Towards a Higher Percentage of Recreational Drugs-Free Among Patients on Methadone Maintenance Treatment in Larkin Health Clinic
Methadone Maintenance Treatment (MMT) Clinic in Larkin Health Clinic was established in 2007 as part of Malaysia’s Harm Reduction Programme, mainly to prevent blood-borne viral infections, improve patients’ mental and physical health, improve their socio-economics ability in society, and curb opiate addiction. A verification study in January 2017 found that only 34.9% of patients on MMT were recreational drugs-free after undergoing treatment. This study aimed to increase the percentage of recreational drugs-free among patients on MMT to 60% within one year. This quality improvement study was conducted among 63 patients and five healthcare providers. Face-to-face structured interviews with the respondents and brainstorming sessions with the healthcare providers were conducted to identify possible contributing factors. Four main contributing factors were identified; (i) healthcare workers were not formally trained for counselling techniques (100%), (ii) ineffective counselling (53%), (iii) unable to resist desire to take drugs (48%), and (iv) society’s negative views (45%). In the post-intervention phase, all contributing factors had improved except for two factors that
were beyond the group intervention, which were easy access for patients to drug supplies (38%) and peer influence (38%). Strategies implemented include Psychosocial Intervention Strengthening Courses, FRAMES counselling techniques (Feedback, Responsibility, Advice, Menu of Options, Empathy, Self of efficacy), Metha Club establishment, group counselling, and reward system in Phase 1. Inter-agencies involvement was held in Phase 2 and reinforcement of spiritual elements was implemented in Phase 3. The Sustainability Phase strengthened the process of defaulter tracing and introduced a drug abuse legal awareness. At post-intervention, the percentage of recreational drugs-free patients had increased from 34.9% (verification study) to 47.9% (Phase 1), 49.2% (Phase 2), 61.3% (Phase 3), followed by 65.1% (Sustainability Phase). ABNA reduced from 25.1% (Pre- Intervention) to -1.3% (Phase 3) and -5.1% (Sustainability Phase), thus the standard set in this study was successfully achieved.