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2 Sep. 2019

Media Release: Harm Reduction Australia & Pill Testing Australia: A Message to All Parliamentarians

Monday 2 September 2019

Recently you received an email from Drug Free Australia that promoted misinformation about pill testing services. Harm Reduction Australia and Pill Testing Australia is seeking to correct the record, so that you make an informed decision regarding pill testing services, as providing evidence-based harm reduction service like pill testing is critical to reducing drug-related harm and improving health outcomes.

It is worth noting that Drug Free Australia has a long history of opposing programs that have been scientifically proven to reduce drug related deaths, disease and other harms.

In this case, it is important to firstly highlight that Drug Free Australia’s messaging fails to appreciate that a key aspect to pill testing services is the opportunity to reach communities of people who use drugs directly in a setting where they are contemplating/intending use. These are people who are unlikely to have ever had contact with health services in relation to their drug use, who don’t have a substance use disorder or current concern regarding their use, and contact with peer-based harm reduction workers and medical advisors in the pill testing service can promote positive behavioural change and bridge the ‘therapeutic gap’ between the community and formalised healthcare settings.
 
Contrary to the opinion of Drug Free Australia and some commentators, young Australians are sensible when they are presented with information that they know is honest and non-judgmental. Today, young people are ignoring advice that they see to be unsubstantiated and driven by prejudice. The idea that most people, when provided with information about the content of their drugs, will ignore that information, regardless of its nature, greatly underestimates the inclination of people to preserve their health. However, Drug Free Australia’s email was fixated on technological details, which we will address here too.
 
The headline claim by Drug Free Australia that our pill testing services trials “failed to identify 53% of the drugs sampled” is simply incorrect.
 
The equipment we use always provides a match to a spectrum contained within a large international data library (of over 30,00 compounds) and therefore does provide an identification of drugs in the sample provided, but we evaluate this according to a score that reflects the level of confidence in the reading provided. This is a standard practice used in analytical laboratories. As a result, it would be correct to say that 47% of the compounds we tested had match scores above the conservative cut-off figures we used. The cut-off figures were based on scores typically found for the analysis of a range of pure substances.  In these cases, we had confidence that we had correctly identified the major component. It follows that 53% had scores were below the cut-off figure – not that they could not be identified. It is also important to understand that in these cases we are cautious in the conclusions we give to patrons utilising the service. We are clear when we are less certain regarding identity of samples and that this is also likely to mean there are other substances in the sample that we may or may not be able to detect.
 
We can improve our testing methods and are always actively pursuing ways to do that, despite the current lack of financial support from any government. At the recent second trial at the Groovin the Moo festival in 2019, our analytical team had access to pure reference materials like MDMA that were sourced from the National Measurement Institute in Sydney which improved our confidence levels in establishing cut-off figures. Indeed, we are now being advised by some of Australia’s leading forensic toxicologists to further improve the accuracy of the information we can provide patrons utilising our services in the future.
 
When provided to patrons, this information can be persuasive. At the recent second trial at the Groovin the Moo festival in 2019, seven samples were identified as the cathinone drug N-ethyl pentylone with scores below our conservatively established cut-off. Despite some uncertainty regarding the identification of these samples, all patrons provided with this information elected to dispose of these high risk substances.
 
In relation to the equipment we use, the Bruker FTIR machines are also used in chemistry and forensic laboratories all around Australia. It is used by these laboratories because it is fast and extremely robust. We agree that it has shortcomings relative to instruments like LC-MS or GC-MS that combine chromatography with mass and potentially fragment mass information. However, overall LC-MS and GC-MS are relatively slow and less robust providing challenges for the deployment of these technologies in the festival environment.
 
In regard to identifying purity and mixtures within drugs presented, we would agree further advancements can be made. However, we do have confidence in the identity of a major component with a score above cut-off. Purity is a problem for FTIR as the match score is likely to correlate poorly with absolute purity. That is why we do not provide advice about purity or dose (quantity of pure substance) when talking with patrons. Nor do we assume the pill is homogeneous, as a sample may not fully reflect the whole contents of that batch. Again, we are clear to patrons on these issues when providing advice.
 
Most importantly, pill testing services provide far more than just a technology to test pills. We are a health and medical service that engages with people just prior to their planned consumption of a drug. And
 
In summary, most of the message you have received is simply factually inaccurate.
 
It is also important to note that while Drug Free Australia often state that one of the ‘real causes of festival deaths’ are ‘allergic-like reactions to MDMA’, there has only been one case of a possible allergic reaction ever reported from the many millions of doses of MDMA that have been consumed in the last 30 years
 
To be clear, the message we always give to every person using our service is simple – if you do not want to encounter drug-related harm the safest way to ensure that is not to use drugs – if they still choose to use the drug after the comprehensive consultation with our analytical, medical and brief intervention teams, then we ensure they are provided with the best knowledge and information of how to reduce the risk of harms and encourage them to seek help in the event of an adverse reaction.
 
None of the advocates of pill testing involved in providing pill testing have ever suggested that pill testing is a panacea. Pill testing cannot be the only response to the potential harms from drug use, but it is part of a much needed broader suite of measures that need to be delivered directly to people who use drugs by peers, health and medical professionals.
 
It is worth noting that just some of the peak bodies supporting pill testing include the AMA, RACP, RACGP, PHAA & RANZCP as well as, many associations representing nurses, paramedics, rural doctors and others also publicly endorsing pill testing.
 
Harm Reduction Australia and Pill Testing Australia are always available to provide further information or details.
 
Links to the reports from our Pilot Pill Testing Programs in Canberra can be found at:
 
Link One - Pill-Testing-Pilot-ACT-June-2018-Final-Report.pdf
Link Two - 2nd-Pill-Testing-Pilot-August-2019.pdf

I would also encourage you to view the 1st Community Service Announcement regarding pill testing that was made free of charge by supporters of Pill Testing Australia – see https://campaignbrief.com/pill-testing-australia-unveils-pro-testing-film-shot-by-dylan-harrison-via-hooligan-collective/

Yours sincerely,
 
Gino Vumbaca
President
Harm Reduction Australia
M: 0408-244-552
E:  gino@3vc.com.au
W: http://www.harmreductionaustralia.org.au 
T:  https://twitter.com/harmreductionau