Heroin continues to be the main drug used in Malaysia, while amphetamine-type stimulants (ATS) have been recently identified as a growing problem. A cumulative total of 300,241 drug users were detected between 1988 and 2006. It is also estimated that Malaysia has 170,000 injecting drug users. HIV prevalence among drug users in the country ranges from 25% to 45%. Currently, there are approximately 380 general medical practice offices that offer agonist maintenance treatments for approximately 10,000 patients. There are 27,756 active patients in 333 general medical practice offices and government-run methadone maintenance treatment (MMT) centers. The Needle Syringe Exchange Program (NSEP) reached out to 34,244 injection drug users (IDUs) in 2011. In the last 2 years (2011 and 2012) the number of detected drug addicts decreased from 11,194 to 9015. The arrests made by the police related to opiate and cannabis use increased from 41,363 to 63,466 between the years 2008 and 2010, but decreased since 2010. An almost four-fold increase in the number of ATS and ketamine users was detected from 2006 (21,653 users) 2012 (76,812). Between 2004 and 2010, the yearly seizures for heroin ranged between 156 to 270 kg. However, in 2010 and 2011, heroin seizures showed a significant increase of 445kg and 410.02 kg, respectively. There has been a seizure of between 600 to 1000kg of syabu yearly from 2009 to 2012. Similar to heroin, increased seizures for Yaba have also been observed over the last 2 years. A significant increase has also been recorded for the seizures of ecstasy pills from 2011 (47,761 pills) to 2012 (634,573 pills). The cumulative number of reported HIV infections since 1986 is 94,841. In 2011, sexual activity superseded injection drug use as the main transmission factor for the epidemic. HIV in the country mainly involves males, as they constitute 90% of cumulative HIV cases and a majority of those individuals are IDUs. However, HIV infection trends are shifting from males to females. There are 37,306 people living with HIV (PLHIV) who are eligible for treatment, and 14,002 PLHIV were receiving antiretroviral treatment (ART) in 2011. The decreasing trend of heroin users who have been detected and arrested could be due to the introduction of medical treatments and harm reduction approaches for drug users, resulting in fewer drug users being arrested. However, we are unable to say with certainty why there has been an increase in heroin seizures in the country. There has been an increasing trend in both ATS users and seizures. A new trend of co-occurring opiate dependence and ATS underscores the need to develop and implement effective treatments for ATS, co-occurring opiate and ATS, and polysubstance abuse disorders. The low numbers of NSEP clients being tested for HIV underscores our caution in interpreting the decline of HIV infections among drug users and the importance of focusing on providing education, prevention, treatment, and outreach to those who are not in treatment.

中文翻译：

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马来西亚的药物滥用和艾滋病毒情况

海洛因仍然是马来西亚使用的主要毒品，而最近发现苯丙胺类兴奋剂 (ATS) 是一个日益严重的问题。1988 年至 2006 年间共查出 300,241 名吸毒者。据估计，马来西亚有 170,000 名注射吸毒者。该国吸毒者中的艾滋病毒流行率为 25% 至 45%。目前，大约有 380 个全科医疗诊所为大约 10,000 名患者提供激动剂维持治疗。333 个综合医疗诊所和政府经营的美沙酮维持治疗 (MMT) 中心有 27,756 名活跃患者。针头注射器交换计划 (NSEP) 于 2011 年惠及 34,244 名注射吸毒者 (IDU)。在过去两年（2011 年和 2012 年）中，发现的吸毒者人数从 11,194 人减少到 9015 人。2008 年至 2010 年期间，警方逮捕的与阿片类药物和大麻使用有关的逮捕人数从 41,363 人增加到 63,466 人，但自 2010 年以来有所减少。自 2006 年以来发现的 ATS 和氯胺酮使用者数量几乎增加了四倍（21,653 名使用者） ) 2012 (76,812)。2004 年至 2010 年期间，海洛因的年缉获量介于 156 至 270 公斤之间。然而，在 2010 年和 2011 年，海洛因缉获量分别显着增加了 445 公斤和 410.02 公斤。从 2009 年到 2012 年，每年缉获 600 至 1000 公斤 syabu。与海洛因类似，在过去两年中也观察到 Yaba 缉获量增加。从 2011 年（47,761 粒）到 2012 年（634,573 粒），摇头丸的缉获量也显着增加。自 1986 年以来报告的 HIV 感染累计人数为 94,841。2011年，性活动取代注射吸毒成为流行病的主要传播因素。该国的艾滋病毒主要涉及男性，因为他们占累计艾滋病毒病例的 90%，其中大多数是注射吸毒者。然而，艾滋病毒感染趋势正在从男性转向女性。2011 年有 37,306 名艾滋病病毒感染者 (PLHIV) 符合治疗条件，14,002 名艾滋病病毒感染者正在接受抗逆转录病毒治疗 (ART)。 被发现和逮捕的海洛因吸毒者呈下降趋势可能是由于引入了药物治疗和减少对吸毒者的危害的方法，从而减少吸毒者被捕。但是，我们无法肯定地说为什么该国的海洛因缉获量有所增加。ATS 使用者和缉获量都有增加的趋势。阿片类药物依赖和 ATS 并存的新趋势强调需要开发和实施针对 ATS、同时发生的阿片类药物和 ATS 以及多物质滥用障碍的有效治疗方法。接受 HIV 检测的 NSEP 客户数量很少，这突显了我们在解释吸毒者中 HIV 感染率下降的情况时的谨慎态度，以及专注于为未接受治疗的人提供教育、预防、治疗和外展服务的重要性。