Pill Testing: A Comprehensive Series on Pill Checking/Testing - Part 1: Get the Facts, Not the Spin

A Must-Read for All Australians, from Politician to Parent to Punter

This is Part 1 of a 2-part series examining the complex issue of pill testing in Australia. Stay tuned for Part 2, which will explore additional aspects and perspectives on this critical topic.

In recent years, the debate surrounding pill testing at music festivals and nightclubs has intensified in Australia. This comprehensive article series aims to provide a thorough examination of the facts, misconceptions, and potential consequences of pill testing programs. By analysing information from various sources, including scientific studies and evaluations, we hope to offer a balanced and informative perspective on this contentious issue.

The Pill Testing Debate

Pill testing, also known as drug checking, has been proposed as a harm reduction strategy to address drug-related deaths and injuries at music festivals and other events. Proponents argue that it can save lives by identifying dangerous substances and educating users about the risks. However, critics contend that pill testing may inadvertently encourage drug use and fail to address the root causes of drug-related harm.

As we explore this complex topic, it’s crucial to approach the information with an open mind and consider the various perspectives and evidence presented.

The Narrative vs. The Science

The Claim: Adulterants and Impurities Are the Main Culprits

One of the primary arguments made by pill testing advocates is that deaths related to party pills are primarily caused by adulterants and impurities. Dr. Alex Wodak, a prominent supporter of pill testing, stated in The Catholic Weekly:

“There are more than half a dozen different techniques available for identifying the ingredients of the pill including detecting the presence of dangerous contaminants.”

This narrative suggests that by identifying these contaminants, pill testing can prevent deaths and injuries.

The Scientific Evidence: MDMA Itself Is the Primary Concern

However, scientific analyses of coroners’ reports on ecstasy-related deaths in Australia paint a different picture. A study examining 392 ecstasy deaths between 2000 and 2018 found:

No deaths were attributed to impurities in the pills.
Only 5% of deaths involved another drug mixed in the pill.
This indicates that MDMA (ecstasy) itself was causal in 95% of deaths.
“Bad batch” deaths were extremely rare in Australia, with only three such cases identified in Melbourne in 2017.

These findings suggest that the primary risk factor in ecstasy-related deaths is not adulterants or impurities, but the MDMA itself.

Understanding How Ecstasy Causes Death

To fully grasp the implications of pill testing, it’s essential to understand the mechanisms by which ecstasy can lead to fatalities. The 2020 study of 392 ecstasy deaths revealed several key factors:

Idiosyncratic Reactions (14% of deaths): Some individuals have a deadly reaction to MDMA, akin to a severe allergy. Pill testing cannot identify who is susceptible to these reactions.
Polydrug Use (48% of deaths): Nearly half of the fatalities involved the co-use of MDMA with other substances, such as alcohol or amphetamines. Pill testing does not assess users for their consumption of other drugs.
Accidents (29% of deaths): A significant portion of deaths were due to accidents, primarily car crashes. Pill testing cannot predict who will engage in risky behaviours while under the influence.
Environmental Factors: A medical journal study on rats demonstrated that factors such as increased ambient temperature and social interaction could turn previously tolerated doses of MDMA lethal. Pill testing cannot account for these environmental variables.

The Prevalence and Danger of MDMA Overdose

Contrary to some claims, MDMA overdoses are a significant and growing concern. Recent studies and data from health organisations highlight the increasing risk of MDMA-related overdoses:

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) reports a rise in MDMA-related emergency department visits and deaths in several European countries over the past decade.
A study published in the Journal of Psychopharmacology found that MDMA-related deaths in the UK increased from 8 in 2010 to 92 in 2016, with many of these attributed to high-dose tablets.
The U.S. Drug Enforcement Administration (DEA) has warned about the increasing potency of MDMA tablets, with some containing doses two to three times higher than what’s considered typical.
Research from the National Institute on Drug Abuse (NIDA) indicates that MDMA overdose can cause potentially fatal complications such as hyperthermia, hyponatremia, and cardiovascular failure.

Pill Testing in Practice: A Closer Look

Examining the practices of pill testing organisations reveals some concerning inconsistencies. For example, Pill Testing Australia’s evaluation report indicates that after testing, a pill is given a white, yellow, or red card. Notably, an ecstasy pill containing no other drug is given a white card, essentially greenlighting its use.

This practice is problematic because:

It fails to address the fact that MDMA itself is responsible for the vast majority of ecstasy-related deaths in Australia.
It may give users a false sense of security about the safety of “pure” MDMA pills.

Potential Unintended Consequences

A 2019 evaluation of a pill testing trial in Canberra by the Australian National University revealed some troubling findings:

Users who received test results confirming that their substance was what they expected were likely to take as much or more than originally intended.
About 90% of the pills tested were ecstasy pills.

These findings suggest that pill testing may actually increase the likelihood of MDMA consumption, potentially leading to more harm rather than less.

The UK Experience: A Cautionary Tale

The United Kingdom’s experience with pill testing provides valuable insights into its potential long-term effects. ‘The Loop,’ a pill testing organisation, began operations in the UK in 2013. Data on ecstasy use and related deaths in the years following the introduction of pill testing reveal a concerning trend:

Ecstasy use increased after the introduction of pill testing, which expanded to 12 cities by 2016.
Deaths related to ecstasy rose from 43 in 2013 to 92 in 2016.

This data suggests that the education provided by pill testing organisations did not reduce the use of MDMA or decrease related fatalities as hoped. The evidence presented in this article challenges many of the assumptions underlying the push for pill testing in Australia. While the intention to reduce harm is commendable, the data suggests that current pill testing practices may not be addressing the primary risks associated with MDMA use and could potentially lead to increased consumption and harm.

As we continue this discussion in Part 2 of our series, it’s crucial for all stakeholders – from politicians to parents to potential users – to carefully consider the complexities of this issue. Effective drug policy must be based on solid scientific evidence and a thorough understanding of the risks involved.