Spiritual enhanced drug addiction rehabilitation (SEDAR) program: An innovative strategy for increase coverage of methadone program in Malaysia

Abstract

Introduction

In Malaysia, national methadone maintenance therapy program was started by the goverment in October 2005 as part of harm reduction approach in reducing HIV prevalence among drug users along with needles and Syringes exchange(NSEP) program. However, slow coverage of MMT treatment occurs due to limited resources in existing health facilities and lack of participation from general practioners(Gps). There is a need for another paltform to increase coverage and participation of GPs in national MMT program.

Objectives

To compare the retention rate and other outcomes measures between SEDAR program and Standard MMT treatment in hospital.

Aims

To determine the feasability of MMT program in mosque environment.

Methods

The pilot MMT program known as SEDAR program was conducted in Ar-Rahman mosque involving 30 clients. Brief spiritual intervention(BSI) was given by mosque staffs on top of standard MMT treatment counseling. BSI include washing body parts with water or “wuduk”, praying in the mosque or “tahiyatul masjid” and recite “doa” in the mosque environment prior to direct observed therapy of methadone in the mosque by the pharmacist. The retention rate, % of urine drugs negative over time period, drug use and HIV risk behavior, quality of live and spiritual progress were measure using specific tools: OTI, WHO Qol, SF36, HIR96.

Results

We expect the SEDAR group in Mosque has better outcomes or comparable with standard MMT treatment in hospital setting.

Conclusions

The SEDAR program is feasable to increase coverage of MMT program in Malaysia.