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Would you like to do a PhD on drug checking with me?

The Loop Australia’s drug checking service at Earth Frequency Festival, May 2024 (Qld)

The supply of illegal drugs is unregulated due to prohibition. Unregulated supply results in drugs being sold that are of unknown content and strength, leading to overdoses which are sometimes fatal. Drug checking (a.k.a. pill testing) services (DCS) are a health response to this problem: members of the public submit substances of concern for chemical analysis and get the results back alongside a tailored health intervention. They empower people who use drugs to make informed decisions about their health, while also enabling communities and authorities to amplify health messages when toxic adulterations are detected.

While relatively new in Australia, DCS have been established for 50+ years in 30+ countries. But there is still much we don’t know. Knowledge gaps include: (1) the medium-to-long-term effectiveness of DCS on reducing drug harms, (2) the effects of the public outputs of DCS on drug harms, (3) how best to leverage community experiences of toxic drug outbreaks, and (4) how best to reach diverse groups.

A PhD candidate is sought to lead a research project to address one or more of these knowledge gaps, supervised by me/Monica, who leads a research program focused on emerging drug market trends. I have a partnership with The Loop Australia, offering access to service-level data and internship possibilities. The candidate may have an academic background in qualitative, quantitative or mixed methods approaches to research. People with living or lived experience of substance use and/or who have worked with people who use drugs are encouraged to apply.

To be considered for this PhD Scholarship at RMIT University, applicants must meet the Eligibility criteria and English requirements as described on the How to Apply page, and should ideally meet the selection criteria below:  

  1. Hold a degree (Honours or Masters) with a demonstrated research component. HD level grades are desirable. Relevant disciplines include but are not limited to psychology, sociology, criminology, health sciences, epidemiology.
  2. Excellent written and verbal communication skills, with an ability to explain technical detail to non-technical audiences.
  3. Previous demonstrated experience conducting quantitative, qualitative or mixed methods research with humans on health or social topics (please describe what kinds of research you have experience with, what roles you played in these projects, and analysis techniques, approaches and software you have used)
  4. Previous interest in, or knowledge of, the drugs and harm reduction fields. While demonstration of existing knowledge of the drugs field is desirable, candidates with demonstrated research expertise in other fields are still welcome to apply.  
  5. People with living or lived experience of substance use and/or who have worked with people who use drugs are encouraged to apply. If you do not hold one of the qualifications detailed under the Eligibility criteria on the How to Apply page, you will only be considered for scholarship if you have previous publications or significant research experience at the discretion of the project lead.

All applicants should email the following to Dr Monica Barratt, monica.barratt@rmit.edu.au

  • a cover letter, which should directly address each of the key selection criteria (see above)
  • your academic transcript
  • your Curriculum Vitae, including a section on research skills and their application
  • a 1-2 page research proposal focusing on responding to unregulated drug markets with drug checking services

The research proposal is a key part of the application process where applicants must demonstrate the value of their research and their suitability for scholarship selection.

Your proposal should be developed under the following headings:

  • Title
  • Research questions you plan to investigate in the context of existing research/literature
  • Methodology/research tasks required to undertake the research
  • Significance and impact of the research

Applications close Sunday 20th October 2024!

Following the scholarship closing date, these applications will be assessed, with applicants making the first round invited to a casual chat. Second round applicants will be asked to participate in an interview.

Drug checking – What can Australia’s Victoria learn from Canada’s Victoria?

Drug checking: What can Australia’s Victoria learn from Canada’s Victoria? was hosted by the Social Equity Research Centre, RMIT University, and Co-hosted by the Students for Sensible Drug Policy, Harm Reduction Victoria, Victorian Alcohol and Drug Association, Yarra Drug and Health Forum and the Victorian Substance Use Research Forum.

In case you missed it, Professor Chris Gill from Victoria, BC, Canada talks about his experiences heading up the chemistry component of Victoria’s Substance drug-checking service, followed by a panel discussion with Chris Gill, Jenn Schumann, Nick Kent, Stephanie Tzanetis, Malcolm McLeod and Sarah Hiley.

Special issue of Drug & Alcohol Review – music festivals

As Deputy Editor for Drug and Alcohol Review, I was asked to write an introduction to a virtual special issue collecting papers from the journal published in the last 4 years on this topic. The papers are available for free download here.

The full introduction is reproduced below:

Dance music festivals are typically outdoor events where electronic dance music is performed to large crowds of festivalgoers. These events have emerged as sites of alcohol and other psychoactive substance use, particularly MDMA (or ‘ecstasy’), other stimulants, as well as psychedelic drugs. While some such festivals are single-day events (typically held in urban locations), they are commonly held over multiple days in non-urban locations, with attendees typically camping at the event for 3 to 5 days (sometimes longer). This virtual issue of Drug and Alcohol Review contains 11 papers published in the journal since 2018 on the topic of alcohol and other drug use and harms, and associated policy and monitoring responses, in these festival settings.

Seven of these papers engaged with populations of festival attendees, typically through surveying them to collected self-reported information [1-7]. The typical age of surveyed festivalgoers was young, with median and average ages in the mid-20s across all studies [1-7]. Four of these studies involved in-situ data collection [4-7] – that is, festivalgoers completed the surveys at the festival they were attending – with the remaining three studies conducted through web surveys that asked people to recall and report on their behaviours at previous festival attendances [1-3]. Only one of these studies combined biological measurement with self-report, and in this study, only the use and markers of alcohol consumption were measured [7]. Illegal drug use, and specifically the use of MDMA, was the focus of the remaining 6 studies of festival attendees [1-6]. Event-based measurement – that is, where questions are focused on characteristics of a specific event (usually the current event or the most recent event attended) – was employed among 3 studies [3, 5, 7], while the use of scenarios and measurement of future intended behaviours was employed by 3 studies [1, 4, 6] – all exploring hypothetical responses by festivalgoers to scenarios where drug checking services were available.

Of the 7 articles reporting research with festival attendees, 4 studies were measuring patterns of alcohol and other drug use [2, 3, 5, 7]; in particular, higher-risk behaviours and harm reduction practices. Two papers confirm that double dropping – taking two (or more) MDMA pills or capsules simultaneously – is prevalent among Australian festivalgoers, with Grigg et al. [3] reporting 48% of festivalgoers (who used MDMA) double dropping at the last festival they attended (data collected 2016) and Healey et al. [5] also reporting 48% double dropped (or intended to do so later in the day) at the festival event where they were surveyed (data collected 2019-2020). Healey et al. also reported on the practice of preloading: consuming all of their drugs prior to entering the (single-day) festival. Of the festival-goers who reported drug use during the festival, 33% reported preloading. This behaviour appeared to be related to how the festivals they attended were policed. Those who agreed that knowledge of or anticipation of police or police dog presence at the festival had altered their drug use patterns were at over double the odds (adjusted odds ratio 2.2) of reporting preloading their drugs before entering the festival. While double dropping practices may be based on past experiences of MDMA pills being relatively weak in Australia, with the rise of high strength pills and capsules, double dropping is much more likely to result in MDMA toxicity. Healey et al.’s findings that preloading with drugs prior to events is commonplace and is a response to policing practices is concerning and should spur more urgent action to overhaul such the relatively heavy-handed policing practices that occur at music festivals in Australia.

The web survey of an international sample of festivalgoers (primarily from Spain, USA and Australia) reported by Fernández Calderón et al. [2] focused on harm-reducing practices, such as avoiding mixing depressants (69%) and limiting the quantities of drugs consumed (62%). Overall, fewer adverse health events were reported by respondents who also took harm reducing measures. Norman et al.’s [7] study used multiple measures of alcohol drinking over a prolonged drinking event, finding that a diverse set of 4 measurements contributed unique and valuable information. Importantly – while only conducted with 14 participants – this study demonstrates feasibility of continuous alcohol monitoring and the use of unobtrusive biological techniques among the festivalgoer population.

The remaining 3 papers that engaged festivalgoer populations were focused on how people might respond to a drug checking service [1, 4, 6].  Taken together, in the Australian context where drug checking has been formally available at only two single events in the ACT [8], these studies indicate a strong desire to use drug checking services if available, with an on-site service (94%) somewhat more popular than a fixed-site or off-site (external to the festival) service (85%) [1]. Lack of support for drug checking from government and police was a considerable barrier, with 94% reporting that they would not use a service if there was the possibility of arrest [1]. One political barrier to drug checking introduction has been the contention that drug checking services would increase the use of MDMA among this population, by ‘giving the green light’ to use drugs. Two of these studies provide data to refute this contention [4, 6].  Hollett and Gately [6] found that both people who had never used MDMA and people with MDMA experience reduced their MDMA risk across on-site and fixed-site drug checking scenarios; however, they noted that people with MDMA experience were less likely to reduce risk than MDMA naïve participants in some situations, for example, when the hypothetical drug checking result showed a high strength MDMA pill or a pill substituted with PMA/PMMA. It may be that certain risks (higher strength; PMA/PMMA) may be perceived as less concerning to those with more experience then to those who are MDMA naïve. Murphy et al. [4] report that neither group (MDMA experienced and MDMA naïve) reported an increased intention to use MDMA in scenarios were drug checking was available. Subjective norms (e.g. items like “Most of my ecstasy-using friends tell me that I should test/check the content of my pill before I use ecstasy” [9]) were associated with intended use of both on-site and fixed-site drug checking services. These studies also found that festival goers were willing to co-pay for a drug checking services – $12 [6] or $10 [1] for an on-site test.

The remaining 4 papers that did not report on festivalgoer populations all focused on the topic of drug checking at music festivals, and included: a representative survey of the Australian population measuring attitudes towards drug checking at music festivals [10], two policy analysis papers on the topic of drug checking in the Australian jurisdictions of NSW and the ACT [11, 12], and one paper from Italy reporting descriptive drug sample data from an operational drug checking service [13]. Through these papers we learn that almost two-thirds of the Australian public (64%) support “pill testing at music festivals” while 22% are opposed, 14% neutral and 1% did not answer. Political affiliation was associated with support, with voters for the two main Australian conservative parties the least likely to support this initiative [10]. The two policy analysis papers utilised document analysis to create detailed timelines of critical policy and advocacy events, utilising news coverage, transcripts of television specials on the topic of drug checking, parliamentary transcriptions and reports [11, 12]. Ritter’s analysis of the debate in NSW synthesises the narratives used by those in favour and those opposed to drug checking, finding that both sides appeared to share a basic goal of ‘saving lives’ but as the beliefs and values underlying this goal differed, the debate continued to remain polarised [11]. Sommerville et al. compared one jurisdiction who had successfully supported drug checking (ACT) with one that had failed to do so (NSW) using the Advocacy Coalition Framework [12]. The key difference identified was that the dominant coalition in ACT was health-led, whereas the dominant coalition in NSW was led by law enforcement. For policy change on drug checking to occur in NSW, both core and secondary beliefs of the dominant law enforcement policy required shifting, a shift that rarely occurs [12]. The final paper in this special issue reported on an active drug checking service in Italy in the festival and party context, focusing on the drugs detected and the use of a Raman spectrometer in the field [13]. Raman instruments are often used for policing application (e.g. the “TruNarc”) and are rugged, field-deployable, are not required to touch the drug sample directly and provide fast results. However, the Raman fails to identify substances when present in low quantities or when a novel substance was not available in its spectral library [13]. Raman instruments are likely to be useful among a suite of analytic tools used in drug checking services, rather than as a stand-alone instrument.

This collection contains only 2 papers from outside of Australia – but it should be noted that Drug and Alcohol Review has also recently published Canadian papers on drug checking (just not in a festival context) [14, 15] as well as papers related to similar drug use practices but within the nightclub setting, e.g. in New York City [16-18].

This showcase of festival-related research provides some pertinent information relevant to advocates and policy makers. It demonstrates that the lack of drug checking in most parts of Australia cannot be blamed on a lack of evidence or on a lack of public support. Indeed, the lack of uptake of drug checking may be much more associated with a clash of values and the location of where the most political power currently lies, that is, within coalitions of partners aligned with law enforcement. As festivals begin to emerge again after the easing of pandemic restrictions on large gatherings, we may see further pushes for policy reform, especially in the event of deaths that could be prevented by service provision as well as public drug alerts derived from checking services.

Dr Monica Barratt
Senior Vice Chancellor’s Research Fellow, RMIT University, Melbourne Australia
and Deputy Editor for Drug and Alcohol Review
References
  1. Barratt MJ, Bruno R, Ezard N, Ritter A. Pill testing or drug checking in Australia: Acceptability of service design features. Drug Alcohol Rev 2018;37:226-36.
  2. Fernández Calderón F, Díaz Batanero C, Barratt MJ, Palamar JJ. Harm reduction strategies related to dosing and their relation to harms among festival attendees who use multiple drugs. Drug Alcohol Rev 2019;38:57-67.
  3. Grigg J, Barratt MJ, Lenton S. Double dropping down under: Correlates of simultaneous consumption of two ecstasy pills in a sample of Australian outdoor music festival attendees. Drug Alcohol Rev 2018;37:851-5.
  4. Murphy S, Bright SJ, Dear G. Could a drug-checking service increase intention to use ecstasy at a festival? Drug Alcohol Rev 2021;40:974-8.
  5. Healey A, Siefried KJ, Harrod ME, Franklin E, Peacock A, Barratt MJ, et al. Correlates of higher-risk drug-related behaviours at music festivals in New South Wales, Australia. Drug Alcohol Rev 2021 [Epub ahead of print]. https://doi.org/10.1111/dar.13404
  6. Hollett RC, Gately N. Risk intentions following pill test scenarios are predicted by MDMA use history and sensation seeking: A quantitative field study at an Australian music festival. Drug Alcohol Rev 2019;38:473-81.
  7. Norman T, Peacock A, Ferguson SG, Kuntsche E, Bruno R. Combining transdermal and breath alcohol assessments, real-time drink logs and retrospective self-reports to measure alcohol consumption and intoxication across a multi-day music festival. Drug Alcohol Rev 2021;40:1112-21.
  8. Olsen A, Wong G, McDonald D. ACT Pill Testing Trial 2019: Program Evaluation. Canberra, ACT: Australian National University; 2019.
  9. Davis AK, Rosenberg H. Using the Theory of Planned Behavior to predict implementation of harm reduction strategies among MDMA/ecstasy users. Psychol Addict Behav 2016;30:500-8.
  10. McAllister I, Makkai T. The effect of public opinion and politics on attitudes towards pill testing: Results from the 2019 Australian Election Study. Drug Alcohol Rev 2021;40:521-9.
  11. Ritter A. Making drug policy in summer—drug checking in Australia as providing more heat than light. Drug Alcohol Rev 2019;39:12-20.
  12. Sommerville K, Ritter A, Stephenson N. Pill testing policy: A comparative analysis using the Advocacy Coalition Framework. Drug Alcohol Rev 2021 [Epub ahead of print]. https://doi.org/10.1111/dar.13352
  13. Gerace E, Seganti F, Luciano C, Lombardo T, Di Corcia D, Teifel H, et al. On-site identification of psychoactive drugs by portable Raman spectroscopy during drug-checking service in electronic music events. Drug Alcohol Rev 2019;38:50-6.
  14. Borden SA, Saatchi A, Vandergrift GW, Palaty J, Lysyshyn M, Gill CG. A new quantitative drug checking technology for harm reduction: Pilot study in Vancouver, Canada using paper spray mass spectrometry. Drug Alcohol Rev 2021 [Epub ahead of print]. https://doi.org/10.1111/dar.13370
  15. McCrae K, Tobias S, Grant C, Lysyshyn M, Laing R, Wood E, et al. Assessing the limit of detection of Fourier-transform infrared spectroscopy and immunoassay strips for fentanyl in a real-world setting. Drug Alcohol Rev 2020;39:98-102.
  16. Kelly BC, Vuolo M. Nightlife scene involvement and patterns of prescription drug misuse. Drug Alcohol Rev 2020;39:888-97.
  17. Palamar JJ, Barratt MJ. Prevalence of reagent test-kit use and perceptions of purity among ecstasy users in an electronic dance music scene in New York City. Drug Alcohol Rev 2019;38:42-9.
  18. Palamar JJ, Le A, Acosta P, Cleland CM. Consistency of self-reported drug use among electronic dance music party attendees. Drug Alcohol Rev 2019;38:798-806.

Victorian coroner recommends drug checking

Today the Coroners Court of Victoria released its findings into a cluster of five drug-related deaths that occurred across Melbourne between July 2016 and January 2017.

The five young males, aged between 17 and 32, were all found to have consumed an unusual combination of two new psychoactive substances, 25C-NBOMe and 4-FA. Most of the deceased thought they were taking MDMA.

Coroner Paresa Spanos has recommended the Victorian government implement a drug checking service as a matter of urgency. This is a service where people could find out the content and purity of drugs alongside a meeting with a health-care worker to talk about their drug use and test results.

She also recommended Victoria implement a drug early warning network. Data from the drug checking service could be cross-checked with other information we have about what drugs are out there, triggering alerts to warn people if an unusually dangerous substance is circulating.

As an expert witness to the coronial inquest, I argued that more timely communication about the dangers of this drug combination to the public may prevent tragedies like these in the future.

Read the rest of my commentary at The Conversation.

I am available for media inquiries on 0407778938. Please leave a text message if I don’t answer immediately.

Some of the suspected NBOMe/4FA capsules photographed by an anonymous community member, January 2017
Images of the suspected NBOMe/4FA capsules provided to me by an anonymous community member, January 2017

What might a completely digital research project look like?

In the last 6 months, many researchers (including research students) have had to adapt their research designs to make them COVID compatible. For many this move has been to digitise their methods. Can we interview people via Zoom calls? How can we recruit if we can’t actually enter the target setting, like the hospital or the public space?

As someone that has been working in primarily digital spaces for the bulk of research career, I don’t really need to do this pivot! Mostly, my work is already fully COVID compatible. (Although, ironically, I had just had a project approved in November 2019 that did involve in-person data generation, and now am having to change this to online workshops!).

I draw on my experiences doing digital social science research for nearly 20 years, with a focus on illegal drugs, mainly but not exclusively with people who use drugs recreationally.

Digital technologies provided a way of reaching this population. They are considered hard to reach because they do not typical come into contact with health, justice, and social services. In the 2000-2010s, web forums were a popular location for group discussions either directly about drug use or more tangentially in relation to settings of use, like dance music festivals or nightclubs where drugs are typically consumed.

In the early 2010s, the first darknet markets emerged, where drugs are traded in ebay like marketplaces accessible through anonymising software, e.g. Tor. These spaces not only functioned as marketplaces but also had web forums which hosted discussion between market participants who typically were also people who consumed drugs. Drug use and harms discussion also takes place in these settings, in addition to discussions about the marketplaces themselves.

In the later 2010s and into 2020, the digital ecosystems within which we are living in have shifted such that big tech companies – Facebook, Google, Twitter – are major players in how people can discuss drugs and associated issues in digital spaces.

Here I wanted to reflect on three different aspects of my digital research practices that may assist people facing this COVID methods pivot.

Cross-sectional transnational anonymous web survey
During the last 6 months, at Global Drug Survey, we decided to launch a special edition of the annual survey that focused on how drug use may have changed over the period of lockdown – in our survey this was Apr-May-June of 2020. We just released findings last week, here’s an Australian findings summary. You can read more about how we do GDS here. To summarise, the GDS survey is anonymous, the GDS organisation is independent (so can be nimble in responding to new drug trends), and we rely on partnerships with media and community organisations to promote the survey and return findings to those organisations rapidly.

I’m also part of the Global Cannabis Cultivation Research Consortium. Just this month we launched our second global anonymous survey of cannabis cultivators (if you are, or if you know, a cannabis grower – do check it out!). The first one was conducted in 2012-2013 when the policy landscape of cannabis was quite different to 2020. We have written about the specific challenges of transnational digitally mediated survey research here.

Text chat qualitative interviews
During my PhD in 2008, I used text chat programs to do qualitative interviews with young people who were involved in online forums where drugs were discussed. They were typically also engaged in the dance music and clubbing scenes. You can read more about that method here. Back in 2012, my conclusions were that people who use drugs found online interviewing to be “an acceptable and convenient way to contribute to research” and that “[w]ith adequate preparation to develop technical and cultural competencies, online interviewing offers an effective way of engaging with young people that is worthy of consideration by researchers in the alcohol and other drug field”.

Since then I’ve supervised students and have led an NHMRC funded project which employed these methods successfully. Dr Jodie Grigg used encrypted chat interviews with a similar population in 2016, Michala Kowalski used encrypted chat interviews to interview people who bought drugs from darknet markets in 2018, and Robin Van Der Sanden is currently interviewing people who report buying or selling drugs using social media apps or platforms in 2020. Jodie, Michala and Robin are all utilising the wickr platform, as unlike any of the alternatively, wickr does not require that the interviewer have the phone number of the interviewee. This makes it possible to conduct truly anonymous interviews.

Digital engagement with research sites and/or communities
Back in the 2000s doing my PhD about online forums where drugs were discussed, I noted that there were very different reactions by online communities to research. It ranged from actively welcoming, to supportive, to neutral, to actively opposed! I’ve written about my experiences engaging with these digital communities here.

Increasingly, the data generated by individuals in digital spaces becomes the data that can be utilised for research. We need to ask some important questions though. Who owns the data? Who should we be engaging here? My approach has typically involved an active engagement of people and groups: I’ve written about this approach with my colleague and friend Dr Alexia Maddox in this paper. As just one example, the approach of the digital community Bluelight.org is outlined here and here.

A paper decades in the making

The following questions are posed in our article “Coming Out”: Stigma, Reflexivity and the Drug Researcher’s Drug Use, published today in Contemporary Drug Problems. Download the accepted version here.

Should drug researchers who have direct personal experience of taking illegal drugs discuss these experiences in their work?

Are experts at least partly impaired in their understanding of drug use if they do not have that key component of expertise — personal experience?

Should researchers be open about their own personal experiences of drug use and the role these experiences have played in shaping their own research?

Why might it be important for drug researchers to publicly disclose their own drug use when it comes to engaging with policy makers and with the public at large?

Is it possible that by widening the concept of who uses prohibited substances we can break down the othering that occurs in public discourse and in public policy?

Conversely, by staying quiet about our use of prohibited substances, do we not perpetuate a false dichotomy between the researcher and the researched?

What are the implications of privilege and intersectionality for decisions about whether and how to disclose drug taking and drug use identities?

In short – Are we ready to come out?

In announcing the publication of this journal article today in Contemporary Drug Problems, I’d like to thank a few people. My co-authors, Anna, Judith and Gary, with whom I have had the pleasure of discussing this topic and nutting out a shared position for around 4 years now. My husband and family, for supporting my engagement with this topic and supporting this rather unusual career of mine. A much wider network of colleagues and mentors who have supported my work. And you, the readers, with who I look forward to further discussion once you’ve had a look at what we have written.

Are blogs even a thing anymore?

I began this blog in 2010, when the internet looked a little bit different to today. But I’ve just gotten a new job at RMIT University (hello again Melbourne!) and I’ve decided there is still a role for the humble blog. I’ve even renamed this website from the quaint sounding ‘Drugs, Internet, Society’ to ‘Drugs in Digital Society’. Perhaps in 5 years I’ll just say ‘Drugs’. Perhaps we are already so embedded in the digital that it almost ceases to be a thing that we speak of – it’s more like the air we breathe these days. (See The end of cyberspace).

I look forward to sharing more of my stuff with you in the months to come!

Pill testing is still a great idea, if we use the right equipment

Andrew Leibie (Pill testing sounds like a great idea, but there’s a catch, Sydney Morning Herald, 20/1) argues that pill testing is flawed. The technology is not accurate or reliable. It can’t detect all ingredients in pills, including some of the new drugs that are active in micro-doses. It can’t provide data on dose or concentration. He also argues that the evidence from countries where pill testing is conducted shows that it doesn’t work. He concludes that “the reality is that pill testing kits will never be able to detect all the illicit drugs entering the community”.

Many of the statements Leibie makes are factually correct. The problem is that he makes a number of assumptions about what pill testing is and how to evaluate it.

Image: Energy Control

First, let’s start with a summary of what we are talking about. ‘Pill testing’ (or drug testing) is a service that invites ordinary citizens to anonymously submit samples of illegal drugs for forensic analysis, and provides individualised feedback of results and counselling as appropriate. This kind of testing service has been operating in some form for 50 years across multiple countries around the world, with the longest running services operating in Austria, the Netherlands, Switzerland and Spain.

Leibie assumes that ‘pill testing’ involves colour reagent test kits. But pill or drug testing services acknowledge that testing kits as a main testing tool are poor technology. They only use test kits as their main tool when they don’t have access to better technology, due to lack of funding or government resistance to their operation.

Fully funded pill testing services use proper laboratory equipment. Mobile laboratories in Switzerland and Austria can determine contents and purity comprehensively in less than 30 minutes, with a minority of samples that require additional analysis sent to the main laboratory. In the UK, infrared spectrometers are used in the field, [edit: alongside other techniques, thanks Fiona Measham!] providing indicative results in less than one minute. Reagent test kits may be used to determine which next test to conduct. A suite of tools is needed depending on the drug, its form and whether there is evidence of multiple drugs.

Although testing services acknowledge the limitations of using test kits as the only analysis method, there is still important information that can be gleaned for consumers under specific conditions. For example, in the case of a pill sold as ecstasy or MDMA, the use of a Marquis kit can definitely tell you whether or not an MDMA-like substance is present can definitely tell you when there is no MDMA-like substance present and can be used to rule out MDMA as a possible component [edit: thank you to Earth Erowid]. For the consumer who is not interested in consuming anything but an MDMA-like substance, a negative result on the Marquis will prevent the use of the unknown substance. In many surveys of people who use drugs, including a recent survey that I led of 800 Australian festivalgoers (paper under review), the vast majority say they would discard a drug in this scenario. This decision could save their life if the drug they were about to consume was high dose NBOMe or PMA.

Yes, I agree with Leibie that there are scenarios where the use of test kits alone is problematic. One such scenario is where Ecstasy/MDMA is combined with another potent drug, like an NBOMe, as mentioned by Leibie. In this instance test kits would indicate an MDMA-like substance, leaving the consumer in the dark about the NBOMe. Another scenario is a pure MDMA pill that is high dose, with reagent kits unable to provide purity or dose information. These flaws underscore the importance of governments supporting the use of more sophisticated laboratory equipment in the field. They are not an argument against pill testing altogether.

Leibie also implies that testing has to be fast in order to be acceptable to the target group. We asked festivalgoers in our survey how long they would be willing to wait. Most were willing to wait half an hour, and many were willing to wait days or even weeks to find out what is in their drugs. A testing service does not just have to be stationed at a festival. It can also be available through fixed site booths, as it is conducted in the Netherlands, where people can have drugs tested in the late afternoon in preparation for their activities that evening or the next weekend.

It is absolutely true that reagent tests are not comprehensive. And this is why we need to fund access to laboratory-grade equipment to find out quickly what is contained within particularly lethal batches. A rapid turn-around of information from a credible source can make a difference. For example, in the Netherlands, a pill was identified through their testing service with high dose PMMA in late 2014, just prior to New Year’s Eve. Dutch services distributed warnings widely and no deaths were reported. Unfortunately the UK did not have a similar warning system and recorded 4 deaths due to consumption of this same pill.

Which leads me to the most inaccurate part of Leibie’s piece. His depiction of the UK is nonsense. Firstly, the UK did not have a pill testing service in 2015. Secondly, even now, the UK has one service, The Loop, which conducts testing at a handful of events. It is nonsense to try and evaluate the effectiveness of The Loop by pointing to one statistic about the number of NPS related deaths across the whole country a full year before any testing had been conducted in that country.

The technology is available for an Australian testing service to test samples and disseminate accurate information that could help people avoid harms and help health workers treat people more effectively. There should not be a need in this country to use old technology to provide a substandard service, unless governments continue to ignore the needs of people who use drugs in our community. Until that point, test kits and online reports will be the best information people have, with all their flaws.