On-site ecstasy pill testing - a consideration of the issues from a policing perspective

Australasian policing has a long history of supporting a range of initiatives, such as methadone programs and needle and syringe provision services, that reduce illicit drug- related harm. These programs have been supported because the evidence base pointed to the benefits of doing so. It is therefore appropriate that the same evidence-based tests be applied to the issue of ecstasy pill testing. In doing so, it is important to remain cognisant that both the (Australian) Ministerial Council on Drug Strategy and the Intergovernmental Committee on Drugs have rejected pill testing as an appropriate harm minimisation practice. In considering the broad issue of ecstasy use, it is important to be careful in the use of terminology. In this paper the term ecstasy is used to describe the illicit tablets that are purported to contain 3,4-methylenedioxymethamphetamine (MDMA). In the same way, the paper uses the term MDMA when referring specifically to that substance. It is also important to differentiate between the overall objective of reducing the harm associated with ecstasy (and other similar drug) use, and one particular method that seeks to achieve this outcome, namely on-site pill testing. In this way, the key issue is not whether all reasonable measures should be introduced to reduce the (albeit rare) death and injury associated with ecstasy use, but rather whether on-site pill testing is the best, or even a useful, way of achieving this outcome. Ecstasy is unusual in that the setting in which the drug is taken and the subsequent behaviour of the user, have a very large impact upon the level of harm that stems from that use. In particular, when ecstasy is taken in environments with a high ambient temperature and where a high level of vigorous activity is undertaken by the user, this substantially adds to the risks associated with the use of the drug. Another critically important factor in the majority of serious adverse outcomes stemming from ecstasy use, is the concurrent use of alcohol or other drugs. The overwhelming majority of ecstasy users who become ill after taking ecstasy have also used alcohol and/or other illicit drugs concurrently. It also appears that those who use these other substances also have more serous outcomes than do users of ecstasy alone. In this way, most serious adverse outcomes from ecstasy use might, most accurately, be regarded as stemming from the combined use of ecstasy and other drugs. (Editor' s abstract)