In the Lancet Global Health, Martin Wegman and colleagues present their study of opioid use in opioiddependent individuals released from compulsory drug detention centres (CDDCs) compared with those from voluntary methadone treatment centres (VTCs) in Malaysia. This study was the fi rst prospective observational study to compare drug-use outcomes between the two facility types. The investigators showed that opioid-dependent individuals in CDDCs were signifi cantly more likely to relapse to opioid use after release than opioid-dependent individuals receiving methadone in VTCs (in unadjusted analyses, CDDC participants had signifi cantly more rapid relapse to opioid use post-release compared with VTC participants [median time to relapse 31 days {IQR 26–32} vs 352 days {256–inestimable}, log rank test p<0·0001).

As such, the fi ndings of this study make another contribution to the growing literature base on the ineff ectiveness of CDDCs in treating drug dependence. The study also builds on an expanding evidence base of scientific research into the eff ectiveness of pharmacological drug dependence treatment approaches. These fi ndings are an important addition to the many reports on CDDCs undertaken mainly by non-governmental organisations committed to promoting human rights of marginalised and vulnerable individuals, but which at times have not contained the scientific rigour needed to warrant government attention, especially from governments that do not welcome criticism of the CDDCs’ approach to curtailing drug use and drug dependence.

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