Evaluation of treatment outcomes of methadone program and knowledge awareness survey on drug abuse In Penang, Malaysia

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Date
2009
Authors
Gillani, Syed Wasif
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Abstract
A cross-sectional descriptive survey was conducted in Pulau Pinang, Malaysia, to provide the information regarding to the therapeutic effectiveness in the management and treatment of Addiction in three registered methadone clinics of Pinang state. Subsequent study was carried out to determine the level of knowledge in high prevalence area (Sg. Cheenam), among university students (USM) and treatment seeking group of addicts (out-patients of Methadone Maintenance Treatment (MMT)). Self administered questionnaires were developed to collect the required information from above three sample population knowledge and management practices of practitioners in methadone clinics. Stratified random sampling technique was used to collect data from Sg.Cheenam village, convenience sampling technique was employed to collect university sample while all the active out-patients on MMT were included in the survey. Data was analyzed statistically by applying appropriate statistical tests. A to~ of 175 persons from village, 180 students and 283 out-patients of MMT were surveyed for their knowledge about drug abuse and characteristics. Seven percent (7.3%) participants from village, 20.7% of students and 35.1% out-patients claimed they were active in drug-taking activities. Majority of addicts in three groups, experienced first drug abuse at the age of 19-25 years. Heroin was still the drug of choice found in the survey, intravenous injection was the pronounced route of administration. The overall mean scores of knowledge was 21.3 for villagers, 28.1 for university students and 21.9 for MMT patients. There was no significant difference found between the MMT patients and villagers groups while the university student group was found to be significantly higher when compared with the other two groups. Three methadone management therapy clinics of Pinang state were surveyed in the study. It was found that more then 70% dose setting were inconsistent with the national protocol. Seventy-eight percent (78%) of out-patients experienced chronic infection. Ninety-eight percent (98%) of them were confirmed to Hepatitis C virus. No single person was found on supportive therapy for chronic infection. Data showed that only 3.7% of total out-patients showed improvement in their quality of health after taking methadone treatment. A total of 23.7% drop-out cases were found during (Jan 2007- May 2008) survey. It is concluded that there is a sizable gap of lack of knowledge found among the village and out-patients of MMT. Educational programs are required for people, to increase their awareness about the addiction and drug abuse. Management and treatment practices are quiet inconsistent to protocol, so there is a need to increase the methadone prescribing trainings for practitioners. Strong recommendations are made for the update of national guideline on evidence - base4 management and treatment setting.
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Keywords
Treatment outcomes , Drug abuse in Penang, , Methadone program
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