With the spate of festival deaths over the 2018-19 summer, the prevention of drug related deaths has again come into the national spotlight.
The five deaths at music festivals in NSW are the focus of a coronial inquest.
In the aftermath of the deaths, there is a furious debate emerging around pill testing. Some vehemently oppose, while others, including leading medical identities, have thrown strong support behind the harm-minimisation approach to young people and drug taking.
The country’s top medical bodies, including the Royal Australasian College of Physicians, the Australian Medical Association, and the Royal Australian College of General Practitioners, publicly support pill testing in Australia.
The harm-reduction approach for drug taking at music festivals has attracted other high-profile advocates, like the former Australian Federal Police commissioner Mick Palmer.
These parties believe that informing drug-users about the substances they intend to take leaves them to make more educated decisions.
Dr David Caldicott, the clinical lead of Pill Testing Australia, explained that pill testing is provided in conjunction with a medical consultation. Visitors are advised about how reactions are different for every person and medical history is discussed and taken into consideration with test findings.
However, many believe that pill testing creates a false sense of security for drug-takers.
Tasmanian Health Minister Michael Ferguson made the following statement to SBS in February.
“We know there have been cases where people have died after using illicit drugs that are pure, so to offer a testing service that would suggest drugs are safe just because they don’t have additives in them would be incredibly irresponsible and dangerous, and offer people a false sense of security.”
The main argument for pill testing is that because it’s hard to know exactly what a user is taking, helping them identify the substance they’re about to ingest, and educating them on the effects, will hopefully help mitigate deadly consequences.
However, it’s hard to know exactly how an individual will react to a substance, especially when other compounds are in the mix.
MDMA is under the microscope as a contributing factor to the deaths at the centre of the coroners inquest. MDMA is short for Methylenedioxymethamphetamine.
The victims took varying doses, from just one pill to possibly nine. Doses varied in purity, as well as whether other substances were present.
MDMA is a stimulant that speeds up the body and brain. Physical side-effects include sweating, jaw clenching, and even hallucinations. Users can experience euphoria and other effects within half an hour of ingestion.
Due to the combination of increased body temperature and the warm weather at the outdoor music festivals, plus the addition of alcohol (a diuretic) and dancing, the resulting dehydration and overheating causes serious complications or death.
Conversely, users may imbibe too much water which causes cells to swell— medically referred to as hyponatraemia.
Australians typically think they are getting MDMA when they purchase ecstasy tablets, however it’s not always the case. Often there are other substances mixed in – even household products.
Findings from Australia’s first official pill testing trial at the 2018 Groovin’ the Moo music festival revealed that of the 84% of people who had their pills tested (thinking they had purchased MDMA), only 51% of pills tested actually contained any MDMA.
A mix of drugs and other factors were responsible for most drug-related deaths in Australia in 2016. Rarely was MDMA solely responsible for the deaths.
In one music festival death in 2017, 16 different substances were found in the deceased’s system, including alcohol, MDMA, and cocaine. When alcohol, a depressant and common partner of drugs, is mixed with stimulants it further inhibits the respiratory system and contributes to complications.
It is interesting to note there has been an overall increase in the presence of stimulants in toxicology reports of drug-related deaths in the past five years.
No matter what side of the fence you’re on when it comes to drug use, it is widely believed by the medical experts that education and the harm-minimisation of pill testing can save lives.