Will Pill Testing Prevent Drug Deaths?
Pill testing and pill testing kits have been a hot topic in the media this year, especially around music festivals after several deaths linked to ecstasy pills last year. At Encounter Youth, we know that only a minority of people choose to take illicit drugs and most (if not all!) people are aware that they are unsafe. However, pill testing and pill testing kits are being promoted as a way to make drugs ‘safer‘. So what is pill testing and will it prevent drug-related deaths?
Can’t people just buy pill testing kits online?
Firstly, it is important to distinguish the difference between ‘pill testing’ and ‘pill testing kits’. Pill testing, in the context of something like a music festival, refers to the establishment of a mobile pill testing laboratory. This lab is operated by experts that will obtain a sample of a pill and test it with verified tests. This is in contrast to pill testing kits. These kits are usually purchased online and a person choosing to purchase pills will use the kit to give them an indication of what chemicals may be present in those pills.
The most common pill testing kit is a Marquis Reagent Test. The Marquis Reagent is a liquid which produces a colour reaction when mixed with certain chemicals often found in drugs. For example, if somebody tests a scraping of a tablet that contains MDMA (the chemical contained in Ecstasy), the liquid will turn from colourless to purple/black. However, even if the test shows that MDMA is present, that does not mean the pill is safe. The test will not show how much MDMA is present and will not show how a person’s body will react to this drug.
Another problem is that more often than not, there are other chemicals present as well. For example, tablets sold as ecstasy in 2015, went through comprehensive lab tests. Results published on ecstasydata.org found a total of 134 substances other than MDMA. The Marquis Reagent pill test can, at best, distinguish between 8 of these chemicals. A full suite of seven different pill testing kits can only distinguish 16 chemicals in addition to MDMA. This means any of the 118 other chemicals could be present but undetected. A mobile pill testing lab may be able to conduct more accurate, comprehensive tests and detect a wider range of chemicals. This is one of many reasons why pill testing through a mobile lab is definitely more preferable than making pill testing kits available for personal use and is what I will focus on for the rest of this article.
Potential benefits of pill testing
The benefit of testing pills is the potential to reduce harm. The test can give a person choosing to take drugs a red flag that there may be chemicals present that are more likely to cause harm. The person can then be informed about what is really in their pills and how those substances may affect them. There may still be unknowns, such as other undetected chemicals, which means taking those pills is still not safe, but having some information is better than having none.
Another significant benefit of pill testing is that there can be additional trained staff stationed at the lab to talk to the people submitting their drugs for testing. These conversations can be used to stage brief interventions, provide education and connect a person to support services. It gives an additional pathway out of illicit drug use should a person choose to take it.
Finally, the results of the pill tests can be used to track emerging trends in the illicit drug market. These trends can be used to inform law enforcement and provide education to young people about emerging concerns and strategies to stay safe in environments where they may encounter illicit drugs.
Potential challenges of pill testing
The major challenge is that pill testing can be perceived to be the silver bullet that will prevent drug-related deaths. This is not the case. Illicit drugs are dangerous for many reasons, not least because both their manufacture and their use are unregulated. Illicit drugs can, and do, cause overdoses, even when people are taking what they think they are. It is also never known how a person’s body will react to a drug. Often the stories we hear of a drug overdose, there are many people, even a whole group of friends, who share the same batch of a drug and only one person has the bad reaction.
When considering implementing something like pill testing, there are also legal questions to overcome. What are the duty-of-care requirements for the staff that conduct the tests? How would policing practices need to change around a pill testing station to allow people to submit illicit drugs for testing? Will the staff testing the pills have legal protection, since they will be handling illicit substances? What could the legal consequences be if a person is informed about a dangerous substance in their pills but chooses to take them anyway? These are tough questions. They are important questions to ask and have clarity on before implementing organised pill testing in Australia. A good place to start may be by examining the implementation of the Medically Supervised Injecting Centre (MSIC) in Kings Cross. Many of the legal obstacles to pill testing are similar to that of the MSIC and many lessons could be learned from this successful harm reduction initiative.
Even for legal drugs, the only acceptably safe way to use them is under clinical advice by a registered doctor who understands a person’s medical state and medical history. As we tell students in our Party Safe Education™ program, by the very nature of their unregulated production and trade, illicit drugs are unsafe. However, the reality is that some people do use illicit drugs and will continue to do so. Pill testing kits have some potential to reduce harm and could be used in resource-poor settings or in areas where it is not viable to have a pill testing station.
A more viable proposal, particularly for events like music festivals, is to have pill testing in a mobile lab. Whilst it requires more resources, this option would allow people who choose to purchase illicit drugs to access accurate information about what may be in a particular pill and support services that can help them. Making pill testing available to people who choose to use drugs is not the silver bullet, but it does give them the ability to make a more informed choice. They ultimately bear the full responsibility for their own choices, but making a more informed choice is always better than making an uninformed one.