Nine pill testing myths

From politicians to the public, the same myths keep being rolled out about pill testing. Here are nine of the most common.

There’s no proof pill-testing will save lives

They’ve been testing pills in 20 other countries for at least two decades and there is, in fact, considerable evidence that it helps reduce harm.

There’s only been one sanctioned trial in Australia – at last year’s Groovin The Moo festival in Canberra – but there were positive signs. Only 20 people sought assistance from ACT Ambulance (most for intoxication linked to alcohol and/or MDMA) compared with 30 the previous year. Two people were taken to hospital for intoxication, but neither had attended the testing facility.

There has not been the opportunity to do a large-scale controlled experiment in Australia, but a UK study showed that where when pill testing was in operation, hospital attendances dropped in nearby areas by as much as 95%.

It’s not just about numbers, however. Pill testing has been shown to change the black market. Products identified as particularly dangerous tend to disappear from circulation, and  the contents of tested pills starts to match the expected ingredients.

David Caldicott, an emergency room doctor from Canberra, led the Groovin The Moo trial and has been openly and loudly advocating for pill testing for nearly two decades.

“We’ve known since 2002 that at venues which offer pill testing, fewer people consume their drugs, fewer drugs (in terms of quantity) are consumed, and fewer people mix their drugs,” he says. “All of these are independent risk factors for overdose, which in turn is a risk factor for death.

“So if we can reduce the risk of overdose, we can infer that we will reduce the likelihood of anybody dying from a drug overdose. There is far more evidence that it will reduce harm, than any of the evidence for what we’re doing already.”

Increased policing is a better approach

“You can’t even stop drugs getting into prisons. What hope have you stopping all drugs getting into a music festival?” is Caldicott’s succinct response.

The problem is that music festivals are just a microcosm of society. In a 2016 survey, 43% of Australians over the age of 14 said they had used an illicit drug at some point in their life, and nearly 30% of people in their twenties had done so in the previous year.

Pill testing and policing must work together. “It’s not one or the other,” Caldicott says. “We work closely with ACT Police, with them stopping drugs getting into the festival, and they do it really well because they use technology and not dogs. But we’re the safety net. Why rely on a single line of defence?”

Groovin The Moo organisers offered to provide police with any leftover drugs for more rigorous testing, with the aim of investigating the origin of the drugs and tracing chains of supply. This was declined, but the offer remains open

And the sniffer dogs? They were criticised as ineffective by the NSW Ombudsman as long ago as 2006. They concluded that they detect few drugs, but in over three quarters of cases result in innocent people undergoing intrusive strip searches.

No one is going to go to a nearby tent, wait for 30 minutes to get results and then listen to a lecture on drug safety

But people do, both overseas and in Australia, as shown by the success of the Groovin The Moo trial.

Wait times also don’t seem to be a major factor – when pill testing is carried out overseas 30 minutes is a pretty standard waiting time, in part due to the demand for the service.

In fact, in a survey of people who attend nightclubs and music festivals and use psychoactive drugs, over 94% said they would use a drug checking service, with 80% willing to wait an hour for results.

Additionally, most people also said they would be happy to pay between $5 and $10 for a test to be carried out. However in practice, it would be far better for there to be no direct cost to the attendees, says Caldicott.

In a separate survey at a major Australian music festival, nearly 85% of people (60% of whom had used ecstasy in the previous year) said they believed pill testing should be combined with harm reduction advice.

“The first thing this generation cares about is itself,” says Caldicott. “This is not a generation that is the slightest bit interested in missing out on the end of their $200 festival by having to be taken away in an ambulance.”

Who is liable if a person takes a tested drug only to have a reaction that causes harm or their death?

Only the people themselves. At Groovin The Moo everyone taking advantage of the pill testing service signed a form acknowledging that the results of their test did not indicate that the drugs were safe to take.

While they were waiting for those results, a trained counsellor talked with them about their choice to take drugs and the risks involved, and when the results were presented a chemist and medical clinician explained them, and the effects that each drug might have.

The risks of all the contents of a pill are made clear to the people having them tested. There is never any suggestion that any ingredients are “safe” –the entire process is built around communicating the risks.

Pill testers are not liable for people acting against medical advice given by medical professionals.

“Before they’re even allowed into the facility where this is conducted, they are advised that if you wish to stay completely safe from drug consumption today, you should not use any drugs,” Caldicott says. “We don’t ever give the impression what they’re about to be doing is about to be safe.”

More broadly, peer counsellors – in Canberra run by DanceWize – talk to attendees not just about the drugs themselves, but also about what they could do that day to reduce the chances of being harmed. That includes the temperature and their level of hydration.

People take pills without knowing what is in them, so they’ll still take them after having them tested anyway

Not according to multiple surveys and feedback from pill testing sites. People say the results will affect their decisions about whether or not to take the drugs. That’s the whole point of doing it.

In an Australian survey at a major music festival many people said they would not take pills shown to contain contaminants, including methamphetamine, ketamine and PMA. At pill testing services there are significant amounts of drugs handed over for disposal following testing.

The changes in drug taking behaviour may also last beyond the festival. In a New York study, half of the people interviewed said would be less likely to use ecstasy again if they learned their pills contained methamphetamines or bath salts.

“This is not a stupid group of consumers,” says Caldicott.

Next they will want to have a pill stand selling it straight to the kids at these concerts

That’s not really a myth; it’s just a stupid comment. No-one involved in pill testing has suggested this.

Allowing this gives the impression it’s acceptable to do drugs, which will increase use

People already choose to use drugs. It is an awkward fact of modern life that it is accepted and normal in many social circles, including those of older generations.

Pill testing is an opportunity to try to keep people safe in an environment in which drug use tends to be common (and peer pressure is strong) and to engage with them about drug use and its implications

“I’m at a loss to understand how turning up with a shipping container and a medical team somehow emphasises the normality of drug use,” quips Caldicott.

He and other advocates in Australia have created a medical code of conduct around pill testing. Even the Salvation Army have signed up to it.

Pill testing doesn’t measure the dose, so overdoses will still happen

Pill testing equipment can detect the dosage of drugs, even new synthetic ones, and it automatically red flags any ingredients it can’t identify.

But that’s not actually the point. Overdoses can occur with any drug. Pill testing is about identifying specific risks associated with the quality and make-up of specific drugs and with talking with people about the need to take any at all.

“The dose is not what we would use to persuade people one way or the other,” Caldicott says. “It’s something we might allude to, but we wouldn’t hang our hats on it.”

Pill testing will end up costing the taxpayer more

It doesn’t have to. Millions of dollars already are being spent trying to reduce the impact of illicit drugs in society; it’s just a matter of using it wisely. In the 2006 report, the NSW Ombudsman noted that considerable cost was spent on ineffective sniffer dogs, and according to Caldicott, pill testing could easily be budgeted for by redirecting just a fraction of that money.

Additionally there are direct and indirect savings to be made through less hospital admissions, and the future benefit of tax income from a life otherwise cut short. “If you can create a music festival where it’s generally less likely for people to overdose, you’ll save society a fortune,” says Caldicott.

For him, and other pill testing advocates, it comes down to whether all the tools in our arsenal are being used.

“Right now, in Australia, are we doing everything that can be done to ensure that young people can get home safe? Explain to me why we’re not doing that?

“This is life or death, and it needs to be treated with more respect.”

This article was first published on Australia’s Science Channel, the original news platform of The Royal Institution of Australia.