The quiet champions of pill testing preventing “harrowing” deaths

Sep 1, 2023
: Professor Mal McLeod with the Ultra-Performance Liquid Chromotography – Photodiode Array, or “Ursula”, in Canberra’s fixed-site pill-testing centre.

You have only to walk into Canberra’s fixed-site pill testing site to have one of the chief criticisms of such schemes palpably refuted.

The criticism is that permitting drug testing sends a message that illicit drug use is not only OK, but safe as well.

The messages at the city-centre site – in text on the walls, in the liability waiver all participants must sign and in the very vibe of the cramped space – are all one way.

Don’t.

The waiver form has a boxed enjoinder: “The only 100% guaranteed way to make sure that you are not harmed by consuming drugs is to NOT consume drugs.”

From the walls, in plain frames: “You can never be sure the drugs you’re taking are safe” and “It [pill testing] can’t predict how your body or brain will react.”

The space is open only six hours a week and it is small: a plain waiting room, some other small spots for health professionals and counsellors and the thin testing room itself.

This is the spot where Professor Mal McLeod goes quietly about the business of saving lives in the Canberra region, though the analytical chemist is slow to embrace the lifesaver tag.

“I try not to talk about saving lives,” he says. “It’s possible we do, but it’s very hard to prove. But even if we’re preventing bad experiences or the odd overdose or whatever, that’s a positive.”

One recent Netherlands experience was different, with authorities there identifying a new drug, PMA, and issuing an alert. No-one died. The same pill was circulating in the UK, where there had been no warning. Mulitple deaths resulted.

A recent Churchill fellow, Professor McLeod, had been initially sceptical about working on the program when approached by the force of nature that is Dr David Caldicott, emergency physician and fearless advocate of drug testing and harm reduction.

“I went into it with a scientific mindset,” Professor McLeod says. “I certainly had an open mind. In the lead-up to the first festival [2018], I wasn’t sure what the outcomes would be. The most important question was to do the chemistry right.

“I think over time, as I’ve been engaged in the process, we’ve developed the chemistry plenty …. I’ve certainly got the sense now that this is a worthwhile thing to do …

“My focus is still on the science but I wouldn’t still be doing this if I thought it was a waste of time.”

In contrast to the forthright and very prominent Dr Caldicott, Professor McLeod is softly spoken and quickly points to the favourable independent evaluations of the science he brings to the program. When he started in 2018, he had been shocked by the sheer number of young people taking drugs. And he has stuck with his work despite the considerable early resistance by many in the community and many politicians.

“If you don’t do it, you’re never going to know whether it works or not,” he says, noting that resistance now “has pretty much gone” – in only five years.

“I’ve interacted with many of the people who were initially critics … I think they’ve come round.”

Once again, Canberra leads the nation. In a recent presentation to the ACT chapter of the Australian Academy of Forensic Sciences, Professor McLeod mentioned the pleas of coroners in both NSW and Victoria for testing after inquests into six deaths at NSW music festivals and five Victorian deaths at home and in city locations.

Victorian Coroner Paresa Spanos called for the “urgent implementation of public services that check the content and purity of illicit drugs” following what the Coroner called the “harrowing deaths” of the five young men.

The first three out of 28 recommendations from NSW Deputy Coroner Harriet Grahame were that NSW “permit and facilitate” a suitably qualified organisation “to run front-of-house medically supervised pill testing/drug checking at music festivals; that it fund the establishment of a permanent drug checking facility; and that it “research and support the development of technology to allow for the most sophisticated and detailed drug analysis to be made available on site at music festivals”.

While other jurisdictions begin to catch up to the ACT, the Territory, via the agency of Professor McLeod, has been refining and improving what it can do since that first test at Groovin’ The Moo in 2018.

LSD testing was launched in April this year. Fentanyl test strips are coming into play for the pain drug that is up to 100 times more lethal than heroin, the drug responsible for the spike that has taken United States drugs deaths past 100,000 per annum. In the corner of Professor McLeod’s testing room is a new machine that can separate, identify and report on purity for 10 targeted drugs in less than three minutes. Formally known as the Ultra-Performance Liquid Chromotography – Photodiode Array, from Waters Australia, the big black box is known as “Ursula” to the test-site crew.

If it can’t work it out, materials go back to Professor McLeod’s home base, the ANU, for the “investigation of unknowns” with more equipment and resources (particularly including Gas Chromotography – Mass Spectrometry) than at the fixed city site – but, as yet, the team is not allowed to report these results back to those whose samples cannot be identified immediately.

“I think there’s some convincing [of government] to do there …” Professor McLeod says. “I think it’s a bit strange.”

Even with all these advances in the ACT, Australia is still somewhat behind a number of other countries.

Dr Caldicott, on Harm Reduction Australia’s website, puts it typically bluntly, reminding himself that “in Australia in the 21st century, we still have to push for harm reduction to hold the place of pre-eminence that it should, in any modern national drugs policy.

“As a simple emergency physician, I see those who object to harm reduction in the same light as those who object to immunisations, blood transfusions, or gravity – scientifically without foundation, and forwarding personal opinions that should never be let within several kilometres of being able to influence national policy.”

 

JOHN MENADUE. A Repost: Drug policy reform series

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