Taking a reading of the pills

This summer, people at eight festivals around the country accessed practical harm-reduction services. The low-key approach received much praise from everyone involved. Russell Brown talks with those behind the free substance tests, whose job is made all the more difficult for having to operate under the legal radar.

It’s day one of the festival, and Wendy Allison is seeing a problem.

She and her harm-reduction team have been checking the contents of drugs brought for testing by festival-goers – and alarm bells are ringing.

Most of the powders presented throughout the day as MDMA (ecstasy) have not been MDMA but various cathinones – part of a group of chemicals colloquially known as “bath salts”.

Most cathinones do not present a critical risk of harm in themselves, but they typically react badly with other drugs – most notably with alcohol. Their preponderance is such that Allison decides it’s something the festival’s medical staff should know about.

But there’s a problem. Officially, Allison isn’t doing what she’s doing. Or rather, the festival promoters have agreed to allow her to offer harm-reduction advice on site on the basis that they don’t explicitly know that the advice will include drug checking.

The reason for this wink-and-a-nod agreement is that section 12 of the Misuse of Drugs Act puts the event organisers in peril of up to 10 years imprisonment if they “knowingly allow” the consumption of controlled drugs on the site they control.

That in turn could also void their event insurance. They literally can’t afford to know the details of harm reduction.

But Allison is unwilling to take the step of telling the medics without asking the organisers’ permission. In the gathering dusk, she reaches the production manager on his mobile phone and explains the situation. The manager listens carefully and says “Yes, do that”, and tells her who to seek out in the medical team.

The medics, it turns out, are very grateful for the heads-up. They’re keen for her to come along to other events they’re working on. It’s a good result. But getting to that result has meant defying the law.

“It was the common sense thing to do,” says the manager who cleared Allison to talk to the medics. “But right up until that point, I was prepared to deny we had any knowledge of it.”

The head of the festival’s medical team confirmed that the advice from Allison had been extremely useful. “We only had anecdotal evidence when we arrived,” adding that, if such harm-reduction services were standard at festivals, it would help save lives and reduce harm to people attending the events.

Another festival promoter told us he considered allowing drug checking at his summer show, “but we were advised that the Police would prefer we didn’t do it”.

He says if the law was changed, “I’d absolutely do it. I don’t want kids taking bullshit drugs and passing out. They need to be informed.”

He emphasised that his major problem – and the bane of any festival promoter’s life – was alcohol, and pre-loading in particular.

Still another promoter was keen to allow drug checking but bowed to the qualms of the site owners.

Nonetheless, this past summer, Allison and her volunteers, under the banner Know Your Stuff, conducted 318 tests on substances presented to them at eight events. Some events were essentially private parties, but the largest, the one described above, was host to thousands.

Allison has been conducting drug checking using Marquis and Mandelin reagent kits for several years, but last summer was the first time she’s had access to a portable FT-IR spectrometer.

The briefcase-sized device, which uses a frequently updated online reference library to identify drugs in samples, was purchased jointly by the New Zealand Drug Foundation and New Zealand Needle Exchange Programme.

“Adding to the tool kit so people at festivals can get accurate information about what they’re taking isn’t a new idea. We’ve seen this sort of service work overseas. Knowing this, we decided to invest in the latest technology. It could be the thing that saves a life,” says Drug Foundation Executive Director Ross Bell, who joined the volunteer testing team at the large festival.

At outdoor events, Know Your Stuff set up in a two-room tent. ‘Clients’ found the tent – by successfully interpreting the signage or word of mouth, the service cannot be advertised – and came in to talk about harm reduction. If they wanted drugs tested, they were shown to the back room of the tent, where each test was conducted using the same process.

The client scrapes three small samples onto a plate (all samples must be handled only by the client), and two are tested with reagents. The client is informed of the result. The third sample is then moved onto the testing plate of the spectrometer where two analyses are done: one for the main ingredient, another to discover whether there is a mixture of substances.

Unlike the reagent kits, the spectrometer test is non-destructive – meaning the client has to be warned not to dab a finger and lick off the sample afterwards. Drugs cannot be consumed in or near the tent.

“Having the spec there has improved our service a great deal,” Allison says, “but both methods have their advantages and disadvantages. For example, the spec can’t pick up LSD because LSD comes in such small doses that it doesn’t actually register against all the other things you will find on a blotter or in a liquid sample.”

“Reagents are really good at picking up the cathinone family. We can very quickly look at a reaction and say, yes, this is a cathinone, but it isn’t very good at distinguishing between them. But if you then take that sample and put it on the spec, it can tell you exactly which cathinones are present. Similarly with ketamine and cocaine, reagents are not very good at picking those up, but the spec is.

Each has its advantages.”

The spectrometer’s ability to pick up multiple substances in a sample turned out to be important. “We found a number of samples that had a cathinone mixed in with MDMA, which suggests MDMA may be being included in pills that are mainly cathinones in order to baffle reagent tests.”

But reagents have another, perhaps unexpected advantage. People take them more seriously.

“The visual reaction you have there in front of the client is actually quite important psychologically for priming people to be told their sample isn’t what they thought it was,” Allison explains.

“When they actually see it happen in front of them, they have a lot more trust in the result. The machine doesn’t even go beep – it just does its thing, and we tell them the result.

“You can show them the chart and say ‘This is what it’s supposed to do’, and then they see what it does do and it’s not that. So they have a buy-in to the process.”

Nearly half of clients with samples that were not as they had presumed chose not to take the drug and had access to a jar of acetone in which to dispose of it. Those who said they would still take their drug (in some cases, people who had simply paid for cocaine but got amphetamine) were counselled on minimising risk.

There was some good news. Samples presented by users as LSD (the second most common presumed substance presented behind MDMA – ‘unknown’ was third) were much more likely than in past years to be what they were presumed to be.

Correspondingly, fewer samples of the potentially deadly LSD substitute 25i-NBOMe were encountered. No 4-FA (the chemical implicated in the recent deaths of several people in Melbourne who thought they were taking ecstasy) was found.

Some substances – most notably cannabis, but also GHB and psilocybin mushrooms – were likely in use but not presented.

Demographic trends emerged: on the second day of the festival described above, older punters came in – and their MDMA generally was MDMA and not cathinones. The inability to advertise meant that only 5–10 percent of recreational drug users came into contact with the service, however, and even fewer at the largest event.

But notably, Know Your Stuff was not able to test for dose, meaning that, if any of the very high dose MDMA pills being found in Europe were present in New Zealand, they were hard to spot.

“It is of concern,” says Allison. “We were brought several pills this year that were larger than usual. If a pill tests as having MDMA as the main ingredient and it’s a large pill, we can advise to approach with caution. We do have scales and weigh anything that looks like an unusually large pill or dose. One pill this year weighed nearly 400mg and contained MDMA – for this person, we advised that, if they intended to take it, to only take a fraction of it and await developments before considering taking more and even then to approach fractionally.

“Our advice is always assume it’s very pure, and if you intend to take it, do not assume that one pill equals one dose. It’s always safer to take in fractions, and we do advise people to weigh their doses – however, we can’t do this for them due to the legality issue of ‘helping’ people take drugs.

“The bottom line is that, until we have NMR or GC-MS testing available to us to test purity, users will be vulnerable to this. It is a real concern that’s likely to grow, and we are limited to advising extreme caution. I am unsure how effective it is to tell people to only take a half without being able to back it with a test reading of purity to show a good reason why, but it’s all we can do right now.”

“What I’d like to see,” says Allison, “is for the law to get out of the way of this – specifically, a change to section 12 to make an exception for harm-reduction practices. It’s a small change to the Act. It’s not condoning drugs, it’s not legalising – what it’s doing is decriminalising organisers who get us in.”

“The only solution ultimately will be an amendment to the Misuse of Drugs Act,” agrees Associate Health Minister Peter Dunne.

“For practical reasons, and no other, that’s not likely for a little while yet. The prospect of getting something through Parliament as a one-off is pretty remote. So it will have to wait for the overhaul of the Act, which is due in the next couple of years or so.

“For the moment, and in the discussions I’ve had with officials, there’s a general acknowledgement of the value of this form of testing. What it’s really going to come down to is the Police exercising some sort of discretion. Now, that’s fine until you get a zealous cop who sees his chance to stamp his mark on something at a local level.”

The Police response to our questions (“All we are able to say on this,” said a spokesperson) was measured, if inscrutable.

“Police applaud event organisers who operate responsibly and ensure event goers have a good time without over-indulging,” said a Police statement.

“The use of drug-checking kits is a matter for event organisers to consider. However, Police will continue to maintain an appropriate presence at these types of events to ensure people have a good time safely. Police will also respond to any drug or alcohol related harm event which occurs at this type of event.”

Putting this form of harm reduction on a more certain footing would have many advantages. While Allison shares information with medics (and sometimes bar staff) where possible, the law discourages the kind of coordination that would make the service most effective. She would also like to coordinate better with chillout zones, “to the extent that they exist. It’s actually quite a gap in event infrastructure in New Zealand – an acknowledgement that people have difficult experiences and may even end up needing to be in what I would call ‘psychedelic first aid’.

“People end up being dealt with by security or site management – who aren’t trained, don’t know what they’re doing and can often make the situation worse or escalate it to a medical situation where all it needed was for someone to sit down quietly with them and let them get their shit together. I think that’s a service that could run quite neatly alongside what we do.”

Allison and Dunne both envisage this kind of joined-up approach becoming part of health and safety expectations for events so that, instead of voiding promoters’ insurance, it becomes a condition of it.

For the moment, says Allison, “It’s working, but it’s only working because everyone is pretending they haven’t seen us. And that’s not really good enough.

“It should be legal to do what we do.”

Russell Brown blogs at publicaddress.net and co-hosts Media Take.