Local setting Having failed to reduce the incidence of HIV infection, in 2005 Malaysia embarked on a harm reduction strategy.
Relevant changes Standard operating procedures were modified to: (i) escalate the dose of methadone more slowly; (ii) provide ongoing
education and training for medical and correctional staff and inmates; (iii) increase the duration of methadone treatment before releasing
prisoners; (iv) reinforce linkages with community MMT programmes after prisoners’ release; (v) screen for and treat tuberculosis; (vi) escalate
the dose of methadone during treatment for HIV infection and tuberculosis; and (vii) optimize the daily oral dose of methadone (>80 mg)
before releasing prisoners.
Lessons learnt Prison-based MMT programmes can be effectively implemented but require adequate dosing and measures are needed to
improve communication between prison and police authorities, prevent police harassment of MMT clients after their release, and improve
systems for tracking release dates.