‘All of us want to keep our children safe’: Pill testing debate on Q&A

Amanda Lyons

19/02/2019 2:36:39 PM

Dr David Caldicott was hopeful his appearance on ABC’s Q&A would help clear up some misconceptions among the public about pill testing.

The ABC debate show and its panel tackled the contentious issue of pill testing.
The ABC debate show and its panel tackled the contentious issue of pill testing.

This summer in Australia has seen the debate over pill testing heat up while the number of drug overdoses occurring at music festivals continues to rise.
The debate was brought to the ABC’s Q&A program last night, with the following panellists:

  • Former Australian Federal Police Commissioner, Mick Palmer
  • Acting Assistant Police Commissioner for New South Wales, Stuart Smith
  • Medical Director of the NSW Kings Cross Medically Supervised Injecting Centre, Dr Maryanne Jauncey
  • Author, educator and former drug user, Kerryn Redpath
  • Emergency medicine specialist and ‘pill testing pioneer’, Dr David Caldicott
Prior to his appearance on Q&A, Dr Caldicott explained his intentions for taking part in the show to newsGP.
‘I’m rather hoping it will be an opportunity for people who clearly have misconceptions about what’s involved [in pill testing], to address those misconceptions,’ he said.
‘I think there has been a degree of misunderstanding, at best, and dishonesty, at worst, about what pill testing can and can’t do, and what it’s trying to do. We refer to them as “zombie arguments” –arguments that are dead, but refuse to lie down.
‘Our hope is that we’ll try to knock off as many as possible.’
The debate began with a question each from Adriana Buccianti and Tony Woods, both parents who have lost children to drug overdose at a music festival, and who are on opposing sides of the issue.
Ms Buccianti asked the panel, ‘How much longer do we have to ignore the evidence and the will of the people?’
Dr Caldicott said he believed the opposition was largely political rather than evidence-based.
However, Ms Redpath cited two prominent toxicologists, Dr John Lewis and Dr Andrew Leibie, who are opposed to pill testing, and told the audience, ‘I believe everyone wants to save lives … but we have a very different way of looking at it.’
Mr Woods, conversely, asked the panel, ‘Drugs are idiosyncratic, so how will pill testing save lives? It won’t.’
In response, Dr Caldicott explained that one of the main purposes of the pill testing process was to provide education.
‘One of the greatest misconceptions is that what we’re trying to do is trying to treat overdoses with pill testing – we’re not,’ he said. ‘We’re trying to stop people putting pills in their mouths.’
Dr Caldicott further explained that even if a drug was found by testing to be what the consumer expected it to be, they would still receive education about the possible harmful effects of taking that drug.
‘This is the safety net – this is the last chance a potential consumer of a drug has before consuming that drug,’ he said.
The panel also explored issues of legality and law enforcement, in relation to music festival drug use, as well as services such as medically supervised injecting rooms.
Superintendent Smith did not accept the argument that pill use at festivals could be compared to a safe injecting room, and should therefore be afforded the same latitude.
‘I still can’t see a time where I would feel comfortable with telling an individual they can use an illicit drug,’ he said.
‘It doesn’t require an intent behind it, the possession of the pill and then obviously the supply back to any individual … certainly there would be an offence committed.’
Dr Jauncey, however, believes the discussion around drug use needs to be entirely reframed. 
‘We need to not deal with personal drug use as a crime, but as a health issue,’ she said.
She discussed the difficulties many drug users face when seeking treatment for their addiction, and suggested a way in which treatment services could be boosted.
‘If we could shift some of those resources away from the criminal response, into the health response, so that people do have access to treatment … that’s how we could fundamentally shift what’s going on.’
However, Superintendent Smith was uncertain that the evidence from other countries that permit pill testing was compelling enough to justify its implementation in Australia.
‘I look at the other countries and I see prescribed opiate-based drugs that are a disaster,’ he said.
‘And if we accept that we need to change what we are going to do at dance festivals, we need some assurance around it – and I just don’t see it.’
However, in response, Dr Jauncey pointed out the distinction between making drugs available and acknowledging they are being used.
‘We need to remove the criminal response merely to the possession of a small quantity for your own personal use,’ she said.
Mr Palmer agreed with Dr Jauncey that personal drug use should be treated as a health issue rather than a criminal or law enforcement one.
‘Festivals are generally full of recreational drug users … in my experience, 95% of whom would never come to the attention of police other than being arrested or apprehended with drugs at a music festival,’ he said.
He also advocated a different approach to other, more problematic, drug users.
‘We need to understand the human nature of this, have more compassion to how we deal with it,’ he said. ‘And we’re not going to do that if we keep on demonising and arresting the people who simply take the drugs.’
In the end, Dr Caldicott observed that the world has changed in the 19 years that the pill testing debate has been taking place in Australia, with recreational drug use becoming increasingly accepted among younger generations – whether we like it or not.
‘If we have a more sophisticated conversation with young people, and listen to their voices, we might get to the place of safety that we all crave far faster,’ he said.
However, Ms Redpath made the further observation that many legal drugs such as alcohol and opioids still remain a serious problem, even though they are regulated, which to her made a similar regime for more illicit drugs seem uncertain.

Harm minimisation Illicit drugs Pill testing Q&A

newsGP weekly poll Which of the RACGP’s 2022 Advocacy Priorities would most benefit your practice?

newsGP weekly poll Which of the RACGP’s 2022 Advocacy Priorities would most benefit your practice?



Login to comment

Dale van der Mescht   20/02/2019 8:56:44 AM

Why don’t we work together with the drug dealers to test them before they sell them!?

David Maconochie   20/02/2019 9:14:11 AM

My instinctive reaction to pill testing is "no", as I believe that in offering pill testing, society is further legitimizing drug use. However, I am happy to hear that there is a strong emphasis on education about the potential for harmful effects.

In the end, it boils down to a simple equation, we may have data that shows that at each individual event the availability of a pill tester may reduce the number of drug related deaths, but does the number of deaths in society as a whole decrease?

Medic   20/02/2019 12:21:31 PM

Debate on pill testing (PT) should be separated from drug injx rooms: former deals predominantly with (pharmaceutically naive/uneducated) young healthy indivs who use oral party drugs (mainly MDMA) occasionally/for 1st time; latter generally chronic addicts of more potent (injx) drugs.

Drs knowingly possessing illicit drugs (for PT) is legally inconsistent. All indivs, even Drs, need to operate within rules of law. If advocates state focus of PT is education (educ), & PT is but "hook" to lure kids in for that educ, then just keep the educ & remove PT by Drs. We can provide self-testing kits (for free), perhaps provide instructions on how to properly conduct PT, then allow the client to PT by themselves. Dr at no time in "possession" of illicit drug.

It is inconsequential if self-test kit are less reliable since: (1) focus is on educ & not PT (reliability) per se; (2) (per admission by PT advocates themselves) sophisticated machine cannot guarantee 100% accuracy anyway.

Dr Oliver Frank   20/02/2019 12:38:18 PM

If our objectives are:
1. To educate people about the drugs that they are considering using
2. Making it possible for prospective users to know what it is in the drug that they have bought or are about to buy,

we could achieve this by making all drugs legal and sold by registered suppliers. The suppliers would be obliged to provide education before the sale.

This would remove the criminal elements from the trade, including corrupt police and politicians, and those who profit from the manufacture and distribution of drugs currently classified as ‘illicit’. It is a sad realisation that these groups are probably the strongest opponents of the legalisation of all drugs.

Dr Peter J Strickland   20/02/2019 7:12:12 PM

I really cannot believe that any doctor could recommend pill-testing at such things as music festivals etc. We are here to save lives, and NOT to put young people at risk. If an illegal drug pill is determined to be 'OK', then that is completely subjective, i.e it could be safe for one person, disastrous for another.
There is only one view that should be taken by the medical profession --no condoning of taking any of these illegal and often unknown -content pills. To have to take any of these pills to enjoy a music festival begs the question of what is going on in the mind of these youngsters. Responsibility for taking any substance (alcohol, cannabis, MDMA, heroin, amphetamines etc) is the responsibility of the individuals involved, and if they want pill-testing at events then they pay for the WHOLE cost of any such testing. Condoning any untested and illegal dangerous drugs cannot and should not be tolerated by society, and only long-term solutions condoned.

Dr.Gnanasegaran Xavier FRACGP N0.519256   20/02/2019 11:04:26 PM

Methadone or Suboxone maintainance program is a success story in Malaysia,even needle exchange and free condom have some success in reducing HIV TRANSMISSION. For pill testing if you are to use amphitamine like stimulants or heroine it is legally wrong.Alse completely isolating them from drugs has only incurred expanses.

Dr Ian Hilliar   22/02/2019 8:59:28 AM

Amanda, you and your subject, Dr Caldicott, may not realise it , but I do not know any doctors who actually watch Q&A anymore. Tony Jones believes himself to be almost as clever as his heroes, Rudd, Gillard, and Turnbull, but he is merely a slightly tubbier guppy in a very shallow pond of minnows. Still, I might actually watch the ABC this monday evening when Dr Jordan Petersen will be a guest on their ABC.