Dr Farhana Sabri
Dr Farhana SabriDeputy Director (research), Islamic Science Institute, Associate Researcher, Malaysia Substance Abuse Council (MASAC)

The Ministry of Health Malaysia has recently announced a game-changer policy – the decriminalisation of drug addicts and addiction. The concept and the rationale for this policy is clear.

The MOH states that decriminalisation means the removal of criminal penalties for individuals who possess and use a small quantity of drugs for personal use. This clearly does not include drug trafficking,  which remains a crime.

For a very long time, Malaysia has been treating drug addicts as criminals by imprisoning them. This provided the addicts with limited intervention and treatment appropriate for drug addiction, let alone evidence-based treatment.  This game-changer policy indicates that the government seriously acknowledges that drug addiction is a complex disease and must be treated as one.   The complexity of this disease is attributed to the many factors that could lead someone to drug addiction; biological, physiological, psychological, socio economic status, and demographic differences etc.  Each of these factors demands a critical look in order to treat drug addiction holistically.

One way of tackling drug addiction is by looking at it from a biological perspective. When someone consumes a drug, it changes the biological function of the brain. Reversing this biological change is difficult. This explains why drug addiction is a relapsing disease and takes a life-long journey for recovery.

For the government to embark on this policy, medical treatment for drug addicts must be complemented with psychosocial treatment, which requires not only physicians and pharmacists, but also psychologists and counsellors who are experts in drug addiction. Therefore, more manpower is required to treat drug addicts in Malaysia. The National Institute on Drug Abuse (NIDA) in the United States asserts in their treatment principles for addiction that there is no single treatment that can suit all problems. Thus, the treatment must be an integrated approach where the addicts themselves are not only the only ones who receive treatment, but we must also offer help for their family members and significant others who have been affected by the addiction problems.  This integrative approach will definitely need counsellors, psychologists, and social service workers who can address these problems.

In many cases drug addiction is not a stand-alone problem for drug addicts. Many drug addicts are also suffering from mental health problems such as depression, post-traumatic stress disorder, and psychosis symptoms (i.e. hallucinations and delusions) simultaneously. A situation when a drug addict has a drug use disorder and simultaneously experiences mental health disorder is called dual-diagnosis.  In this situation, the addict either developed mental health problems first followed by drug use problems or vice versa. Each disorder requires their own treatment plan which needs to be administered to the drug addicts simultaneously to treat the drug addiction problems effectively.

For the Ministry of Health of Malaysia, this game-changer policy not only involves physicians and pharmacists, but also other experts – counsellors, psychologists, and social workers. For this new policy to work, the government should also focus on developing these resources in order to treat drug addiction problems effectively in Malaysia.