Every drug harm-reduction intervention has been preceded by the same debate
There’s been another death of a young woman caused by consumption of illicit drugs at a music event, this time in western Sydney.
Yet despite some impassioned opposition, including letters to this newspaper, the debate about pill testing in Australia appears to have reached a tipping point.
It now seems more a matter of when rather than if trials will commence across the country. Indeed the family of the 19-year-old woman who died on Saturday have come out begging NSW Premier Gladys Berejiklian to allow a pill testing trial.
Every year about 19,000 Australians die from smoking, 5000 from alcohol and 2000 from illicit and prescribed drugs.
So are we right to be so concerned about the five deaths that have occurred in the past six months after young people have taken drugs at a music event?
The answer is a definite yes if any of these young people is among your loved ones.
Of course you would have wanted everything done to protect them, and would now want to protect other young people from succumbing to a similar fate.
But even without a personal connection, a majority of Australians supports pill testing.
In fact, the benefits of pill testing seem to be worthwhile while the risks appear to be minimal.
Why has this debate reached its present intensity? First, many Australians have come to the conclusion that the present policy simply isn’t working well enough. Too many young, healthy Australians are dying after taking drugs at music events every summer, despite all the police and sniffer dogs.
Second, many people have come to the conclusion that more than a few of these deaths might have been prevented if pill testing had been readily available.
Although there is a strong case from more than two decades of experience in Europe, we will never know for certain whether that is also true here unless we evaluate pill testing in Australia.
Sound familiar? It should. We have had much the same debate every time a new drug harmreduction intervention has been proposed. One side argues that the existing policy is working quite well and that people who are prepared to use illicit drugs get what they deserve. If no one took drugs at a music event, they say, then there would be no deaths.
The other side argues that young people have always experimented with drugs. A decade of just saying no to drugs has had minimal effect on behaviour.
Older and more experienced generations have a duty to protect younger and less experienced people. This includes being openminded about possible benefits of new and improved technologies.
The debate about pill testing is very similar to previous debates about proposed harm-reduction interventions, including methadone treatment for heroin dependence, needle and syringe programs to slow the spread of HIV, medically supervised injecting centres to reduce overdose deaths, and condom promotion to reduce teenage pregnancies and sexually transmitted infections.
These were all essentially debates about pragmatism versus abstinence: the world we actually live in versus the world that some people would like us all to live in; compassion versus indifference: evidence versus intuition; valuing incremental benefits versus demanding perfect but probably unachievable results.
Despite claims to the contrary, pill testing doesn’t send a green light to young people considering taking drugs at a music event.
Many young people enjoy going to these events where some of their friends have already decided to buy and take drugs. Rightly or wrongly, most young people will be influenced by the behaviour of their friends. So the question then becomes: is a tested drug safer than an untested drug? Testing does not eliminate all risks but tested drugs will always be safer than untested drugs.
Pill testing can never be a silver bullet that protects everyone taking drugs at a music event from all possible harms. Nor do advocates for pill testing claim it to be any silver bullet. But if saturation policing and sniffer dogs were a silver bullet, then this debate would not be taking place.
Some opponents have claimed pill testing inadvertently assists drug traffickers by providing a false promise of safety. The evidence suggests pill testing at an event discourages sellers to ply their less risky products, lest disappointed and angry customers start demanding their money back.
But one expert says pill testing has serious flaws that should be considered. John Lewis, an academic associated with the Centre for Forensic Science at the University of Technology Sydney, said in a letter to The Australian last week that there are “issues” that counter arguments for public testing.
He says it is “not possible” for any equipment to identify all of the hundreds of synthetic cannabinoids, benzodiazepines, amphetamines and opiates used in recreational drugs.
It has also been suggested that pill testing could be a Trojan horse for drug decriminalisation. But what is the aim of policymakers? Is it to try to keep every young person attending a music event alive and well, or is it to make sure that drug policy doesn’t change?
Pill testing doesn’t imply that taking illicit drugs is safe.
Staff are instructed to avoid giving any guarantee a tested pill is free of risk. Alex Wodak, president of the Australian Drug Law Reform Foundation, argues that these days pill testing with highquality equipment even in temporary facilities at a music event is almost as accurate as it would be if it were conducted in a hospital laboratory. In the case of NSW he argues persuasively that if “this Premier doesn’t introduce pill testing then the next one will. And if the next premier doesn’t, then the premier after that one will.”
As is the case throughout Australia, pill testing seems to be merely a matter of time. Keeping people alive so that they can try well-established programs such as Alcoholics Anonymous and Narcotics Anonymous is surely something to be welcomed.
Staff are strictly instructed to avoid giving any kind of guarantee that the tested pill is free of risk