Premier, please help us save young lives: a plea from 27 doctors for pill testing

Dear Premier,

Over several decades, we, along with many of our clinical predecessors, have been involved in the treatment of people suffering harm from drugs and alcohol at St Vincent’s Hospital.

The mainly young people who have unintentionally overdosed or been poisoned by drugs at music and dance festivals held in inner-city locations have often presented to us for our care.

Senior pill-testing chemist Mal Mcleod demonstrates how a pill might be tested at the Groovin' the Moo festival in April.Credit: Dion Georgopoulos

We regret that our culture is one in which people use drugs, including alcohol, to excess, but we acknowledge that experimentation with drugs, including alcohol, is unfortunately common among young people.

We have seen the serious harms done to individuals, families and communities by these drugs.

As front-line clinicians, we wish to see the adoption of policies most likely to minimise this damage.

A number of our medical peers presented scientific evidence about maximising the safety of young people to the recent coronial inquest into the death of six patrons at NSW music festivals. Based on this evidence, they strongly recommended the establishment of a pill testing trial – recommendations that the NSW Deputy Coroner accepted and supported.

We encourage the NSW Government to adopt the recommendations of this coronial inquest. Specifically, we encourage the government to prioritise methods that show evidence of reducing drug harms and deaths.

We support a well-designed pill testing trial to complement the compelling evidence that already exists. So far, the available evidence – including from the ACT’s experience with drug testing in 2018 and 2019 – suggests it is potentially an effective way of reducing the harms associated with drug use and saving lives.

From our experience, we believe pill testing at festivals has the added advantage of bringing a young person face-to-face with a trained counsellor before they ingest the drug. Evidence to the coroner demonstrated that none of the young people had ever spoken with an expert about the risks of MDMA or the potential danger of mixing drugs and alcohol. An opportunity for a trained counsellor to provide personalised information in a non-judgmental environment, including the offer of a pathway to treatment if necessary, is priceless.

It is our fundamental belief that prioritising enforcement over a public health approach to drug use has unintended consequences. A core value of St Vincent’s is human dignity. Accordingly, we find it abhorrent that strip searches are used to investigate young people – including children – for personal possession. Strip searches, as currently conducted, demean both the individual and the police conducting the search.

Dr Jennifer Stevens, one of 27 senior clinicians from St Vincents Hospital who wrote the open letter to the Premier. Credit: Renee Nowytarger

We admire and applaud the work of NSW’s police for the many ways they keep our community safe. However, strip-searching young people for investigation of personal possession is not something police should be asked to undertake, nor should young people have to endure.

We note that another recommendation of the coroner’s report – and which has been made at previous inquests – is the holding of a NSW Drug Summit. A previous summit in 1999 was a watershed moment for public health policy in the state and was responsible for establishing the Medically Supervised Injecting Centre in Kings Cross, which has saved hundreds of lives.

We believe a summit in 2020 could be similarly defining.

Young people who experiment with drugs and alcohol should have their safety as our highest priority. They should be able to look back one day, as many of us do, and be grateful they survived the "invincibility" of youth.
Equally, let us look back – as their parents, as their clinicians, as their policymakers and leaders – and know we did what we could to help them stay safe, founding our actions on the evidence-based methods that are likely to prove the most successful.

Premier, if you choose to boldly heed the evidence and respond accordingly, we will stand alongside you, shoulder to shoulder, in any implementation.

Dr Jennifer Stevens is the director of the acute pain service at St Vincent's Hospital. Her co-signatories on this open letter to the Premier are:

Professor Kay Wilhelm AM, Director of Psychiatry

Professor Richard Day AM, Director of Clinical Pharmacology

Professor Peter MacDonald, Co-Head, Transplantation
Research Laboratory

Dr David Williams, Director of Gastroenterology

Dr Michelle Moyle, Director of Anaesthesia

Professor Richard Chye, Director of Supportive and Palliative Care

Dr John Rooney, Director of Orthopaedics

Dr Monique Malouf, Director of Lung Transplant

Dr Paul Jansz

Dr Elias Moisidis, Director of Plastic and Reconstructive Surgery

Assistant Professor Steven Faux, Director of Rehabilitation and Pain Medicine

Dr Mark Winder, Director of Neurosurgery

Dr David Ende, Director of Urology

Professor Michael Feneley AM, Director of the Heart Lung Program and Cardiology

Professor Jacob Sevastos, Director of Nephrology

Dr Paul Preisz, Director of Emergency Medicine

Assistant Professor Nadine Ezard, Clinical Director, Alcohol and Drug Service

Dr Anthony Chambers, Director of Surgical Oncology

Assistant Professor Anthony Grabs, Director of Trauma

Dr Vincent Lamaro, Director of Gynaecology

Assistant Professor Alexander Beveridge, Director of Geriatrics

Professor Christopher Hayward

Professor Milton Cohen AM

Dr Priya Nair, Director of Intensive Care

Assistant Professor Richard Gallagher, Director of Cancer Services, Director of Head and Neck Surgery

Dr Greg O’Sullivan OAM