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The pros and cons of pill testing


Last weekend saw Australia’s first state government sanctioned pill testing trial at the Groovin the Moo music festival in Canberra. Noffs Foundation chief executive, Matt Noffs, who is a member of the Safety and Testing and Advisory Service at Festivals and Events (STA-SAFE) consortium, suggested that the trial was a success in terms of reducing harms to festival attendees.

In recent years, there have been a number of deaths in Australia as a result of toxic quality pills being consumed at music festivals and nightclubs, as well as party drug-related overdoses. In response, public health experts and other commentators have promoted pill testing as an intervention that should be introduced in order to reduce drug-related harm among young people in recreational settings.

However, others have opposed any such proposals, most frequently using the argument that abstinence is the only way to ensure young people are safe from the effects of illegal drugs. This FlagPost briefly canvasses some of the main arguments for and against pill testing.

Pill testing

While producers of regulated pharmaceutical drugs must adhere to strict production standards, illegal drugs are not subject to such requirements. As a result, illicit drug markets have long been associated with harms arising from poor product safety. These harms typically arise due to contamination and adulteration, which can cause poisoning, or unintentional overdose by users due to uncertainty about the strength and purity of the drugs.

Pill (and other drug) testing may be described as ‘a service that invites ordinary citizens to anonymously submit samples of illegal drugs for forensic analysis, and provides individualised feedback of results and counselling as appropriate’. Ideally, armed with information on the purity and composition of their drugs, would-be users are able to make an informed decision on whether or not to take them.

Pill testing services have been operating in some form for around 25 years in a number of countries.

Arguments for pill testing

There is support for the trial of pill testing in Australia among public health organisations and some federal parliamentarians. In 2014 Professor Alison Ritter, Director of the Drug Policy Modelling Program at the National Drug and Alcohol Research Centre (NDARC) outlined a number of reasons why pill testing should be piloted:

  • pill testing has been shown to change the black market, with products publicly identified as dangerous being found to leave the market

  • ingredients of tested pills started to correspond to the expected components over time, suggesting that pill testing can place pressure on manufacturers to refrain from using adulterants in drugs

  • pill testing changes behaviour, with research suggesting that negative results would deter a majority of people from consuming drugs and spur them to warn their friends

  • visits to pill-testing booths create an opportunity for providing support and information over and above the testing itself and

  • pill testing enables the capture of long-term data about substances in the drug market and the potential for a warning system against new, unexpected, or very dangerous drugs and consumption trends.

Arguments against pill testing

Perhaps the main arguments against pill testing are that, firstly, on-site tests have a limited capacity to accurately detect harmful substances, and, secondly, by permitting on-site pill testing, contradictory messages are being sent about the risks related to the use and possession of controlled substances.

Andrew Leibie, a scientist with Safework Laboratories and a member of the International Association of Forensic Toxicologists, has raised some concerns with regard to the usefulness of on-site pill testing. These may be summarised as follows:

  • on-site drug testing is fast and easy, but not particularly accurate. Proper analysis of pills requires highly sophisticated laboratory equipment and can take days of work by trained scientists

  • on-site pill testing kits are severely limited in what they detect, with test kits unlikely to detect contaminants or other toxic compounds in pills

  • on-site tests cannot test for concentration and high doses of ecstasy and methamphetamine are often fatal by themselves and

  • on-site tests cannot detect new designer drugs on the market, such as NBOMe—or N-Bomb—which has been linked to three deaths in Melbourne in 2017.

Leibie also expresses the concern that pill testing services could leave consumers with a false sense of security that the party drugs they buy may be safe, when this is not the case.

It should be noted that in his critique Leibie focuses on the limitations of colourimetric tests and other on-site test kits, in comparison to laboratory testing. However, these limitations are well documented, and, according to Dr Monica Barratt, a researcher with NDARC, acknowledged by most pill testing services. Barratt argues that pill testing services only use such kits as their main tool when they don’t have access to better technology. Fully-funded pill testing services typically use proper laboratory equipment, as was the case at the Groovin the Moo festival. NBOMe was believed to have been detected at the Groovin the Moo festival, along with n-ethylpentylone, a stimulant responsible for the hospitalisation of 13 people in New Zealand recently.

Harm minimisation versus zero tolerance

Arguments for and against pill testing are typically informed by broader debates about the merits of harm minimisation versus zero tolerance approaches to illicit drugs.

From a harm minimisation perspective, completely eliminating a drug or drugs from society is an unrealistic aim that typically causes more harm than good. As a result, we would do better to restrict the damage caused by them, even if this means an overall increase in the use of drugs. From a zero tolerance standpoint, illicit drug use should be prohibited under any circumstances. Harm reduction measures—such as pill testing—it is argued, can encourage and enable drug use, keep people stuck in a pattern of addiction, and serve as a Trojan Horse for drug law reform and the legalisation of drugs.

There is constant tension in Australia between advocates of these perspectives, and frequent calls for a shift in emphasis between demand, supply, or harm reduction measures. However, Australia’s broad approach to illicit drugs under the National Drug Strategy remains one of harm minimisation, and the country has in place a significant number of measures to reduce the harms caused by drugs. These include Sydney’s Medically Supervised Injecting Centre, needle and syringe programs and opioid substitution treatment.

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