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April 4, 2018

Drug checking: a harm reduction strategy

Drug checking: a harm reduction strategy

Drug checking is an approach to harm reduction, in that the focus is to mitigate the risks for people who decide to take illicit drugs.  Broadly speaking, drug checking aims to warn against very harmful and unexpected ingredients, and to arm consumers with more knowledge of the strength and presence of key drugs in their substance.

We take a closer look at what drug checking is, how it works and the need in Australia, and how drug checking has the potential to reduce the harms associated with illicit drug use.

What is drug checking?

Drug checking facilities are typically set up in places where illicit drug use may commonly occur, such as music festivals, clubs or dance parties. They are set up to inform and educate consumers by testing drug samples in real time – allowing services to transmit safer-use messages that can cover a wide array of topics, such as acute/short-term hazards, long term hazards, legal risks and harm minimisation strategies1.

Drug checking services use different analytical methods to determine the content and purity of samples of illicit drugs brought to the service by members of the public.

Drug checking services tend to have three main goals: to prevent people from using especially dangerous or contaminated substances, to communicate safer-use messages, and to improve the users’ factual knowledge about substances and risks1.

It is especially important to note that drug checking does not promote illicit drug taking, and people who choose to get their substances tested have already purchased their drug with the intention to use them. A key component is to provide clear, factual and accurate information to members of the public, which may prevent illicit drug use in a particularly risky way.

How does it work?

Drug checking can be done using several different analytical methods, and the information that tests can provide varies significantly in both the quality and accuracy of results.

Physical testing is a process where the physical characteristics of a substance are recorded, such as the diameter and thickness of a pill.  Sometimes scrapings of the substance are taken for further analysis, and there are user-facilitated online forums where people will post about their experience.

Home testing kits provide a colour reagent test which may indicate the presence of specific substances (such as MDMA) by changing the colour of a small sample. These tests have been shown to be relatively unreliable compared to lab testing, and sometimes provide false positive or false negative tests2. Colour is also a highly subjective analysis method, in that different people will see colours differently. These tests do not provide purity or quantity of specific substances and do not detect any other ingredients.

Lab and further chemical analysis require specialist equipment and are the best possible drug checking technology. These tests will vary in cost and level of information that they provide, however they typically provide a better insight into the ingredients of a substance and the level of purity.

Why is drug checking important in Australia?

When compared to European countries that share similar reported data, Australia has the second highest total estimated consumption of the four most common stimulants: methamphetamine, cocaine, MDMA and amphetamine3. The 2016 National Drug Strategy Household Survey found that 20-29 year old’s are still over-represented in terms of illicit drug use when compared to other age groups above 14 years4. It was found that 7% of people in their 20’s had recently used ecstasy, 7% had used cocaine and 5.5% had used meth/amphetamines4. A separate study found that 70% of ecstasy users reported using ecstasy at clubs, festivals and dance parties5.

Since the data is self-reported, it is likely that illicit drug use among Australian 20-29 year old’s is higher. A recent study found that self-reported drug use was around half of what was indicated by oral drug tests6.

In recent years, several young people died and dozens were hospitalised after taking ecstasy or other substances at festivals and nightclub venues7. People generally have no control over the purity, strength and ingredients of prohibited substances, which can lead to these serious and unintended consequences.

This is where drug checking has the potential to reduce the level of harm by testing substances, providing relevant information and connecting people to relevant services.

Drug checking services provide a safe space for people to actively participate in reducing the harms associated with illicit drug use.

How effective is drug checking at reducing harm?

Although drug checking services have been implemented internationally since the early 1990’s, there is limited published evidence on the effectiveness of these programs in terms of changing people’s behaviour. Previous programs have been implemented in Austria, the Netherlands, Spain, Portugal, Switzerland, Luxembourg and France.

Research from Austria found that 50% of people who have their drugs checked said their results affected their consumption choices5. Two thirds of people in this study stated that they would not consume a drug if negative results were found5.

Recently, a not for profit NGO called The Loop has provided drug checking services at music festivals, clubs and other leisure events in the UK. The Loop use lab analysis techniques and provide an insight into the ingredients and purity of certain substances. They have used Twitter and relevant stakeholders at music festivals to get any warning messages out if a particularly dangerous drug is analysed. The Loop has had significant success in the UK and are continuing their work with a focus on providing program evaluation as they progress8.

Helping to reduce stigma

There are two ways that drug checking is impacted by stigma.

The first is referring to the stigma around a drug checking program – where communities may not be aware of the harm reduction approach and the perception of drug promotion is amplified. It is common for there to be a misconception that drug checking enables illicit drug use, and so the organisations who implement these programs are often faced with community backlash.

The second is referring to the stigma surrounding an individual who wants to seek help with respect to their substance use, but doesn’t want to be seen participating in drug use, or seeking help.

Drug checking programs typically work with relevant stakeholders such as emergency services and local health organisations, to promote the services available to the public in terms of substance use. This collaborative approach has the potential to break down stigma around substance use, and encourage help-seeking in the community.

References
  1. EMCDDA. (2001). An inventory of on-site pill testing interventions in the EU. Lisbon : European Monitoring Centre for Drugs and Drug Addiction .
  2. Camilleri, A. M., & Caldicott, D. (2005). Underground pill testing, down under. Forensic Science International, 151, 53-58.
  3. ACIC. (2017). National Wastewater Drug Monitoring Program . Canberra: Australian Criminal Intelligence Commission.
  4. Australian Institute of Health and Welfare. (2016). National Drug Strategy Household Survey 2016: Detailed findings. Canberra: Australian Institute of Health and Welfare.
  5. Ritter, A. (2014, November 11). Six reasons Australia should pilot ‘pill testing’ party drugs.
  6. Miller, P., Curtis, A., Jenkinson, R., Droste, N., & Bowe, S. P. (2015). Drug use in Australian nightlife settings: estimation of prevalence and validity of self-report. Addiction, 1803 – 1810.
  7. Butterfield, R., Barratt, M., Ezard, N., & O’Day, R. (2016). Drug checking to improve monitoring of new psychoactive substances in Australia. Medical Journal of Australia, 144-145.
  8. Volteface. (2017). Pentylone: What is it, why should we care and how can Multi Agency Safety Testing help?