OPINION: Reducing risk through pill testing
Thursday, 10 January 2019
Written by Professor Alison Hutton, School of Nursing and Midwifery.
Australia has always been a country that allows free speech, and a debate that is not going away at the moment is pill testing. Even though it is an illegal activity, taking drugs (often in combination with alcohol) is common at outdoor music festivals. Evidence of drug usage at these events can be found in reported presentations to on-site care and media reports of illness and death at these events. In 2016 in Australia, five deaths were reported and many more hospitalised due to drug overdoses, and in the last few weeks another two. The way drugs are viewed in wider society, however, restricts the implementation of harm minimisation strategies at festivals and, as you know, we are currently having this debate right now. Policing methods can be ineffective and, in some cases, may increase harm. For example, young people who are scared of being caught with drugs by police during searches at entry points to or within the music festival site have been known to ingest all their drugs at one time to avoid getting caught by police – often with fatal consequences.
Club drugs such as Methylenedioxymethamphetamine (MDMA), cocaine (coke) and amphetamines (speed) are closely linked to dance music and electronic music festivals – even though the most commonly reported drug taken at outdoor music festivals is cannabis. Researcher Tina Van Havere found that 44% of outdoor music festival goers took cannabis, followed by MDMA (19%) and cocaine (11%). The music genre also plays a part in determining what types of drugs are likely to be consumed.
Excessive drinking and the ingestion of drugs by young people at music festivals is a serious public health issue. To support young people to reduce harm we need to think more broadly than targeting the individual in a paternalistic way and expecting them to comply. Young people need to be actively engaged in choices that affect their health. My research has shown that preventative health messages are more likely to be effective for young people in specific contexts. The event environment of an outdoor music festival is an appropriate place to engage young people in practices that can minimise harm with non-medical initiatives that ensure the continued health of attendees at that event. This is where initiatives like pill testing can fit in.
Pill testing at an event does not mean that those people administering the testing are condoning drug taking. Pill testing is a form of harm minimisation, which can be and should be a part of in-event care. A historical example of harm reduction and health promotion being used with traditional services is the safe injecting room in Sydney. This initiative was controversial when it was first implemented but has proven to be successful over the years. The philosophy behind this initiative is that it recognises that drug dependence is chronic, with relapse being an in-built part of behaviour. This means we concentrate on reducing the negative consequences of drug use on a person’s health and well-being. The same can be said with pill testing; pill testing recognises that people use illicit substances at events – in fact we know people have been using illicit substances at festivals since Woodstock.
Pill testing is an opportunity to test drugs that people have purchased to consume, and the act of this test is an avenue to educate and have a conversation with those that choose to purchase illicit drugs. As with any type of harm minimisation strategy, it’s not just about stopping the behaviour, it’s about gaining a better understanding of the behaviour.
Education and harm minimisation strategies such as pill testing should be considered as a means to reduce the risky behaviour of illicit drug use at large festivals. We need to be talking about it instead of driving discussions about illicit drug use underground. Harm minimisation strategies can create an avenue to start a conversation with young people about what they are taking and why. Reducing harm in this cohort could have far-reaching impacts for those individuals and their families.
Professor Alison Hutton is recognised as a world leader in mass gathering health and research at the University of Newcastle.