In Malaysia, over half of all HIV infections are transmitted through sharing contaminated needles and syringes. To combat the spread of the epidemic, the government in 2006 spearheaded 'harm reduction' interventions (pdf) which included a program where people who inject drugs are provided unused needles and syringes in exchange for used injecting equipment. Those who are addicted to opioids such as heroin, the most commonly used illicit substance in Malaysia, can also enroll in rehabilitation for synthetic opioid replacement therapy. Synthetic opioids, taken orally, help stabilize the opioid cravings of patients, thus enabling them to work. The move to introduce harm reduction in Malaysia revealed something that caught people by surprise—many of the fishermen from port city on the east coast of peninsular Malaysia use drugs.