A Fifty-year challenge in managing drug addiction in Malaysia

The history of substance abuse in Malaysia can be divided into pre- and post-independent era. In pre-independence, the main drug of abuse was opium which was initially consumed by immigrants from China who were introduced by the British colonialist to work in \ud Malaya. The post-independence era began in the 1960s when young adults were inß uenced by the “Hippy” subculture. At this time, consumption patterns changed where more Malays were involved in drug abuse compared to other ethnic groups (1, 2). \ud By the early 1980s, the prevalence of drug addiction increased and this increasing trend made the Malaysian government consider heroin addiction as a national threat. The national anti-drug task force was formed to control trafÞ cking and to rehabilitate addicts who \ud were involved in heroin addiction (3). Legislation was introduced where mandatory death sentence was implemented for those who smuggled more than 15 grams of heroin. Drug addicts found to be positive for heroin were forced to undergo compulsory \ud rehabilitation for two years (4). Nationwide, up to 28 government drug rehabilitation centres were established, and at any particular period, each centre accommodated up to 500 inmates. Approximately RM50 million a year was spent to run these centres (5). The centres were initially managed on a total abstinence philosophy; however this approach produced poor results. The latest survey showed that 85% of drug addicts relapsed after completing their rehabilitation at these centres (4, 6). In view of the poor results, substitute treatment with methadone was introduced recently to these centres (7).One of the visions of the Malaysian government was to create a drug addiction free nation by the year 2015. However, the increasing number of drug addicts has caused a surge in demand for rehabilitation centres, resulting in the inability of these centres to cope. For example, the number of drug addicts increased by 1% from year 2001 to 2002, but the number of drug addicts detected in year 2003 was 36,996, a 16% jump from the previous year (31,893). Furthermore, the National Drug Agency reported that 45% of the cases were repeat addicts. As for distribution of new cases, by ethnic group the Malays constituted 71%, Chinese 10.6% and Indian 8.2%. The majority (70%) were in the socially and economically most productive age group (20-39 years) and almost 98% of the addicts who occupied these rehabilitation centres were male. Currently, the number of drug users in the country is estimated to be 250,000 but the number is predicted to reach half a million by year 2015 (3, 8-10). The resulting economic,human resource and social loss is not quantiÞ able as the vacuum left by these people in various employment sectors are currently being Þ lled by migrant workers. Thus, it is evident that the increasing trend in drug addiction poses a threat to the future of the nation (1, 6, 9)

Critical Review on Factors That Influence Continuous Engagement Towards CCBT

Substance abuse is an epidemic that spreads among adults, adolescents and even children in Malaysia. Substance abuse is categorized as a mental disorder, whereby, Cognitive Behavioural Therapy (CBT) is an approach that provides face to face physiological therapy for patients could resolve this issue. Computerized Cognitive Behavioural Therapy (CCBT) is a progression of information technology that is provided for patients encounter substance abuse. CCBT is a computerized therapy conducted at patient’s own pace. Ensuring patient’s continuous engagement towards CCBT becomes an issue. Patients that experience early gains, loss of interest and improvement symptom would sign up for alternative services that eventually causes disengagement and dropout from CCBT program. Interface design for CCBT is known as one of the important elements that effects patient’s engagement along CCBT program. Therefore, in this study, influential factors regarding CCBT’s interface design was investigated, whereby, five prominent models was reviewed. Content analysis methodology was employed to discover influential factors regarding CCBT’s interface design. Four influential factors was discovered namely engagement, dropout, culture and interface. These factors are known to ensure patient’s continuous engagement towards CCBT program. CCBT’s interface design plays a vital role in delivering the therapy program. Indirectly, CCBT’s interface design plays an important role to ensure patient’s continuous engagement till the completion of CCBT program. Therefore, these factors would guide researcher, service provider, developers and clinicians in designing engaging interface for CCBT

SIMPTOM KEMURUNGAN DALAM KALANGAN PENAGIH DADAH WANITA DI PUSAT RAWATAN DAN PEMULIHAN DADAH

Kajian ini bertujuan untuk mengenal pasti simptom kemurungan dalam kalangan penagih dadah wanita yang sedang menjalani rawatan dan pemulihan penagihan dadah. Pengenal pastian simptom kemurungan dalam kalangan penagih dadah wanita penting bagi mengelakkan masalah dual diagnosis yang boleh memberi risiko penagih dadah wanita pada tingkah-laku relaps, tingkah-laku penagihan impulsif dan penularan penyakit berjangkit khususnya penyakit bawaan darah. Kajian rintis ini dilaksanakan menerusi kaedah penyelidikan kuantitatif dan dapatan dikumpul melalui kaedah tinjauan dengan menggunakan borang soal selidik. Instrumen M.I.N.I. Neuropsychiatry telah digunakan bagi mengukur kemurungan, manakala jenis penyalahgunaan bahan khususnya dadah diteliti berdasarkan instrumen ASSIST (Alcohol, Smoking and Substance Involvement Screening Test). Seramai 31 dari 180 orang penagih dadah wanita telah dipilih secara rawak mudah dan data dianalisis secara deskriptif. Dapatan kajian mendapati, seramai 12 orang daripada 31 orang responden kajian menyatakan mereka mengalami simptom gangguan kemurungan yang digariskan oleh ‘Diagnostic Statistical Manual Mental Disorders’ (DSM-IV) seperti rasa sedih, murung atau pilu secara berpanjangan atau hampir setiap hari sekurang-kurangnya dalam tempoh dua minggu sehingga menyebabkan individu kurang berminat menikmati perkara terdahulu sehingga mengganggu aktiviti sosial. Manakala selebihnya lagi responden tidak menunjukkan simptom kemurungan dan ia mungkin dipengaruhi oleh proses rawatan dan pemulihan. Penyalahgunaan dadah jenis methamphetamine seperti syabu dan ‘ecstasy’ boleh memberi implikasi negatif terhadap kesihatan mental penagih. Perhatian yang serius perlu diberikan kepada penagih dadah wanita yang menderita dengan masalah ‘dual diagnosis’. Hasil kajian penting sebagai informasi kepada pihak yang bertanggungjawab mengenai kepentingan saringan kesihatan mental secara klinikal kepada penagih dadah khususnya wanita dan keperluan integrasi rawatan kesihatan mental dalam program rawatan dan pemulihan penagihan dadah yang mempunyai masalah ‘dual diagnosis’.   Kata Kunci: Dadah, kemurungan, penagih dadah wanita, pusat rawatan pemulihan, simptom   ABSTRACT This study aims to identify symptoms of depression among female drug users that are treated at a Cure and Care Drug Rehabilitation Centre. The identification of depression symptoms among female drug user is crucial to prevent ‘dual diagnosis’ problem that can cause female drug users to be at risk of having relapse behavior, impulsive addiction behavior and transmission of infectious diseases especially blood related disease. This pilot study used quantitative method and data were collected via survey involving a set of close-ended questionnaire. M.I.N.I Neuropsychiatry Instrument was used to identify depression symptoms, while Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) instrument was used to determine types of specific substance abused among the female drug users. 31 of 180 female drug users were randomly selected using simple random sampling technique and data were descriptively analyzed. The findings indicated that 12 out of 31 respondents reported having depression symptom as outlined by Diagnostic and Statistical Manual of Mental Disorders (DSM-V) such as prolonged sadness, moody or melancholy continuously for at least two weeks and had caused loss of interest in enjoying things they preferred to in the past and distributed their daily social activities. However, the remaining respondents did not report any depression symptom and it could be due to the current treatment and recovery process they undergo.  Methamphetamine drug abused such as syabu and ecstasy had negative effects to users’ mental health. Serious attention should be given to the female drug users who are suffering from dual diagnosis. The findings are crucial for the relevant and responsible authorities to providing clinical mental health screening for the addicts especially the female drug addicts.  An integrated mental health treatment among the female drug users with ‘dual diagnosis’ is recommended in the treatment and rehabilitation program.   Keywords: Depression, cure and care rehabilitation centre, drug, female drug users (FDU), symptom   Cite as: Ismail, R. F., Rashid, R. A., Abd. Wahab, H., & Ishak, Z. (2019). Simptom kemurungan dalam kalangan penagih dadah wanita di pusat rawatan dan pemulihan dadah [Depression symptoms among female drug users at cure and care rehabilitation centre]. Journal of Nusantara Studies, 4(2), 168-192. http://dx.doi.org/10.24200/jonus.vol4iss2pp168 -19

Kemurungan dan lain-lain komorbiditi penyakit dalam kalangan wanita yang terlibat dalam aktiviti pelacuran di Kuala Lumpur

Manuskrip ini bertujuan untuk memeriksa kemurungan dan hubungan kemurungan dengan lain-lain komorbiditi penyakit dalam kalangan wanita yang terlibat dalam aktiviti pelacuran di Kuala Lumpur. Seramai 126 orang wanita yang terlibat dalam aktiviti pelacuran telah ditemu-bual secara bersemuka dengan menggunakan borang soal selidik. Alat Ujian Diagnostik Temu Bual M.I.N.I Neuro-psikiatri 6.0 Versi Bahasa Malaysia digunakan untuk mengukur kemurungan. Manakala lain-lain komorbiditi penyakit diukur berdasarkan status penyakit berjangkit seperti Penyakit Menular Seksual, Hepatitis, HIV dan AIDS. Hasil kajian dianalisis dengan menggunakan perisian SPSS versi 21. Ujian deskriptif digunakan untuk menentukan status kemurungan. Ujian Khi Kuasa Dua digunakan untuk mengenal pasti perkaitan di antara status lain-lain komorbiditi penyakit berjangkit dengan kemurungan. Hasil analisis ujian deskriptif mendapati seramai 92 orang dari 126 orang wanita yang ditemu-bual telah melaporkan adanya simptom gangguan kemurungan. Hasil analis ujian Khi Kuasa Dua (p≤0.05) mendapati status penyakit berjangkit khususnya Hepatitis C mempunyai perkaitan yang signifikan dengan kewujudan kemurungan dalam kalangan wanita yang terlibat dalam aktiviti pelacuran di Kuala Lumpur. Penemuan kajian menggambarkan wanita yang terlibat dalam aktiviti pelacuran dan turut menghidapi penyakit Hepatitis C didapati lebih cenderung untuk melaporkan gangguan kemurungan. Justeru, program pendidikan dan rawatan kesihatan mental yang mengkhususkan kepada wanita yang terlibat dalam aktiviti pelacuran perlu diintegrasikan secara bersepadu dalam program-program pencegahan penyakit berjangkit

Sexual Behaviour among Male Methamphetamine and Heroin Dependents in Selected Areas in Malaysia (Tingkah-laku Seksual dalam Kalangan Lelaki Ketagihan Metamfetamin dan Heroin di Beberapa Tempat di Malaysia)

ABSTRACT This study aims to describe the pattern of sexual behaviour among methamphetamine and heroin users. I

The Development of the Malay Garden Concept

This study discusses the development of the Malay garden concept using the old Malay manuscripts and site observation to the Malay villages along Peninsular Malaysia. The inherited landscape design concept can offer as a guideline to conserve the integrity and the authenticity of the traditional Malay garden design and the strength of these characters will extensively use in developing the concept of landscape design in Malaysia due to the increasing awareness of design and the quality of life. Keywords: Malay Garden, Malay Landscape, Cultural Landscape, Quality of Life eISSN 2398-4279 © 2018. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Review of computerized cognitive behavioural therapy based on culture centered design for substance abuse in Malaysia

Addiction is an activity that includes video games, internet, gambling and substance abuse such as drugs, cigarettes and alcohol. These symptoms had spread among adults, adolescents and children. The phenomenon could be resolved through various approaches in the area physiological therapies such as Cognitive Behavioural Therapy (CBT). CBT plays a vital role, whereby it is a face-to-face therapy between patient and counsellor that treats emotional and physical health conditions. The advancement of information technology has spawned new innovations for therapy using computer known as Computerized Cognitive Behavioural Therapy (CCBT). The central issue concerning CCBT focuses on the patient’s continuous engagement throughout entire therapy. It is known that continuous engagement in using CCBT is dependable on the patient’s cultural background. Indirectly, it proves the existence of factors that influence patient’s preferences and engagement towards CCBT. Therefore, designing appropriate design interface based on Culture Centred Design (CCD) in order for patient to sustain their engagement level towards CCBT is essential. Furthermore, patients also fail to complete the therapy due to the lack of interest and focus, resulting in disengagement towards CCBT. Various engagement models and theories on developing cultural based interface for CCBT was discussed. Therefore, research aims to review literatures, identify factors that prone to provide continuous engagement CCBT interface which would trigger and guide future research works

REVIEW OF COMPUTERIZED COGNITIVE BEHAVIOURAL THERAPY BASED ON CULTURE CENTERED DESIGN FOR SUBSTANCE ABUSE IN MALAYSIA

Addiction is an activity that includes video games, internet, gambling and substance abuse such as drugs, cigarettes and alcohol. These symptoms had spread among adults, adolescents and children. The phenomenon could be resolved through various approaches in the area physiological therapies such as Cognitive Behavioural Therapy (CBT). CBT plays a vital role, whereby it is a face-to-face therapy between patient and counsellor that treats emotional and physical health conditions. The advancement of information technology has spawned new innovations for therapy using computer known as Computerized Cognitive Behavioural Therapy (CCBT). The central issue concerning CCBT focuses on the patient's continuous engagement throughout entire therapy. It is known that continuous engagement in using CCBT is dependable on the patient's cultural background. Indirectly, it proves the existence of factors that influence patient's preferences and engagement towards CCBT. Therefore, designing appropriate design interface based on Culture Centred Design (CCD) in order for patient to sustain their engagement level towards CCBT is essential. Furthermore, patients also fail to complete the therapy due to the lack of interest and focus, resulting in disengagement towards CCBT. Various engagement models and theories on developing cultural based interface for CCBT was discussed. Therefore, research aims to review literatures, identify factors that prone to provide continuous engagement CCBT interface which would trigger and guide future research works