The deaths of three people after overdosing on MDMA at a Melbourne nightclub in January — and the hospitalisation of 20 at a dance party in February — focused attention over summer on the wilful refusal of Australian governments to consider allowing pill-testing of recreational drugs, and the death toll it is inflicting on young people. The ACT government has just knocked back a proposal for pill testing at the Groovin The Moo music festival, but it should reconsider. It will save lives. 

Victorian Police Commissioner Graham Ashton responded to February’s bout of overdoses by insisting pill-testing couldn’t work because it took too long. The debate back then wasn’t helped by a bizarre contribution in the Fairfax press by a toxicologist Andrew Leibie, who attacked pill-testing as inaccurate and potentially harmful.

Leibie’s piece was forensically dissected by the Dr Monica Barratt of the National Drug and Alcohol Research Centre, UNSW, and comprehensively demolished by the crew at the Erowid blog. The truth: pill-testing can be done relatively quickly, on-site, with the right equipment and trained people, and provide not merely a test for the presence/absence of MDMA and other chenicals, but also test purity. It can be done as quickly as 20 or 30 minutes, based on European experience. And Ashton’s argument that police pill-testing takes a long time reflects that they’re usually doing it for criminal investigations, where evidence will be tested to the criminal standard of proof in court — not to let a party-goer know if they’ve got what they think they bought.

All it takes is some investment — the easy part — and a shift in mindset about drugs to reap the benefits, which are considerable: users can find out if the drugs they have purchased don’t contain MDMA, or if their purity is too high, or if they contain other harmful drugs, and then decide whether to discard them (“around 80-90% will discard or decide not to take drugs when they go through a testing process and find out it has something else in it,” Barratt told Crikey).

Law enforcement also gains an advantage: pill-testing provides data on what is currently available on the street to users, what purity is being provided, what adulterants are being used and what new drugs are becoming available — data that is currently available mainly via waste-water testing (the presence of drugs in human waste is a handy population-level guide to what drugs we’re taking). And health professionals gain an advantage from having a point of contact with drug users who may not otherwise interact with the health system, providing an opportunity for intervention, warnings and a trusted point of contact if the user decides they need help.

Barratt also explains that there is a range of pill-testing scenarios rather than just event testing, noting that Victorian police already do their own testing of drugs obtained via controlled purchases, but don’t share the results with the public, such as via alerts that a particularly dangerous chemical has become available. Postal testing of drugs is also available in some states in the US, where authorities provide results under an anonymous online code, a process that can take weeks (Barratt however notes that her own surveys show around half of users would be willing to wait weeks for a comprehensive test).

[Do pill-testing kits encourage illegal drug use?]

Another option is a permanent “drop-in” pill testing centre where users could wait 20 minutes or half an hour and have their drugs tested before heading to venues, meaning they’re making decisions — and have access to trained staff — before they’ve started partying. Or there is “traditional” in-venue pill testing, using not just colour reagent test kits that indicate the possible presence or absence of MDMA or other drugs, but High Performance Liquid Chromatography to determine purity — although such equipment, while sufficiently mobile, needs trained users.

Current law enforcement methods are increasing the risk of harm — the presence of sniffer dogs at events just prompts people to consume their drugs early, or to purchase inside a venue from someone with whom they’ve never dealt. And police buy-in is needed for pill-testing, which won’t work if users are reluctant to approach testing vans or centres. “It needs collaboration with law enforcement and civil society,” Barratt said, “otherwise users will be scared off from testing.”

One of the longest-standing objections to pill-testing is that it provides a publicly funded validation service for dealers, who can pretend to be users and have their wares tested, then use the results as a selling point to push more dangerous products out of the market. In fact, from a harm minimisation point of view, this is a positive outcome, but evidently rubs people the wrong way. However, it’s analogous to arguing that any public infrastructure or service, or information, is used by criminals as well as other members of the community and therefore shouldn’t be provided.

Dr Alex Wodak, president of the Australian Drug Law Reform Foundation and a veteran advocate of harm-reduction policies, sees the reluctance around pill-testing as another symptom of a drug policy system that is biased in favour of law enforcement and supply control. “There’s around $1.7 billion in federal, state and territory funding directed at drug policy — that’s 2009 figures, the most up to date one we have — and around 66% of that is directed at supply control, including agencies like the police and customs and border control. There are a large number of vested interests in this default position of focusing on supply control.”

He notes that reform advocates need vast amounts of independent research on the benefits of harm-reduction policies — such as the safe injecting room currently under consideration in Victoria — even to have them considered, while law enforcement approaches that have a poor record of outcomes are rarely challenged. “Everything is seen through a criminal justice prism. If you want a new initiative on law enforcement — go for it. If you want a new initiative on harm reduction, the sky will fall in,” Wodak said.

Whatever the rationale for rejecting pill-testing, it comes with a human cost. There’s no guarantee that pill-testing would have prevented the deaths or hospitalisations from the summer overdoses in Melbourne — the best it can ever do is reduce the risk of overdose, not eliminate it. But reducing the risk will mean fewer overdoses, and we’ll lose fewer of our young people. Given how clear the case is for pill testing, those politicians and police who oppose it wear the responsibility for those lives.