We Are Willing To Break The Law To Save Lives

03/03/2016 10:10 AM AEDT | Updated 15/07/2016 12:51 PM AEST
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Woman's tongue with white tablet balancing on tip, profile, close-up

This blog was co-authored by Associate Professor David Caldicott, Clinical Senior Lecturer, Emergency Medicine, A.N.U. and Associate Professor, Health & Design, University of Canberra, and Will Tregoning, Executive Director and Founder of Unharm.

The recent 4 Corners program, 'Dying to Dance', ignited a furious debate. The program showed some reckless drug taking, although more common and more moderate behavior received less emphasis. The program showed that considerable drug use occurs at these youth music-dance events, notwithstanding saturation policing and the ubiquitous sniffer dogs.

The debate since the program has been mainly about pill testing. Should pill testing be evaluated in Australia?

Although pill testing has been allowed in half a dozen European countries for up to a quarter of a century, the NSW Police Minister and NSW Premier are steadfastly opposed. How could pill testing be allowed anywhere? How could it be carried out? Does pill testing produce serious negative consequences? How is pill testing insured?

These are all important and legitimate questions. But the most important question is whether or not pill testing saves lives or prevents severe illness. It is not possible to answer this question with the same precision as for clinical interventions, such as the effectiveness of antibiotics in infections.

But we do know that pill testing identifies potentially dangerous adulterants. And we know that when young people at music festivals are told that the drugs they have bought are toxic, the drugs are almost always discarded. We know that after pill testing has been provided at a youth music event, the drugs available become less risky as more dangerous drugs become worthless.

Ironically, pill testing is already available in Australia. It has been for some years. The reagent kits available for checking drugs are not illegal and are sold in many outlets.

So a more primitive and less accurate system of drug testing is available without education of consumers, while a more accurate system provided with education of consumers about reducing risk is banned. Does this make sense to you?

If the children of senior politicians were attending youth music festivals and were intent on taking drugs, would the same Ministers and Premiers who today oppose pill testing prefer their own children to use tested or untested drugs?

Pill testing is provided in a temporary laboratory with a gas chromatograph-mass spectrometer used to identify the material that has been bought from an unregulated supplier. A tiny part of a pill or a small amount of powder is put into a machine by a trained technician. The customer returns about half an hour later to get the results. Trained peer interviewers explain the results to the customer and provide advice about fluid intake, avoiding overheating and other measures to reduce risk. Experience with pill testing has been positive.

In contrast, the NSW Ombudsman's 2006 report concluded that sniffer dogs are very inaccurate, detecting drugs where none are present and missing drugs when they are present. They also frighten many young people into taking all the drugs in their possession to avoid being caught. Sometimes this results in serious illness or even death. Sniffer dogs are also expensive.

Evaluation of pill testing in Australia is supported by two mothers who have lost children to drugs taken at youth music events, Mick Palmer, a former Commissioner of the AFP, Nick Cowdery, a former NSW DPP and many alcohol and drug clinicians and researchers. It is also supported by a resolution from the Australian Medical Association from November 2005, calling for a trial in an Australian jurisdiction.

We need to raise $100,000 to conduct a trial and will do so from benefactors and crowd-funding. We are negotiating to identify a festival promoter who will allow us to conduct a trial. Doctors, analysts and peer interviewers have offered their labour for free -- at an estimated value of $40,000. We prefer to avoid confrontation with a government, but if the only way we can save lives is through civil disobedience, we will do so.

We had to resort to civil disobedience in 1986 to start needle syringe programs in Australia. Independent research showed that it saved thousands of lives and billions of dollars. We had to resort to civil disobedience in 1999 to start the first medically supervised injecting centre in Australia.

On his retirement as NSW Premier, Bob Carr said that this was one of his 10 proudest achievements. On both occasions, we were vilified and told that the sky would fall in, drug use would soar, people who use drugs would not attend, and that there would be no benefits and serious negative consequences.

Sooner or later, pill testing will be implemented in all states and territories in Australia, whether Mr Baird and Mr Grant like it or not.

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