Dr Nurafiqah Mohd Salleh, Senior Lecturer at the Department of Social and Preventive Medicine (SPM), Faculty of Medicine, Universiti Malaya, calls for a critical reassessment of Malaysia’s drug policy, particularly the continued reliance on punitive approaches in addressing substance use. Drawing from a public health perspective, she emphasises that the current paradigm, which leans heavily towards criminalisation and incarceration, may not adequately address the complexity of drug dependence.
In her article “Antara rawatan dan pemenjaraan: Menilai semula dasar dadah negara” published by Berita RTM, she highlights that substance use disorder is not merely a legal issue but a multifactorial health condition. It is influenced by a combination of biological vulnerability, psychological factors, and social determinants such as poverty, trauma, and marginalisation. As such, approaches centred solely on punishment risk overlooking the underlying drivers of drug use while also limiting opportunities for recovery.
She further notes that incarceration, while intended as a deterrent, often produces unintended consequences. Individuals with drug dependence who are imprisoned may face disrupted social support systems, reduced access to continuous care, and increased stigma upon release. These factors collectively contribute to a higher likelihood of relapse and hinder reintegration into society. From a systems perspective, this also places additional strain on correctional facilities without achieving sustained public health gains.
In her analysis, Dr Nurafiqah underscores the importance of differentiating between drug use and drug dependence, as well as recognising the heterogeneity of affected populations. For example, women who use drugs may have distinct pathways into substance use, often linked to experiences of violence or caregiving burdens. Such nuances require tailored interventions rather than uniform punitive measures.
Dr Nurafiqah advocates for a recalibration of national drug policy towards a more balanced and evidence-informed framework. Key elements include the following:
- Expansion of treatment and rehabilitation services, including integration into primary healthcare and community-based settings
- Adoption of harm reduction strategies, aimed at minimising adverse health outcomes such as infectious diseases and overdose
- Strengthening of psychosocial support systems, to facilitate long-term recovery and reintegration
- Enhanced intersectoral collaboration, particularly between health, social welfare, and law enforcement agencies
She also stresses the importance of addressing stigma, which remains a significant barrier to care. Negative societal perceptions towards individuals who use drugs often discourage help-seeking behaviour and reinforce exclusion. Reframing drug dependence as a health issue is therefore essential, not only for policy reform but also for improving access to services.
From a policy standpoint, Dr Nurafiqah suggests that Malaysia is at a pivotal juncture. Existing efforts in prevention and harm reduction provide a foundation, but greater coherence and integration are needed to achieve a comprehensive national response. Legislative reforms that support diversion to treatment, rather than incarceration for minor drug-related offences, may represent a pragmatic step forward.
Conclusion
Dr Nurafiqah’s perspective reflects a broader shift towards public health-orientated drug policies globally. By prioritising treatment, prevention, and social support, Malaysia has the opportunity to develop a more effective and humane response to substance use.
Future Outlook
Advancing this agenda will require sustained commitment to evidence-based policymaking, capacity building within the healthcare system, and continued engagement with communities. A balanced approach that aligns legal frameworks with public health principles can contribute to improved outcomes for individuals, families, and society at large.
Article Written by Dr Nurafiqah Mohd Salleh
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