A national network of pill testing sites would minimise the harm caused by drugs and save lives, the ACT's Population Health Minister has said, after researchers discovered three new types of psychoactive drugs in Canberra and recommended expanded drug market monitoring.
Emma Davidson backed the suggestion of researchers, who have again recommended a drug testing network that could act like infectious disease monitoring, which tracks emerging health risks and allows health authorities to prepare and respond.
"More pill testing sites across Australia means more lives saved. We've seen firsthand in Canberra that people will check their drugs when the option is available and that almost one in five people discard their drugs at the testing clinic when they learn what is in it," Ms Davidson said.
"People take drugs and it is a health issue. Australians cannot make safer choices unless they have access to the right support and services such as pill testing.
"A national network will mean greater access for people to pill test and help minimise harm to the individual and their community."
Researchers who found the three previously unknown psychoactive substances through Canberra's fixed pill testing site have suggested a network of monitoring sites around the country would improve the way health services can respond to illicit substances.
The call comes after evidence of a bad MDMA batch in Melbourne, which has sent more than half a dozen people to hospital following a music festival this month and prompted fresh calls for on-site pill testing in Victoria.
Three new types of psychoactive drugs were identified in Canberra following complex analysis after they were presented at the fixed pill-testing site in the city centre, which is the first of its kind in Australia.
Researchers from the Australian National University detailed the makeup of the drugs in a peer-reviewed paper published in Drug Testing and Analysis on Friday.
The samples were presented to the CanTEST site for analysis, where on-site testing returned results inconsistent with what the person presenting the samples had expected. The person then surrendered the drugs.
"Subsequent laboratory analysis of these substances at the nearby Australian National University (ANU) identified each as consisting of primarily one compound, for which little information was available in the scientific literature," the researchers' paper said.
The analysis at the university, led by Professor Malcolm McLeod, used techniques that included nuclear magnetic resonance spectroscopy.
The first substance was presented and believed to be a derivative of a stimulant used to treat attention-deficit/hyperactivity disorder, but was found to be a variant of cathinone, commonly known as "bath salts".
The second substance, presented as a type of ketamine, was found to be a new type of benzylpiperazine stimulant, which is a type of MDMA substitute.
"While derivatives of these stimulants first emerged in New Zealand in the early 2000s, we actually don't know a lot about them," Professor McLeod said.
"As for the third one, the client reported some uncertainty about the identity of the substance. They thought it was a cathinone drug, a stimulant that can have similar effects to amphetamines, but wanted to have it tested to avoid any nasty surprises.
"We later identified the drug to be a new phenethylamine drug known as propylphenidine. Phenethylamines are a category of stimulant drugs that includes amphetamine, methamphetamine and MDMA."
The analysis was a "bottom up process" using the university's laboratories to look at the molecule within the drug sample and determine its composition, he said.
Professor McLeod agreed the system in Canberra, which partners instant drug checking with more complex laboratory analysis at the university, was a proof of concept for how drug monitoring could take place in other parts of the country.
"The other program that goes on is wastewater analysis that gets trotted out every year. ... They can only see what they look for, so they're never going to see substances like this," he said.
"I think drug checking is a really powerful way to monitor the market."
The compounds have been added to routine on-site testing, which allows the CanTEST service to continue monitoring how prevalent the substances are in the local drug market.
"In this instance, as the substances did not appear in widespread use in the community, and no specific information linked substance use to identified harms, no community notification was issued," the paper said.
The researchers said drug checking services were perhaps one of the most likely places new drugs would be identified.
"In the same way that emerging infectious disease monitoring networks can gain valuable time in the early identification of strains of particularly virulent agents, drug checking can be the first opportunity to identify agents of potential and particular harm," the paper said.
Dr David Caldicott, an emergency department doctor at North Canberra Hospital who has led Canberra's pill testing efforts, said the "gold standard" for scrutinising the substances harming people would be to sample drugs on the market across Australia.
"In Europe, they have a process called Euro-DEN, which monitors drugs across Europe. Now that is only through emergency departments. But what we're suggesting is, wouldn't it be fantastic if there was an Australia-wide process of monitoring illicit drugs prior to them harming people?" Dr Caldicott said.
"That's the real issue here for us: trends in drugs happen as quickly, perhaps even quicker, than trends in music. They are super fast."
Dr Caldicott said recent overdoses in Melbourne may have been prevented if health officials had known what substances were circulating in the community through drug testing services.
"How much better would that have been if we had been able to identify it in Melbourne prior to it harming anybody?" he said.
"There has not been a meaningful argument mounted against drug checking and pill testing probably for the last decade and most of it is sadly political."
The Victorian Major Events Minister, Steve Dimopoulos, has said the state's government has no plans to allow pill testing at music festivals and claimed the government was focused on harm minimisation.
Victorian State Coroner John Cain in September repeated a call for the state to offer drug testing after a 26-year-old died, suspected of overdosing on a "blue punisher" pill.
NSW Premier Chris Minns has not ruled out a pill testing trial in the state, which will this year hold a drugs summit.
Dr Caldicott said if an Australian centre of disease control were established, it could also be charged with monitoring drugs.
"So there are a lot of alignments happening currently and a lot of opportunities that are possible, but it does require a step away from the ideological objection to drug checking and a step towards saying, 'We're going to find out as much as we can about these drugs as early as we can'," he said.
Dr Caldicott said Canberra had become a centre of expertise on drug checking and the experts involved were very enthusiastic to share that experience.
"There is a standing offer, since 2019, for us to provide a free trial to any jurisdiction. We will up and take our gear to any jurisdiction and show them how we approach the issue and help them train up their own people," he said.
