Music festivals, drug use and safety: Do we really have a so-called "soft approach" in this area?

During the week I was asked to give evidence at the NSW Coronial Inquest into Music Festival Deaths. Many of the parents of the young people that died over the summer months were present in the courtroom and I was fortunate enough to get to meet a couple of them. I can't even begin to imagine what they have been through and are continuing to deal with while listening to the testimony provided around the circumstances of their children's deaths. It truly must be heartbreaking ...

Some of what I said was reported in the media and it was interesting to see what different outlets highlighted. When everything you say is published in bite-sized pieces or 'grabs', there is a risk that the message is misinterpreted. Over the past few days some commentators have used extracts of my testimony and resulting media interviews to support their view that pill testing shouldn't be introduced and that the only way forward is to simply push the 'Just Say No' approach even harder. In response to this I would just like to make my views crystal clear on this incredibly complex issue. Here are some edited extracts of the 16-page written report that I prepared in response to a series of questions I was asked by the Coroner.

One of the key questions was "Do you support pill testing and believe it is useful in harm reduction?" - I answered it as follows:

"I totally support pill testing – I think it is important for potential users of drugs to have as much quality information about the drug they are considering using. It can also provide invaluable intelligence to public health authorities and law enforcement about current drug markets. Pill testing programs around the world (and there are a number of them – all run in very different ways) often have another benefit in that they are able to access a group of drug users who usually do not come into contact with health agencies, i.e., when the user gets their pill tested they get to speak to a health professional who does not only tell them about the contents of their pill but can also make them aware of the potential risks of using a drug like ecstasy.

One of the greatest problems around illicit drugs is that those who choose to use them do not know what they are taking. Drugs like ecstasy, popular at music festivals, are often manufactured with little, if any, 'quality control'. Sometimes that may result in particularly dangerous adulterants being present in the pills or powders that people use. Pill testing aims to provide those using illicit drugs with additional information about the substances they are considering using, thus reducing the potential harms associated with that drug use, i.e., if a particularly dangerous substance is identified in a pill or powder then the potential user may choose to make the decision not to take it ...

There is, however, one issue that concerns me. Pill testing allows the user to access more information about what it is that they are planning to use. Unfortunately, as far as some users are concerned, they believe that if you do know what you are taking, it is safe. It needs to be noted that this message is not one that is ever conveyed by pill testing services across the world. I have been fortunate enough to visit pill testing services in The Netherlands, Austria and Switzerland and in all of those countries, no-one is ever told that the drug they have had tested is 'safe' …  Pill testing is not a simple and straightforward strategy that can just be implemented without thinking through all of the potential consequences. As far as some young people are concerned, regardless of what experts in the field are stressing, if a substance is tested and it is found to contain MDMA, they believe it is safe. If the strategy was to be introduced (in whatever format – on-site or off-site), targeted education campaigns highlighting what pill testing actually is and isn't, would need to be developed … (in addition) … the messaging that is developed and disseminated needs to be thought through extremely carefully. Over the years, there have been many examples of messages actually having unintended adverse consequences, e.g., "One of the greatest risks associated with taking a pill is that you don't know what you're taking" has now lead to the belief that if you do know what is in it (e.g., pharmaceutical or OTC medication, or a pill has been tested), then it is 'safe'."

The final item I was asked to provide was "any comment that you consider to be within your area of expertise that you believe is relevant to the Coroner's inquest". My answer was as follows:

"Regardless of what is put into place, we are going to continue to see drug-related deaths at festivals. We can try to ensure that people are well-educated about the risks (physical, psychological and social) associated with drug use, do our best to ensure that illicit substances do not come into the event (but at the same time ensuring that we do not maximise harm by being too heavy-handed) and, most importantly, provide an environment that is as safe as possible but festivalgoers are going to make their own decisions about whether or not they choose to use substances.

Of course, every drug-related death that occurs at dance events and other nightlife venues is a tragedy, but they are extremely rare. From a festivalgoer's perspective the risk of dying after taking ecstasy/MDMA or any other drug is extremely low. Every weekend tens of thousands of young people across the country take a pill or capsule and 'party' and return home safely. I am often asked by young people why one person died after taking a drug and their friends who all took the same thing experienced no problems at all. My answer may seem pat but it is honest. Realistically, most deaths (but certainly not all) come down to two simple words – 'bad luck'.

This Coronial Inquest provides us the with the opportunity to identify (and hopefully implement) best-practice when it comes to keeping young people safer at music festivals. In my opinion, Australia was once a world leader in this area. With the refusal of government to consider the introduction of pill testing programs (in whatever format), together with a more aggressive approach to policing these events (e.g., greater police presence and the use of drug detection dogs) we now fall behind a number of other countries …"

I've been around for a long time now. Back in 1995 when a 15-year-old Sydney schoolgirl died after taking ecstasy there was understandable community outrage and calls for governments to get tougher on drug use, particularly around dance events. There were claims made that schools were "teaching young people how to use drugs safely" and as a result, programs were shutdown, resources recalled and destroyed, as well as some agencies threatened with defunding. At the same time, policing was increased and for the first time, mass media campaigns specifically targeting ecstasy use were rolled out. I couldn't tell you how many committees and expert panels I was on over the next few years that were set up to try to deal with the dance event and drug use issue … Since then there have been more media campaigns highlighting the risks associated with the use of ecstasy and other drugs, as well as a dramatic increase in policing. When I read some commentators call to get tougher, I wonder what more can they want? Do they really want to see members of the armed forces together with tanks at the front gates of a dance event? I'm sure we could start throwing more young drug users into juvenile justice centres or prisons if that's what they want but I'm not too sure how effective that would be and it all sounds great until it's your child that gets caught! Someone wrote yesterday that "we have allowed this soft approach to flourish" … Since 1995, what exactly do these people mean by this so-called "soft approach"?

Let's make it clear what approach we are currently taking ...

• As a society, we can, and we do tell our young people that the use of all drugs, whether they be legal, illegal or pharmaceutical, is potentially dangerous. 
• Through school-based drug education programs, students are taught that there are a range of physical, psychological and social harms associated with all drug use. Not only are they provided information about the dangers of drugs and drug use, they are also taught about positive decision making, identifying support networks and peer refusal skills.
• Young people are constantly warned that if they get caught with illegal drugs there are consequences.
• At the same time, this current generation of young people are exposed to more policing than almost any other generation before them and have to deal with law enforcement strategies that simply weren't around when we were young, e.g., drug detection dogs and roadside drug testing. 
• Young people believed to be in possession of drugs can now be stopped, searched and even strip-searched based on a dog sitting in front of them, even though the available evidence suggests that these animals are wrong up to 70% of the time.

That is the so-called "soft approach". Really? How much more education can we provide and how much tougher can we get? All that is being done and young people are still dying. 

I have no easy answer to this problem - I've been here before and I feel like we're going around in circles. All I want is to try to ensure that we keep our young people as safe as possible. We're never going to be able to prevent all drug-related deaths but what we're doing now is clearly not working. What we have implemented since 1995 has clearly not reduced drug use or drug-related harm in this area. Now that doesn't necessarily mean that we have to throw it all away, but we have to be willing to start to look at alternative strategies and ideas. No one initiative is going to be a 'silver bullet' and solve the problem and, sadly, this obsession with pill testing (by both sides of the debate) is holding us back from being open to other potential positive ways forward.