Drug Safety Testing: Saving lives, increasing awareness

 

The content of this blog is available to download as a briefing here >

 

Knowing what is in any drug, and how strong it is, can reduce the risk of overdose, poisoning or long term damage. So ‘drug safety testing’ involves people handing over a sample of their drugs voluntarily, and without fear of arrest, for testing to identify what it contains, including any contaminants and its strength. People are also given advice on how to minimise the harms from taking drugs. Testing is either carried out on the spot, or results are provided within a few days.


Where is drug safety testing happening?


Drug safety testing is happening in a growing number of countries including Austria, Canada, Colombia, Mexico, the Netherlands, Switzerland, United States and the UK. This briefing discusses testing using sophisticated analytical equipment, not DIY kits that cannot identify many contaminants, or strength.


  • In the UK, onsite drug testing (called Multi Agency Safety Testing - MAST) with results in half an hour was piloted at two festivals in 2016, and is being rolled out more widely (See Box). Samples can also be sent by post to WEDINOS1, the Welsh Government funded drug testing facility, with results put online in 72 hours, detailing the major constituents, but not strength.


  • In Swiss cities like Bern and Zurich, clubbers drop off drugs for testing midweek at a city centre location, and get the results back by Friday. They phone a drug counselor who gives out harm reduction advice and tells them what is in their sample and its strength.


  • The Netherlands has long had drug testing, including in city centres with results usually within 1-2 days.2


  • Austria’s ‘Checkit’3 project has a mobile facility providing on-site testing at music events throughout the year.


How does testing help to reduce risk?


High and variable strength drugs, and contaminants, are key drivers of drug related fatalities. Testing so people know what they are taking reduces the risk of overdose or poisoning, as does tailored expert advice on the safest way to consume (or not consume) them. It also provides an opportunity to deliver targeted health advice to ‘hidden populations’ not engaged with drugs services, and to monitor drug content and trends. Where exceptionally strong, contaminated or mis-sold drugs are found, medical and emergency services can be alerted, and public warnings issued.


Drug safety testing has benefits for all drug users, at festivals, nightclubs, and also in the wider drug using population given the uncertainty surrounding the contents of illegal drugs. e.g. Copenhagen’s new drug consumption room will have drug safety testing for people using heroin, to identify contaminants and variable strength, and so help reduce harm including fatal overdoses.


“Martha wanted to get high, she didn’t want to die. Every time a festival takes place, I dread that there will be another me. This approach - drug safety testing - is based on realism, it’s based on a modern society.” - Anne-Marie Cockburn of the Anyone’s Child Project whose daughter Martha died of an accidental overdose after taking MDMA that was 91% pure.


MAST - Multi Agency Safety Testing of Drugs in the UK


‘The Loop’4 has worked with police at nightclubs and festivals to test seized drugs since 2013, and in 2016 ran the UK’s first ‘front of house’ testing service for users at two music festivals - Secret Garden and Kendal Calling. Both were successful, with 300 tests carried out. About 1 in 5 people used The Loop’s services to dispose of the rest of their drugs on learning the contents. Substances identified included ground-up malaria pills, and the pesticide boric acid sold as cocaine, and concrete as ecstasy.5 Doses of MDMA in ecstasy pills varied from 20mg to 250mg - a level where overdose risk would be high (a standard dose is 80-120mg).6 The service was delivered with cooperation of local police, public health officials, events managers and local authorities. Police agreed to a ‘tolerance zone’ of non-enforcement around the testing venue to instil confidence among users. The service was rolled out to more festivals in 2017 with 700 tests carried out at ‘Secret Garden Party’ alone.


The Loop’s team of PhD chemists analyse samples using analytical techniques including FTIR spectroscopy attached to a TicTac specialist drug identification database of drugs, UV spectroscopy, wet chemistry and reagent tests. Test results are provided as part of a 15 minute individually tailored talk where a qualified drugs counsellor explained the potential harms of the substance, and gave safer use advice. The substance was destroyed in the testing process and no drugs returned to service users.  National media coverage was positive and focussed on the reduced harms and the increased awareness about safer drug-use.7, 8, 9


Why is drug safety testing needed in the UK?


It is no secret that people take drugs at music events, clubs and elsewhere. In the UK, at least 1 in 20 16-24 yr olds took ecstasy in 2015–16.10 1 in 8 regular users of nightclubs used ecstasy in the past month,11 rising to as many as 1 in 3 at some large dance music events. But there are associated risks and some are fatal. In England and Wales ecstasy-related deaths have increased from 8 in 2010, to 57 in 2015 (see figure 1).12 This 5-fold increase in deaths mirrors a 5-fold increase in the MDMA content in ecstasy pills over the same period. Further deaths were linked to an increase in pills containing far more toxic chemicals including PMMA.


“I have no information for the last year [2015] that anyone died linked to ecstasy in Switzerland...No deaths.” - Hans Jorg Helmlin, Head of Drug Safety Testing Laboratory, Kantonsapothekeramt, Bern13



Are there downsides?


Some have expressed concern that safety testing of illegal drugs could encourage use, but there is no evidence to support this including from countries like Switzerland that have had drug safety testing for many years. The reality is that drug use among young people has already become widespread, and only those intending to take drugs will have them tested. Addressing rising drug-related deaths must be the priority - and drug safety testing can save lives.


References


  1. http://www.wedinos.org

  2. https://www.jellinek.nl/informatie-over-alcohol-drugs/drugs-test-service/

  3. http://www.checkyourdrugs.at/

  4. The Loop -  www.wearetheloop.org

  5. National Pesticide Information Centre, ‘Boric Acid - General Fact Sheet’, http://npic.orst.edu/factsheets/boricgen.html

  6. Global Drug Survey, 13/06/2016, ‘Dosing for pleasure and why less is often more’, https://www.globaldrugsurvey.com/dosing-for-pleasure-and-why-less-is-oft...

  7. The Guardian, 24/07/2016, ‘Secret Garden Party pioneers drugs testing service for festival goers’ https://www.theguardian.com/society/2016/jul/24/secret-garden-party-pion...

  8. The Daily Mail, 25/07/2016, ‘Festival lets drug users have their pills tested without fear of arrest: More than 80 substances handed over to experts in bid to reduce accidental overdoses’ http://www.dailymail.co.uk/news/article-3706252/Festival-lets-drug-users...

  9. The Telegraph, 24/07/2016, ‘Secret Garden Party tests illegal drugs for festival-goers - but lets them take the rest’ http://www.telegraph.co.uk/news/2016/07/24/secret-garden-party-tests-ill...

  10. UK Home Office, July 2016, ‘Drug Misuse: Findings from the 2015/16 Crime Survey for England and Wales’, Page 18, https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil...

  11. Ibid, Page 17

  12. Office for National Statistics, September 2016, ‘Deaths Related to Drug Poisoning, England and Wales’, https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarri...

  13. BBC Newsbeat, 24/11/16, ‘Clubs, Drugs and Saving Lives’, http://www.bbc.co.uk/iplayer/episode/p04hbs6c/newsbeat-documentaries-clu...