Pill testing in Australia

Drug checking, or pill testing, isn’t a new idea – in fact it’s existed in Europe since the 1990s and is a well-known strategy to reduce some of the risks and harms associated with drug use.¹

It’s currently available in at least 28 countries across Europe and the Americas – as well as New Zealand.²

There’s a lot of talk about drug checking in Australia right now, with services now available in the ACT and Queensland. And soon to be in Victoria, too.

But - what is drug checking and how does it work?

What is drug checking?

Drug checking is a shift towards a health-based approach to alcohol and other drugs, which can reduce harms.³

This harm reduction strategy allows a person to test their drugs to find out what’s actually in it.⁴ It also provides service attendees the chance to speak to trusted health professionals and peer workers about the drug or their drug use.⁴ The services are usually free or low-cost and anonymous.⁵

They can be ‘fixed site’ or ‘mobile’ services:⁵

Mobile services are set up in places where drug use often happens, such as music festivals or clubs.

Fixed site services are often found in community health centres, supervised injecting facilities or treatment services.

The technology used at these sites is more accurate and reliable than DIY testing with reagent kits, which first became popular in the ‘90s.^{6, 7}

Watch this video to learn more about how drug checking works.

What are the benefits of pill testing?

Drug checking (pill testing) can help:

• prevent people from using unusually strong or contaminated drugs
• communicate messages around safer drug use and reducing harm
• improve people’s knowledge on how certain drugs can affect them.^4,8,9

Every year in Australia there are thousands of hospitalisations and deaths after people have taken drugs.^10,11

In many cases, the drug was stronger than expected, entirely different than the drug they thought they were getting, or had other drugs and additives mixed in that they didn’t know about.¹⁰

By testing their drugs, people can find out what it actually contains and how strong it is. This can lead a person to decide not to take it, potentially saving their life.^4,8

As well as preventing avoidable deaths, drug checking:

• Allows people to talk about staying safe and connect with support services in a judgement-free space. For many people, this is the first time they’ve talked with a health professional about their drug use.^8,9
• Helps to detect potentially dangerous drugs in markets. This is particularly useful for ambulance and hospital workers, and for alerting the public.^8,12
• Collects information on drug use and purity trends. This info is used to help build research and knowledge to assist health services in reducing drug-related harms. For example, services can provide harm reduction messages for people to take a smaller dose when data suggests an increase in average purity for a drug type.^8,12,13

The majority of Australians support drug checking

Australians are increasingly supportive of drug checking:

• In the 2022-23 National Drug Strategy Household Survey, 64% of Australians supported drug checking, compared to 57% in 2019.¹⁴
• In the 2022 Australian Election Study survey, 68% of Australians supported drug checking, compared to 63% in 2019.¹⁵

Several credible public health bodies across Australia have thrown their support behind drug checking, including:

• Public Health Association Australia
• Australian Medical Association
• Pharmaceutical Society of Australia
• Royal Australian College of Physicians
• Royal Australian College of General Practitioners (RACGP).

Drug checking in each state/territory

In July 2022, the ACT was the first Australian state/territory to trial drug checking, with the opening of CanTest. In June 2024, the decision was made to continue the service until at least June 2027.¹⁶

In April 2024, Queensland launched their permanent drug checking service, CheQpoint, which includes two fixed-site locations and mobile services at festivals.¹⁷

In Victoria, the state coroners court made seven recommendations for drug checking from 2021-24.^18-23 This was amplified by united support from nearly 90 organisations.²⁴ After a spike in drug overdoses at festivals in early 2024, the state government finally agreed to implement drug checking.²⁵

In NSW, in 2019 the state coroner recommended that NSW trial drug checking as soon as possible.²⁶ There was a trial at the Uniting Medically Supervised Injecting Centre in 2024.²⁷ To date the NSW Government hasn’t introduced drug checking for the general public.^28,29

In Northern Territory, a survey of music festival attendees found 73% of respondents supported drug checking, this increased to 81% among respondents who use drugs.³⁰ While the former chief minister said in 2021 that he was open to the idea of drug checking, no further progress has been made.^31,32

In Tasmania, calls for drug checking were reignited in 2023, after a drug-related death at the Panama Festival the year prior – but the state government remains opposed.³¹ In February 2024, a poll of voters in the state indicated almost two-thirds (65%) supported drug checking.³³

In South Australia, the state government responded to a question in Parliament in 2022, saying it does not support or plan to implement drug checking.³¹

The state government in Western Australia ruled out drug checking in 2019, after a wave of drug-related deaths at festivals saw calls for it to be implemented. They have not changed that stance.³¹

The evidence shows that drug checking works

Many studies around the world have found that drug checking can change people’s drug-taking behavior, helping to save lives.^4,8

In New Zealand in 2023, 98 drug checking clinics tested 2,602 samples.^34,35 They found that clients were more likely to use in less risky ways, including:

• when results weren’t what the person expected, 40% said they wouldn’t take the drug
• 31% said they would now take a lower dose than previously planned
• 36% said they would avoid mixing with alcohol, other drugs or medications
• 53% reported they would test any other drugs they were using, up from 29% in 2022.^34,35

In Australia, a review of the ACT CanTEST pilot found that one in ten (10%) samples tested were discarded at the service.

When results weren’t what the person expected, one third (32%) said they definitely wouldn’t use the drug.⁹

Similar results have come out of Queensland. The first summary report from CheQpoint showed that one in six (16%) people discarded the drug or said they wouldn’t consume it.³⁶ And, almost one in four (23%) said they planned to take less of the drug.³⁶

Drug checking allows for lifesaving drug alerts

Drug alerts from findings at drug checking services work, too.

In 2014, there were pills in Europe that people expected to be MDMA, but contained a dangerous dose of another drug.²⁴

In the Netherlands where they have had drug checking services since 1992, they quickly issued an alert and there were no deaths related to that pill.²⁴

In the UK, where there was no drug checking service and no warnings were issued, the same pills were associated with several deaths.²⁴

CanTEST and CheQpoint have also identified several high-risk drugs prompting the release of health alerts to inform and warn the public. This includes nitazenes and synthetic cathinones.^37,38

According to a recent Australian survey of people who used illegal drugs and who had seen a recent drug alert, over half changed their use of the drug type mentioned in the alert.³⁹ This included:

• stopped using the drug entirely (18%)
• avoided using drugs matching the alert specifically (20%)
• changed their use behaviours (18%) – most commonly by practicing safer dosing by using a smaller amount, or ‘starting low, going slow’.³⁹

Drug checking and drug alerts have shown real results in helping people who use illegal drugs to make safer choices – and Australia’s adoption of drug checking is a big step towards a health-based approach to drug use.

More info

• Pill Testing Australia
• CanTest
• CheQpoint
• The Know
• ADF Pill Testing Position Paper
• What is pill testing and how does it work?
• Drug checking and early warning systems: Knowing the harms can prevent the harms