Dangerous delusion of the pill testing solution

The summer of 2019 became one of the most deadly in the nation’s history of festival overdoses when Alex Ross-King, 19, became the fifth reveller to die since October. Too many issues remain unresolved for a test to be the sole solution to the drug crisis.

• Gladys Berejiklian debates pill-testing with Kochie
• Alex Ross-King fifth person to die at music festivals

The emotion-fuelled pill-testing debate has been flamed by yet another festival death but leading scientists say our country’s response must be managed through cool heads as opposed to dangerous rhetoric.

The summer of 2019 became one of the most deadly in the nation’s history of festival overdoses when bubbly 19-year-old Central Coast teenager Alex Ross-King died in her Westmead Hospital bed, becoming the fifth reveller to do so since October.

Five young people have died from suspected drug overdoses at music festivals in as many months.

MORE NEWS:

Daley backflips on ‘rip up’ light rail gaffe

FBI exposes global prostitution ring in Australia

‘No revenge’: Priest’s plea after fatal stabbing

Just seven days ago Alex spent her final moments alive at Sydney’s FOMO music festival in Parramatta on a sweltering Saturday afternoon. It was here that the first signs of her ecstasy overdose began to manifest.

She was led to the medical tent by friends before being rushed to hospital, where her family could only watch on as she died within hours.

Alex’s death was a tragedy of the highest order and her family are justified in writing to NSW Premier Gladys Berejiklian to demand an explanation.

But, as University of Technology Sydney forensic scientist John Lewis puts it, the response needs to be the right one or we risk pouring petrol on an already out-of-control blaze.

“The debate about pill testing has become a very emotional one, which is very understandable,” he said.

“If you had a child who died in the same manner you would also be angry. In fact, we should all be a little angry.

“The problem is that scientists are not the ones weighing in, it is festival owners and people who are claiming to have evidence a trial will work when that evidence is rather shallow. I am interested in the science and whether it will work both logistically and from a chemical analysis perspective.”

The family of Alex Ross-King have called for pill testing to be introduced in the wake of their daughter’s death. Picture: Instagram

Dr John Lewis, who is associated with his university’s Centre for Forensic Science, said a festival would need a commercial quality mass-spectrometer, which costs roughly $500,000 to test products to the degree in which the data is accurate.

He also said that even those tests would not provide three-dimensional modelling of an ecstasy pill, so only the surface level of the pill or any scrapings could be tested.

Because chemical substances are not evenly distributed through the pill, it creates a situation where a pill could be cleared for consumption without actually being tested.

The second issue, as Dr Lewis explains, is that MDMA is often laced with synthetic compounds which cannot be detected.

“We need to get away from the spin around pill-testing and look at what can and will happen if it takes place,” he said.

“It might not be able to detect synthetics such as Carfentanil, which is 10,000 times more potent than morphine because there are more than 700 of these synthetics which pop up all the time and can be put in these pills.

“To put it in perspective, Carfentanil is used by the Canadians to anaesthetise moose and boars so they can perform surgeries on the animals.

“So if you test a pill that has Carfentanil in it and you can’t detect it, the lack of a warning creates the false sense of security that you can take the standard doses that you normally take with your drugs.

There was a heavy police presence at the FOMO music festival this year. Picture: David Swift.

“The problem is that the additives interact with a person’s body at the same time and actively reduce your tolerance levels so you might not be able to take as much any more. The only way you’ll find this out is when you stop breathing.”

The NSW Health guidelines set up to combat festival deaths also paint a sobering picture of the sheer gravity of the problem.

Despite drug use in the wider population plummeting to less than a quarter of Australians, the majority of festival- goers are openly admitting to using ecstasy.

“Music festival patrons report higher levels of illicit drug use compared with the general population,” the NSW Health report said.

“A survey conducted at a major music festival in 2016 found that 60 per cent of patrons had taken ecstasy in the last 12 months.”

When extrapolated to take into consideration the FOMO music festival, that data suggests that roughly 6600 of their attendees were using ecstasy.

These figures are being used by proponents of pill testing to make the case that the battle is lost and our only option is to allow kids to take drugs in the safest possible manner.

Royal Australasian College of Physicians president Martyn Lloyd-Jones explained that viewpoint yesterday when he proclaimed pill testing to be the answer.

Grieving families are justified in asking Premier Gladys Berejiklian for answers. Picture: Dylan Robinson

“Ideally, we would all like young people and the wider public not to use drugs illicitly. However, the reality is that they do in large numbers and the moral message to abstain from taking drugs is not getting through,” he said,

“The evidence to date shows that existing policies in place at festivals to discourage drug taking, including heavy police presence, sniffer dogs and searches, are not effective. These policies are failing our communities and our young people, leading to unnecessary deaths.”

The physicians college would have us abandon the fight to keep drugs from young people simply because we are losing that fight.

When asked what evidence the college had used to justify the claim that a heavy police presence and sniffer dogs were not effective, the college could only point to the report produced by the pro-pill testing lobby in the wake of the Canberra trial.

It could not provide a detailed analysis of whether the situation would be worse without police checking bags. It simply proclaimed as a matter of fact that “heavy” policing was not working.

Dr Lewis suggests that this response is incorrect because, if indeed such a large number of people are using ecstasy at festivals, then pill testing becomes a logistical nightmare.

“Are we going to have a line for 6600 people to test their drugs and who would actually wait in that line?” he said.

“So what would happen is there would be an incredible amount of pressure on drug testers to speed up the process, which always leads to mistakes.

“Then you have to ask yourself if the people who are likely to line up in a diligent manner are the ones likely to take high doses. And if a person tests their pill and it is found to be dangerous, will they do the right thing and throw it out or sell it to some poor fool.”

This raises the issue of liability.

Pro-pill testers often point to the Canberra trial as evidence of success but those who set up the trial released a report — drafted by Harm Reduction Australia — which detailed significant failures of the process.

State toxicologist Professor Andrew Dawson.

They were so worried about being liable for a death they forced anyone participating in the tests to sign a death waiver.

“(A) key condition identified by legal and insurance advisers was the need for a waiver form to be signed by all patrons,” the report said.

“The wording of the form was drafted with input from a medical clinician and from a pro-bono lawyer who assisted in this task.”

The wording adopted by the pill testers released everyone involved in testing from “any liability for personal injury or death suffered by me arising or connected in any way from the Services.”

Lawyers working for the pill testers were right to note the clear liability issues which may fall to the state if the practice becomes widespread and endorsed by Ms Berejiklian.

All legality issues aside, the biggest and most simple issue with pill testing is that MDMA itself is a toxin capable of killing.

Even a pill of 100 per cent purity can result in death, as explained by the state’s chief toxicologist Professor Andrew Dawson, who has intimate knowledge of the five fatalities.

In an unbearably hot summer festival in Sydney’s west the conditions are ripe for death by drug-induced overheating.

“Normally, what will happen to people is that they will often get increasingly agitated, they can then become confused and that’s often a sign they already have a temperature,” Professor Dawson said.

“They may not always be aware that they’re actually hot. Once your temperature starts going above about 41 degrees, you’re at a temperature where you start cooking an egg. So, the proteins in the body start poaching and you get multiple organs shut down. And that’s actually what causes the death. Patients can very rapidly deteriorate.

People attending music festivals are encouraged to make sure that their friends are ok. Picture: Flavio Brancaleone

“They can get a temperature of 39 or 40 degrees and rapidly within 10-15 minutes to 40 to 43 degrees. And that’s life threatening. So it can be back that fast. So it’s very important to understand that individuals may not be aware that they’re actually unwell. It’s really important that bystanders and friends are looking out to make certain that people are all okay because the individual may not realise you’re unwell.”

So, if pill testing does not stack up logistically and scientifically, then is there still merit in the suggestion that it is better than doing nothing?

Well, no.

As Dr Lewis puts it, the trial risks encouraging drug use and because there is no safe drug use, the problem could be worsened by a trial. Instead, he would like to see more medical staff at festivals and greater early intervention through education campaigns.

This is the approach being taken by NSW Health chief medical officer Dr Kerry Chant who drafted the interim guidelines festivals must abide by.

Her team would constantly be reviewing the guidelines and in the wake of the deaths was open to implementing tougher standards for festivals to adhere to.

“These guidelines were a first step in strengthening and increasing the harm reduction messaging,” Dr Chant said.

There may be a dozen options better than pill testing, but if the debate continues to be muddled by misinformation, Australia will be so distracted by the rhetoric that legitimate solutions are not considered.