Unlikely response to festival drug testing
SUMMER means many things in Australia.
Interminable cricket coverage, heat that makes you sweat in crevices you never knew you had and, of course, festival season.
Music festivals are big business and no matter your taste, chances are there's one for you.
Into old-school sounds and a lip-syncing Janet Jackson? May we suggest RNB Fridays. Something more contemporary? Check out Falls Festival. Dance your thing? Buy a ticket to Festival X. And on it goes with most every musical genre accommodated.
According to a report by Live Performance Australia, both contemporary music festival revenue and attendance grew by over 26 per cent in the 2016-2017 period, alone.
But more festivalgoers inevitably means more drugs, chemical cocktails that are often of dubious origin and even more questionable composition that will let you dance all night.
Or, as we've found in some high-profile cases, not.
As ingrained as these gatherings in the cultural landscape are news articles about the attendees who never made it home.
Young people doing what young people do, like 18-year-old Hoang Nathan Tran, 21-year-old Diana Nguyen, 23-year-old Joseph Nguyen Nhu Binh Pham, 19-year-old Callum Brosnan, 22-year-old Joshua Tam and 19-year-old Alexandra Ross King.
All died recently as a result of taking MDMA, or ecstasy. Five of the six also had other drugs in their system.
This spate of deaths from late 2018 to 2019 resulted in a NSW Coroner's Report which was released in November and brought forth a raft of recommendations.
A key component of which is on-site pill testing.
Professor Alison Ritter, a specialist in drug policy from UNSW, supports the idea.
For a start, it's what young people want, too.
"More than 82 per cent of the 2300 young Australians aged between 16 and 25 years… supported its introduction. They want to make informed choices," she says.
It's part of a global trend, and as Ritter points out, pill-testing has been long available through community organisations and local government in the Netherlands, Switzerland, Belgium, Germany and Spain.
She says at the most basic level, pill testing changes behaviours.
"Research from Austria shows 50 per cent of those who had their drugs tested said the results affected their consumption choices. Two-thirds said they wouldn't consume the drug [which was found to be tainted] and would warn friends in cases of negative results."
If this was the only benefit of pill testing, it would be worth further investigation and large-scale trials, but it's not.
Evidence shows it can also impact the black-market drug supply for the better, with dangerous pills removed from circulation.
"There's research from Europe that's shown that when they identify a particular pill or drug - say the pink ones with the X and Y logos on them - word gets out that they contain a dangerous substance. So if a dealer tries to sell them, people say no.
"What this research has shown is that over time, they were detecting less and less adulterants in the drug-checking program because dealers have to adapt to the marketplace and savvy consumers are not going to purchase a substance where there's been an alert put out by the public health officials about it."
Ritter adds that although not everyone immediately discards potentially adulterated drugs, those who choose to still partake will often reduce how much they ingest.
'WHAT I DIDN'T EXPECT TO HEAR'
Few are better placed to comment on the impact of pill testing at the coal face than Dr David Caldicott from the ANU College of Health & Medicine and Pill Testing Australia.
Twice, he has been part of a team that provided government-sanctioned on-site facilities at Groovin the Moo festival.
"We knew it would work because it's worked everywhere else it's been tried and we've been campaigning for it for over 20 years," he says.
"What I wasn't expecting was the expressions of gratitude from festival goers - I was a bit mortified quite frankly. While the purity of the product certainly increased from the first year to the second, it also wasn't as high as people were expecting."
Another of Caldicott's in-the-field discoveries was that lurking in what were purportedly MDMA capsules was a "particularly nasty" chemical called n-ethypentylone.
Users have described it as 'cracky' and far less pleasant than MDMA and its physical effects can include raised pulse and blood pressure, high body temperature, convulsions, rapid muscle breakdown and multiple organ failure.
Psychologically speaking, there's agitation, paranoia, compulsion to redose, difficulty sleeping for up to 36 hours, and temporary psychosis.
Perhaps most disturbing is its potency. According to knowyourstuff.nz - which operates with the New Zealand Drug Foundation - "A common dose for MDMA is around 100 milligrams, whereas a dose for n-ethylpentylone can be as little as 30 milligrams. If people believe they have MDMA and take 100 milligrams of n-ethylpentylone, then they are going to be in a very risky situation."
Beyond the mere chemical identification of pills, advocates are quick to point out that it does not take place in a vacuum.
Rather, it is the starting point for holistic discussion focused on health care as opposed to committing a prosecutable crime.
"The basic premise is that pill testing should not occur in isolation," says Dr Martyn Lloyd-Jones, an honorary senior lecturer at The University of Melbourne.
"It comes with advice about risks and avoiding harm. For example, if you are going to take a drug then do not combine it with alcohol, ensure you are adequately hydrated, that you use with friends and not alone etc. It's about the availability of health services to provide advice, support, assessment and linkage to treatment for those (few) who wish to access further care. It's also linked with feedback processes to potentially act as an early-warning system on particularly dangerous (deadly) pills, even to link in with police to provide further forensic testing to provide information about what (substances) are out there."
'I'VE HAD MY GEAR ANALYSED'
Matt*, a 22-year-old call-centre worker living in Sydney, needs no convincing.
"I've been to two Groovin the Moo festivals where there was pill-testing and both times I've had my gear analysed," he says.
"I'm thankful I did because the second time they found something that definitely wasn't MDMA and I was like, 'F**k that'.
"You never really know what you're getting with pills but I'd rather write off $200 or $300 than have my organs shut down.
"I can't say pill testing saved my life but I can't say that it didn't. I'd like to see more of it to be honest because people are kidding themselves if they think drugs are only at music festivals. I do pills at least once a month just going out with mates and it would be great to know what was in them instead of just rolling the dice."
It's not just Matt and his mates gambling on powder every other weekend. The Australian Drug Trends Report 2018, commissioned by the National Drug and Alcohol Research Centre, surveyed 800 participants and found cocaine use jumped by 11 per cent year on year with ecstasy/MDMA at some of the highest levels since the survey began in 2003.
From a budgetary standpoint, pill testing is a solid call.
"One of the things about drug checking is that it is relatively inexpensive compared to either providing treatment or emergency healthcare or policing," says Ritter.
It's a point of view that has found support at the highest level of Australian politics.
Greens leader Richard Di Natale, a former drug and alcohol doctor, has not only suggested the remit of pill testing go beyond music festivals and into the wider community but had it costed out by the independent Parliament Budgetary Office.
For $4 million a year over four years, there could be 18 pill-testing services in major cities and rural areas, each with a spectroscopy testing machine and five staff including trained peer-support workers. Each facility would run four days a week ten hours a day.
By way of comparison, Free TV Australia will deliver 1000 hours of Aussie television content to broadcasters in the Pacific, as the result of a $17.1m government fund over the next three years.
While no one is suggesting that the thin blue line should donate its services gratis to what are commercial events, in just a seven-month period between this year and last, the NSW Police Force alone raked in almost $13 million in revenue for enforcement duties at festivals.
The calls for pill-testing at festivals have been received differently by various state governments.
The ACT, for example, has conducted sanctioned pill testing at two Groovin the Moo events while its NSW neighbour has drawn a firm line in the sand over the issue, which is not to say the latter has not responded to the issue in some positive ways.
A spokeswoman for the premier said the government will consider the coroner's recommendations and that NSW Health has developed harm-reduction guidelines for music festivals in consultation with experts.
"We have already taken considerable steps to improve safety at music festivals and some of the recommendations for measures such as peer-based harm reduction services are already occurring," she said.
NSW'S OPPOSITION TO PILL TESTING
Following the December 1 death of a 24-year-old man at the Strawberry Fields Festival at Tocumwal in southern NSW, Premier Gladys Berejiklian doubled down on her opposition to pill testing.
"What questions would you be asking me if we allow pill testing and over a summer 10 people died… after someone told them there were no impurities in their pill - we'd be having a very different conversation," she told journalists.
"For every person whose life might be saved by pill testing, if that were the case, there could be 10 others that succumb because they're given a false sense of security."
As pressure intensified on the NSW state government over the issue, Berejiklian announced the introduction of amnesty bins at festivals, where attendees could dump their pills without penalty.
One of the most oft-cited sticking points around pill testing is that it's often perceived as being just about the chemical analysis rather than the start of a process.
"Visits to pill-testing booths create an important opportunity for providing support and information over and above the testing itself," explains Ritter.
"They enable drug services to contact a population that is otherwise difficult to reach because these people are not experiencing acute drug problems. Indeed, the intervention has been used to establish, and as the basis for, follow-up work with members of not-yet-problematic, but nevertheless high-risk, groups of recreational drug users."
Will Tregoning from unharm.org, a not-for-profit founded in 2014 that's focused on preventing drug addiction, is also in favour.
"These services have been operating internationally for around 30 years and have been really successful in engaging people who use drugs in health consultations, where they receive the results of pill analysis," he says.
"It facilitates what might be the first discussion they've ever had with a health professional about their drug use. There are myriad benefits beyond what's in a certain pill. For example, emergency services can better manage a critical incident by knowing what they're dealing with."
The challenge for Tregoning and many others in favour of pill testing lies in convincing authorities that just saying no is not a sufficient response to the reality of illegal drugs.
He says that positive changes are taking place though: "I think community sentiment is on board. We have majority support in Australia for pill testing. Even in parliament, there is
extensive support. The barrier right now is a relatively small group of reactionary politicians highly committed to the 'just say no' message as a way of demonstrating a particular version of toughness which they find plays well to minority groups that they focus on in their constituency".
That 'toughness' has also been kicked up a notch with the policing of drugs at festivals via sniffer dogs. It's an approach that was marked out for criticism by NSW Deputy Coroner Harriet Grahame in her report where she recommended a ban on dogs entirely.
While these measures certainly do recover illegal drugs, Graham pointed to research published in the International Journal of Drug Policy which found that they also lead to festival goers taking drugs before the festival, ingesting double the dose or panicking and swallowing drugs quickly to avoid detection.
THE RISE OF STRIP SEARCHES AT FESTIVALS
Of even more concern is the use of strip searches for drug detection. Across the two days of 2018's Splendour in the Grass festival, for example, a single NSW senior constable strip searched 19 patrons.
During an investigation by the Law Enforcement Conduct Commission, it was found that the searches yielded a single Valium tablet.
Moreover, under questioning, the officer agreed that the searches across the event were not lawful and only ten per cent of them - one of which was on a 16-year-old girl - yielded illegal drugs.
After being strip-searched at the Hidden festival in Sydney, Lucy Moore took to Facebook in a post that makes for harrowing reading.
Aside from feeling "completely humiliated and embarrassed," she included details such as, "As I have learned, police cannot ask you to squat and cough but police were asking us to do this". She also raised concerns about privacy: "Not only did I see other people being [strip] searched, during my search the door was left half open and only 'blocked' by the small female cop. I could easily see outside which means that attendees and male cops could have easily seen in as well." She was 19 at the time.
Moore's experience formed part of the UNSW's Rethinking Strip Searches by NSW Police report which called the practice "inherently humiliating and degrading" and found that the number of NSW Police searches has increased by almost 50 per cent in the four financial years 2014-2018.
And the horror stories just keep on coming.
At a five-day NSW Law Enforcement Conduct Commission hearing into several strip searches undertaken at the Lost City Music Festival, an event for children aged 13-17 held at Sydney Olympic Park in February, the counsel assisting the commission Dr Peggy Dwyer told the proceedings only five of 30 teenagers police strip-searched during the event had a parent or guardian present while the procedure was completed, despite it being required by law.
While it should be acknowledged that the conduct hearing taking place at all is a step in the right direction, this hopeful positivity is immediately clouded by revelations such as that from a 15-year-old boy who was told, during a drug strip search by an officer, "Hold your d**k and lift your balls up and show me your gooch".
The commission heard the boy was separated from his older brother and placed in a security area before police searched both his wallet and phone, including his messages, without permission.
All of this was prompted by a lone sniffer dog loitering near him. The practice has sparked unprecedented action among frontline doctors.
In November, 27 senior clinicians from Sydney's St Vincent's Hospital wrote an open letter urging NSW Premier Berejiklian to scrap strip searches and adopt pill testing.
"We find it abhorrent that strip searches are used to investigate young people - including children - for personal possession," wrote Dr Jennifer Stevens. "Strip searches, as currently conducted, demean both the individual and the police conducting the search."
The letter followed a recent incident in which a teenage girl went to police for help after hiding two pills vaginally.
Rather than being sent for a medical help, she was subjected to a strip search and three internal medical examinations, which uncovered no drugs but appalled medical staff at the inner-city hospital.
But it seems the police are not backing down. Or at least the NSW Minister for Police isn't. Asked to respond to data sourced by the Redfern Legal Centre - which found that 122 underage girls had been strip searched in the state since 2016 - David Elliott said, "I've got young children and if I thought the police felt they were at risk of doing something wrong, I'd want them strip-searched."
What's all the more galling for the likes of Tregoning is that government spin is playing a role in what can genuinely be a matter of life and death.
"What we're seeing is a failure of leadership in parliament," he says. "The most frustrating thing is that in both major parties there would be people who recognise that this is a valuable thing to do.
"The barriers are all political in the sense that it's all about how might we create the best bang for our buck in terms of meeting the perceived agenda of our constituents.
"It's not like, 'How can we do the best thing for the health and welfare of people in this state?' It's, 'What are people going to think of us as a party? How can we message this? How
can we make this work best for us?' And the fact that that kind of calculation happens in a context where people are dying is appalling."
To paint law-enforcement as the one-dimensional bad guys in all of this is both unfair and misleading. It is also decidedly unhelpful in a debate which is easily oversimplified.
Professor Paul Komesaroff from Monash University notes, "It's a complicated environment. There are serious risks, and we've got to work our way through it in a careful and mature way. Neither side is completely in the clear. We will have to work very carefully with the police force, and in a number of places, including especially Victoria at the moment, that's one of the main sticking points. I think the police have looked at this in an appropriate and honourable way, and they're concerned about the ambiguous positions that they will be put in.
"On the one hand, it's their job to enforce the law as it stands at the moment. On the other hand, if there's pill testing, there will be clearly some sort of process according to which people who are in possession of illegal substances will somehow have to be ignored or excused.
"But we can find ways around these issues. It's not a discussion where one side is going to crash through and defeat the other. There needs to be a process of co-operation, where people acknowledge the issues and the tensions and find ways to work together to solve the problem."
For David Caldicott, much of this has already been achieved. Albeit on the smaller scale of the ACT.
"We've been able to sit down with our counterparts in law enforcement, and commit to try and make our festivals 'death free' as a priority, rather than the focus on them being 'drug free'.
"Law enforcement has a critical role in reducing supply - that's what they do best. But reducing demand? That's my gig. So while other jurisdictions rely entirely on police interdiction, here in the ACT, we have a safety net that acknowledges the reality of consumption. I mean, if we can't keep drugs out of our prisons, what chance do we have of keeping them out of festivals?"
"While the equation that pill testing = lives saved is an oversimplified one with far too many variables to definitively conclude one way or another, Caldicott will say this: "From the earliest days of pill testing, we've known that it reduces the rates at which people mix their drugs, and the absolute quantities of drugs consumed.
Both of those are independent risk factors for overdose, and subsequently death."
It's on the topic of mortality that his soft Irish brogue hardens into something steeped in years of frustration.
He points out that the organisation he works with, Pill Testing Australia, has offered every jurisdiction in the country a free trial at a time and festival of their choosing. Take up has been theoretical at best and politely declined at worst.
"I have a theory why our opponents are so against what we do. It's not about the pill testing itself - it runs far deeper than that," says Caldicott.
"It represents a far scarier prospect for those so committed to an approach to drugs that globally has passed its sell-by date. Pill testing represents a place where discussions about drug policy are happening around Australian dinner tables, and discussion is the last thing that advocates of prohibition want. And for some, that's terrifying."
This season, as with many before it, festivalgoers - rather than politicians - are the ones who will be taking all the risks on the pill-testing issue. And like too much cricket, sun and time spent at the beach, tragedy is likely to become just another all-too predictable part of the Australian summer.