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Objective Develop and apply new costing methodologies to estimate costs of opioid dependence treatment in countries worldwide. Data Sources/Study Setting Micro-costing methodology developed and data collected during randomized controlled trial ( RCT) involving 126 patients ( July 2003- May 2005) in Malaysia. Gross-costing methodology developed to estimate costs of treatment replication in 32 countries with data collected from publicly available sources. Study Design Fixed, variable, and societal cost components of Malaysian RCT micro-costed and analytical framework created and employed for gross-costing in 32 countries selected by three criteria relative to Malaysia: major heroin problem, geographic proximity, and comparable gross domestic product (GDP) per capita. Principal Findings Medication, and urine and blood testing accounted for the greatest percentage of total costs for both naltrexone (29-53 percent) and buprenorphine (33-72 percent) interventions. In 13 countries, buprenorphine treatment could be provided for under $2,000 per patient. For all countries except United Kingdom and Singapore, incremental costs per person were below $1,000 when comparing buprenorphine to naltrexone. An estimated 100 percent of opiate users in Cambodia and Lao People's Democratic Republic could be treated for $8 and $30 million, respectively. Conclusions Buprenorphine treatment can be provided at low cost in countries across the world. This study's new costing methodologies provide tools for health systems worldwide to determine the feasibility and cost of similar interventions. [ABSTRACT FROM AUTHOR]

Introduction and Aims. The prevalence of hepatitis C virus (HCV) among heroin dependants in treatment was estimated at 89.9%; however, virtually no information exists on the prevalence or risk behaviour among the larger population of drug users not in treatment. This study assessed the prevalence of HCV and associated risk factors among this group with a view to designing more effective intervention programs. Design and Methods. A cross-sectional survey of 552 not-in-treatment drug users recruited from five key urban centres across peninsular Malaysia with on-site serological testing for HCV and HIV seropositivity was conducted. Results. HCV prevalence was 65.4% for the overall sample, but higher among injecting drug users (67.1%) relative to non-injecting drug users (30.8%). Bivariate analysis suggested seven risk factors though only sharing injecting paraphernalia and lifetime homosexual/bisexual behaviour remained significant in multivariate analysis. Discussion and Conclusions. With the majority (65.9%) sharing injecting equipment and about the same proportion (65.4%) being HCV positive, the risk of further transmission to new drug users is high. It is imperative that the nascent needle and syringe exchange and condom distribution program and its ancillary services—launched in 2005 to fight HIV—be fine tuned, as a first step, to control HCV. With its greater infectivity and non-symptomatic character, HCV is more insidious. Given the shared risk factors of HCV and HIV, routine screening of drug users for HCV—currently non-existent—should be instituted. This, with other intervention measures, will help detect and control HCV at an earlier stage while also checking the spread of HIV.[Vicknasingam B, Narayanan S, Navaratnam V. Prevalence rates and risk factors for hepatitis C among drug users not in treatment in Malaysia. Drug Alcohol Rev 2009;28:447–454] [ABSTRACT FROM AUTHOR]

The article presents a study comparing the efficacy of heroin substitutes naltrexone, buprenorphine, and no additional treatment in patients for the maintenance of heroin abstinence, relapse, and reduction of HIV risk behaviors. The design and setting of the research, which involved 126 detoxified heroin addicts from outpatient clinics and detoxification programs in Malaysia, is explained. A significant reduction in HIV risk behaviors was reported across all three treatments. Researchers say their findings support the widespread dissemination of maintenance treatment, which could reduce problems associated with heroin dependence.

The article discusses the treatment of heroin addiction in Malaysia. It mentions the various process undergone in the approach to reduce heroin addiction in the country as drug abuse problem creates a threat to public health and social security. It notes the policies introduced by the Malaysian government which involve methadone substitution therapy and counseling. It also emphasizes the strengthening of the Narcotic Department of the Royal Malaysian Police.