Background: Opioid dependence (OD) is a chronic,
relapsing condition representing a significant societal
burden in Asia. Opioid maintenance treatment (OMT) in
combination with psychosocial treatment is considered to
be the most effective strategy to treat opioid dependence. In
Malaysia, about 52,000 patients reported receiving OMT in
December 2012.
Objective: The International Survey Informing Greater
Insights in Opioid Dependence Treatment (INSIGHT) project
aimed to assess aspects of OMT access and quality of care
by surveying patients and users with opioid dependence,
and healthcare professionals treating opioid-dependent
patients.
Materials and Methods: Using a structured questionnaire, 50
patients who were currently receiving OMT (or had received
OMT in the past 3 months) and 77 physicians were surveyed
in Malaysia regarding the provision and quality of OMT.
Results: Patients were predominately male and in their
thirties. Nearly all patients (98%) reported currently
receiving methadone liquid; almost half (48%) reported ever
having received psychosocial counselling and only 14% had
ever received buprenorphine−naloxone in the past. Most
physicians reported they were treating their patients with
OMT (77% on methadone and 15% on
buprenorphine−naloxone), and 3% used psychosocial
counselling alone. Although methadone maintenance doses
were close to levels recommended by WHO guidelines,
induction doses of methadone, and both induction and
maintenance doses of buprenorphine were well below these
levels in Malaysia.
Conclusions: The findings suggest that OMT
implementation in Malaysia can be improved by providing
patients with more education on treatment options, better
access to available treatments, including abuse-deterrent
formulations, and psychosocial support.