title: Emerging Drug Use Trends in Kelantan, Malaysia.
abstract: The primarily rural and agrarian Kelantan province of Malaysia has high rates of drug use and is characterized by unique sociocultural factors. Combining qualitative and ethnographic methods, we investigated drug use and treatment needs of people who use drugs (PWUD) in rural areas of Kelantan. In February 2014, field visits, participant observation, and focus group discussions (FGDs) with 27 active PWUD were conducted in rural areas surrounding the capital city of Kelantan. The findings indicate a high prevalence of opiate and amphetamine type stimulants (ATS) use in these areas. FGD participants reported initiating drug use at early ages due to peer influences, to relieve boredom, to cope with problems, and a high saturation of villages with other PWUD was reported as a major contributor to their own continued drug use. They reported a trend of drug use initiation at younger ages and increased drug use among females. Participants were interested in treatment; however, their limited knowledge about treatment options and perceived limited availability of services were barriers to treatment seeking. Easy access to drugs, primarily from Thailand and facilitated by the use of mobile phones, resulted in an expanding prevalence of drug use that underscores the need to bolster education and prevention efforts and accessibility of treatment services in Kelantan.
authors.affiliation: a Associate Research Scientist, Department of Psychiatry , Yale School of Medicine , New Haven , CT , USA.
authors.forename: Alethea
authors.initials: A
authors.lastname: Desrosiers
authors.affiliation: b Postdoctoral Associate, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA & Lecturer , Advanced Medical and Dental Institute, Universiti Sains Malaysia , Penang , Malaysia.
authors.forename: Weng-Tink
authors.initials: WT
authors.lastname: Chooi
authors.affiliation: c Associate Professor, School of Social Sciences , Universiti Sains Malaysia , Penang , Malaysia.
authors.forename: Norzarina Mohd
authors.initials: NM
authors.lastname: Zaharim
authors.affiliation: d Medical Lecturer, School of Medical Sciences , Universiti Sains Malaysia , Kelantan , Malaysia.
authors.forename: Imran
authors.initials: I
authors.lastname: Ahmad
authors.affiliation: d Medical Lecturer, School of Medical Sciences , Universiti Sains Malaysia , Kelantan , Malaysia.
authors.forename: Mohd Azhar
authors.initials: MA
authors.lastname: Mohd Yasin
authors.affiliation: d Medical Lecturer, School of Medical Sciences , Universiti Sains Malaysia , Kelantan , Malaysia.
authors.forename: Sharifah Z
authors.initials: SZ
authors.lastname: Syed Jaapar
authors.affiliation: e Professor, Department of Psychiatry , Yale School of Medicine , New Haven , CT , USA.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Schottenfeld
authors.affiliation: f Associate Professor, Centre for Drug Research , Universiti Sains Malaysia , Penang , Malaysia.
authors.forename: Balasingam
authors.initials: B
authors.lastname: Vicknasingam
authors.affiliation: g Associate Professor, Department of Psychiatry , Yale School of Medicine , New Haven , CT , USA.
authors.forename: Marek C
authors.initials: MC
authors.lastname: Chawarski
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D019969:Amphetamine-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D017144:Focus Groups; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
keywords: Amphetamine type stimulants (ATS) use; Malaysia; drug treatment needs; opiate use