Compulsory drug detention shows higher relapse rates

Burnet Institute

08 December, 2016

Professor David Wilson, Burnet's Head of Infectious Disease Modelling

People with chronic opioid use disorders are more likely to relapse and do so sooner if they are treated in a compulsory drug detention centre rather than a voluntary drug treatment centre using methadone maintenance therapy, according to the first study comparing the outcome of both approaches published in The Lancet Global Health.

Approximately 600,000 people are detained in compulsory drug detention centres without due process in East and South East Asia each year, despite reported human rights abuses and lack of evidence that they effectively treat addiction.

The Lancet study, co-authored by Burnet’s Head of Infectious Disease Modelling Professor David Wilson, supports international calls for all countries to eliminate compulsory drug detention centres, and scale up evidence-based treatments such as methadone in voluntary community treatment settings.

In 2010 Malaysia introduced voluntary treatment centres providing methadone that began to replace many compulsory centres.

But government and public resistance to the closure of compulsory detention remains high because of a zero-tolerance approach to drugs and under-recognition of the effectiveness of voluntary centres.

The Lancet study used a unique opportunity in Malaysia where both centres coexist to focus on 89 people from compulsory centres and 95 from voluntary centres who met criteria for an opioid use disorder and had drug tests and interviews on study entry and repeatedly after release (at one, three, six, nine or 12 months post-release).

Those held in compulsory centres were 84 percent more likely to relapse to opioid use, confirmed by urine toxicology testing, and did so 10 times sooner – within 31 days, compared with 352 for those in voluntary centres.

One month after their release, over half (51 percent) of those released from compulsory centres were drug-free, compared with nearly all (91 percent) of those from voluntary centres.

After a year, only one in 10 (10 precent) of those from compulsory centres was still drug-free, compared with half (50 percent) of those from voluntary centres.

The study was conducted by researchers from the University of Malaya, Yale University School of Medicine, University of Florida College of Medicine, the Malaysian National Anti-drugs Agency, The World Bank Group and Burnet Institute.

Contact Details

For more information in relation to this news article, please contact:

Professor David Wilson

Head of Infectious Disease Modelling


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