Compulsory drug detention centres: time to question their continued use?

In the Lancet Global Health, Martin Wegman and colleagues present their study of opioid use in opioid-dependent individuals released from compulsory drug detention centres (CDDCs) compared with those from voluntary methadone treatment centres (VTCs) in Malaysia.1 This study was the first prospective observational study to compare drug-use outcomes between the two facility types. The investigators showed that opioid-dependent individuals in CDDCs were significantly more likely to relapse to opioid use after release than opioid-dependent individuals receiving methadone in VTCs (in unadjusted analyses, CDDC participants had significantly 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).