Challenge in managing drug addiction in malaysia--论文代写范文精选

海洛因吸毒者一旦发现被迫接受强制戒毒两年。全国范围内建立了28个政府戒毒康复中心。最新的调查显示,85%的吸毒者离开康复中心后复发。介绍美沙酮替代治疗，马来西亚政府的愿景是让人们远离毒品。然而,越来越多的吸毒者造成康复中心的需求激增,导致无力应付。下面的essay代写范文仍讨论这一问题。

Introduction 
  The history of substance abuse in Malaysia can be divided into pre- and post-independent era. In preindependence, 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 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). 

  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 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 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).

 Challenges to Treating Drug Addiction in Malaysia 
  Substance abuse is one of the leading and most complicated health and social problems faced by our country. Unfortunately, after three decades of managing these problems, outcomes are unpromising and poor. This could be due to several reasons. Firstly, treatment policy has been conÞ ned to a single treatment modality, which is the regimental rehabilitation programme. Secondly, the medical therapeutic approach has been totally ignored by this policy, despite strong evidence that addiction to drugs is a medical condition. It was only recently that the medical profession was called to review the treatment policy and provide input in the management of addiction in Malaysia. 

  Thirdly, it is the stigma of the illness and rehabilitation treatment itself, which has resulted in patients being hesitant of seeking early treatment. It was reported that there is the fear of rejection by the community and losing their freedom once they enter a rehabilitation programme in Serenti Centres (6, 7, 9). As everyone who enters the Serenti Centre is required to undergo rehabilitation and be detained for two years, this causes the inmates to be deprived of work. Most of them have to give up their occupation during detention and by the time they leave the centre, they lose their opportunity to work. 

  This could be one explanation why many of them resort to crime once they are discharged from the Serenti Centre. Some addicts reported that they perpetrated crime in order to support themselves and their families. However, this reason is only part truth as it was found that many did it to support their addictive habit. This is because they abstained from taking drugs while in the Serenti Centre, but the rehabilitation centres do not cure them of the illness. Therefore, once discharged from the centre, they relapse (6, 7, 9). The types of crimes reportedly done by drug addicts are snatch theft, selling drugs, fraud, house breaking, homicide and suicide. 

  The involvement of drug addicts in crime could lead them to be imprisoned. Imprisonment adds another problem as it further stigmatises the drug addict since the community take this as conÞ rmation that drug addicts are hard-core criminals. This leads to a total rejection from their families and the community. The drug addict thus loses hope and eventually becomes depressed. As a result of family rejections the only person they can conÞ de in is other drug addict peers. This is also the time when addicts share needles, thus worsening the addiction problem. This process may explain the whole cycle of addictive behaviour and how it is associated with HIV and AIDS (1,6). 

  It is very unfortunate that in the past, the medical community dealt with these addicts when they have already contracted these horrendous complications. The consequence of past inappropriate policies is a continually increasing number of infectious diseases among people who use drugs and an escalating incidence of HIV or AIDS in Malaysia. It has been reported that the cumulative number of HIV infections reported to the Ministry of Health Malaysia up to December 2005 was 70,559 cases with 8,179 positive for AIDS. Most (81.5%) of the HIV infected persons were young males (age 20-40 years) (1, 6, 7, 9). 

  The effect of failed treatment in Serenti centres affects the addicts and cause misery to their family members as 50% of drug addicts undergoing rehabilitation programmes are sole breadwinners. The impact of losing their sole breadwinner for two years caused extreme Þ nancial and emotional hardship, and stress in the family system leading to family disruption. This could be one explanation why children of drug addicts are at more risk of becoming drug addicts (6, 7, 9). Due to needle sharing, families of addicts are also at risk from HIV and AIDS. There are reports where drug addict husbands, infected with AIDS, transmit the disease to their spouses and children. This is another disaster, which could have been prevented from the beginning if the addiction cycle that was worsen by the Serenti form of rehabilitation was stopped and replaced (6, 7, 9). Therefore, is it past time that the Serenti rehabilitation programme be reviewed? There has been much concern expressed by the public as well as by professionals about the failure of the Serenti treatment programme in tackling heroin addiction in Malaysia. It is, therefore, timely for the government to evaluate the cost-beneÞ t of the Serenti rehabilitation programme. （essay代写)

  Among the Þ rst consideration should be the duration and the type of drug addict who needs the treatment. It is suggested that the duration of stay in Serenti should be shortened from 2 years to about 3 to 6 months. There are many advantages of shortening the rehabilitation period (6, 7, 9). Firstly, this ensures that addicts will be able to go back into the community without depriving them of their potential either as workers or breadwinners of the family. Secondly, this is cost-saving for the government. It was reported that the government paid RM3000 to maintain one addict in a Serenti Centre for a month. Reducing the stay to six months will incur only a quarter of the cost incurred currently. Nevertheless, the most expensive cost is still borne by the drug addicts’ familieswho suffer Þ nancial and emotional loss at being left without anyone to look after needs. This loss is of course unquantiÞ able in ringgit and cents (6, 7, 9).（essay代写)

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