International Journal of Psychosocial Rehabilitation
Rehabilitation Effort been Effective?
F. Scorzelli, Ph.D.
Health Sciences, NEU
Scorzelli JF (2009).
Has Malaysia’s Drug
Journal of Psychosocial Rehabilitation. 13(2), 21-24
The review of Malaysia’s intensive
rehabilitation program indicates that it is not working in that the
recidivism rate is still over 50%. Furthermore, methamphetamine
ecstasy has recently been introduced in the country, and this has
country’s drug problem. The author provides the reasons for this
Key words: heroin, marijuana, Malaysia, death
Malaysia, a country
in Southeast Asia, has a
24,821,286 million people, and gained its independence from Great Britain in 1957
Intelligence Agency, 2007)). It is a racially mixed country in
of the population are Malays, 32% Chinese, and 8% Indians (Central
Agency, 2007). Malaysia is an
and all the Malays are Muslims. Even though most of the
population of the
country is forbidden from drinking alcohol, Malaysia is the tenth
consumer of alcohol in the world (Arokiasamy, 1995). This
consummation pertains to the non-Malays in that 34% of them are viewed
drinkers. (Arokiasamy, 1995). Of these two groups, alcohol
dependence appears to relate more to the Indians because of poverty and
easy assess to alcohol (Arokiasamy, 1995). In fact, the average
consummation of alcohol by Indians is 14 liters a year, and the average
alcohol dependence is 22 years (Arokiasamy, 1995). Regardless of
data, the country does not view alcohol as a problem, and except for a
groups in the large cities, there is really no treatment services
this client population.
1983, Malaysia declared its
problem a national emergency, and enacted severe enforcement
That is, anyone convicted of trafficking (based on the amount of the
the person’s possession when he or she is arrested) was sentenced to
death. This pertained to 15 grams of heroin and 200 grams of
cannabis. Further, if a person was arrested for possession, he or
would be sent to a governmental rehabilitation center for two
individual was also registered as a drug offender with the
that time, the drugs of abuse were heroin, opium and cannabis. Malaysia has a policy
turkey” detoxification for a person addicted to an opiate.
a person is placed in small cell for a week where he or she goes
withdrawal. Once the withdrawal ends, the person is medically
and sent to a rehabilitation center. The only exception to the
turkey” detoxification” is if the individual is 55 years of age or
older or has
medical complications. If this is the case, he or she is admitted
hospital, and goes through withdrawal with medication.
there are 29 governmental rehabilitation centers in Malaysia, of which
one is for
women. It should be noted that 97.3% of the persons incarcerated
possession in the country are male, between the ages of 22 to 29
Home Affairs, 2005).
discharged from the rehabilitation center, the person has one year of
probation where he or she has two urine tests a month. If the
positive, the person is required to go for counseling. Even
test is positive, the drug abuser would not be sent back to a
center, and this would only occur if he or she is arrested again for
As stated, at the beginning of the country’s stringent enforcement
drugs of abuse were heroin, opium and cannabis, with most offenders
heroin intravenously (66.3%) (Ministry of Home Affairs, 2005).
governmental studies, the reasons given for drug abuse pertained to
pressure and poverty (Scorzelli, 1989).
problem of heroin abuse in Malaysia is further
because of HIV and Hepatitis C. Because of the high incidence of
heroin usage, the country has a large number of people infected with
In a survey of 300,241 registered drug users from 1988 to 2006, it was
that 18.49% were infected with HIV (UNICEF, 2007). In another
the National Institute of Drug Abuse (2006), 177 male heroin users who
being treated in a rehabilitation center were medically examined.
group, 19.2%. had HIV, 89.9% Hepatitis C, and 15.7% had
Also, only 8% of these men said that they used a condom.
treatment provided by the rehabilitation center is based on the model
therapeutic community. The therapeutic community is a
with treatment stages that reflect increased level of personal and
responsibility. There is peer influence that is mediated through
variety of group processes. The treatment stages in the rehabilitation
in Malaysia are
identified by the
color of the inmate’s shirt. The lowest or first level is a red
and the inmate can progress to a yellow, green and white shirt.
inmate remains a red shirt until he or she has been at the center for
months. The yellow shirt involves eight months, and this is
another eight months as a green shirt. When the inmate wears a
shirt, he or she has only four months to serve at the rehabilitation
center. If an inmate tries to escape, he or she is given a
shirt to wear. In a way, a blue shirt stigmatizes the person
since he or
she is at the lowest level in the rehabilitation center. At the
of the person’s commitment to a rehabilitation center, he or she is
paramilitary drills and callisthenics for several hours a day, and for
religious instruction daily by an Imam. Those inmates who are not
have religious services once a week. As the inmate progresses to
levels, he or she has less physical activity, and receive counseling
(individual, group and family) and vocational training. With
the latter, most of the inmates are either un or under-employed when
arrested (Scorzelli, 1989). However, the vocational training
does not involve areas of high technology, but consist of such things
rattan making, shoe repair, mushroom farming, brick laying, welding,
repair. Therefore, there is little employment status or career
when the inmate is released.
1986, the government started to keep records of recidivism, and using
as the baseline, recidivism in the country is over 50%. In a
by UNICEF (2007), there were 22,811 registered drug users in 2006, and
(54.5%) were repeat offenders. Although the reason for this high
recidivism is not known, some believe it is due to the treatment
the inmates (Office of Home Affairs, 2005). This pertains both to
level of vocational training, and the qualifications of the counselors
religious instructors. That is, many of the counselors are not
professionally trained, and they and the religious instructors often
little knowledge about drug abuse. In addition, the one year
period is poorly managed, and many discharged inmates simply vanish and
participate in the process. In contrast to this, is the
that relapse is part of the disease of drug addiction, and since
based on drug usage since 1986, the rate would be high (a person could
after 10 years of sobriety and would still be included in the
the last five years, Malaysia’s drug
worsen with the introduction of methamphetamine (referred to as sybu)
ecstasy. The death penalty remains for both of these drugs if a person
apprehended with 50 or more grams of the drug(s). According the
government, sybu comes from the Philippines and ecstasy
from Thailand (Office of
Crime, 2003). Reasons given for the introduction of these new
concern the fear of contracting HIV from IV heroio use (Ministry of
Affairs, 2005). Although heroin is still the drug of choice,
reports that 60% of the inmates at a rehabilitation center in Sabah are
abusers (Ministry of Home Affairs, 2005). To complicate the
more, there have been reports of ketamine and cocaine abuse. In
cocaine, the drug is still a rarity in the region.
recent changes in the drug usage in
Malaysia has resulted
treatment changes. First of all, methadone maintenance was
few years ago. Yet, this treatment is only for those persons who
volunteer and have not been arrested for drug abuse. Those
go through cold turkey detoxification. Secondly, there has been
development of over 60 private treatment facilities. Again, these
for those persons who volunteer for treatment and have not been
for those who have been discharged from a rehabilitation
Many of these facilities have a religious orientation (Islam or
like the governmental rehabilitation centers, are based on the
community model. There is no data yet on the success of the
maintenance program or the effectiveness of the private treatment
the Current System
change the current situation in Malaysia, it is the
the author that there has to be a change in the nature of the
training, and the treatment approach. As indicated by the
(Dongus, 2005; Greenwood,, Woods, Guydish, & Bein, 2001; Huvvard,
& Anderson, 2003; McLellan, et al., 1999; Sindelar, Jofre-Bonet,
& McLellan, 2004) there is a relationship between viable employment
drug treatment success. Work appears to be a reinforcing factor
helping a recovering drug abuser maintain his or her sobriety.
the importance of viable employment in the rehabilitation of the client
abuses drugs the vocational training provided at the
centers need to change. Specifically, training as computer
electronic technicians may provide a better incentive then rattan
inmates to remain drug free upon their discharge. Furthermore,
implementation of a transitional or supported employment model would
helpful. White shirted inmates who appear committed to stop their
usage could be identified and sent to large corporations to work while
on-the-job training would help make
them aware of the world of work, and the opportunities that are
the private sector. Also, there is no reason while outstanding
could not be hired by corporations prior to their
Lastly, the development of self-employment options for the inmates
make the employment options upon the inmate’s release more
terms of further education, there may be a problem because of the
educational system. Modelled after the United Kingdom, a student
to take a series of tests, beginning at age 12. If he or she
standardized test, he or she can only attend school until 15 years of
age. The second exam is given at 15 years of age, and if a person
the examination, he or she must leave school at 17 years of age.
examination, which is for college admission, is offered when the
student is 17
years of age, and if he or she fails, his or her education ends.
Nevertheless, there is a possibility that there may be some inmates who
progressed far enough to take some college classes. Therefore it
that changing the nature of training and providing an opportunity for
transitional employment would be important factors in helping a person
a drug free life style.
terms of treatment services, it is
possible that a more intensive treatment model is needed. One
intensive program is the matrix treatment model. The matrix model
developed as a response to the cocaine epidemic of the 1980’s.
of the matrix model are to achieve the following: cease drug use,
the client in treatment, help the client learn about issues that are
to addiction and relapse, receive direction and support from a trained
therapist, receive education for family members affected by addiction,
client become familiar with self-help groups, and receive monitoring by
and breath analysis (Rawson, et al., 1995). The components of the
involve therapist support, group/individual counselling, 12-steps,
prevention and education, family education, and monitoring whether the
has used drugs (Rawson, et. al, 1995). An important part of the
involves the training and treatment manuals that describes a protocol
evaluating the effectiveness of the intervention. In fact, the
Institute of Drug Abuse (2006) indicated that 5,000 cocaine and 1,000
methamphetamine addicts have participated in this treatment
Further, research has indicated that there has been a significant
drug abuse among the participants (National Institute of Drug Abuse,
An important factor in implementing this model is that the counsellors
professional trained, preferably with a master’s degree. As of
most of the counsellors in the treatment centers do not have a master’s
degree. Because of this need, many of the universities in Malaysia are
programs in drug counselling.
on a review by the author, Malaysia’s attempt to
its drug problem does not appear to be working. The reasons for
failure appear to pertain to low level of vocational training provided
inmates, as well as the diluted treatment services that they
receive. Fortunately, the government has acknowledged these
problems, and are attempting to change the services received at the
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