recovery included not receiving psychoactive medications like methadone or buprenorphine. With more information, XR-NTX could be a viable option for PWID in Ukraine, especially if concerns regarding withdrawal and psychological support are adequately addressed.
  3. Copenhaver M, Shrestha R, Wickersham JA, Weikum D, Altice FL
    J Subst Abuse Treat, 2016 Apr;63:61-5.
    PMID: 26879859 DOI: 10.1016/j.jsat.2016.01.002
    The present study examines the factor structure of the existing Neuropsychological Impairment Scale (NIS) through the use of exploratory factor analysis (EFA). The NIS is a brief, self-report measure originally designed to assess neurocognitive impairment (NCI) by having patients rate a range of items that may influence cognitive functioning. Stabilized patients on methadone maintenance therapy (MMT; N=339) in New Haven, CT who reported drug- or sex-related HIV risk behaviors in the past 6 months were administered the full 95-item NIS. An EFA was then conducted using principal axis factoring and orthogonal varimax rotation. The EFA resulted in retaining 57 items, with a 9-factor solution that explained 54.8% of the overall variance. The revised 9-factor measure--now referred to as the Brief Inventory of Neuro-cognitive Impairment (BINI)--showed a diverse set of factors with excellent to good reliability (i.e., F1 α=0.97 to F9 α=0.73). This EFA suggests the potential utility of using the BINI in the context of addiction treatment. Further research should examine the utility of this tool within other clinical care settings.
  4. Vijay A, Bazazi AR, Yee I, Kamarulzaman A, Altice FL
    J Subst Abuse Treat, 2015 Jul;54:29-36.
    PMID: 25841703 DOI: 10.1016/j.jsat.2015.01.014
    Little is known about attitudes toward and experiences with opioid maintenance therapy (OMT) among people who inject drugs in Malaysia, a country where people who inject drugs comprise 1.3% of the adult population.
  5. Aziz Z, Chong NJ
    J Subst Abuse Treat, 2015 Jun;53:47-51.
    PMID: 25616750 DOI: 10.1016/j.jsat.2014.12.008
    The aim of this study was to examine opioid-dependent patients' satisfaction with the methadone maintenance treatment (MMT) program in Malaysia and identify predictors of satisfaction. We used an interviewer-administered questionnaire developed and validated by Rankin Court, New South Wales, Australia. Of 502 patients approached in 11 MMT centers in Malaysia, 425 agreed to participate giving a response rate of 85%. In terms of overall satisfaction, a high percentage of respondents (85%) were satisfied with the MMT services. A logistic regression analysis showed that only "centres" and marital status were associated with overall satisfaction and that being single (OR 3.31; 95% CI 1.52 to 7.20) or married (OR 4.06; 95% CI 1.76 to 9.38) was associated with higher odds of overall satisfaction compared to being divorced or separated. An analysis of the responses pertaining to the most desired changes required at the center found dosing hours, waiting area and staff shortages to be common. The findings acquired from this survey will be useful to attain a clearer perspective on what aspects of the MMT service need to be reviewed for the improvement of service delivery.
  6. Al-Darraji HA, Wong KC, Yeow DG, Fu JJ, Loeliger K, Paiji C, et al.
    J Subst Abuse Treat, 2014 Feb;46(2):144-9.
    PMID: 24074846 DOI: 10.1016/j.jsat.2013.08.023
    People who use drugs (PWUD) represent a key high risk group for tuberculosis (TB). The prevalence of both latent TB infection (LTBI) and active disease in drug treatment centers in Malaysia is unknown. A cross-sectional convenience survey was conducted to assess the prevalence and correlates of LTBI among attendees at a recently created voluntary drug treatment center using a standardized questionnaire and tuberculin skin testing (TST). Participants (N=196) were mostly men (95%), under 40 (median age=36 years) and reported heroin use immediately before treatment entry (75%). Positive TST prevalence was 86.7%. Nine (4.6%) participants were HIV-infected. Previous arrest/incarcerations (AOR=1.1 for every entry, p<0.05) and not being HIV-infected (AOR=6.04, p=0.03) were significantly associated with TST positivity. There is an urgent need to establish TB screening and treatment programs in substance abuse treatment centers and to tailor service delivery to the complex treatment needs of patients with multiple medical and psychiatric co-morbidities.
  7. 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.
  8. Scorzelli JF
    J Subst Abuse Treat, 1988;5(4):253-62.
    PMID: 3216439
    The multifaceted drug prevention education and rehabilitation system of Malaysia appears to have contributed to the steady decrease of the number of identified drug abusers in the country. In this article, those components of the Malaysian system that would be most applicable to the American effort were examined. In the same manner, because the fastest growing minority group in the United States are Asian Americans, in which a significant proportion involve persons from Southeast Asia, those components in the Malaysian system that are applicable to Southeast Asian Americans were examined.
  9. Teoh Bing Fei J, Yee A, Habil MH, Danaee M
    J Subst Abuse Treat, 2016 10;69:50-6.
    PMID: 27568510 DOI: 10.1016/j.jsat.2016.07.006
    Methadone maintenance therapy has been found to be an effective harm reduction treatment for opioid use disorder. However evidence of its benefits over a longer duration of treatment is limited as most studies focus on its short term benefits. As methadone maintenance therapy reaches a decade since its implementation in Malaysia, this study sought to examine the effectiveness of methadone treatment, change in quality of life among patients since entry to methadone treatment, as well as factors predicting the magnitude of change in quality of life. This study found that methadone maintenance therapy was effective in reducing heroin use, injecting practices and crime, and in improving in social functioning and physical symptoms, but not in reducing sex-related HIV risk-taking behavior. Though patients had a significantly better quality of life at follow-up than at entry to methadone maintenance therapy, the improvement in quality of life was not significantly greater as the duration of treatment increased. Age above 50 years old, human immunodeficiency virus (HIV) positive status and physical symptoms predicted a poorer improvement in quality of life between baseline and follow-up. On the other hand, patients with hepatitis B showed a greater improvement in quality of life in the social relationships domain compared to patients without hepatitis B. In conclusion, methadone maintenance therapy is an effective treatment for opioid use disorder and improves quality of life but its benefits in further improving quality of life beyond a decade of treatment need further evaluation.
  10. Bojko MJ, Mazhnaya A, Marcus R, Makarenko I, Islam Z, Filippovych S, et al.
    J Subst Abuse Treat, 2016 07;66:37-47.
    PMID: 27211995 DOI: 10.1016/j.jsat.2016.03.003
    Opioid agonist therapies (OAT) to treat opioid addiction in people who inject drugs (PWID) began in Ukraine in 2004. Scale-up of OAT, however, has been hampered by both low enrollment and high attrition. To better understand the factors influencing OAT retention among PWID in Ukraine, qualitative data from 199 PWIDs were collected during 25 focus groups conducted in five Ukrainian cities from February to April 2013. The experiences of PWID who were currently or previously on OAT or currently trying to access OAT were analyzed to identify entry and retention barriers encountered. Transcribed data were analyzed using a grounded theory approach. Individual beliefs about OAT, particularly misaligned treatment goals between clients and providers, influenced PWID's treatment seeking behaviors. Multiple programmatic and structural issues, including inconvenient hours and treatment site locations, complicated dosing regimens, inflexible medication dispensing guidelines, and mistreatment by clinic and medical staff also strongly influenced OAT retention. Findings suggest the need for both programmatic and policy-level structural changes such as revising legal regulations covering OAT dispensing, formalizing prescription dosing policies and making OAT more available through other sites, including primary care settings as a way to improve treatment retention. Quality improvement interventions that target treatment settings could also be deployed to overcome healthcare delivery barriers. Additional patient education and medical professional development around establishing realistic treatment goals as well as community awareness campaigns that address the myths and fears associated with OAT can be leveraged to overcome individual, family and community-level barriers.
  11. Gill KK, van der Moolen S, Bilal S
    J Subst Abuse Treat, 2021 Aug 02.
    PMID: 34535321 DOI: 10.1016/j.jsat.2021.108583
    INTRODUCTION: Quitting tobacco is often viewed as a difficult experience as the dependence includes sets of behavioral, cognitive, social, and physiologic phenomena that prevent most smokers from having a successful first attempt of quitting. The aim of this qualitative study was to gain insight into and understand the motivation for attempts to quit smoking in relation to the stages of the behavior change model.

    METHOD: The study team based this qualitative study on Alfred Schütz's social phenomenology framework. The study team planned for fourteen in-depth interviews with patients registered at a Quit Smoking Clinic. Each in-depth session lasted 45-60 min and we audio recorded them with consent. Following full verbatim transcription, the study team carried out detailed thematic analysis using Nvivo software.

    RESULTS: Out of a total of 14 patients, 10 agreed to participate (response rate 71.4%). Seven participants (70%) had successfully quit smoking, while the remaining 30% relapsed after the first quit attempt. The study team extracted from the data three key themes with eight child nodes: barriers to quitting smoking, reasons for quit attempt, and how to quit. Unsuccessful attempts were related to tobacco addiction and successful attempts were based on the need to improve one's health and family. The study explored two intrinsic (self-realization and healthy lifestyle) and two extrinsic motivations (family's health and role model for children) for attempting to quit.

    CONCLUSION: The study highlights the importance of psychological support in successful quit attempts. Treatment providers should encourage behavior change through intrinsic goals, as such goals, compared to extrinsic goals, have a long-term and positive impact because they can activate autonomous motivation.

  12. Kelly PJ, McCreanor K, Beck AK, Ingram I, O'Brien D, King A, et al.
    J Subst Abuse Treat, 2021 Dec;131:108568.
    PMID: 34446323 DOI: 10.1016/j.jsat.2021.108568
    BACKGROUND: Mutual support groups play an extremely important role in providing opportunities for people to engage in alcohol and other drug (AOD) treatment and support. SMART Recovery groups employ cognitive, behavioural and motivational principles and strategies to offer support for a range of addictive behaviours. COVID-19 fundamentally changed the way that these groups could be delivered.

    METHODS: A series of online meetings were conducted by the lead author (PK) and the SMART Recovery International Executive Officer (KM), with representatives from the SMART Recovery National Offices in the Ireland (DO), United States (MR), Australia (RM), and Denmark (BSH, DA), and the United Kingdom (AK). The meetings focused on discussing the impacts of COVID-19 on SMART Recovery in each of the regions.

    RESULTS: As a result of restrictions to prevent the transmission of COVID-19, the vast majority of SMART Recovery face-to-face meetings were required to cease globally. To ensure people still had access to AOD mutual support, SMART Recovery rapidly scaled up the provision of online groups. This upscaling has increased the number of groups in countries that had previously provided a limited number of online meetings (i.e., United States, England, Australia), and has meant that online groups are available for the first time in Denmark, Ireland, Hong Kong, Spain, Malaysia and Brazil.

    DISCUSSION: Whilst the urgent and rapid expansion of online groups was required to support people during the pandemic, it has also created an opportunity for the ongoing availability of online mutual support post-pandemic. The challenge for the research community is to critically evaluate the online delivery of mutual support groups, to better understand the mechanisms through which they may work, and to help understand the experience of people accessing the groups.

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