Nurul Izzah To Run New Opioid Addiction Treatment At Penang Mosques

Naltrexone may cost almost RM6,000 per patient, including the cost of rehabilitation.

KUALA LUMPUR, June 10 – Permatang Pauh MP Nurul Izzah Anwar plans to open a drug addiction clinic near a mosque in Penang that uses naltrexone, a new medicine to treat opioid addictions.

The PKR lawmaker told Malay Mail that the programme, pending approval by the Health Ministry, will evaluate the effectiveness of both naltrexone and an older drug, methadone, in treating opioid dependency.

“So Permatang Pauh will be home to the first ever global study comparing between methadone and naltrexone,” Nurul Izzah was quoted saying.

She said last January that naltrexone cost A$3,000 (RM5,896) per patient, including the cost of rehabilitation. Suppliers have reportedly quoted around RM3,000 per implant, one form of naltrexone, that usually lasts for three months, a cost that Nurul Izzah said was still lower in the long run than incarceration.

The Penang opioid treatment programme is a replica of the Ar-Rahman project, where the Ar-Rahman mosque in Lembah Pantai here ran a methadone clinic for heroin addicts in 2010. Nurul Izzah oversaw the project as Lembah Pantai MP then. It has since been discontinued due to a funding shortage.

According to Nurul Izzah, the naltrexone treatment will be run by three mosques in Permatang Pauh, with a clinic near one of the mosques dispensing the addiction medicine.

She said the end goal was to decriminalise drug use, but she decided to start with harm reduction to make it easy for public acceptance of decriminalisation later.

Dr Adeeba Kamarulzaman, an expert from Universiti Malaya on addiction treatment, said there was little evidence that incarceration reduced substance abuse, pointing out that the number of repeat drug offenders in prison showed instead that jail intensified substance dependence.

“They tend to relapse… or in many cases they become worse because they find this new network,” Dr Adeeba told Malay Mail.

Naltrexone works differently from methadone and buprenorphine because the latter two are opioids which help reduce cravings by not producing a high when activating opioid receptors, while naltrexone, a non-opioid, destroys any desire to take opioids by blocking opioid receptors, according to US-based web guide Addiction Center.

Vox reported in 2017 a US study in The Lancet that found it was significantly more difficult to start naltrexone because it required a long detox period, between three and 10 days of no opioid use, compared to buprenorphine that only needed partial detoxification of between 12 hours and two days.

Naltrexone requires patients to go through withdrawal because it only works once opioids are out of their system, said Vox. Because naltrexone is not an opioid, it will not curb withdrawal symptoms.

Naltrexone was as effective as buprenorphine, however, once patients managed to get on the treatment, the study found.

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