On 12-13 December 2013, the Policy Team of the Malaysian AIDS Council in cooperation with the Royal Malaysian Police held a workshop on Police Leadership in Public Health. To some, the role of police and health staff in improving public health seems distinct. Immiscible. However, the 1967 Malaysian Police Act states that one of the key general duties of Police is to give assistance in the carrying out of any law related to sanitation and quarantine, and that police should give assistance in the protection of life and property. (Section 20) In our sessions with police, we emphasise that both police and public health NGOs have the same objective: creating safe and healthy communities.
In the sessions, we spoke primarily about methadone and how there is a plethora of evidence that methadone enables persons dependent on opiates towards breaking the cycle of drug-seeking behaviour, meaning that the individual no longer needs to spend the entire day looking for money to purchase illicit drugs. When this occurs, 'fundraising' crime decreases. The individual can now focus on securing stable housing and employment, and has more time to focus on familial relationships. Currently in Malaysia, persons detained for drug use have no access to methadone in police holding cells, or lockups. As a result, persons previously on the methadone program will undergo severe withdrawal. When he is released, the doctor providing methadone substitution will have to start from scratch. This means he will need to start on a very low dose, managing the increase of the dose, which can take weeks to months. In the mean time, patients may still seek illicit drugs as the methadone dose given is insufficient. This increases the risk of HIV and other blood borne diseases, and increases likelihood of fundraising crime. As such, it is very important that the Royal Malaysia Police allow the continuation of methadone in police custody, as in the end, all parties benefit.
The National Anti-Drugs Agency (known by its Malay acronym AADK) has methadone programs in its voluntary outpatient clinics. A key observation from the workshop was that police members stated that AADK Cure & Care voluntary programs were ineffective and did not produce results. Statistics from the Centre of Excellence for Research in AIDS (CERiA), however, show that out of 28,663 individuals attending these services from 2010-2013, 77.6% of individuals had improved family relations, 72.1% had obtained permanent homes, and 75.9% had been prevented from rearrest.
Methadone substitution has thus not only reduced spread of HIV via injection, but has also improved quality of life for persons who use drugs, persons around them, and the community at large. In order for these results to continue making positive changes, it is extremely important that police ensure that essential medical services including methadone and anti-retroviral therapy continue in the lockups.
*This workshop was funded by the European Union.