Right: testing of pills is routine and accurate, provided it is done by professionals. Advocates of testing point to the sometimes haphazard nature of the current situation.
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Background information
Pill testing or drug checking, as it is known in the Northern Hemisphere, is a way to reduce the harm from drug consumption by allowing users to find out the content and purity of substances that they intend to consume. This empowers users to make safer choices: to avoid more dangerous substances, to use smaller quantities, and to avoid dangerous combinations.
Pill testing services have developed over the last twenty-five years in twenty countries and are being considered in others, although attempts to implement them in some jurisdictions have been hindered by local laws.
Pill testing initially focused on MDMA (the primary component of ecstasy) consumed at electronic dance music events but the services have broadened as drug use has become more complex. These developments have been strongly affected by local laws and culture, resulting in a diverse range of services, both for mobile services that attend events and festivals and fixed sites in town centres and entertainment districts. For instance, staff may or may not be able to handle illegal substances, which limits the use of testing techniques to those where the staff are not legally in possession of those substances.
People intending to take drugs provide a small sample to the testing service (often less than a single dose). Test results may be provided immediately, after a short waiting period, or later. Pill testing services use this time to discuss health risks and safe behaviour with the service users. The services also provide public health information about drug use, new psychoactive substances and trends at a national level.
The pill testing equipment used in Australia
Australia's first professionally administered pill-testing facility was in a mobile laboratory at Canberra's Groovin' the Moo festival in April, 2018. The testers used an infrared spectrometer to identify substances in a sample of each pill.
The Loop, a pill testing service in the United Kingdom, has explained how the infrared spectrometer works. 'Infrared spectroscopy works by shining different wavelengths of infrared light onto a solid sample which will partly absorb certain wavelengths according to its chemical structure. Because every drug has a unique chemical structure, the absorption behaviour is unique for every compound which allows us to plot a graph called an absorption spectrum. We can then use a computer algorithm to compare this unique absorption spectrum to a huge database of substances measured by labs around the world to locate the closest match with extreme accuracy.'
(Commercially available "do it yourself" pill-testing kits have been used by some festival-goers for years. Each kit contains a solution which, dropped onto a grounded-up sample of a pill, will change colours to show the presence or absence of a substance such as MDMA. But these kits cannot confirm dose levels of a particular drug and do not provide information on other potentially dangerous cutting agents.)
Impact of pill testing
Pill testing has been shown to be an effective way to reduce the harm from drug use through informing safer use, limiting use, and helping users avoid the most dangerous substances. The services also provide monitoring and detection of new psychoactive substances to inform public health interventions. The Loop have stated that 20% of samples are handed in for disposal and 40% of service users reduce intake. KnowYourStuffNZ have found that, when substances are not as expected, half of service users state they will not take that substance and a quarter say they will take a smaller quantity. Pill testing services also reach drug users who are not reached by existing services. Evidence from research conducted by Austrian pill testing service CheckIt! found 58% of people who use the service would not otherwise seek out harm reduction information, and about 75% are more likely to access harm reduction services if pill testing is included.
Academic research from the United Kingdom has found that one in five substances where not what they were expected to be and two-thirds of misrepresented samples were disposed of. Such on-site testing accesses otherwise hard-to-reach user groups to reduce the harms associated with drug use.
How pill testing was trialled at a music festival in Australia
Based on the Canberra's Groovin' the Moo festival trial, the process operates in this manner:
1. Attendees queue outside a tent in the medical precinct of a festival.
2. Once inside, they sign a waiver releasing the testers from liability.
3. They also speak to a peer educator to ensure they understand that the test does not guarantee the safety of the drugs.
4. Each attendee provides a sample of their drug to a licensed chemist who photographs and weighs it before putting it under an infrared spectrometer where it is mounted on a piece of diamond and shot with laser light. Through the light reflected, the chemist can tell what is in the sample.
5. The attendee then has a consultation with another peer educator to discuss their options now they know what is in their drug.
Pill testing in other countries
There are currently 14 pill testing organisations in Europe, each with varying analysis technology and methods of operation.
The Netherlands
The Netherlands founded the Drug Information and Monitoring System (DIMS) in 1992, which was the first pill testing initiative in Europe. It currently operates at 23 fixed sites across the country. DIMS is recognised as an official branch of the public health system.
The DIMS pill testing facilities offers its services to the public for two to three hours a week, using a reliable laboratory technique - gas chromatography-mass spectrometry (GC-MS) - to inspect pills.
People with ecstasy pills can go to the facilities and have their drugs tested for composition and dose, and receive this information within a week via a text or phone call.
DIMS staff also offer one-on-one intervention sessions to discuss the dangers of taking illicit drugs and are offered harm-reduction reading materials.
According to the Global Drug Survey 2016 most young people will now purchase drugs from alternative sources before festivals rather than from dealers at events, as these stationary labs allow them to have their drugs tested before events.
Austria
Checkit! is an onsite pill testing service that has appeared at events, nightclubs and festivals in Austria since 1997.
Pill testing is a part of Austrian drug policy and Checkit! is a collaborative project between Addiction Support Services Vienna and the Medical University of Vienna. Pill testing is considered a legal procedure in Austria if it is conducted by a scientific institution.
Checkit! uses a number of analysis techniques that do not require a permanent laboratory (including high performance liquid chromatography) that can reliably determine compounds in pills within 20 minutes.
Checkit! communicates the danger of pills through a colour-coding system (yellow for pills that have the expected contents and red for pills that the researchers deem risky); reports with aggregated data from testing is then posted online.
At each large music event around 400 people use the pill testing services and Checkit!'s testing has been shown to decrease consumption of ecstasy pills among festival patrons if the pills contain unexpected compounds or high dosages of MDMA.
Switzerland
Pill testing has been offered in Zurich since 2001 through mobile onsite testing at nightclubs and events run by an organisation called Safer Party as well as the Drug Information Centre (DIZ), which provides pill testing twice a week.
Pill testing is considered to be an important part of Swiss drug policy and these testing sites are run through Zurich's city government.
In 2016, 2,078 substance analyses were performed through Safer Party and the DIZ, with 794 online alerts published as a result that indicated unexpected psychoactive substances in pills or dangerously high dosages of MDMA.
3,050 visitors used the pill testing and counselling services in 2016 and the researchers continue to emphasise to visitors that consuming drugs despite testing remains a risky activity.
Spain and Portugal
Energy Control was founded in 1999 and operates four fixed laboratory sites in Spain and Portugal as well as mobile, on-site testing at nightclubs and festivals.
The organisation offers both extremely reliable testing within the labs and a scaled-down version for its mobile sites that can tell visitors the contents of their pills and the quantity of those compounds.
The fixed labs are open to the public once a week and each collect between 50 and 80 samples weekly. The mobile sites each collect up to 150 samples per night.
Energy Control also surveys its visitors to track their harm reduction strategies and evaluate the success of the service. It has been able to compile a huge amount of data about the illicit drug market, and regularly publishes academic papers.
Energy Control also tests LSD (acid) at its labs and in 2014 identified 24 samples on the first day of Portugal's Boom Festival that contained 25x-NBOMe, a potent, potentially life-threatening synthetic hallucinogenic compound.
After an alert was disseminated, researchers found that on the second day of the festival an unexpected proportion of tests were for LSD.
Energy Control has operated in Colombia since 2013, offering high quality analyses at nightclubs, festivals and events.
United Kingdom
The Loop is an organisation founded in 2013 that runs onsite drug testing at festivals and clubs, providing harm reduction materials, brief interventions with the service users and medical assistance.
The Loop uses technology that can tell visitors the ingredients and quantity of compounds in their pills after approximately 45 minutes.
United Kingdom police are supportive of the service, and The Loop works with police, health and welfare organisations, researchers and politicians.
The service tests 100 to 200 samples from ecstasy pills per day and reached a maximum capacity of testing in 2017 with 500 pills being tested per day across three music festivals.
The Loop also posts warnings on its Twitter account about dangerous ingredients in pill batches or pills that contain extremely high quantities of MDMA.