In Malaysia, drug addiction problem is regarded as nation chronic disease that still entails long term treatment and support even tough the government has spent over a million of ringgit to overcome it. In 2005, Malaysia has started in a government facilities to provide methadone maintenance treatment (MMT) program, a psychotropic medication method to opioid dependence patients. This program is initiated to effectively overcome the addiction problem by using methadone syrup, a controlled medicine that can only be dispensed by authorized health practitioners or pharmacists in order to avoid any misconducting while doing the treatment process. Currently, the program has involved few agencies such as prisons and National Anti-Drug Agency (NADA) premises. In NADA, the program was implemented in Cure & Care (C&C), Cure & Care Service Centres (CCSC), drug rehabilitation center and possibly to be extended to reach more drug addicts.
It is no doubt that MMT program has reported successful in reducing drug retention rate of opioid dependence patients. It was reported that patients on methadone treatment showed improvement in quality of life which demonstrated by reducing heroin use, HIV risk behavior and criminal activity. However, a part of the program itself have far encountered many challenges during its implementation. There were complains from the health practitioners or pharmacists on the dispensing process due to the usage of syringe during manual dispensing had caused severe exhausted hands and prone to human error. This conventional manual methadone dispensed by syringe if prolonged will lead to carpal tunnel syndrome caused by compression of median nerve at the wrist whereby if severe will result in hand weakness. It is likely that the patients registered under this program are allowed for a maximum of seven bottles of take-home methadone dose which needed them to drink up to seven days of each bottle.
Since the methadone syrup is highly concentrated with thick solution, thus full force of energy is required during dispensing. Besides, each patients coming for the treatment have required to different intake of methadone doses depending on each patients’ past history of the drug intake. Consequently, this has resulted in high percentage of error such as non-accuracy dispensing and inefficient dispensing flow due to human error. In fact, inefficient time taken and management during methadone treatment therapy due to number of patients treated by the pharmacists per day is low.
An automated methadone dispensing machine is locally designed and fabricated for MMT program mainly to maximize pharmacist workflow productivity, reduce the occupational hazard of carpal tunnel syndrome and improve the performance procedure of methadone treatment therapy. To ensure the feasibility of the machine, the machine performance were evaluated through efficiency and accuracy tests that is thoroughly investigated to solve existing problems with the manual dispensing process.
The developed prototype machine has used the concept of portability for easy to carrying anywhere. A simple wire connection between the machine and laptop give direct end user interactions for machine operation by simply clicking the button to dispense, withdraw and flush through the command window. Beside, the machine is proven to be highly efficient and accurate in conducting the methadone dispensing process, provided excellent stability of the mechanical component parts. It is hoped that the automated methadone machine dispenser will further reduce the alarming high relapse rate of drug-addicted patient and at the same time significantly improve their quality of life under current treatment program.
By: Nur Syahira Annuar
Supervisor: Dr. Mohd Sayuti Ab Karim
Last Update: 27/10/2022