Ev­ery drug harm-re­duc­tion in­ter­ven­tion has been pre­ceded by the same de­bate

The Australian - - THE NATION - ROSS FITZGER­ALD Ross Fitzger­ald is emer­i­tus pro­fes­sor of his­tory and pol­i­tics at Grif­fith Univer­sity.

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

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