Pill testing

Pill testing
IN THE ACT

On Friday 22 September 2017, ACT Minister for Health and Wellbeing, Meegan Fitzharris announced a pill testing service would be available during the Spilt Milk festival on 25 November 2017.  The pill testing service is not proceeding at this time.  The ACT Government does, however, remain committed to preventing and reducing the harms associated with drug use, and will continue to explore opportunities to deliver pill testing at a future event.

What is pill testing?

Pill testing is a harm reduction service (also known as drug checking) that analyses the contents of drugs and helps you avoid taking unknown and potentially dangerous substances often found in illicit drugs.

Service staff test a small sample of your pill, then interpret and provide the results with information about the risks of consuming the substances identified in the sample.

Pill testing facilities have been effectively used internationally since the 1990’s and are currently available in approximately 20 countries in Europe, the Americas and New Zealand.

What is harm reduction?

Harm reduction includes measures aimed at reducing the adverse health, social and economic consequences of the use of drugs, for the user, their families and the wider community. Harm reduction makes up one of the three pillars of the balanced harm minimisation approach outlined in the National Drug Strategy 2017-2026.

Why should I test my pill?

The evidence shows that pill testing can help to keep young people safe.

The composition of illicit drugs is highly variable and unpredictable. The makers of illicit drugs will frequently cut pills with other substances, or substitute other more dangerous drugs entirely. Drugs may also be produced and distributed in unfavourable environments.

Pill testing enables better risk management by consumers. It helps you make an informed decision on whether or not to take the drug if it is found to contain unexpected substances.

How is pill testing conducted?

Pill testing services are typically conducted at events by medical staff and analytical chemists using mobile laboratory equipment.  Event patrons may be asked to undertake a pre-test self-assessment which will ask what he or she believes the substance is and to then provide a small scraping of the substance onto the test equipment.

After the pill has been tested, the staff will provide the patron with information regarding the results, discuss the risks of drug taking, and provide an opportunity to discard the illicit substance in the amnesty bin.

Evaluation

Testing can potentially identify a bad batch of pills and provide Health officials and event organisers with an opportunity to warn people before they are taken. The collection of data is an important part of evaluating the delivery of pill testing services.

What is an amnesty bin?

The amnesty bin contains bleach, which completely destroy any drugs deposited in them to the extent that they could not be recovered or used. The substances could then be disposed of as standard medical waste.

Does pill testing make taking illicit drug use safe?

No, consumption of illicit drugs carries an inherent risk of harm. Pill testing services operate on a harm reduction principle. Pill testing services provide information on the contents of the drugs tested, which might include unexpected contaminants or substances, the risks involved, and how to reduce them. Even with laboratory equipment testing, service staff never advise users that the drug they are taking is ‘safe.’

Also, chemical analysis is not able to determine with certainty whether a person will have a toxic reaction to taking a pill, although certain contaminants are highly toxic and likely to cause harm if ingested. Illicit drugs such as amphetamines and MDMA are inherently unsafe and pill testing cannot certify that a person will not suffer an adverse reaction as a result of taking them.

Are legislative changes needed to allow pill testing to happen in the ACT?

There are no plans to change the legislative status of illicit drugs in the ACT. The possession, supply, and use of illicit drugs remains illegal in the ACT. However, pill testing is a method of harm minimisation and aims to keep people safe.

What evidence is available that pill testing actually reduces harm?

Available evidence indicates that providing consumers with information about the content of illegal drugs they intend to ingest can reduce rates of overdose or toxicity from unknown substances.

There is also evidence that pill testing facilitates engagement of festival patrons in counselling. A report from Austria found that half of those who had their drugs tested stated the results affected their consumption choices and two-thirds said they would not consume the drug and would warn friends in case of negative results.

A recent published review of pill testing by an NGO at eight festivals in New Zealand analysed 330 samples. The testing service identified 39 different psychoactive substances. More than 75 per cent of patrons believed their substance was MDMA or LSD. Only 66 per cent of samples were actually MDMA or LSD, and 38 per cent of samples were not exactly what patrons believed them to be.

The NGO reported the impact on patron’s behaviour being significant with patrons making more considered and safer decisions. 63 per cent of patrons indicated they did not intend to take the drug when they learnt it was not what was expected.

The available literature does not provide evidence that pill testing prevents deaths among festival patrons. Any such effect would be difficult to study due to the unpredictable nature of adverse events from illicit drug consumption.

Does pill testing promote or condone drug use?

No- evidence suggests that people don’t end up consuming more illicit substances as a result of a pill testing service. Pill testing services are a unique opportunity to effectively encourage people who use illicit drugs to modify their behaviours in ways that reduce risks of harm to their health.


PILL TESTING IN THE ACT: KEY OPERATIONAL ELEMENTS

Operational elements of pill testing services offered by a harm reduction service at a major music festival

  • A separate stand-alone service will be established, located in close proximity to the event’s medical area.
  • The staff undertaking pill testing will be appropriately trained in using pill testing equipment
  • Staff who are trained in drug counselling will deliver advice and intervention about drug use
  • The equipment used for pill testing must be able to reliably, within an acceptable timeframe, identify the major drug present in an unknown tablet or powder as well as potentially detect adulterants and/or substances that are unknown.
  • Regular communication should flow between the event organiser as well as ambulance and medical personnel in the nearby medical area to share information on the results of pill testing; this regular communication should assist with informing medical procedures in the case of overdose or other adverse event.
  • Pill testing has limitations and these must be communicated to patrons of the pill testing service. This includes communicating that pill testing does not guarantee identification of each substance contained within a substance.
  • Each patron must be directly notified, regardless of the pill testing result, that drug taking is inherently unsafe. Each patron must be notified that safe disposal of drugs is the best way to avoid health risk.
  • The service must provide an amnesty bin for safe disposal of drugs. The drugs contained in amnesty bins must be destroyed on site, such that they cannot be reconstituted and safely disposed of at the conclusion of the event by the harm reduction service.
  • The harm reduction service will collect evaluative data, which would include but not be limited to:
    • The number of patrons attending the service
    • The number of brief interventions as well as pill tests delivered
    • The number of patrons who discarded their drug at the service
    • The chemical content detected in each sample tested
  • This data must be shared with key stakeholders so that it may inform possible pill testing in the future, both for safety and operational aspects. This might include for example, communicating to police and public health of the circulation of illicit drugs, notably contaminated drugs, substances of high purity or novel psychoactive substances.