Those who oppose pill-testing do so in the face of increasing evidence that it does reduce harm
The second trial of pill-testing at a Canberra music festival has left its opponents without a leg to stand on, advocates say, so strong were its results.
But the RACGP, while it supports pill-testing as a harm-minimisation measure, has stopped short of endorsing it in an official statement.
More than 230 partygoers queued up to submit their drugs to the 10-minute test run by Pill Testing Australia at the Groovin’ the Moo festival last month, and were quick to discard drugs that were found to be dangerous, organisers said.
Of 171 samples submitted for testing – more than twice the number at last year’s trial at the same festival – seven were found to contain n-ethylpentylone, one of the cathinone or “bath salts” class of stimulants that has been linked to dozens of deaths overseas.
But of potentially greater concern to testers was the prevalence of high-purity MDMA pills.
Associate Professor David Caldicott, a pill-testing advocate with Harm Minimisation Australia and an organiser of both trials, is an emergency doctor at the Calvary Hospital in Canberra and a clinical senior lecturer at the Australian National University.
He was extremely pleased with the results of the second trial.
“I’m probably the wrong person to ask because I thought it was an outrageous success,” he told The Medical Republic. “But it’s probably difficult for any of our opponents to come to any other conclusion.”
The pharmacological and demographic data from the trial was yet to be analysed in detail, but he hoped that analysis would help explain some key differences between this year and last year.
Not only were there a higher proportion of n-ethylpentylone tablets, there were also fewer samples with no active substance and more with MDMA of a dangerous level of purity.
“A lot of people are focusing on the n-ethylpentylone, which is obviously quite alarming. But the less sexy element of this is, compared to last year, the marked increase in quality and purity of ecstasy or MDMA we were identifying. And probably as a baseline that’s more important than the n-ethylpentylone.
“One of the great criticisms of pill testing is that it has no effect on ecstasy consumption, and we showed quite clearly that a lot of the people who came to us didn’t have a lot of understanding of what high-purity MDMA could do to them. And when we told them, they were clearly committed to altering how they were going to consume their pills, and I think that is reflected in the number of casualties.”
He said out of the more than 20,000 patrons only one was taken to hospital for an alcohol or drug reaction. “Which is a remarkable result. Clearly a lot of people were consuming drugs, only one person was transported. We’re happy to say that at the moment the ACT is offering the safest music festivals in Australia.”
Two people died from suspected overdoses at a festival in Toowoomba, Queensland, over the Easter weekend and eight people died at festivals in NSW and Victoria between September last year and January this year.
NSW Premier Gladys Berejiklian said last week that regardless of the Canberra festival trial, “I don’t think it works. I don’t think the evidence is there and I don’t support it.”
And Victorian Premier Dan Andrews said in late January, after a mass overdose with no fatalities at a Melbourne event, that there would be no pill-testing in his state.
Professor Caldicott said it was clear that the current tactics of saturation policing and sniffer dogs provided no extra level of safety at festivals.
“For a fraction of the price we can provide a service that not only advises people acutely about what they’re doing, but also in a long-term educational way immunises them about some of the myths about drug consumption that are out in the market.”
The readiness to discard dangerous pills showed that young people – at least this subset –were neither stupid nor reckless, even if they were recreational drug takers.
“This is one of the things that irritates me the most about the narratives that come out of the conservative side of politics in Australia,” Professor Caldicott said.
“These young people are not at all stupid, they are intelligent, they ask very bright questions, they want to engage. But they want to engage with a source of information they feel they can trust, and that chance has largely been squandered the past 20 years. We feel we’re re-engaging them on that.
“These are not primary school kids – obviously they should be told never to take drugs because they’ll make them terribly sick. But festival-goers who are already using drugs need a nuanced message, and that’s something we can provide with the information we’re generating in the pill-testing program.
“People are quite happy to abandon their purchases if they’re advised what might happen to them if they don’t.”
He said it wasn’t yet clear why the testing found different results from last year, but it could be that trust had grown and the population seeking testing this time was a more experienced group.
Professor Caldicott said support for pill-testing was increasing among the general public, especially among parents and grandparents, and 12 medical bodies had given their backing, including the RACP, RANZCP, RDAA and the Australian College for Emergency Medicine.
“We’re running out of people who are against us. The obstacles are exclusively political.”
Professor Caldicott said it would be “lovely” to see a statement of support from the RACGP, even though president Dr Harry Nespolon and Hester Wilson, chair of the college’s Specific Interests Addiction Medicine network, were already on the record as backing pill-testing.
“It would add weight. What better people to talk to young people about drugs than our colleagues in general practice?”
Dr Nespolon said the college endorsed pill-testing but that its limitations had to be acknowledged.
“We endorse pill-testing at music concerts, but we know that it’s not going to save everyone’s lives – that it will potentially help that group of people who do get their pills tested,” he told The Medical Republic.
“Ideally they would not be taking any pills, which is the lowest risk, but given that that’s not going to happen, we would support harm minimisation.
“Is [testing] going to stop these deaths? No, the deaths won’t stop while people are taking these drugs. Will it decrease the number? Probably.”
Several toxicologists have expressed doubts in the media about the infrared spectrometry technique used.
But Dr Nespolon said while it wasn’t a perfect method, no test was going to provide perfect quality control “for drugs that have been manufactured in backyards”.
“People have to understand what the value of the test is, as with any other – tests we do here in the consulting rooms aren’t perfect.”
Dr Nespolon said the lack of casualties at Groovin’ the Moo festival could have something to do with the number of festival deaths over the summer.
“[They] may have been a salutary lesson to the next group. But then people unfortunately tend to forget these things very quickly.”
Dr Nespolon said a position statement from the college was unlikely to budge Ms Berejiklian.
