Pill testing proves value of compassionate health interventions

As Australia’s first government-backed pill testing service hits two years in operation, its impacts are evident on both a local and national scale. 

A free and confidential service, CanTEST enables members of the public to bring in recreational drugs for analysis, providing patrons with information and advice based on the testing results. It’s about working with young consumers of drugs in a way that minimises harm.   

Since opening in July 2022, the team at CanTEST has spoken with close to 2,000 patrons and tested more than 2,600 different individual substances. We have issued 19 community notification warnings, including two red notifications for substances classed as true health emergencies, which led to public health alerts in the Australian Capital Territory (ACT) and Victoria. 

By demonstrating that consumer behaviour can be more effectively changed by a compassionate, health-centred approach than by stigmatising rhetoric, pill testing threatens to undermine the foundations of outdated drug policies.  

Monitoring the market

In the significantly underfunded area of drug policy in Australia, harm reduction services represent only 1.6 per cent of spending, while law enforcement takes the lion’s share with 64 per cent of the total budget. This disparity is in spite of mounting evidence that harm reduction is considerably more effective in changing behaviours. 

Illicit drugs flow through communities in a very similar way to infectious diseases. By operating continuously – outside of the sporadic provision at music festivals – we have been able to monitor patterns within the market as they emerge.  

Infectious disease experts are always looking out for the troublesome priority pathogens that we know are out there. At CanTEST we consider, with some intensity, Drug X, whatever that might be, and wherever it might come from. 

We have identified illicit substances previously undescribed in scientific literature and were able to warn the public early about the presence of nitazenes – a synthetic opioid estimated to be a hundred times more potent than heroin – in the Australian market. We have also been able to document the increasing purity of cocaine in the local market. 

We’ve been looking hard for fentanyls, a true healthcare emergency for the United States, but thankfully have yet to find any.  

Community impact and support

As the first, and now longest running such service in Australia, CanTEST’s expertise has been in high demand. Ours has been an enabling role, an example to other jurisdictions as to what success can look like.  

We’ve been delighted to advise colleagues and counterparts in several jurisdictions as they’ve begun taking their first steps in their own journeys – Queensland and Victoria have now introduced trial or permanent pill testing.  

The service has altered views on harm reduction approaches to drugs. Service users are clearly very enthusiastic about it, but in a highly health-literate jurisdiction, non-users also understand the aims and achievements to date.  

Public approval in the ACT continues to soar, and an injection of $1.8 million in ACT government funding will ensure the service can continue to operate until mid-2027. Local polling suggests that more than 90 per cent of the local community approve of and appreciate the service. Only a fraction of this number would be users of the service itself.  

While those providing the service are doing so on its own merits, those opposed have realised that pill testing represents a battle for the hearts and souls of those still yearning for the ‘good old days’ of prohibition.  

Pill testing is an important service in its own right, but its impact seems to be extending beyond that of what it was originally intended to do. It has become a flashpoint, sparking major shifts in the never-ending ‘war on drugs’.  

Working with users and providing them with information, changes behaviour more than the stigma and shame of prohibition. Compassion works 

CanTEST is a collaboration between Directions Health Services, the Canberra Alliance for Harm Minimisation and Advocacy (CAHMA), Pill Testing Australia and ACT Health, with advice provided by scientists from ANU.