July 13, 2023
Pill testing in Australia
The Queensland government recently announced that pill testing will be allowed for the first time, making them just the second Australian jurisdiction to do so.1 The ACT is also currently trialing a fixed-site drug checking service, while other states and territories are yet to follow.2
Pill testing, or drug checking, 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 illicit drug use.3
It’s currently available in 20 countries across Europe and the Americas – as well as New Zealand.4
What is pill testing?
This harm reduction strategy allows a person who is already in possession of a drug to test it to find out what’s actually in it.5
Pill testing services are set up in places where drug use often happens, such as music festivals or clubs. They can also be set up in community health centres or treatment services – like these ones in Toronto and the CanTEST service in Canberra.
Pill testing is a shift away from drug responses that punish people, which can often increase harms instead.6
What are the benefits of pill testing?
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.7
In Australia, there have been several hospitalisations and deaths of young people after taking substances at festivals and nightclubs.8
In many of these cases, the person took a substance that was stronger than expected, or it had a dangerous contaminant they didn’t know about.9, 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.5, 11
As well as preventing avoidable deaths, pill testing can:
- Create an opportunity for conversations about harm reduction and accessing support services between people who use drugs and testing staff. For some people, this might be the first chance they’ve had to talk with health services about their drug use, and pill testing provides a unique opportunity to do this in a safe and non-judgmental space.7, 11
- Help detect potentially dangerous substances in drug markets. This is particularly useful for emergency services and alerting the public to dangerous drugs in the community.12
- Collect information on drug use trends in festival and nightlife environments. This info can be used to help build research and knowledge to assist health services in reducing drug-related harms.12, 13
Do Australians support pill testing?
Australians are becoming more in favour of pill testing.
- In the 2019 National Drug Strategy Household Survey, 57% of Australians supported pill testing, and 27% were directly opposed.14
- In the 2019 Australian Election Study survey, 63% of Australians supported pill testing, and 21% were directly opposed.15
In NSW, a 2019 inquest into six drug-related deaths at festivals prompted the state coroner to recommend NSW trial pill testing as soon as possible. But the NSW government hasn’t yet introduced it, although some ministers are supportive.16, 17
In Victoria, the state coroner also recommended the state trial pill testing as a matter of urgency after an investigation into the deaths of five young men.10 But the Victorian government has refused to introduce a pill testing trial.18
Public health experts across Australia have thrown their support behind pill testing:
- Public Health Association Australia
- Australian Medical Association
- Pharmaceutical Society of Australia
- Royal Australian College of Physicians
- Royal Australian College of General Practitioners (RACGP)
Does pill testing work?
Many studies have found that pill testing can change people’s drug-taking behavior, helping to save lives.5, 7
Drug checking has been in place in Switzerland since the 1990s, where they’ve seen a 250% increase in tested samples over the past decade. Drug checking services are now a central part of Swiss drug policy, helping to reduce harm for people who use drugs and wider society.12
In a study of the UK’s first onsite drug checking service, 49 people (21%) chose to dispose of their substance upon hearing the test result. Another 22 said they would take it over a longer period of time, and seven said they would take a smaller amount of the drug.19
While in Australia, a review of the CanTEST pilot found that when results didn’t align with the expected drug, 61% of people said they definitely wouldn’t use it.2
The CanTEST pilot has also identified several potentially dangerous drugs prompting the release of health alerts to inform and warn the public.20 This included a new ketamine-like substance, never detected before globally.2
In early 2023, CanTEST also found a synthetic opioid metonitazene – up to 200 times more potent than morphine. The adverse finding resulted in the person throwing away the drug – a potentially life-saving discovery.20
In the 2019 ACT trial of pill testing, the substance N-ethylpentylone was found on seven occasions, which has been linked to multiple overdoses at overseas music festivals. In each case it was found, the person discarded the pill.21
While over in New Zealand in 2022, 73 drug checking clinics tested 1,720 samples.22 They found that clients were more likely to use in less risky ways, including:
- 29% of people said they would now take a lower dose than previously planned
- 27% of people said they would avoid mixing with alcohol, other drugs or medications
- 29% of people reported they would test any other drugs they were using.22
Running more trials is the best way to strengthen the evidence-base for pill testing and gather further public and political support, so we can take a positive step towards reducing drug-related harm in Australia.
- The Honourable Yvette D'Ath. Pill testing gets the green light 2023 [04.07.2023]. Available from: https://statements.qld.gov.au/statements/97250.
- Olsen A, Baillie G, Bruno R, McDonald D, Hammoud M, Peacock A. CanTEST Health and Drug Checking Service Program Evaluation: Interim Report 2022 [04.07.2023].
- Caldicott D. Pill testing is coming to Queensland. Here’s what can we learn from programs overseas 2023 [04.07.2023].
- ACT Health. Pill Testing 2023 [04.07.2023].
- Maghsoudi N, Tanguay J, Scarfone K, Rammohan I, Ziegler C, Werb D, et al. Drug checking services for people who use drugs: a systematic review. Addiction (Abingdon, England) [Internet]. 2022 [21.06.2023]; 117(3):[532-44 pp.].
- Grigg J, Barratt MJ, Lenton S. Drug policing down under: An investigation of panic consumption, internal concealment and the use of drug amnesty bins among a sample of Australian festivalgoers. International Journal of Drug Policy [Internet]. 2022 [21.06.2023]; 106.
- Olsen A, Wong G, McDonald D. ACT Pill Testing Trial 2019: Program evaluation 2019 [04.07.2023].
- Sommerville K, Ritter A, Stephenson N. Pill testing policy: A comparative analysis using the Advocacy Coalition Framework. Drug and alcohol review [Internet]. 2022 [21.06.2023]; 41(1):[275-84 pp.].
- Grahame H.Inquest into the death of six patrons of NSW music festivals 2019 [04.07.2023].
- Bucci N. Victorian coroner backs pill testing after inquest into deaths of four men and a boy 2021 [04.07.2023].
- Giulini F, Keenan E, Killeen N, Ivers J-H. A Systematized Review of Drug-checking and Related Considerations for Implementation as A Harm Reduction Intervention. Journal of Psychoactive Drugs [Internet]. 2023 [21.06.2023]; 55(1):[85-93 pp.].
- Magnolini R, Schneider M, Schori D, Trachsel D, Bruggmann P. Substances from unregulated drug markets - A retrospective data analysis of customer-provided samples from a decade of drug checking service in Zurich (Switzerland). International Journal of Drug Policy [Internet]. 2023 [21.06.2023]; 114.
- Groves A. ‘Worth the test?’ Pragmatism, pill testing and drug policy in Australia. Harm Reduction Journal [Internet]. 2018 [04.07.2023]; 15.
- Australian Institute of Health and Welfare.National Drug Strategy Household Survey 2019 2020 [04.07.2023].
- McAllister I, Makkai T. The effect of public opinion and politics on attitudes towards pill testing: Results from the 2019 Australian Election Study. Drug and Alcohol Review [Internet]. 2021 [04.07.2023]; 40(4):[521-9 pp.].
- Thomson A, McGowan M. ‘Join the movement’: Minister calls for pill testing trial in NSW. Sydney Morning Herald [Internet]. 2023 [04.07.2023].
- McGowan M. Dominic Perrottet’s hardline stance on drugs is ‘magical thinking’, says pill testing advocate 2023 [16.06.2023].
- Godde C. Victoria won't follow Qld on pill-testing site trial 2023 [04.07.2023].
- Measham FC. Drug safety testing, disposals and dealing in an English field: Exploring the operational and behavioural outcomes of the UK's first onsite 'drug checking' service. The International Journal on Drug Policy [Internet]. 2019 [04.07.2023]; 67:[102-7 pp.].
- Booth G.What is pill testing and how does it work?Australian National University [Internet]. 2023 [04.07.2023].
- Vumbaca G, Tzanetis S, McLeod M, Caldicott D. Report on the 2nd Canberra GTM Pill Testing Service 2019 [04.07.2023].
22. New Zealand Drug Foundation.Drug checking data report 2022 2022 [04.07.2023].