The evidence is in, says one advocate – it's up to the NSW government how many drug-related deaths it requires to act on it.
A letter petitioning for fixed and mobile drug checking sites across NSW has been signed by 20 groups across the medical, welfare and legal spheres, including the RACGP.
The petition calls on NSW Premier Chris Minns to stop “putting lives at risk” by implementing drug checking ahead of this year’s summer festival season.
The premier has previously said that no action will be taken prior to the promised, but not yet scheduled, statewide drug summit.
“It’s impossible for people to know what they’re really taking, and the consequences can be deadly,” the letter reads.
“Drug checking is a simple, proven step you can take to prevent drug-related health emergencies including overdose deaths.”
In concurrence, Dr Hester Wilson, RACGP’s addiction medicine specific interest group chair, added “I encourage the NSW Minns Government to support the safety and wellbeing of NSW residents by allowing both mobile and fixed substance safety checking sites to operate in NSW.”
Speaking to The Medical Republic, Dr David Caldicott, emergency consultant and senior clinical lecturer at ANU said these calls for drug checking were “not new” – he was first quoted in TMR on this topic in October 2015.
“There has never not been, and there is never not going to be, a need for this,” he said.
Dr Caldicott said opposition to drug checking was unfounded, based solely on a distain for the idea, and had “nothing to do with science or evidence … it’s all political and ideological”.
“The medical and scientific community have got to find a way to help our political offsiders embrace something which they pretended for nearly a decade was the wrong thing to do,” he said.
Likening the opponent position to banning blood transfusions for all, on the ground that there is religious objection, Dr Caldicott said that the “position that the opponents of drug checking are taking is that we don’t agree with drugs, therefore, all of you and all of your families will bear the brunt of harms associated with drug consumption where there is, in fact, another way”.
“To me, that’s unacceptable,” he said.
Dr Caldicott said that while a petition might not add to the strength of the evidence, and that many had their minds made up already, he hoped the discussion and a summit might create a “tipping point” to empower the government to concede to the evidence.
The current push for drug checking follows the success of the ACT’s CanTEST program, which has now had its funding extended to December 2024. It found that over 10% of substances were discarded following testing after its first year.
Dr Caldicott said that for the ACT trial, the first step was convincing law enforcement that testing worked and that the current approaches did not.
He compared the validity of a war on drugs to the validity to a war on chairs and said the idea of a drug-free Australia was a fallacy born from “magical thinking”; he said it was time to get “pragmatic” by addressing the number of people harmed by drugs.
According to Dr Caldicott, the answer may lie in reframing the narrative around drug checking and allowing politicians to take this as a win.
“A lot of the time when you want to do something bold and new in society, you have to pretend that it wasn’t your idea and you have to allow your political offsiders to take all the credit for it,” he said.
“We need to gather around [politicians], support them, and say, you know, that’s a brilliant idea, well done you for coming up with it yourself all on your own.”
As more previously illicit drugs were being “re-medicalised”, such as MDMA and psilocybin, and the “lines between morality, law and health are [becoming] even more blunted and blurred”, the future of managing addiction and illicit drug must be through a healthcare framework and cannot rely on law enforcement.
“If you took the budget that we spend on sniffer dogs at music festivals, and just turned it around and gave it to drug checking facilities, the impact on music festival related deaths would be astonishing,” he said.
Dr Caldicott hopes that political reengagement will rejuvenate the clinicians involved in drug safety advocacy and care, that have “had the stuffing beaten out of them” after decades of campaigning, with little movement.
“This is not a problem that’s going away for Australia. This is a problem that anything a lot of people anticipate will escalate.”
Despite his wariness about the political landscape around drug testing, Dr Caldicott is confident that implementation was an “inevitability” – it’s just a matter of “what sort of appetite do governments have for casualties before they accept the inevitable”.
