Pill Testing: Arguments For and Against

Concerts are a known risk site for use of drugs. Pill testing is the answer, says Dr Alex Wodak.
Concerts are a known risk site for use of drugs. Pill testing is the answer, says Dr Alex Wodak.

Tens of thousands of young people attend music festivals every year amid a national debate about whether Australia should introduce pill testing at public events for those intending to use illicit drugs. The Catholic Weekly presents two expert views, one for and one against pill testing.

For: Screening means less danger

By Dr Alex Wodak AM

Already six young people have died in Australia this summer after taking untested drugs at youth music events. Governments respond to drugs at these events by emphasising and generously funding attempts to reduce the availability of drugs.

But despite costly saturation policing, drugs are still apparently readily available. This is hardly surprising, as authorities seem unable to prevent drugs from entering even our maximum-security prisons.

Drug education and admonishing lectures by politicians have very limited effect on the desire of young people to take drugs.

See related article: Church urges nations, society to address ongoing issues related to drugs.

Ecstasy (MDMA) is the more common drug taken at these events. More than 10 per cent of Australians over the age of 14 years have taken ecstasy. Pure ecstasy at an appropriate dose carries a small risk but the black market pills available may contain high doses of MDMA and/or lethal contaminants.

Harm reduction pill testing has been available at youth music events in the Netherlands since 1992 and in a number of other European countries for many years. Patrons at a festival can enter the pill testing tent, sign a form waiving legal liability from the testing facility, before scraping a small quantity of their pill into a special container, which is then inserted into a sophisticated laboratory machine to accurately identify the contents.

There are more than half a dozen different techniques available for identifying the ingredients of the pill including detecting the presence of dangerous contaminants. Experts then explain the results of the test, emphasising that the safest way to take the pill is not to take it. Other harm reduction advice is also provided.

In many European venues, if a dangerous pill is detected a photograph of the pill and some text is flashed on networked video screens around the venue. Patrons with dangerous pills are encouraged to discard their pills into secure amnesty bins. The majority of patrons advised to discard their pills do so.

A sample of the drug methoxetamine or MXE found at parties and festivals. Photo: GreenZeb/Wikimedia Commons, CC BY-SA 3.0
A sample of the drug methoxetamine or MXE found at parties and festivals. Photo: GreenZeb/Wikimedia Commons, CC BY-SA 3.0

Pill testing benefits individuals who avoid taking known dangerous pills. The health education messages are effective because they are provided in a non-judgemental manner by trained staff, at a time and place where the question of taking or not taking a pill is being actively considered.

Pill testing also helps other patrons reduce their risk by the rapid and effective dissemination of information about dangerous pills. Pill testing encourages less risky drugs to push out more dangerous drugs from the local drug market.

As is often the case with messy public health type interventions, evaluation is more complicated than for clinical interventions. When the results of multiple different kinds of studies are considered together, it is clear that pill testing reduces but does not eliminate deaths and hospital admissions.

Providing more information to people about health risks generally improves health. Keeping people ignorant about health risks often damages health. The risks of pill testing are minimal and have been greatly exaggerated by politicians opposed to pill testing.

The debate about pill testing in Australia has followed a similar trajectory to previous debates about other new harm reduction interventions. Sooner or later, common sense and compassion will help Australia to protect its young citizens.

I find it very hard to believe that the Jesus in Matthew 25 who had sympathy for the hungry, the thirsty, strangers, the naked and those in prison would have supported withholding pill testing.

Dr Alex Wodak AM is the President of the Australian Drug Law Reform Foundation.


Against: Testing is a furphy that can only spread drug usage

The pill testing lobby are obscuring the real issues at stake, says DFA’s Gary Christian.Photo: Will Turner/Wikimedia Commons
The pill testing lobby are obscuring the real issues at stake, says DFA’s Gary Christian.Photo: Will Turner/Wikimedia Commons

By Gary Christian

Every death from a party pill in Australia has a toxicology analysis of what caused the death in the coroner’s report, so there are no mysteries about what is causing these deaths.

But here is the appalling news – the cause is very different from what you are hearing from pill testing proponents and from an Australian media that has largely failed its due diligence on this story.

The only Australian study on an extensive number of ecstasy-related deaths looked at 82 coroners’ reports from between 2001 and 2005. First, that is a lot of under-reported ecstasy deaths in five years. Second, 23 per cent of those deaths were caused solely by the MDMA in the pill. Another 59 per cent were caused by MDMA when used with other legal and illegal drugs.

Conclusion? Eighty two per cent of the 82 deaths reviewed were directly attributed to MDMA. Ecstasy is the killer. Third, none of these 82 deaths were from impurities or other unknown drugs in the pills. And recent coroners’ reports concur. The Daily Telegraph reported on 15 January that Professor Dawson had indicated MDMA was implicated in early toxicology tests on four recent NSW deaths.

The other evidence-free assertion we keep hearing is that many deaths are from MDMA ‘overdoses’. The truth is that MDMA overdoses are rare, with most deaths from a single pill or from MDMA ingestion within the normal range of recreational use.

Even Harm Reduction Australia’s senior organisation, the US Drug Policy Alliance, says ecstasy overdoses are rare. So why does HRA keep promoting this dangerous myth that misleads the public into thinking the MDMA purity of a single pill needs quantifying?

Why, then, are people dying? The reality is that most deaths outside polydrug use are due to something akin to an individual allergic reaction to MDMA. In 1995, Anna Wood took the same tablet as five other friends, but she was the one that died.

The truth is that MDMA overdoses are rare, with most deaths from a single pill or from MDMA ingestion within the normal range of recreational use.
The truth is that MDMA overdoses are rare, says Gary Christian.

So, advising a potentially allergic user to take only half a 100 per cent pure MDMA pill won’t help anymore than eating half a peanut instead of the whole will stop anaphylactic shock for those allergic to peanuts.

With that knowledge, the results of this pill testing push will be frightening. What better way is there to broaden the pool of prospective drug users than to suggest pill testing makes ecstasy use safer? Expect an accelerating number of deaths from this craven misinformation.

There are practical issues too. John Lewis, a forensic scientist at UTS, says pill testing equipment will never provide safety because scrapings from a pill wrongly assume that contained substances are uniformly distributed.

Additionally, the three deaths in Melbourne where purported ecstasy pills contained 4-FA and 25C-NBOMe require equipment so sophisticated that police sent samples to Spain for verification. Also, pill testing won’t reduce drug use and its risks as is claimed.

A festival-goer with a tested ‘dangerous’ pill will simply ask friends next time where the ‘safe’ MDMA ones are purchased.

Why aren’t the pill testing promoters telling the truth about ecstasy, saying pill testing is about safety when it’s not? Maybe there’s something to hide, like another agenda.

Of course, only they know their own motives.

Gary Christian is a specialist researcher in AOD and Community Health for Drug Free Australia.