Pharmacy needs to get serious about pill checking and other harm minimisation measures, writes Liam Murphy
I’m just going to get straight to the point: the pharmacy industry and its governing bodies need to step up now and show their support for broadening the scope of harm minimisation to include the implementation of drug checking at festivals in Australia.
After processing that sentence you might be nodding your head, or you might be asking “why?”
To begin to justify this stance, let’s start by acknowledging three key points relevant to this topic:
- There are a range of substances/drugs that are illegal in Australia because of the century long “war on drugs”.
- Because these substances are illegal in Australia, there is no regulation or quality control with regards to what is going into products consumed. For example, a pill that someone buys at a festival could be made up of talcum powder or it could contain any number of other toxic substances
- Regardless of their legal status, these drugs are still being widely consumed by Australians, often with no knowledge about what they are really taking.
So, what exactly is “drug checking”?
Emergency medicine consultant and harm reduction advocate, Dr David Caldicott, describes drug checking, which is also known as “pill testing,”, as “a process that allows a consumer to know what is in their product prior to consuming it.”
It also helps set the scene for alcohol and drug researchers to investigate what Caldicott refers to as a predominantly “invisible cohort of functional consumers”.
The festival scene provides a good testing ground to trial drug checking, but its potential applications are boundless.
Implementing drug checking is not a means of promoting drug use, nor is it about telling people that their pill doesn’t contain harmful additives and then telling them it is safe to use. I see it as a platform for professionals to engage in a non-judgemental discussion with users, ensuring that people are able to make more informed decisions and recommending that people exercise caution and use these substances in a safer manner.
If we, as pharmacists and trusted health care professionals, really care about creating positive interventions in the community, then this initiative has the potential to create an absolute gold mine for interventions like those outlined above.
There is also the potential to create a whole new breed of pharmacist that can specialise in mental health and harm reduction and apply their knowledge in a previously uncharted way.
I was fortunate to spend the last week involved in the NAPSA congress representing The Roaming Pharmacist with my partner Luke Vrankovich. It is encouraging to see the potential and passion that these students will bring to the profession in the coming years.
It is apparent that there is a sentiment among these future pharmacists that they would like to break the shackles of being designated to traditional ‘community’ or ‘hospital’ pharmacy roles.
Along with the current legal status of some drugs, it is stigma attached to drug use and a lack of political courage that have stifled the progression of harm reduction to expand beyond the successful Opioid Substitution and Needle and Syringe programs already in place.
In NSW, the recently retired Premier Mike Baird was a vocal critic of pill testing. He is on the record as saying, “Don’t do it. That’s the best form of safety. Don’t take pills and you’ll be fine.”
I admit that there is logic in his statement. However, history has shown us that this idealistic approach alone does very little to reduce the wider harms of drug use in the community.
The Australian Greens, spearheaded by former drug and alcohol medical practitioner Richard Di Natale, are the first major party to openly endorse pill testing measures in their party policies.
As drug specialists, pharmacists are practicing under the current Professional Practice Standards set by the PSA, hence harm minimisation should be at the forefront of our practice.
Despite the recent decision to change codeine to a Prescription Only schedule item in Australia, the pharmacy industry was vocal in asserting our abilities to reduce the harms of over-the-counter pain reliever abuse in the lead up to the decision.
Unfortunately, we must accept the unfavourable outcome, but realise that it gives us an opportunity to use this momentum of advocacy to look laterally at how we can diversify and continue to strengthen our impact on healthcare in Australia.
How can we get this done?
Well, I don’t have all the answers, but I do have a few ideas.
Firstly, as Australia’s peak pharmacy professional organisation, the Pharmaceutical Society of Australia should make it a priority to release a position statement on drug checking at festivals. I recognise that there’s a chance I might not like the response, but at the very least it will thrust the issue into the spotlight for further debate.
Secondly, we should encourage our future generation of pharmacists to explore more options relating to harm minimisation in their studies and in their pharmacy practice. There are a range of ways pharmacy academics as well as students undertaking honours projects could utilise their time to contribute to our understanding of the possible implications that this would have.
If you are a pharmacist, student or a member of the public that has a spare hour and wants to learn more, then simply type “What’s In My Baggie?” into Google and follow the featured YouTube link for a fantastic documentary on an underground movement for pill testing in the United States.
Liam Murphy is the founder of The Roaming Pharmacist.
Image: Fish Taco