DECEMBER 16 ― The Honorable Deputy Minister’s comment in a recent article (Defending Malaysia’s zero tolerance drug policy, Jazlan claims US’ liberal approach failed ― Malay Mail Online, December 15, 2016) regarding methadone unfortunately highlights a misconception towards methadone replacement therapy that many of its critics believe in, i.e. that offering methadone to addicts is merely helping them substitute one addiction for another. This misconception is superficial and all too simplistic.

There are significant differences between taking methadone and being addicted to heroin or morphine. First, methadone reduces the cravings and the symptoms associated with heroin or morphine withdrawal; both of which are major factors in causing patients to relapse. Second, patients taking methadone do not experience the "high” or euphoria associated with heroin or morphine, allowing them to be productive and get jobs. Third, methadone is taken by mouth, unlike heroin or morphine, and patients are able to avoid the harmful effects of injections such as the risk of contracting or spreading blood-borne diseases like HIV and hepatitis. Furthermore, patients who receive their methadone from public health facilities receive regular checkups with their doctors, pharmacists and nurses which helps them improve or maintain their health. While the "cold turkey” approach may appear to work in the short term, a large number of patients relapse and, according to the study currently debated, in as short as 31 days. 

As a clinician, my explanation above may sound overly technical, so allow me to relate to you the words of a methadone patient that I had the privilege to serve years ago as a pharmacist in the Ministry of Health:

"People say being addicted to methadone is the same as being addicted to heroin. It is completely different. When I was on heroin, every waking moment was consumed with the thought of how to get my next dose, be it through begging, stealing or borrowing. I could not hold a job because I was either high or experiencing withdrawal all the time. I had no savings because any money I had went towards buying more heroin. With methadone, I am finally able to hold a job. I am clear-headed and I can focus on my work. Nobody can tell that I am on medication. Best of all, I have finally started saving money for myself and my parents.”

The words of his mother who accompanied him to the clinic were more direct:

"Heroin took away my son, methadone gave him back to me.”

* Mark Cheong is lecturer at the School of Pharmacy at Monash University Malaysia.

** This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail Online.