Malaysian Drug Policy: A Reduction in Prohibitionist Elements and Increased Propensity towards Harm Reduction

Rusdi AR, et al, in the 2008 article , 'A Fifty-Year Challenge in Managing Drug Addiction in Malaysia' point out that one of the visions of the Malaysian government is to create a drug addiction free nation by the year 2015. (at 3) They go on to point out that outcomes of efforts so far have been poor and that projected figures of drug addicts will reach half a million by 2015 due to the single treatment modality of regimental rehabilitation and the ignoring of the medical therapeutic approach. (Id)

There are two things that I'd like to say about this, the first related to the idea that we can create a drug-free nation. Such a contention is rooted in idealistic rhetorics and must be set aside if we are to be serious about fighting the drug epidemic. This statement by the Malaysian government is interesting for the fact that it mirrors a statement made by the U.S. Congress in 1988 aiming for a 'drug-free America by 1995'. In fact, Ethan A. Nadelmann in his article 'Commonsense Drug Policy' states: 'U.S. drug policy has failed persistently over the decades because it has preferred such rhetoric to reality and moralism to pragmatism.' [In James A. Inciardi and Karen McElrath (eds), The American Drug Scene: An Anthology (5th ed, 2008) at 464]

Nadelmann then asks us to: 'Imagine instead a policy that starts by acknowledging that drugs are here to stay, and that we have no choice but to learn how to live with them so that they cause the least possible harm.' (Ibid) This approach is known as the harm reduction approach which is gaining momentum all over the world, including developing countries such as Malaysia. Harm reduction advocates recognize that prohibition has failed to reduce drug addiction rates and recommend public health approaches to help mitigate harmful effects to society caused by drug abuse. An example of a harm reduction method is the syringe exchange program, which enables addicts to obtain sterile needles, reducing the risk of the spreading of HIV/AIDS. The syringe exchange program has attracted much controversy not only in the more conservative developing countries but also throughout developed countries, as some deemed it to 'condone illicit and immoral behaviour' etcetera. (Id at 466) However, these critics fail to realise that programs such as these 'bring hard-to-reach drug users into contact with health care systems', among other benefits. (Ibid)

I am an advocate of harm reduction in drug policy as opposed to over-emphasis on prohibition, but it should be noted that these two are not necessarily mutually exclusive. (Herbert D. Kleber and James A. Inciardi, 'Clinical and Social Implications of Drug Legalization')

The second thing I'd like to say is that the current regimented rehab program and punitive drug policies have to change. Gary Reid, Adeeba Kamarulzaman and Sangeetha Kaur Sran point out in their 2007 article 'Malaysia and Harm Reduction: The Challenges and Responses' that 'increasingly draconian punishments' have only led to even higher drug addiction rates and higher rate of relapsing drug users. In this article the authors detail the plan for methadone substitution therapy in Malaysia, and this is indeed very good news for harm reduction efforts in Malaysia.

I will write more about methadone therapy in the future but for now, this blog entry is mainly intended to be a brief introduction to the idea of harm reduction. In thinking about harm reduction, I am particularly fond of a quote by John Stuart Mill that I found in the 2008 book Public Health Law: Power, Duty, Restraint by Lawrence O. Gostin: '... the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others...' (at 47) Another good quote to think about is the one by Nadelmann at page 467: 'Prejudice and political cowardice are poor excuses for allowing more citizens to suffer from and die of AIDS, especially when effective interventions are cheap, safe and easy.' It should be noted that Nadelmann goes on to say at 472: 'As the evidence comes in, what works in increasingly apparent. All that remains in mustering the political courage.'