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The students who were current vape users were more likely to use other substances or to engage in sexual activity than were nonusers (Table 1). These data corroborate a recent study that showed an association between vaping and risky sexual, substance-use, and violence behaviors.⁵ These associations are not causal but suggest that certain students are inclined toward a variety of risky behaviors.

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https://bpspubs.onlinelibrary.wiley.com/doi/epdf/10.1111/j.1476-5381.2012.01941.x

 “Alcohol is certainly a damaging drug, but to suggest that MDMA is less damaging than alcohol does not agree with the scientific evidence. Comparing these two drugs is like comparing an F1 sports car to a basic family saloon. MDMA is an extremely powerful drug, which heats up the brain, causing a massive increase in neurochemical activity, dramatic changes in mood state, and it takes the brain several days to recover. Regular MDMA usage impairs memory, reduces problem-solving ability, reduces white cell blood count, increases susceptibility to infections, causes sleep problems, and enduring depression. In pregnant women MDMA impairs foetal development. We and other research groups worldwide have compared the psychobiological functioning of recreational Ecstasy/MDMA users with alcohol drinkers, and in numerous studies it is always the Ecstasy/MDMA users who are comparatively worse. The ‘family car’ may kill more people each year than the F1 speed machine, but to suggest that the latter would be safer for everyday driving is completely erroneous. MDMA kills many young people each year, and the death toll is currently rising.”  By Andy Parrott, Professor of Human Psychopharmacology, School of Health Sciences, Swansea University. (2018)

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Demographics, circumstances, toxicology and major organ pathology

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But it won’t work and is fraught with dangers. What if we don’t know what we are testing for? New psychoactive compounds are being developed all the time. In any case, is the drug we’re testing for consistent throughout the pill? We could easily miss it by scraping a little from the surface. And perhaps the deadly threat lurks in ­unidentified contaminants.

There is much to be considered — maybe first is the fact no forensic toxicologist I know recommends pill testing or believes it is practical.

Fitzgerald states the risks of pill testing appear to be minimal. That is curious. In a ­recent toxicology publication, a leading forensic scientist reported there was great concern in the US that these novel illicit substances typically are outside the scope of routine drug testing by hospitals and laboratories or below the sensitivity levels for detection. If major forensic facilities have difficulty in identifying these subs­tances, it stands to reason that on-site pill testing could not adequately identify most of the potentially lethal components in a pill scraping.

In another recent publication, Australian forensic laboratories noted there were about 740 new psychoactive substances ­reported to the UN Office on Drugs and Crime from 2009 to 2016.

Again, leading Australian forensic institutions using high-resolution mass spectrometry struggle to keep up with ever-increasing variations in synthetic substances. Pill testing may identify some of these within the time and scope of the on-site facility, but the risk of an adverse or fatal episode ­remains with several hundred substances not detected.

Fitzgerald reckons there is a strong case from more than two decades of experience in Europe, but that’s ignoring the exponential increase in deadly adulterants.

The issue of pill testing should be decided on forensic science. The ability to identify a wide range of components in a compound ­depends on the ability to test a ­representative portion of the substances, and that representation is incumbent on the pill being ­homo­geneously mixed when produced. If the pill has not been manufactured to ethical pharmaceutical standards then there is a risk of the pill tester missing the more toxic ingredients of the substances.

If pill testing were trialled, you would need sophisticated instrumentation such as high-resolution mass spectrometry to rapidly analyse the contents of the unknown substance. Such instrumentation is not amenable to on-site music festival venues. Crit­ically, operators of the instru­mentation would need to ensure their database of compounds is up to date. As newer synthetic drugs are regularly ­entering the market, forensic laboratories are struggling to obtain appropriate and ­expensive analytical reference material to identify unequivocally all ingredients in a pill.

To date, analytically trained ­experts have yet to explain ade­quately ­the complexity of attempting to test pills reliably and quickly at an on-site venue to be reasonably confident they can eliminate minute amounts of ­potentially lethal ingredients such as the deadly carfentanil.

Before moving ahead with a policy to trial pill testing, we need some sobering facts. The efficacy of pill testing is best left to forensic scientists, while the value of pill testing as a means of harm ­reduction is the domain of ­researchers into behavioural patterns of users and their potential for risk-taking. A 2004 study by the National Drug and Alcohol Research Centre into risk factors and risk perceptions found that those who perceived the possibility of getting caught or being ­involved in accidents were less likely to drive while impaired. Conversely, the perception of not getting caught or having an ­adverse reaction contri­buted to their drug-taking behav­iour..

John Lewis is honorary associate at the Centre for Forensic Science at the University of Technology Sydney

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