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Photo: Getty Images
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SocietyAugust 19, 2017

How to help people do drugs safely: let them know what they’re really taking

Photo: Getty Images
Photo: Getty Images

For nearly 25 years Dr Fiona Measham has documented how and why humans do drugs. She spoke to Simon Day about how helping people know what exactly they’re taking is making doing drugs safer in the UK.

For all of human history we’ve loved getting intoxicated. Almost every society, tribe and culture has taken drugs to enhance life’s pleasures, dull it’s pain, or find a higher purpose. Humans have continued to take drugs despite their modern criminalisation, and in spite of their known health dangers. And that means there are obvious risks.

Last summer there were six drug related deaths at festivals in the UK – the highest number on record. The UK has some of the strongest and cheapest recreational drugs in the developed world, and this was leading to tragedy.

So, with the engagement of police, the public health sector, and event organisers, Dr Fiona Measham, professor of criminology at Durham University, offered a solution to helping people take drugs more safely at festivals and nightclubs around the UK. Her charity, The Loop, provides forensic analysis of drugs for festival goers. In a safe, confidential environment, revellers can get their stash tested so they know exactly how strong it is, and exactly what their taking – because it’s not always what it says on the packet. The testing also comes with guidance about the risks of the drug they plan to take, and advice about how to be as safe as possible.

“Everyone had the feeling that we have got to do things differently. You can’t let more and more young people die at festivals from drugs – and drug testing is part of that,” says Measham.

Ecstasy pills tested by The Loop, which contained over 200mg of MDMA. (Photo supplied)

The results were important. At one festival where their lab was was set up, hospitalisations from drugs was reduced from 19 to one (a statistic Measham recognises she is just one part of). One in five of the people who had their drugs tested chose to voluntarily hand over more drugs for disposal because they weren’t comfortable taking them after the consultation. And it has provided Measham – who researches trends in recreational drug taking – valuable data about the changing way Brits are getting intoxicated to help them do it more safely.

Humans aren’t going to stop doing drugs – and Measham thinks they probably shouldn’t anyway – so she wants it to be as safe, and as informed as possible.

Drug testing sounds like something Lance Armstrong has to do, explain what drug testing at a festival looks like, and what you are trying to achieve by testing the drugs?

Drug safety testing is the forensic testing of the drugs themselves, not testing for drugs in an individual. Drug safety testing has been going for a about 50 years now, but it’s not very well known. I think it used to happen in San Francisco 50 years ago, then it died out a bit. Then in the early 1990s, it started up again in the Netherlands. In the Netherlands they have had a drug testing service where people can bring their drugs get advice, about the drugs, and the benefits and dangers of that for the individual, they can avoid contaminants, they can know the purity of the drugs, and there are less chance of them overdosing.

But the benefits for wider society is you can track drug trends. For me as an academic tracking drug trends, this is exactly what should be happening, because you can hopefully avert public health problems for an individual, but also on a wider scale you can monitor the market and see if there are particular concerns and unless you are doing that sort of testing it’s not possible.

You can analyse police seizures, but inevitably, police seizures in a way they are the failed criminals, the drugs people don’t take.

The only way you can find out what people are taking is having that individual connection – asking them what they think they are taking then you test it and find out what they are actually taking. Because otherwise if you do the testing you don’t necessarily know what they’ve bought it as, so you don’t necessarily target the right people with the right information. To give an example of that we were testing a nightclub in Manchester, and five people went to hospital in one night in this nightclub. They thought they’d bought ketamine. When we tested it, it was a new psychoactive substance called methoxetamine, which is a bit like ketamine, but lasts a lot longer, it causes a lot more agitation and anxiety. And these people needed to be held down by security staff, they were in an absolute frenzy.
We could then put out a warning to people in Manchester that weekend, please be careful if you have bought what you think is ketamine because it could be methoxetamine. If we put out a warning to methoxetamine users, ketamine users wouldn’t have taken any notice. So you need to know that it is being mis-sold because then your harm reduction advice is focused on ketamine users. The only way you can make that connection is talking to individuals and get the drugs off them to test.

How long have you been doing this work?

I have been doing research at festivals for about ten years and had relations with the police and the paramedics, and with the festivals themselves, so I was talking to them about these ideas and saying it is happening in the Netherlands, in Spain, in Austria and Switzerland and it is getting really good results. Meanwhile, in the UK, the drug related death rate has been going up rapidly, and it is a real concern. In Europe, their drug related death rate was stable or going down.

I started to have conversations with the police and paramedics about drugs safety testing, and realised that we gradually over the years that it was possible to introduce it, and that is what we did last summer. We introduced at two festivals as a pilot, because a pilot is manageable and doesn’t sound scary. They went really well.

At two of the headline festivals in 2015, 19 people were taken to hospital, and then in 2016 when we were there, only one person was taken hospital. You can’t say it’s only because of us, but one of the things the paramedics said was that because we were testing they felt more confident to treat people on site and not take them to hospital because they knew what they were dealing with. We gave confidence to the emergency services on site, because they had information.

The other example I give, when we gave people results of their test, we gave it as part of this harm reduction package, and we said to them “these are the dangers from this particular drugs, these are the ways we recommend people think about taking it in particular way, please don’t take it with these medications, or it doesn’t go well with alcohol,” all those sorts of messages. Then at the end of the session we would say do you have any other drugs that you would like us to dispose of now you have heard of the test results? One in five said yes and gave us more drugs.

We were really pleased with that and we were taking one fifth of the drugs out of circulation that were potentially dangerous, and the police were really pleased with that because a fifth of all drugs were being disposed of. The festival were really pleased about that.

This summer we are going to be doing it at eight festivals. We think we will reach half a million people because these festivals are 75 – 80,000 people each. What we hope, in a few years time, that will be a norm at all festivals and people will be able to have their drugs tested.

We are trying to set up in nightclubs and city centres. The idea is to have a booth or kiosk, so people who aren’t going to festivals, or even a nightclub, they could be going to a house party or a bar, anybody can get their drugs tested on the weekend, in any city. That is my dream one day.

How much disparity is there between what people think they’ve bought, and what they’ve been given?

In fact in the UK most of the drugs were what people expected. It was less than one in ten. So it is a quite different situation in the UK to New Zealand [where drug testing found more than 30% of drugs were not what users believed they were]. We have a problem with the high purity of drugs, drugs are very cheap and very easily available. And that is a problem because people are overdosing because they don’t realise how strong they are.

Quite often the pills were testing have over 200mg of MDMA in them, and we put out warnings about high strength pills and people are just taking way way too much.

In 2010 eight people died of ecstasy is the UK, then in 2015 57 people died from ecstasy related deaths.

Dr Fiona Measham (L), outside The Loops testing tent at Parklife festival. (Photo supplied)

How dangerous is it if you’re taking something and it’s different to what you think it is?

There is a vulnerability for young people who are inexperienced and have a low tolerance and they don’t realise how strong the pills are. I was at festival a few years ago and an 18 year old triple dropped in one go and was dead within three hours. A lot of the messaging, the harm reduction advice is we say start with a quarter of a pill and regularly drink water. A quarter of a pill could contain 60-70mg of MDMA, which is like a standard dose for a small person.

But there are contaminants as well. Last summer when we were testing boric acid was being sold as cocaine, we found malaria tablets had been ground up and sold as cocaine, we found 100% concrete had been sold as ecstasy pills. If we identify those, we can put out warnings on social media. We will tweet an alert and then the police and the event retweet it. The police prefer us to do that because there is more credibility as a professional harm reduction organisation. If the police did it no one would believe them anyway.

What is the difference with the drugs that are coming into the New Zealand market?

The different dangers are there is far more misselling in the market, there is far more variable contents. As I understand it from the testing in new Zealand last summer, a third were not what they were sold as, and very low purity, and there were a lot of cathinones as well instead of the anticipated drugs. They can be quite variable in terms of their effects. That seems to be more of a concern in New Zealand – less of the standard drugs and more of the psychoactive substances.

What does a drug testing tent, or kiosk, look like? How does it work?

We have a big tent at a festival and it will be divided, the front half for public access, the back half a pop up lab without any access from the public. The whole of the tent is a tolerance zone from the police so they won’t arrest anybody going into the tent, and they will stay well away.

A member of the public will come into the front, they will drop off one dose of the substance, so one pill or a scoop of powder, put it in a little baggy, post it into a bin, they get a unique ID number and asked to come back about half an hour later.

The samples go to the lab. We have a whole room full of equipment that will do all the tests, and identify to the best of their ability the substance of the sample. Then we have some booths for semi privacy, and they will go into the booths with a drugs worker and they will give them the tests results, but not until they have talked to them about their drugs history, about whether they are on any medication, and then they give them the test results.

We don’t ask them about what they plan to do. Because we don’t want to be seen to be condoning or inciting drug use, that is a legal grey area.

The other thing we found, people came for testing in groups. The average number was four. They would obviously pull together to put one pill in for testing.

The Loop’s drug testing lab at Parklife festival in Manchester 2016.

I’m guessing no one gets their pills back after testing?

Nobody gets any drugs back. The drug is mostly destroyed in the testing process. But we can’t give the drug back anyway because that would technically be ‘supply’ if you give people drugs. So we don’t give anything back.

I am sure you are trying to achieve a space of safety and openness and communication, rather than showing up like they are going to speak to their mum, or doctor?

Absolutely, it is a fine balance. It is a fine balance, we mustn’t be, and we can’t be seen to be, encouraging or condoning drug use. We have to be professional and ethical but also we want to be welcoming. It’s confidential, it’s non judgemental, it has to be appropriate to the festival atmosphere.

Last summer, people put their head in the tent and they were sort of saying really? Is this legal? Are the police going to jump out from behind a curtain and arrest them. So there was an element of suspicion. But they were also very trusting to go ahead with it.
This summer we have had so much publicity, people know who we are, they know what we are doing, we don’t have to win people over like last year. It was very much uncharted territory last summer.

What were you trying to achieve with your first appearances at festivals?
I am first and foremost an academic, the important things for me, it is a recognition from all the stakeholders including the police, public health and the events industry that public health is more important than criminal justice. That is the bottom line. That is really important.

The thing that was really pleasing for me was that our biggest supporters were the police. They have not been at all obstructive. The cuts to the police in the UK have been getting greater and greater since 2010. Police budgets have been cut 20% since 2010, 20,000 less police. The consequence of that is they can’t arrest everyone for everything.

Festivals have been one of those areas, where police are targeting violence, inquisitive crime – tent theft, and dealers. They don’t have the resources to go around arresting everyone for possession for personal use. The police know that and everyone else knows that. So the questions is what else can you do to increase safety and reduce drug related harm.

The thing that is great about doing this is it’s exciting, it’s controversial, it’s seen as radical. But it still has the support of all the stakeholders.

Has this work influenced drug law policy?

This is carrying through to other things with the police. In Bristol in the UK for the past year they have had a drug education pilot, where the possessions of drugs in Bristol are decriminalised. If you are caught in Bristol in possession of any drugs, you don’t got through the criminal justice system, you got through a drug education programme instead. As long as you go on the course and you productively engage there is no further action and no criminal record. For any drugs.
This is the best kept secret in Bristol. It is seen as very successful. The police initiated it and the police are very happy with it.

While the conservative government is very much supporting the Misuse of Drugs Act, and basically supports prohibition. At local level the police are the ones who are saying we can’t be enforcing these laws anymore, so we are going to prioritise harm reduction. So the police are doing really interesting radical things, far away from Westminster. This is just one of those things and they’ve said yes, you can test on site.

How has the UK got the point where it is the police advocating for a harm reduction approach to drugs?

I think the mantra would be – The War on Drugs, it failed. Law enforcement officials at the front line are away of that than everyone else. They threw everything they could at prohibition and it hasn’t stopped demand. If you don’t stop demand then you won’t stop supply because there is profit there. There are going to be people who take the chance no matter what is involved as long as there is profit at the end of it.

There is an argument that some would give that they can see less harm from drugs like cannabis and ecstasy than they can see from alcohol or tobacco.

There is a lack of logic in the Misuse of Drugs Act. One in two smokers die of disease related to smoking. In the UK they say the ecstasy death rate is one in six million. Those disparities mean that people question a prohibition regime.

What do you think would be the most successful approach to the regulation of recreational drugs.
I think the current situation the least successful that we could have. You’ve got two extremes where either you have criminal organisations control drugs, and there is very little way you have in controlling them, and how much they sell if for, the quality. You’ve got virtually an unbridled criminal organisations selling illegal drugs. At the other end of the scheme you have industries selling these psychoactive substances with no regulation.
My ideal would be some sort of middle ground, where you have some control over these substances, some sort of government control. I would probably advocate a strict regulatory model.  

I’ve got concerns about unbridled capitalism just as much as about criminal organisations. The problem with both of those there is not enough control of psychoactive drugs. It’s about appropriate regulation and control.

Why doesn’t prohibition work?

There is such strong demand for intoxication, and there has been in pretty much all societies and cultures and tribes, throughout history, there are issues in how do we channel that desire for intoxication away from more harmful substances. How do we effectively channel people towards drugs that are less harmful or drugs that we know more about.

At the moment we have massive problems with synthetic cannabinoids in the UK. This is an illegal market. And it is causing huge social problems on the streets, especially amongst homeless people and in prisons as well. They became a drug of poverty, people taking the drug to escape the desperate situations of their lives. They are definitely not party drugs anymore.

Because in the UK we have relatively cheap and accessible ecstasy, cocaine and ketamine, and things like that, those tend to be the drugs people were taking going to parties and festivals.

Why has there been this permanent historic desire in humans for intoxication?

It’s been described as the fourth drive by Siegel, after food, sex and sleep. There are all sorts of reasons throughout history. Spiritual reasons, religious reasons, creative reasons, people take drugs for artistic creativity, to relax, to party for sociability. It is clear there is a demand there, that is why I think it is important that we have appropriate strict regulation and control, because there are harms as well, and it would be foolish to suggest that they are are harmless. But there are very different harms.

For example caffeine, caffeine is a really interesting stimulant that pretty much all societies use on a daily basis, and you could consider it to be a drug. Yet it is addictive and it can kill people. But we accept that everyone can take it in an acceptable, moderate, social way. Very few countries have got great restrictions on caffeine. That’s a great example of a drug that most people seem to use in an appropriate way.

Would a drug free society work? Is that a realistic or desirable goal?

Do we want to have that. I am not a puritan. I drink alcohol. I think there is a place for sociable intoxication, I do everything in moderation. People can get pleasure from that. You can see people get pleasure from intoxicating experiences. And also people from psychedelic and hallucinogenic experiences – people have life changing experiences. One of the interesting things now from the research with psychedelics now, they are now looking at how it might have a role to play in treating anxiety and depression, and posttraumatic stress. We are just at the start of our understanding of psychoactive drugs and what they can do. So we wouldn’t really want to curtail that research. I know one of the concerns in the UK is that prohibition has curtailed that research. It’s very difficult to get a licence for testing, ironically the drugs are very expensive and difficult to get through legitimate channels, where it would be easy and cheap [to buy illegally].

Someone was telling me they just wanted to get a few grams of MDMA for research purposes and it was going to be £65,000. We calculated to buy it in Manchester where I live that it would be about £300.

I don’t think we are going to see a society where we are not going to have any intoxication. I don’t know why we should or why we would want to. So it is about how it can happen. We want to use drugs to maximise the pleasures and minimise the pain – and they have a role to play in both of those.

A fresh way to deal with drugs is needed more than ever in New Zealand. The Drug Foundation’s roadmap for reform Whakawātea te Huarahi – A model drug law to 2020 and beyond is available online.

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