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| ID | Type | Description | Link |
|---|---|---|---|
| F30MH105153 | U.S. NIH Grant/Contract | View source | |
| K24DA017072 | U.S. NIH Grant/Contract | View source | |
| R01DA025943 | U.S. NIH Grant/Contract | View source | |
| HIRGA E000001-20001 | Other Identifier | Malaysian Ministry of Education (High Impact Research Grant) |
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1) Policy change affecting C&Cs; 2) interm analysis revealing overt differences
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| Name | Class |
|---|---|
| Yale University | OTHER |
| World Bank | OTHER |
| Doris Duke Charitable Foundation | OTHER |
| National Institute of Mental Health (NIMH) |
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This observational study compares the health and social outcomes between opioid-dependent individuals who are either recently released from a compulsory drug detention center (CDDC) or recently discharged from a voluntary treatment center (VTC) providing methadone maintenance therapy, in Malaysia.
In July 2010, the National Anti-Drug Agency of Malaysia (NADA) introduced a non-punitive system of treatment and care for people who use drugs, voluntary treatment centers (VTCs), called 'Cure & Care' clinics, offering free methadone maintenance therapy (MMT) to opioid-dependent drug users. These centers were opened alongside existing compulsory drug detention centers (CDDCs), where people who use drugs continue to be detained involuntarily without access to evidence-based treatment. Given that both of these programs are operated by NADA but espouse vastly different responses to drug use, we compared health and social outcomes between opioid-dependent individuals recently released from CDDCs and recently initiated into MMT in the new VTCs.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Compulsory Drug Detention Center | Conventional drug treatment in Malaysia and Southeast Asia including detention for an average of 2 years, including educational and job skills programs and physical education. Medical therapies for treating substance use disorders, such as opioid-agonist treatment (OAT), are unavailable. | ||
| Voluntary Treatment Center | Voluntary drug treatment facilities, called 'Cure and Care' centers in Malaysia, that provide methadone maintenance therapy in addition to psychosocial interventions, recreational programming, and vocational training, among other activities. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Methadone | Drug |
|
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of opioid use (urine-toxicology) | Year following release from CDDC or discharge from VTC |
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of any drug use (urine-toxicology) | Includes opioid, amphetamine and benzodiazepine use | Year following release from CDDC or discharge from VTC |
| Occurrence of amphetamine use (urine-toxicology) |
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of drug or methadone use (self-report) | Sub-measures include opioid use, any drug use (opioid, amphetamine, benzodiazepine), methadone use, buprenorphine use | Year following release from CDDC or discharge from VTC |
| Addiction Severity (self-report) |
Inclusion Criteria:
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The study will be conducted among opioid-dependent individuals initiating MMT in C&C Centers and opioid-dependent individuals being released from Pusat Serenti who consent to participating in the study.
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| Name | Affiliation | Role |
|---|---|---|
| Frederick Altice, MD | Yale University | Principal Investigator |
| Adeeba Kamarulzaman, FRACP | University of Malaya | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27964869 | Derived | Wegman MP, Altice FL, Kaur S, Rajandaran V, Osornprasop S, Wilson D, Wilson DP, Kamarulzaman A. Relapse to opioid use in opioid-dependent individuals released from compulsory drug detention centres compared with those from voluntary methadone treatment centres in Malaysia: a two-arm, prospective observational study. Lancet Glob Health. 2017 Feb;5(2):e198-e207. doi: 10.1016/S2214-109X(16)30303-5. Epub 2016 Dec 8. |
| Label | URL |
|---|---|
| Link to dataverse site with protocol, study questionnaires, individual de-identified data and analytic code | View source |
| ID | Type | URL | Comment |
|---|---|---|---|
| Study Protocol | View IPD |
See links at end of this record for accessing de-identified data and documentation.
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| ID | Term |
|---|---|
| D009293 | Opioid-Related Disorders |
| ID | Term |
|---|---|
| D000079524 | Narcotic-Related Disorders |
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D008691 | Methadone |
| ID | Term |
|---|---|
| D007659 | Ketones |
| D009930 | Organic Chemicals |
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| NIH |
| The University of New South Wales | OTHER |
| Burnet Institute | OTHER |
| University of Florida | OTHER |
| National Institute on Drug Abuse (NIDA) | NIH |
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| Year following release from CDDC or discharge from VTC |
| Occurrence of benzodiazepine use (urine-toxicology) | Year following release from CDDC or discharge from VTC |
| Occurrence of methadone use (urine-toxicology) | This is a proxy for linkage to methadone therapy | Year following release from CDDC or discharge from VTC |
| Occurrence of buprenorphine use (urine-toxicology) | This is a proxy for linkage to buprenorphine therapy | Year following release from CDDC or discharge from VTC |
| Occurrence of no-methadone use (urine-toxicology) | This is a proxy for retention in methadone therapy | Year following release from CDDC or discharge from VTC |
| Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Occurrence of non-fatal overdose (self-report) | Year following release from CDDC or discharge from VTC |
| Rates of injection-related HIV risk behaviors (self report) | Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Rates of sex-related HIV risk behaviors (self report) | Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Opioid cravings (self report) | Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Motivation to change drug use (self report) | Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Police harassment (self report) | Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Health-related quality of life (self report) | Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Social Support (self report) | Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Occurrence of HIV seroconversion (antibody test) | Year following release from CDDC or discharge from VTC |
| Rates of employment (self report) | Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Total monthly income (self report) | Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Days of criminal activity (self report) | Compared at 3, 6, 9 and 12-months following release from CDDC or discharge from VTC |
| Detention in CDDC/Incarceration in jail or prison | Year following release from CDDC or discharge from VTC |
| Individual Participant Data Set | View IPD |
| Analytic Code | View IPD |