Pill testing could have prevented 64 festival deaths: Research

New research using the National Coronial Information System (NCIS) to investigate drug-related deaths at music festivals throughout Australia suggests scores of fatalities could have been prevented had harm-minimisation strategies, such as pill testing, been in place.
 
Conducted by Monash University, the analysis involved a thorough search of the NCIS to determine the frequency of deaths involving alcohol and other drugs at music festivals in Australia between 1 July 2000 and 31 December 2019.
 
The researchers revealed at least 64 deaths took place over this period, most of which involved males (73.4%) aged in their mid-20s (range 15–50 years). Drug toxicity was the most common primary cause of death (46.9%) followed by external injuries (37.5%).
 
The drug most commonly detected or reported as being used was MDMA (65.6%), followed by alcohol (46.9%) and cannabis (17.2%), with most cases reporting the use of two or more drugs (including alcohol) and 36% reporting a history of drug misuse in the coroner’s findings.
 
Most deaths were unintentional, with less than a fifth of cases (17.2%) involving intentional self-harm.
 
‘The findings suggest that drug-related deaths at music festivals in Australia typically involve young people using multiple illicit substances in combination with alcohol,’ the authors concluded.
 
‘Most are unintentional and could potentially be prevented through the implementation of a range of harm-reduction strategies, including mobile medical care, drug-checking services, and increased consumer education and awareness.’
 
The paper, published in the International Journal of Drug Policy, was released shortly after eight attendees at a Melbourne electronic dance festival were hospitalised and placed in an induced coma due to suspected MDMA overdoses.
 
Meanwhile, a separate study undertaken by Australian National University clinicians revealed that three new recreational drugs never before reported in Australia were recently identified by chemists at CanTest, Australia’s only fixed-site drug checking service.
 
According to the researchers, led by Professor Malcolm McLeod, the drugs could have effects similar to other stimulant-like substances such as MDMA and ketamine.
 
It’s not yet known how dangerous these substances are or what short- and long-term health impacts they have on the user.
 
Professor McLeod said one substance submitted for testing, which the client believed to be a derivative of methylphenidate (sold as Ritalin), was actually a new variant of cathinone or ‘bath salts’ – a dangerous family of chemicals that in some cases have proven lethal.
 
‘Although there are a range of cathinone variants circulating in the community, finding a new one is obviously of concern because we don’t know how it will affect people or what the health consequences are,’ he said.
 
‘The second substance we analysed, which the client believed to be a ketamine-like substance, was in fact a new type of benzylpiperazine [BZP] stimulant, often used as a substitute for MDMA.’
 
While BZP derivatives first emerged in New Zealand in the early 2000s, Professor McLeod said much remains unknown about the substances.
 
‘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,’ he said.
 
‘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.’
 
Co-author Dr David Caldicott, who is also the clinical lead for CanTEST and Pill Testing Australia, said the findings demonstrate the ‘understated ability’ of pill-testing services to inform and advise individuals about their choices.
 
‘After making the discoveries, CanTEST workers were able to immediately notify the community to let people know about these new substances and their potential risks,’ he said.
 
‘It turns out that drug-checking services can not only change the behaviours of consumers, but when done rigorously, can also identify totally novel drugs as they emerge, and possibly even before they get a hold on local markets.
 
‘This is potentially of huge public health importance, not just to Canberra, but to the rest of the world, and has probably not been fully appreciated to date.’
 
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