tag:theconversation.com,2011:/ca/topics/party-drugs-25416/articlesParty drugs – The Conversation2021-08-12T22:46:04Ztag:theconversation.com,2011:article/1656122021-08-12T22:46:04Z2021-08-12T22:46:04ZAfter the last ‘summer of terrible drugs’ it’s time to make NZ’s temporary drug checking law permanent<figure><img src="https://images.theconversation.com/files/415776/original/file-20210812-16-183ol7v.jpg?ixlib=rb-1.1.0&rect=9%2C0%2C5988%2C3935&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">www.shutterstock.com</span></span></figcaption></figure><p>With the summer music festival season approaching (COVID willing), hopes are high that the current temporary recreational drug checking law will become permanent. If and when that happens, New Zealand will take another small step down the long drug reform road from criminalisation to harm prevention. </p>
<p>Submissions to parliament’s health select committee on the <a href="https://www.legislation.govt.nz/bill/government/2021/0034/latest/LMS493289.html?search=ts_act%40bill%40regulation%40deemedreg_drug+and+substance+_resel_25_a&amp;p=1">Drug and Substance Checking Bill</a> have now closed, with a report due in October. If the <a href="https://www.legislation.govt.nz/act/public/2020/0063/latest/LMS430928.html">stop-gap law</a> rushed in for the 2020-21 summer is made permanent it will allow buyers of otherwise illegal drugs to have them independently checked without either the user or testing agency risking prosecution.</p>
<p>It’s an important service, given the dangers inherent in the illicit drug market and the chances of substances being cut or compromised with other toxic stimulants, as happened with some <a href="https://www.nzherald.co.nz/nz/wellingtonians-warned-harmful-substances-in-party-drugs-well-distributed-across-nz/KCEWCNW4G3AMRZ5CZACVMV2V2I/">MDMA circulating</a> last year.</p>
<p>Making testing legal, even if what is being tested isn’t, is a tacit acknowledgement that New Zealand’s “war on drugs” – which began 122 years ago with the <a href="http://www.nzlii.org/nz/legis/hist_act/opa19011ev1901n26307/">Opium Prohibition Act</a> – needs rethinking.</p>
<p>Despite generations of effort, the supply, demand and diversity of illegal drugs have grown, not diminished. Profit, pleasure and addiction have proved exceptionally powerful forces both <a href="https://www.unodc.org/unodc/en/data-and-analysis/wdr2021.html">internationally</a> and domestically. </p>
<p>And while border seizures were <a href="https://www.nzherald.co.nz/nz/covid-19-coronavirus-drug-seizures-at-border-decline-dramatically-after-year-of-pandemic/DCILXNEZJEWHGK3J4MJOAWTW2M/">way down</a> due to COVID-19 restrictions, the black market in New Zealand for illegal drugs (not counting cannabis) is still worth an estimated <a href="https://www.police.govt.nz/about-us/publication/national-wastewater-testing-programme-quarter-1-2021">NZ$77 million per quarter</a>.</p>
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<h2>Success and failure</h2>
<p>New Zealand first tried a different approach in 1987. The then Labour government introduced a national needle exchange program — a world first that allowed intravenous drug users to receive clean needles. The program significantly <a href="https://www.scimex.org/newsfeed/needle-exchanges-helped-reduced-nz-hiv-transmissions">reduced the risk of catching HIV</a> or hepatitis C, <a href="https://www.beehive.govt.nz/release/needle-and-syringe-exchange-programme-saves-lives">saving lives</a> and tens of millions in health spending.</p>
<p>The next innovation was a world-leading attempt to legalise and regulate the rapidly evolving synthetic drug market. It ultimately <a href="https://www.rnz.co.nz/news/the-wireless/375177/a-drug-experiment-gone-wrong">fell over</a> due to practical problems implementing the Psychoactive Substances Act, public backlash and resistance to animal testing.</p>
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Read more:
<a href="https://theconversation.com/we-cant-eradicate-drugs-but-we-can-stop-people-dying-from-them-54636">We can't eradicate drugs, but we can stop people dying from them</a>
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<p>This pattern of innovation and failure has continued. While the use of <a href="https://www.legislation.govt.nz/regulation/public/2019/0321/latest/LMS285243.html#LMS285242">medical cannabis</a> became legal in 2019, the referendum on legalising recreational cannabis <a href="https://www.theguardian.com/world/2020/nov/06/new-zealand-narrowly-votes-no-to-legalising-cannabis-in-referendum">failed</a> at last year’s general election.</p>
<p>A <a href="https://www.legislation.govt.nz/act/public/2019/0042/latest/whole.html">2019 amendment</a> to the Misuse of Drugs Act did pass, however, giving police clearer discretion not to prosecute for possession of small amounts of illegal drugs. Despite room for improvement, the new system has seen <a href="https://www.nzherald.co.nz/nz/politics/drug-law-impact-revealed-number-of-people-charged-per-month-dropping-dramatically-less-bias-against-maori/WQBN5JSLNN5XTN4HYZAFUT7XSE/">fewer prosecutions for personal use</a> and has helped shift the focus towards health and away from the criminal courts.</p>
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<h2>Drug checking prevents tragedies</h2>
<p>Given Labour’s parliamentary majority and that the drug checking bill is a government initiative, it’s likely to pass. If for some reason it didn’t, individuals or organisations handling drugs to check them would risk being charged with possession or supply. </p>
<p>Anyone allowing drug testing to operate on their premises would also be at risk because their co-operation could be seen as evidence of knowledge that illegal drugs were being consumed.</p>
<p>Most critically, if drug users can’t get reliable information about what they’re taking, their uninformed choices carry unpredictable and potentially extreme risks. Naïve customers and untrustworthy dealers can be a fatal combination.</p>
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Read more:
<a href="https://theconversation.com/heres-why-doctors-are-backing-pill-testing-at-music-festivals-across-australia-109430">Here's why doctors are backing pill testing at music festivals across Australia</a>
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<p>Between 2017 and 2019, more than <a href="https://www.rnz.co.nz/news/national/398453/synthetic-cannabis-more-than-70-deaths-in-two-years-blamed-on-the-drug">70 deaths</a> were attributed to synthetic cannabis in New Zealand. </p>
<p>When the volunteer drug checking and harm reduction organisation <a href="https://knowyourstuff.nz/">Know Your Stuff NZ</a> checked 2,744 samples of other drugs at 27 events between April 2020 and March 2021, “<a href="https://knowyourstuff.nz/2021/07/07/this-was-the-summer-of-terrible-drugs/">only 68%</a> of all the samples checked were the substance that people expected”. They called it “the summer of terrible drugs”.</p>
<p>Even cannabis sourced illegally for medicinal reasons is often <a href="https://www.stuff.co.nz/national/health/125563016/few-would-provide-an-effective-dose-esr-does-firstofitskind-testing-on-black-market-medicinal-cannabis-products">not what people expect</a>, or even effective. Not surprisingly, then, research has shown <a href="https://www.karger.com/Article/FullText/507049">the vast majority of people</a> would opt to have their illegal drugs tested if they could do so without risk of arrest and could trust the information.</p>
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Read more:
<a href="https://theconversation.com/if-reducing-harm-to-society-is-the-goal-a-cost-benefit-analysis-shows-cannabis-prohibition-has-failed-145688">If reducing harm to society is the goal, a cost-benefit analysis shows cannabis prohibition has failed</a>
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<h2>Protection from black markets</h2>
<p>It’s been argued that drug checking only encourages the use of illegal and harmful substances. But the <a href="https://openaccess.wgtn.ac.nz/articles/report/Drug_Checking_at_New_Zealand_Festivals_Final_Report_/13936346">evidence</a>
suggests <a href="https://pubmed.ncbi.nlm.nih.gov/33677840/">otherwise</a>.</p>
<p>Rather, informed decisions produce changes in behaviour. When drug customers realise they have been misled or have misunderstood the nature of a given substance, they typically take less, or none.</p>
<p>The so-called war on drugs may be turning into a war on misinformation. If the Drug and Substance Checking Act finally comes into force by December, as has been promised, it will reflect a legislative trend toward harm reduction.</p>
<p>It will not stop the illegal use of drugs. But it will be one step further towards making New Zealand citizens safer from the scourge of unregulated and dangerous black markets for drugs.</p><img src="https://counter.theconversation.com/content/165612/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alexander Gillespie does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Drug and Substance Checking Bill currently moving through parliament marks another milestone in New Zealand’s shift away from criminalisation and towards harm reduction.Alexander Gillespie, Professor of Law, University of WaikatoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1080672019-06-06T19:30:55Z2019-06-06T19:30:55ZCan a $12 pill test for ecstasy save lives? Well, it’s complicated<figure><img src="https://images.theconversation.com/files/278224/original/file-20190606-40719-1veur7f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New research into pill testing at festivals shows not everyone reacts to a test result the way you'd expect.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1368670571?src=K3Dkbaqdun0O9Mz6rnoToQ-1-4&studio=1&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>Can a A$12 pill test prevent deaths from ecstasy? Our research, <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dar.12936">published today</a>, finds pill testing provides no magic answer. </p>
<p>We found not everyone acts on the result of a pill test in the same way. It depends on the result, whether they have used ecstasy before and how willing they are to take risks.</p>
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<a href="https://theconversation.com/how-does-mdma-kill-109506">How does MDMA kill?</a>
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<p>Ecstasy users could end up in hospital or dying as they do not know the chemical composition of the substance they are taking. That’s because their pill could contain higher than expected doses of ecstasy or toxic contaminants, both of which could be fatal.</p>
<p>So identifying what’s in their pill, using a pill checking service at a festival or a club, is one option to reduce the risk.</p>
<p>It’s an option that <a href="https://www.ncbi.nlm.nih.gov/pubmed/28635057">Australian research</a> suggests would be popular; some 95% of party-goers who used illicit drugs said they would use a pill checking service if it were available.</p>
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Read more:
<a href="https://theconversation.com/heres-why-doctors-are-backing-pill-testing-at-music-festivals-across-australia-109430">Here's why doctors are backing pill testing at music festivals across Australia</a>
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<p>But only two official services have been offered in Australia. </p>
<p>In 2018, the first government-supported <a href="https://www.abc.net.au/news/2018-04-30/groovin-the-moo-pill-testing-finds-lethal-product/9710112">pill testing trial</a> took place at the Groovin’ the Moo music festival in Canberra. In 85 tests, two lethal substances were detected and five users disposed of their substance once told what they contained. </p>
<p>In 2019 at the same festival, <a href="https://independentaustralia.net/life/life-display/pill-testing-a-life-saving-success--its-time-for-government-funding,12651">a repeat trial</a> detected seven dangerous substances, which were disposed of.</p>
<p>But what would someone do if they discovered their ecstasy was purer than average? Or the pill test was unable to identify the substance? Would this knowledge lead to safer behaviour? This is what our research tried to answer.</p>
<h2>What we found</h2>
<p>We presented almost 300 people at a music festival with different scenarios to find out who was most likely to continue to take risks after a pill test.</p>
<p>Almost 60% of people interviewed said they had used ecstasy before. These prior users said if the pill testing showed a high dose of ecstasy or the test was inconclusive, they would not necessarily take precautions, such as throwing away the pill or taking less of the pill.</p>
<p>But if they discovered their substance contained a toxic contaminant they would be very likely to take precautions.</p>
<p>These findings are important considering some of the recent <a href="https://www.sbs.com.au/news/more-festival-deaths-could-be-examined-in-nsw-inquest">ecstasy-related deaths at Australian festivals</a> have been linked to high doses of ecstasy. </p>
<p>The people who said they had never used ecstasy before were more cautious, regardless of the outcome of the test. They said they would be more likely to take precautions in all the scenarios we presented.</p>
<h2>Why don’t people always act?</h2>
<p>Educating people generally gives them information to make choices. But, for some, simply giving more information about their substance won’t change their tendency to use it.</p>
<p>Our study showed that people who are risk takers in general (referred to as sensation seekers) would be more likely to take risks with a substance if a test was inconclusive or if the substance contained harmful contaminants. </p>
<p>Importantly, these risk takers would also be less likely to take precautions after finding out their pill contained a high dose of ecstasy.</p>
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<a href="https://theconversation.com/explainer-how-our-understanding-of-risk-is-changing-79501">Explainer: how our understanding of risk is changing</a>
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<p>So, pill testing in itself is not the magic answer. This new research suggests that pill testing services at music festivals would be most effective for reducing harm in people who might be trying ecstasy for the first time. </p>
<p>Generally, people who had used before were only more likely to take precautions if the ecstasy contained a toxic contaminant. </p>
<p>And prior ecstasy users who are also risk takers are statistically at the greatest risk of harm even after taking a pill test.</p>
<h2>Do ecstasy users already know what’s safe?</h2>
<p>Could people who have used ecstasy before know more about ecstasy use?</p>
<p>Apparently not. We found people who use ecstasy need drug education to help reduce their risks of harm. They were no more knowledgeable about sensible ecstasy doses or the harmfulness of dangerous contaminants than people who have never used.</p>
<p>So, it is important that formal pill testing services also offer counselling and drug education alongside the test result to decrease the chance of harmful choices, hospitalisation and even death.</p>
<p>Because we found almost 50% of prior ecstasy users said they did not know or trust their supplier, it suggests some people are knowingly taking considerable risks. If these people had access to a pill checking service then their ability to manage these risks would be greatly improved.</p>
<h2>Who pays for pill testing?</h2>
<p><a href="https://www.smh.com.au/national/nsw/pill-testing-trial-ridiculous-baird-20160228-gn5n0l.html">Political</a> <a href="https://www.abc.net.au/news/health/2018-12-21/guide-to-pill-testing-at-australian-music-festivals/10638732">opponents</a> to pill testing are wary of supporting or providing funds for quality-control services for illegal drugs. </p>
<p>However, the festival attendees we surveyed said they would contribute an average $12 towards the cost of such pill testing.</p>
<p>So, given the low knowledge levels in ecstasy users, let’s reframe pill testing as a gateway to engage with illicit drug users to provide other services, such as education and counselling. </p>
<p>This combined harm-minimisation approach could reduce the rates of harm to mostly ill-informed young people attending festivals.</p><img src="https://counter.theconversation.com/content/108067/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>New research shows some festival goers are willing to take a dodgy pill regardless of the test result. So, let’s use pill testing to educate them and others about reducing their risk.Ross Hollett, Lecturer, Edith Cowan UniversityNatalie Gately, Criminology Courses Coordinator, Edith Cowan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1161102019-05-15T21:04:39Z2019-05-15T21:04:39ZRape myths like ‘stranger danger’ challenged by global drug survey<figure><img src="https://images.theconversation.com/files/274444/original/file-20190514-60541-18dufhr.jpg?ixlib=rb-1.1.0&rect=39%2C19%2C4388%2C2927&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Fake news. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/stalking-aggression-721427098?src=e2UHz4ZVGeUb_QwOUkHRXQ-1-55">Shutterstock.</a></span></figcaption></figure><p>Many of the beliefs people hold about rape are downright wrong. For example, women are often told they can avoid sexual assault by monitoring how much alcohol they drink on a night out. “Don’t leave your drink unattended” and “drink from bottles instead of cups” are <a href="https://www.wikihow.com/Avoid-Spiked-Drinks">common pieces of advice</a>. There’s even <a href="https://drinkcheck.co.uk/">a wristband</a> that’s marketed as a “simple, wearable test to see if your drink may have been spiked”.</p>
<p>This is because alcohol and other drugs are widely thought to increase women’s vulnerability to sexual violence. At the same time, such substances <a href="https://pubs.niaaa.nih.gov/publications/arh25-1/43-51.htm">are often said to be</a> the cause of - or an excuse for - sexual aggression in men. This can even lead to double standards in people’s perceptions of sexual assault: <a href="https://journals.sagepub.com/doi/abs/10.1177/0964663907082737?casa_token=670k8IMFaswAAAAA:nB_vub3CZPNH3leNtRi25UBdbRus2ByAYFNfVs8X04OOCTapphh1WS4fCfqGKApBPQZkmPSMIZc">one study</a> found that intoxicated perpetrators tend to be held less responsible for their actions, while intoxicated victims tend to be held more responsible. </p>
<p>Such stereotypical or false beliefs about sexual assault are called “rape myths”, and they have a big impact on the way the victims and perpetrators of sexual assault are treated by society, the police and the legal system. Believing in rape myths often leads people to place responsibility on victims for what happened to them, rather than condemning perpetrators – so-called victim blaming. </p>
<h2>A global phenomenon</h2>
<p>To better understand people’s experiences of sexual assault while intoxicated, we asked the 123,800 people who completed the <a href="https://www.globaldrugsurvey.com/">Global Drug Survey</a> 2019 if they had been taken advantage of sexually while under the influence of alcohol or other drugs – 74,634 chose to answer the question. </p>
<p><a href="https://www.sociologicalscience.com/articles-v5-19-432/">Research has found</a> that some people have trouble using terms such as “sexual assault”, “rape”, “victim” and “perpetrator” to describe their experiences – in part because common rape myths lead people to imagine such scenarios in a certain way. This means that experiences which differ from common rape myths are less likely to be reported, or even labelled as such. </p>
<p>To get around this problem, we asked participants in the Global Drug Survey if they had been taken advantage of sexually while under the influence of alcohol or other drugs. We used this phrase – instead of “sexually assaulted” - to capture a wider range of experiences. We also collected further contextual information including where people were taken advantage of, who they were with and the type of drug they were using. </p>
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<img alt="" src="https://images.theconversation.com/files/274618/original/file-20190515-60532-1x5q85c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/274618/original/file-20190515-60532-1x5q85c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/274618/original/file-20190515-60532-1x5q85c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/274618/original/file-20190515-60532-1x5q85c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/274618/original/file-20190515-60532-1x5q85c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/274618/original/file-20190515-60532-1x5q85c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/274618/original/file-20190515-60532-1x5q85c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Most incidents happened at home.</span>
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<p>When we analysed the results, we found that 19% (14,174 respondents) reported that they had been taken advantage of sexually while intoxicated in their lifetime; 4% (3,252) said that this had happened within the last 12 months. It wasn’t just women who reported being taken advantage of: 8% of male respondents said they had experienced such an incident, and 2% had in the last 12 months. </p>
<p>Figures were higher for people identifying as women, non-binary or as a different gender identity: just over a third of participants from these groups reported being taken advantage of in their lifetime, and around 10% in the last 12 months.</p>
<p>Our findings challenged other dominant assumptions about sexual assault, including the idea that a woman is most likely to be assaulted by a stranger while walking alone outside at night. We found that 67% of incidents occurred in private homes, 70% of victims knew the perpetrator personally and 74% had friends or acquaintances nearby at the time of the incident. </p>
<h2>Context and consent</h2>
<p>Negotiating consent can be complex, especially when drugs or alcohol are involved, and our research found that 26% of respondents who reported being taken advantage of also said they gave their consent to initiate sexual activity. This suggests, too, that consent is best thought of as a process, rather than a one-off “yes” or “no” response. People must be able to withdraw their consent at any point during a sexual encounter.</p>
<p>Also, just because sex is “consensual” does not necessarily mean that it is wanted. It’s worth questioning whether people having sex always feel comfortable or safe saying “no” or withdrawing consent. </p>
<p>The next step is to consider how to best to prevent sexual assault from taking place. Clearly, advising women to monitor their alcohol or other drug consumption or avoid walking alone at night can only go so far, especially since incidents were more likely to occur in private houses, and involve a perpetrator known to the victim. </p>
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<a href="https://theconversation.com/drugs-and-alcohol-complicate-sexual-consent-but-context-can-make-things-clearer-106207">Drugs and alcohol complicate sexual consent, but context can make things clearer</a>
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<p>We must also recognise how categories such as gender, sexuality, race, ability and social class <a href="https://theconversation.com/drugs-and-alcohol-complicate-sexual-consent-but-context-can-make-things-clearer-106207">can affect</a> the way intoxication and sexual assault are talked about and understood. For example, those who do not fit the bill of an “<a href="https://www.utpjournals.press/doi/abs/10.3138/cjwl.22.2.397">ideal victim</a>” may have their experiences of sexual assault discredited by others. Context is also important – the setting, the type of drug and the nature of the relationship between the people involved in sexual activity can also help to explain why people feel some experiences are consensual, and others not. </p>
<p>Above all, people should reflect on the effects that alcohol or other drugs might have on their own feelings, and those of others, during sexual activity. Governments and other authorities such as police and schools should promote ethical sexual behaviour, supporting people to negotiate sex and intimacy, even while intoxicated.</p>
<p><em>If you have been sexually assaulted, there are services which can help you: call the Rape Crisis national freephone helpline on 0808 802 9999 (12-2.30pm and 7-9.30pm every day of the year).</em></p><img src="https://counter.theconversation.com/content/116110/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Adam Winstock is the founder and owner of Global Drug Survey Ltd – an independent self funded organisation based in London. It takes no monies from the alcohol or tobacco industry. No funding was provided to conduct this part of the survey and the researchers retain full control over content and analyses. </span></em></p><p class="fine-print"><em><span>Alex Aldridge does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Almost 20% of people in the 2019 Global Drug Survey had been taken advantage of while under the influence of drugs or alcohol.Alex Aldridge, PhD Candidate, Royal Holloway University of LondonAdam Winstock, Honorary Clinical Professor, UCLLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1106962019-02-07T19:07:53Z2019-02-07T19:07:53ZIn debates about drug use, fun is important<figure><img src="https://images.theconversation.com/files/257659/original/file-20190207-174857-19hll8p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">"Just say no" messages are ignored because young people want to have fun.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/IB5bld_weak">Marvin Meyer</a></span></figcaption></figure><p>Millions of Australians use, or have used, <a href="https://campaigns.health.gov.au/drughelp/drug-trends-and-statistics">illicit substances</a> at some point in their life, while millions more are regular users of legal drugs such as <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.001%7E2014-15%7EMain%20Features%7EAlcohol%20consumption%7E25">alcohol</a>, <a href="http://www.health.gov.au/internet/publications/publishing.nsf/Content/tobacco-control-toc%7Esmoking-rates">tobacco</a> or <a href="https://www.abc.net.au/triplej/programs/hack/misuse-of-pharmaceuticals-on-the-rise/9271046">sleeping pills</a>. </p>
<p>While some people become heavy users of alcohol or other drugs as a way of <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1360-0443.2010.02902.x">coping</a> with past trauma or mental illness, this is not the story for millions of others. Young (and older) people use drugs and alcohol for fun, enjoyment and socialisation.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/three-charts-on-who-uses-illicit-drugs-in-australia-110169">Three Charts on who uses illicit drugs in Australia</a>
</strong>
</em>
</p>
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<p>NSW Greens MP Cate Faehrmann <a href="https://www.smh.com.au/national/i-m-coming-out-about-drugs-it-s-time-get-real-about-pill-testing-20190120-p50shc.html">summed it up well</a> when she explained why she had used MDMA (ecstacy) in her 20s (and since):</p>
<blockquote>
<p>We knew there were risks but we were prepared to take them because having a good time was our priority … The ‘Just Say No’ message was around then too. We ignored it. Some things never change.</p>
</blockquote>
<p>“Fun” or “having a good time” as a reason for drug use is often dismissed as trivial or inconsequential. Why would people risk their health or life for simple fun? </p>
<p>Let’s look at the evidence for why people use three different types of drugs: <a href="https://www.racgp.org.au/download/documents/AFP/2010/August/201008frei_partydrugs.pdf">party drugs</a>, such as MDMA (ecstasy), cocaine or crystal methamphetamine (ice/crystal meth); marijuana; and alcohol.</p>
<h2>Party drugs</h2>
<p>The party drug category includes a range of drugs commonly used for dance parties, particularly MDMA (ecstasy), cocaine or gamma hydroxybutyrate (GHB), as well as crystal methamphetamine (ice). </p>
<p>In <a href="https://www-tandfonline-com.ez.library.latrobe.edu.au/doi/pdf/10.1080/13676260600983668?needAccess=true">studies</a> exploring motivation for party drug use, fun and pleasure are central. Users describe party drugs as giving them energy to dance and socialise, reducing inhibition and enhancing feelings of <a href="https://www-tandfonline-com.ez.library.latrobe.edu.au/doi/pdf/10.1080/13676260600983668?needAccess=true">connection to others</a>. </p>
<p>For some, party drugs also <a href="http://sigmaresearch.org.uk/projects/item/project59">intensify sexual experience</a>. </p>
<p>In these studies, party drug users’ descriptions of fun often relate to the quality of social relationships – drugs are fun because they allow for intense and disinhibited experiences with friends and lovers. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-do-young-people-gain-from-drug-use-18878">What do young people gain from drug use?</a>
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</em>
</p>
<hr>
<p>Some studies have suggested that party drug use can lead to <a href="https://theconversation.com/what-do-young-people-gain-from-drug-use-18878">social benefits</a> that carry through into other areas of life, including building friendship networks and social connections through which people derive support. </p>
<p>Fun, in this sense, is not just about hedonism, but about the experience of belonging and developing social bonds. </p>
<h2>Marijuana</h2>
<p>Marijuana is the <a href="https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/drug-types/cannabis">most commonly used</a> illicit drug in Australia, with 35% of the nation trying it at least once.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/257661/original/file-20190207-174890-xoyyz4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/257661/original/file-20190207-174890-xoyyz4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/257661/original/file-20190207-174890-xoyyz4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/257661/original/file-20190207-174890-xoyyz4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/257661/original/file-20190207-174890-xoyyz4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/257661/original/file-20190207-174890-xoyyz4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/257661/original/file-20190207-174890-xoyyz4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">One in three Australians have used marijuana.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/UoXLndT32Hg">Thought Catalog</a></span>
</figcaption>
</figure>
<p>There are many studies examining reasons why people use marijuana. For some, it is about <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696937/">coping</a> and managing stress or difficult emotions. However, most people <a href="https://www-sciencedirect-com.ez.library.latrobe.edu.au/science/article/pii/S030646030600298X">tend to use marijuana</a> for fun, enjoyment, or relaxation in a social setting. </p>
<p>In the 1950s, sociologist <a href="https://www.jstor.org/stable/2771989?seq=1#page_scan_tab_contents">Howard Becker</a> described the ritual of smoking marijuana as a process in which people formed social ties and established a sense of group identity as they learned how to derive pleasure from the act of smoking marijuana.</p>
<p>For young people, marijuana use can also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847659/">symbolise independence</a> and a sense of freedom – a change in their social status. </p>
<h2>Alcohol</h2>
<p>Understanding what motivates people to drink alcohol is a complex task, given that unlike illicit drugs, alcohol is integrated into mainstream <a href="http://cw.routledge.com/textbooks/anthropologyofstuff/alcohol_home.html">rituals and routines</a> of modern life. We drink together to mark success, to celebrate marriages, to commiserate loss. Bars, pubs and restaurants are the focal points of most adults’ social lives. </p>
<p>The <a href="https://theconversation.com/how-alcohol-makes-you-friendlier-but-only-to-certain-people-41730">physical effects of alcohol</a> – relaxation and disinhibition – are part of the pleasure associated with alcohol. But this can be hard to disentangle from the pleasure of participation in <a href="https://www.jstor.org/stable/4189107?seq=1#page_scan_tab_contents">social rituals</a>. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/zSKsSrXXj7E?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Here’s what happens when we take the first, second and fifth drink.</span></figcaption>
</figure>
<p>As with other drugs, studies which ask people why they drink cite <a href="https://www.sciencedirect.com/science/article/pii/S0376871610000992">social reasons</a> – fun, enjoyment and disinhibition – as common motivations for drinking. </p>
<h2>Why is this relevant?</h2>
<p>Emphasising the social nature of drug use should not detract from the recognition that drug and alcohol use can devastate the lives of some individuals. </p>
<p>There is also a valid argument that the legitimised social status of alcohol allows us to <a href="https://theconversation.com/social-acceptance-of-alcohol-allows-us-to-ignore-its-harms-10045">ignore its health risks</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/history-not-harm-dictates-why-some-drugs-are-legal-and-others-arent-110564">History, not harm, dictates why some drugs are legal and others aren't</a>
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</p>
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<p>However, understanding the social nature of drug use reveals why fun-seeking is so compelling. When people <a href="https://www-tandfonline-com.ez.library.latrobe.edu.au/doi/pdf/10.1080/02614369100390131?needAccess=true">describe fun</a>, they are often talking about an experience of social connection and belonging. Fun is not insignificant in human lives.</p>
<p>Understanding this might help to make sense of why “just say no” messages are so often ignored.</p><img src="https://counter.theconversation.com/content/110696/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer Power receives research funding from the Australian Department of Health, The Victorian Department of Health and Human Services and the Australian Research Council.</span></em></p>People who use party drugs say it gives them energy to dance and socialise, reduces their inhibitions and enhances their feelings of connection to others.Jennifer Power, Senior Research Fellow at the Australian Research Centre in Sex, Health and Society, La Trobe UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1095062019-01-22T18:38:10Z2019-01-22T18:38:10ZHow does MDMA kill?<figure><img src="https://images.theconversation.com/files/253596/original/file-20190114-43541-14qd0qa.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">MDMA itself isn't a dangerous drug. But adulterants found in drugs made by at-home chemists can be deadly. </span> <span class="attribution"><span class="source">from www.shutterstock.com</span></span></figcaption></figure><p>MDMA (Methylenedioxymethamphetamine), commonly referred to as ecstasy, was manufactured as a potential pharmaceutical early last century. It had some limited use in the 1970s as a therapeutic aid in trauma treatment and in relationship counselling, and more <a href="http://www.maps.org/research-archive/mdma/ptsdpaper.pdf">recent studies</a> using MDMA for trauma have shown some promise.</p>
<p>Structurally, MDMA is similar to the stimulant methamphetamine and to the hallucinogen mescaline, and so has both stimulant and mildly hallucinogenic effects.</p>
<p>Most problems with recreational MDMA are acute. Dependence and other long-term problems are quite rare. Less than 1% of all drug <a href="https://www.aihw.gov.au/getmedia/6ada5e0f-40ff-459b-ae6c-b45845a37ccc/aihw-hse-207.pdf.aspx?inline=true">treatment presentations</a> are for ongoing problems with MDMA, such as dependence.</p>
<p>Most fatalities from taking ecstasy are a result of a <a href="https://www.tandfonline.com/doi/abs/10.1080/14659891.2018.1436607?tokenDomain=eprints&tokenAccess=Sn9BHegQ979bPzzjwjr5&forwardService=showFullText&doi=10.1080%2F14659891.2018.1436607&doi=10.1080%2F14659891.2018.1436607&journalCode=ijsu20">combination of factors</a>, not just the drug itself. </p>
<p>Most of these conditions don’t result in death if they are treated early, but because of the stigma associated with using illicit drugs, sometimes people don’t seek help early enough. Any unusual or unwanted symptoms experienced while taking ecstasy should be treated as soon as they appear.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/six-reasons-australia-should-pilot-pill-testing-party-drugs-34073">Six reasons Australia should pilot 'pill testing' party drugs</a>
</strong>
</em>
</p>
<hr>
<h2>Contaminants and polydrug use</h2>
<p>Most people are under the impression drugs are illegal because they are dangerous, but a <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61462-6/fulltext">drug’s legal status</a> isn’t necessarily related to relative danger. In fact, drugs are much more dangerous because they are unregulated, manufactured by backyard chemists in clandestine laboratories. </p>
<p>Unlike alcohol, which is a highly regulated drug, there’s no way to tell how potent illicit drugs are or what’s in them, unless you <a href="https://theconversation.com/six-reasons-australia-should-pilot-pill-testing-party-drugs-34073">test them</a>.</p>
<p>In Australia, what is sold as ecstasy may contain a lot of MDMA or very little. Pills can contain other more dangerous drugs that mimic the effects of MDMA, and benign substances, such as lactose, as filler agents. </p>
<p>A recent report on findings from Australia’s first official pill testing trial at the Groovin’ the Moo music festival last year, found nearly <a href="https://www.harmreductionaustralia.org.au/wp-content/uploads/2018/06/Pill-Testing-Pilot-ACT-June-2018-Final-Report.pdf">half the pills</a> tested were of low purity. Some 84% of people who had their pills tested thought they had bought MDMA but only 51% actually contained any MDMA.</p>
<p>Some of the more dangerous contaminants found in pills include <a href="http://www.drugs.ie/pma">PMA</a> (paramethoxyamphetamine), which is more toxic at lower doses than ecstasy; <a href="https://knowyourstuff.nz/2018/02/07/this-summers-crap-drug-n-ethylpentylone/">N-Ethylpentylone</a>, a <a href="https://adf.org.au/drug-facts/synthetic-cathinones/">cathinone</a> which is a lot more potent than MDMA making it easier to take too much; and <a href="https://www.vice.com/en_nz/article/4x7jen/nbome-in-australia-everything-we-know-about-what-it-is-and-why-its-killing-people">NBOMes</a> (N-methoxybenzyl), which is more toxic at lower doses than other hallucinogenic drugs and can cause heart attack, renal failure, and stroke. </p>
<p>Pills have also been detected in UK and NZ with up to <a href="https://healthcentral.nz/concerns-over-doses-in-ecstasy-pills/">three doses of MDMA</a> in a single pill.</p>
<p>Although it’s possible to take too much MDMA and experience severe toxic effects, as with other illicit drugs, most <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0%7E2016%7EMain%20Features%7EDrug%20Induced%20Deaths%20in%20Australia%7E6">ecstasy-related deaths</a> involve multiple drugs.</p>
<p>Sometimes these drug mixes are unexpected and sometimes people take multiple drugs deliberately. It’s safer for people using ecstasy to limit use of other drugs, including alcohol, to avoid risk of adverse effects.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/while-law-makers-squabble-over-pill-testing-people-should-test-their-drugs-at-home-109421">While law makers squabble over pill testing, people should test their drugs at home</a>
</strong>
</em>
</p>
<hr>
<h2>Heatstroke</h2>
<p>Heatstroke or hyperthermia (dangerously high body temperature) is one of the most common issues among people taking MDMA.</p>
<p>MDMA increases <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008716/">body temperature</a> and sweating, and using it is often accompanied by physical activity (such as dancing) in a hot environment (such as a crowded venue or in the summer heat), exacerbating fluid loss. If you don’t have enough fluids your body can’t cool itself properly.</p>
<p>The effect of ecstasy can be exacerbated by consuming alcohol. Alcohol is a diuretic, so it makes you urinate more and increases dehydration. Dehydration <a href="https://www.hopkinsmedicine.org/healthlibrary/conditions/non-traumatic_emergencies/dehydration_and_heat_stroke_85,P00828">increases risk</a> of heatstroke.</p>
<p>Heatstroke can cause brain, heart, kidney and muscle damage, and if left untreated can cause serious complications or death.</p>
<p>If active, people taking MDMA should drink around 500ml (two cups) of water an hour and take regular breaks. Isotonic drinks (such as Powerade and Gatorade) are also OK.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/253598/original/file-20190114-43520-tm7uxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/253598/original/file-20190114-43520-tm7uxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/253598/original/file-20190114-43520-tm7uxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/253598/original/file-20190114-43520-tm7uxr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/253598/original/file-20190114-43520-tm7uxr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/253598/original/file-20190114-43520-tm7uxr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/253598/original/file-20190114-43520-tm7uxr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/253598/original/file-20190114-43520-tm7uxr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">MDMA increases body temperature and sweating, so users have to stay hydrated.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
</figcaption>
</figure>
<h2>Water intoxication</h2>
<p>People using MDMA can get really thirsty. Some is probably the direct effect of MDMA, some because they’re hot, and some from dehydration.</p>
<p>But if you have too much water the ratio of salts and water in the body becomes unbalanced – basically the level of salt in your body gets too low and your cells start swelling with water. The technical name is <a href="https://en.wikipedia.org/wiki/Hyponatremia">hyponatraemia</a>.</p>
<p>MDMA is an anti-diuretic, so it makes you retain water, which can <a href="https://cjasn.asnjournals.org/content/3/6/1852">increase risk</a> of water intoxication.</p>
<p>People may feel nausea with vomiting, confusion, severe fatigue, muscle weakness and cramps.</p>
<p>People taking ecstasy need to stay hydrated but only replace what is lost through sweating – around 500ml per hour if active and around 250ml an hour when inactive.</p>
<h2>Serotonin syndrome</h2>
<p>The main action of MDMA in the brain is an increase in <a href="https://www.medicalnewstoday.com/kc/serotonin-facts-232248">serotonin</a>, which among other things is responsible for regulating pro-social behaviour, empathy and optimism. This is why people who have taken MDMA feel connection with and positivity towards others.</p>
<p>But too much serotonin can result in “<a href="https://www.nps.org.au/australian-prescriber/articles/serotonin-syndrome-3">serotonin syndrome</a>”. It typically occurs when other drugs that also raise serotonin levels (other stimulants, antidepressants) are taken together with MDMA.</p>
<p>Signs include high body temperature, agitation, confusion, problems controlling muscles, headache and the shakes. People might also experience seizures or loss of consciousness. </p>
<p>It can be fatal if the symptoms are left untreated, so if anyone taking MDMA shows any of these signs they should be treated immediately. It’s safer not to mix different types of drugs, especially if you do not know what’s in them.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/heres-why-doctors-are-backing-pill-testing-at-music-festivals-across-australia-109430">Here's why doctors are backing pill testing at music festivals across Australia</a>
</strong>
</em>
</p>
<hr>
<h2>Other causes</h2>
<p>More rarely, fatalities have been reported as a result of other health complications after taking ecstasy, especially if the person has pre-existing risk factors, such as high blood pressure or a heart condition. Complications related to heart failure, liver failure and brain haemorrhage have been reported in people already at high risk of these problems.</p>
<p>The number of people who die from party drugs is <a href="http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/3303.0%7E2016%7EMain%20Features%7EDrug%20Induced%20Deaths%20in%20Australia%7E6">relatively low</a> compared to other drugs such as heroin, alcohol, and pharmaceuticals. But the media tend to <a href="https://www.sciencedirect.com/science/article/abs/pii/S0955395901000925">report</a> a higher proportion of these deaths compared to other drugs, increasing the perception of harm. Most of the deaths are not directly from the drug itself but other complications or contaminants.</p>
<p>It’s safest not to take drugs at all, but if you choose to, it’s safer to take a small amount first (like a quarter of a pill) and wait at least an hour to make sure there are no ill effects; drink about 500ml per hour of water if active; and don’t mix drugs, including alcohol.</p>
<p>In the absence of a legal, uncontaminated supply of MDMA, when pill testing becomes available in Australia it will at least help people make informed decisions about drug use and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0955395918302755?fbclid=IwAR0AKmYupBDAhRL-LMV_-pkrLcfV2ty4nJbR29il2fqd-0-KqL1I3zTKqqY">reduce the risk</a> of fatalities and other harms. People often <a href="https://theindustryobserver.thebrag.com/study-finds/">choose not to take</a> their pills, or take smaller amounts, when they discover contaminants.</p><img src="https://counter.theconversation.com/content/109506/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee works as a paid consultant in the alcohol and other drug sector. She has previously been awarded grants by state and federal governments, NHMRC and other public funding bodies for alcohol and other drug research.</span></em></p>Every summer we hear of more deaths from drugs at festivals. But MDMA was originally a medicine, so how can it kill users?Nicole Lee, Professor at the National Drug Research Institute, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1095052019-01-15T19:12:28Z2019-01-15T19:12:28ZWeekly Dose: new drug MDPV, or ‘monkey dust’, found in Australia. What is it and what are the harms?<figure><img src="https://images.theconversation.com/files/253600/original/file-20190114-43532-z3jpk2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Users may or may not know they're taking MDPV. </span> <span class="attribution"><span class="source">from www.shutterstock.com</span></span></figcaption></figure><p>Recent <a href="https://www.weeklytimesnow.com.au/news/national/health-warning-issued-over-new-monkey-dust-drug/video/2d04b0572c89c3bcf24c4a2031a24177">media reports</a> have suggested a rise in a dangerous new party drug known as “monkey dust”. This is a slang name for the drug MDPV (3,4-methylenedioxypyrovalerone), as well as other members of the chemical class known as “synthetic cathinones”, or “bath salts”. </p>
<p>The effects of monkey dust are similar to other stimulants such as ecstasy (MDMA) and cocaine. Revellers may be using the drug on purpose as a substitute for these, or may mistakenly think it’s MDMA. However, the potency and effects are different, and can lead to trouble.</p>
<p>Synthetic cathinones are synthetic derivatives of a stimulant found in the <a href="https://adf.org.au/drug-facts/khat/">khat plant</a>, a flowering plant native to the Horn of Africa and the Arabian Peninsula. <a href="https://www.unodc.org/wdr2017/field/Booklet_4_ATSNPS.pdf">More than 140 individual synthetic cathinones</a> have been identified as illicit drugs, so users can never be certain about a substance from its street name alone. </p>
<p>This class also includes drugs you may have heard of before including <a href="https://theconversation.com/weekly-dose-ephylone-the-dangerous-designer-stimulant-found-at-groovin-the-moo-96005">ephylone</a> (the dangerous drug detected recently via pill testing at an Australian music festival), methylone, and <a href="https://theconversation.com/meow-hear-this-mephedrone-is-a-curious-khat-2164">mephedrone</a>.</p>
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Read more:
<a href="https://theconversation.com/weekly-dose-ephylone-the-dangerous-designer-stimulant-found-at-groovin-the-moo-96005">Weekly Dose: ephylone, the dangerous designer stimulant found at Groovin the Moo</a>
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<h2>What is MDPV?</h2>
<p>MDPV was developed by pharmaceutical firm <a href="https://patents.google.com/patent/US3478050A/en">Boehringer Ingelheim</a> in the mid-1960s as a central nervous system stimulant. But development never got far enough for it to be tested on humans.</p>
<p>It <a href="https://doi.org/10.1111/1556-4029.12202">first reappeared</a> in internet drug forum discussions around 2005, and became increasingly prevalent in the United States, Europe and elsewhere over the following years. </p>
<p>MDPV has been illegal in Australia since 2010, and <a href="https://doi.org/10.1111/1556-4029.12202">around the same time</a> in many other jurisdictions including the United States, Canada, and much of Europe, accounting for a decline in its availability.</p>
<p>The Drug Enforcement Administration reported that MDPV accounted for <a href="https://www.nflis.deadiversion.usdoj.gov/DesktopModules/ReportDownloads/Reports/NFLIS_SR_CathCan_508.pdf">more than 50%</a> of all synthetic cathinones encountered in law enforcement seizures in the US by 2011. The proportion had dropped to <a href="https://www.nflis.deadiversion.usdoj.gov/DesktopModules/ReportDownloads/Reports/NFLIS-SR-SynthCannabinoidCathinone.pdf">less than 1% by 2015</a>. </p>
<p>The <a href="https://www.afp.gov.au/news-media/media-releases/brisbane-men-arrested-following-importation-%E2%80%98bath-salts%E2%80%99">recent seizure</a> of more than four kilograms of MDPV imported into Australia suggests a market for the drug still exists.</p>
<p>MDPV is a white crystalline powder in its pure form, but manufacturing impurities often render it from off-white to pale brown. It’s usually sold as a powder, powder-filled capsules or tablets. MDPV and other cathinones are often misrepresented as MDMA for sale due to similar appearance and some common effects. <a href="https://www.ecstasydata.org/results.php?start=0&search_field=substance&s=mdpv">Laboratory testing</a> of street pills containing MDPV shows it’s commonly mixed with other drugs.</p>
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Read more:
<a href="https://theconversation.com/weekly-dose-ecstasy-the-party-drug-that-could-be-used-to-treat-ptsd-55149">Weekly Dose: ecstasy, the party drug that could be used to treat PTSD</a>
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<h2>What does MDPV do?</h2>
<p>An <a href="https://www.who.int/medicines/areas/quality_safety/4_13_Review.pdf">oral dose of MDPV</a> is estimated to be around 5-20 milligrams (compared to 100-150 milligrams for MDMA). The main psychoactive effects last two to three hours, and side-effects persist for several additional hours.</p>
<p>Users <a href="https://www.erowid.org/chemicals/mdpv/mdpv_effects.shtml">report</a> MDPV produces euphoria, feelings of empathy (although less so than MDMA), increased sociability, mental and physical stimulation, and sexual arousal. </p>
<p>Side-effects, particularly at high doses, can include anxiety and paranoia, delusions, muscle spasms, and an elevated heart rate. In extreme cases, <a href="https://doi.org/10.1007/s13181-011-0196-9">MDPV has been linked</a> to rhabdomyolysis (rapid muscle breakdown), brain injury, and death.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/253601/original/file-20190114-43538-1rh26wd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/253601/original/file-20190114-43538-1rh26wd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/253601/original/file-20190114-43538-1rh26wd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/253601/original/file-20190114-43538-1rh26wd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/253601/original/file-20190114-43538-1rh26wd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/253601/original/file-20190114-43538-1rh26wd.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/253601/original/file-20190114-43538-1rh26wd.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Animals in lab studies wanted to self-administer the drug, meaning it’s addictive.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
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<p>Like other cathinones, MDPV is a stimulant and shares some effects with other stimulants such as amphetamine, cocaine and MDMA. <a href="https://link.springer.com/chapter/10.1007%2F7854_2016_53">MDPV produces its effects</a> by inhibiting the reuptake of two important signalling molecules (neurotransmitters) in the brain; norepinephrine and dopamine.</p>
<p>Norepinephine is generally responsible for preparing the brain and body for action in the so-called “fight or flight response”, while dopamine is involved in more complex functions such as arousal, motivation, reward and motor control.</p>
<p>By blocking the ability of certain brain cells (neurons) to reabsorb these neurotransmitters, MDPV effectively increases the intensity and duration of norepinephrine and dopamine signalling. Cocaine works in a similar way, but in a lab test, <a href="https://doi.org/10.1038/npp.2012.204">MDPV was a much more potent inhibitor than cocaine</a>.</p>
<p>Other norepinephrine-dopamine reuptake inhibitors (NDRIs) include pharmaceuticals such as methylphenidate (known as ritalin and used to treat ADHD) and buproprion (an antidepressant). But the psychoactive and stimulant effects of MDPV are much stronger than pharmaceutical NDRIs. </p>
<p>Pyrovalerone – a hybrid of mephedrone and MDPV – is an approved appetite suppressant used medically for weight loss. However, it’s rarely used due to its potential for abuse.</p>
<p>Studies in laboratory animals highlight the stimulating effects of MDPV, and also its potential for dependence. <a href="https://www.nature.com/articles/npp2012233">Mice trained to identify MDPV</a> find it similar to both MDMA and methamphetamine. MDPV stimulates movement in rats approximately ten times more potently than cocaine, and rats will <a href="https://doi.org/10.1111/j.1369-1600.2012.00474.x">readily self-administer MDPV</a>, suggesting it’s addictive.</p>
<h2>Dangers</h2>
<p>MDPV has been involved in dozens of deaths in Europe, detailed in a <a href="http://www.emcdda.europa.eu/system/files/publications/819/TDAS14001ENN_466653.pdf">report</a> by the European Monitoring Centre for Drugs and Drug Addiction, as well as in the <a href="https://www.who.int/medicines/areas/quality_safety/4_13_Review.pdf">United States, Australia, and elsewhere</a>. </p>
<p>But many of these deaths involved extreme doses, repeated dosing (“bingeing”), intravenous use or additional drugs. In <a href="https://www.europeanreview.org/wp/wp-content/uploads/268-274-Synthetic-cathinones-related-fatalities-an-update.pdf">fatal cases</a> involving a single synthetic cathinone, death has been attributed to complications arising from extremely high body temperatures or damage to the vessels of the heart. Fortunately, specialised drug testing can detect MDPV and its derivatives.</p>
<p>Although simple <a href="https://www.dea.gov/sites/default/files/pr/microgram-journals/2012/mj9-1_27-32.pdf">colour-based reagent tests</a> may identify MDPV, these tests may also cross-react with similar cathinones, some of which are less dangerous, and some of which are more so.</p>
<p>For reliable identification, more sophisticated technology such as mass spectrometry or infrared spectroscopy, of the type <a href="https://theconversation.com/heres-why-doctors-are-backing-pill-testing-at-music-festivals-across-australia-109430">drug experts are campaigning</a> to take place at festivals, is required. In this regard, small, portable, and relatively cheap infrared analysers may be useful for on-site testing services.</p>
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Read more:
<a href="https://theconversation.com/while-law-makers-squabble-over-pill-testing-people-should-test-their-drugs-at-home-109421">While law makers squabble over pill testing, people should test their drugs at home</a>
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<img src="https://counter.theconversation.com/content/109505/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Samuel Banister receives funding from the National Health and Medical Research Council and The Lambert Initiative for Cannabinoid Therapeutics.</span></em></p><p class="fine-print"><em><span>Richard Kevin receives funding from The Lambert Initiative for Cannabinoid Therapeutics.</span></em></p>Monkey dust is in the “bath salts” family. Here’s what that means.Samuel Banister, Team Leader in Medicinal Chemistry, University of SydneyRichard Kevin, Postdoctoral research associate, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1094212019-01-08T19:12:30Z2019-01-08T19:12:30ZWhile law makers squabble over pill testing, people should test their drugs at home<figure><img src="https://images.theconversation.com/files/252609/original/file-20190107-32142-1erdnz9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Reagent test kits are not as effective as specialist testing. But it's better than nothing. </span> <span class="attribution"><span class="source">from www.shutterstock.com</span></span></figcaption></figure><p>As the festival season ramps up this summer, so has the ecstasy death toll. There have now been <a href="https://www.news.com.au/national/crime/they-deserve-to-die-we-dont-care-callous-messages-in-the-wake-of-music-festival-drug-deaths/news-story/b2598d2071686d14e7417b7d3f48eaa6">five suspected drug-related deaths</a> that might have been preventable if <a href="https://theconversation.com/six-reasons-australia-should-pilot-pill-testing-party-drugs-34073">people knew what was in the drugs</a> they were taking. </p>
<p>This has led to a flurry of calls for governments to introduce pill testing by specialists at festivals. What many people might not know is they can already legally purchase reagent test kits to test their drugs at home (although possession of the drugs is still illegal). So, do at-home test kits work?</p>
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Read more:
<a href="https://theconversation.com/heres-why-doctors-are-backing-pill-testing-at-music-festivals-across-australia-109430">Here's why doctors are backing pill testing at music festivals across Australia</a>
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<h2>What are reagents?</h2>
<p>Reagents are chemicals that react with a small sample of the drug being tested by changing colour. The most well known reagents are <a href="https://en.wikipedia.org/wiki/Marquis_reagent">marquis</a>, <a href="https://en.wikipedia.org/wiki/Mandelin_reagent">mandelin</a> and <a href="https://en.wikipedia.org/wiki/Mecke_reagent">mecke</a>. The colour change indicates what might be in the drug (which you can check on a chart that comes with the kit).</p>
<p>The kits can be legally sold and purchased as a <a href="https://xtesty.com.au/">single use test</a>, and makers report sales have increased by <a href="https://www.dailytelegraph.com.au/news/nsw/sale-for-diy-drug-testing-kits-soar-110-per-cent-following-music-festival-drug-overdoses/news-story/79cfd976bd80f3f7211856af12a2e5cc">110% in the past year</a>.</p>
<p>However many of these products are not well labelled. For example, the <a href="https://ez-test.com.au/product/ketamine/">ketamine reagent kit</a> is actually mandelin, which is quite good for testing ecstasy, but not as good for testing ketamine. The actual reagent chemicals can be purchased for testing multiple samples. This is also legal, and much cheaper.</p>
<p>In 2017 I was volunteering at a large multi-day Victorian festival, camping with academic colleagues. Having brought reagent testing equipment, when people came to our camp site asking if we’d like to buy drugs, we said “perhaps, but would you mind us testing it first?” Within 24 hours we had identified the dangerous drug <a href="https://en.wikipedia.org/wiki/Para-Methoxyamphetamine">PMA</a>.</p>
<p>We contacted the festival emergency controller. Being an ex-law enforcement official, he knew instructing people to test other people’s drugs would be illegal since the drug testers would momentarily be in possession of an illegal drug. Nonetheless, he didn’t want deaths on his hands and so instructed us to set up a covert pill testing station. </p>
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Read more:
<a href="https://theconversation.com/yes-we-can-do-on-the-spot-drug-testing-quickly-and-safely-73343">Yes, we can do on-the-spot drug testing quickly and safely</a>
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<p>Several concerned members of the community volunteered to handle the illegal drugs brought to the covert pill testing station, all knowing full well they would be breaking the law. Within 48 hours 139 samples had been tested. We suspected a number contained <a href="https://theconversation.com/explainer-what-is-nbome-16950">Nbome</a>, an adulterant found in ecstasy capsules that <a href="https://www.vice.com/en_au/article/3dp5pk/leaked-police-memo-reveals-what-was-in-melbournes-deadly-batch-of-mdma">killed several people in Melbourne</a> only weeks earlier. </p>
<p>Most people whose drugs were tested that we suspected were from this batch simply <a href="https://www.perthnow.com.au/news/wa/ecstasy-pill-tests-will-save-lives-says-perth-researcher-ng-209ae9ed38dd41c1fa2f4038f7e10e81">put these drugs in the bin</a>. A volunteer sent one such discarded sample to a testing service overseas that confirmed what we suspected. </p>
<h2>The limitations of reagents</h2>
<p>Reagent testing is rudimentary at best, but it can identify potentiality fatal adulterants in ecstasy such as PMA and Nbome. However, just because a test shows that a sample contains MDMA, the chemical name for ecstasy, the sample could also contain other dangerous chemicals. This is further complicated given nearly <a href="http://www.emcdda.europa.eu/system/files/publications/8585/20181816_TDAT18001ENN_PDF.pdf">500 new drugs</a> have been identified in the past few years.</p>
<p>Accuracy can be improved by using at least two reagents and triangulating the data. That is, each reagent turns a different colour depending on the drug it is exposed to, so if you do it twice with two different reagents you’ll get a better idea of what the drug contains. </p>
<p>The covert operation in 2017 involved at least three reagents. Nonetheless, we could only speculate the drugs were from the same batch as those that killed several people in Melbourne weeks earlier because the colour pattern we were seeing didn’t show up on the chart. </p>
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<img alt="" src="https://images.theconversation.com/files/252654/original/file-20190107-32133-pz1ee2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/252654/original/file-20190107-32133-pz1ee2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=943&fit=crop&dpr=1 600w, https://images.theconversation.com/files/252654/original/file-20190107-32133-pz1ee2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=943&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/252654/original/file-20190107-32133-pz1ee2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=943&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/252654/original/file-20190107-32133-pz1ee2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1185&fit=crop&dpr=1 754w, https://images.theconversation.com/files/252654/original/file-20190107-32133-pz1ee2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1185&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/252654/original/file-20190107-32133-pz1ee2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1185&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><span class="source">www.dancesafe.org</span></span>
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<p>Had we had access to the internet, we could have downloaded more up-to-date information. For example, <a href="https://bunkpolice.com/">The Bunk Police</a> have an app that provides people with access to an extensive library of videos showing the various reagent reactions of hundreds of drugs.</p>
<h2>More rigorous pill testing</h2>
<p>Given the limitations of reagent testing, <a href="https://www.smh.com.au/national/what-is-pill-testing-20190103-p50pg5.html">many</a> are advocating for more sophisticated technologies. </p>
<p>The first and only sanctioned trial of pill testing in Australia used <a href="https://www.harmreductionaustralia.org.au/wp-content/uploads/2018/06/Pill-Testing-Pilot-ACT-June-2018-Final-Report.pdf">infrared spectroscopy</a>. This technology can quickly identify all known chemicals. It also provides an indication of the purity of each chemical. </p>
<p>Of 83 samples provided for analysis, two contained <em>N</em>-Ethylpentylone, a drug that has only recently emerged. It has caused <a href="https://www.telegraph.co.uk/news/2018/06/10/warning-potent-fake-mdma-drug-causes-psychosis-keeps-users-awake/">deaths and “mass casualty overdoses”</a>. Where very high purity MDMA was identified, people were advised to take lower doses to avoid overdosing. </p>
<p>This trial occurred in the Australian Capital Territory, which is unique since health-care professionals are able to handle illegal drugs for the purposes of analysis. Legislative changes would need to be made to allow sanctioned pill testing to be provided in other states - or at least some form of government support would be needed to run a one-off trial. </p>
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Read more:
<a href="https://theconversation.com/six-reasons-australia-should-pilot-pill-testing-party-drugs-34073">Six reasons Australia should pilot 'pill testing' party drugs</a>
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<h2>In the meantime…</h2>
<p>While politicians continue to debate whether more <a href="https://theconversation.com/yes-we-can-do-on-the-spot-drug-testing-quickly-and-safely-73343">sophisticated pill testing</a> should be implemented in Australia, I recommend people use reagent testing. And so do <a href="http://ssdp.org.au/blog-post/ssdp-australia-position-statement-pill-testing/">Students for Sensible Drug Policy</a> (SSDP), a grassroots network of young people campaigning for drug policy reform. </p>
<p>The University of Melbourne Chapter of SSDP provides students with <a href="https://www.vice.com/en_au/article/qb5zqv/melbourne-unis-student-union-is-going-to-hand-out-free-drug-testing-kits">free access</a> to reagent test kits. Meanwhile, I helped the Edith Cowan University (ECU) student guild in collaboration with the ECU chapter of SSDP, to provide students with information on how to maximise the utility of reagent test kits <a href="https://www.6pr.com.au/podcast/tragedy-reignites-pill-testing-debate/">along with free kits</a> in October last year.</p>
<p>For more accurate information, people can send their drugs overseas to services such as <a href="https://energycontrol-international.org/drug-testing-service/">Energy Control</a> or <a href="https://www.ecstasydata.org/">Ecstasy Data</a>. For a small fee they use sophisticated technologies to allow people to anonymously find out what’s in their drugs. However, mailing illegal drugs involves breaking the law and the turnaround time means people have to plan their drug use well in advance.</p><img src="https://counter.theconversation.com/content/109421/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephen Bright does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>With several music festival patrons dying this year the pill testing debate is in full swing. Yet people can already purchase legally available test kits. Do they work?Stephen Bright, Senior Lecturer of Addiction, Edith Cowan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1076712018-11-27T11:40:12Z2018-11-27T11:40:12ZKim Kardashian West and ecstasy: A reminder of the social dangers of the drug<figure><img src="https://images.theconversation.com/files/247371/original/file-20181126-140513-t0xeqe.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Kim Kardashian West at the 50th anniversary of Cosmopolitan magazine, Oct. 12, 2015.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/los-angeles-oct-12-kim-kardashian-327220835?src=bdCwWMCYXEjxM058sFgT_w-1-5">Kathy Hutchins/Shutterstock.com</a></span></figcaption></figure><p>Kim Kardashian West, who has a reputation for disdaining alcohol, discussed her past use of the drug ecstasy on a recent segment of <a href="https://www.usatoday.com/story/life/people/2018/11/26/kim-kardashian-west-first-marriage-damon-thomas-ecstasy-drugs-sex-tape-ray-j/2112603002/">“Keeping Up with the Kardashians</a>.” </p>
<p>“I did ecstasy once, and I got married … I did it again, I made a sex tape … like, everything bad would happen,” she explained. </p>
<p>We often hear about the dangers associated with ecstasy use. We hear about the dangers of taking <a href="https://www.theguardian.com/society/2017/jul/22/friends-out-ecstasy-deaths-highest-level-pills">too much</a>, the dangers of <a href="https://www.ncbi.nlm.nih.gov/pubmed/27626048">overheating</a> while dancing on it for too long, and of unknowingly being exposed to drugs like “bath salts” that are commonly <a href="https://www.vice.com/en_us/article/3deky8/mdma-molly-bath-salts-nyu-study">cut</a> into the drug. But focus on potential social harms – which is associated with drug use in general – appears to be rare. </p>
<p>Kim unintentionally constructed a timely PSA which helps raise awareness of potential social harms that may result from use.</p>
<h2>What is ecstasy?</h2>
<p>Ecstasy, a common name for MDMA, is a stimulant drug with <a href="https://www.ncbi.nlm.nih.gov/pubmed/20947066">empathogenic</a> effects, meaning it enhances a feeling of “oneness,” openness and empathy. Ecstasy has been among the most popular party drugs since the 1980s and it is well-known for being the “<a href="https://www.newscientist.com/article/dn11530-ecstasy-really-does-unleash-the-love-hormone/">love drug</a>,” as its effects often leave users feeling very close – or even temporarily in love – with others. Like most drugs, ecstasy can impair decision-making, and a study published Nov. 19, 2018, demonstrated that ecstasy use increases <a href="https://theconversation.com/mdma-makes-people-more-cooperative-but-only-with-those-they-trust-107113">cooperativeness</a> among people you trust while you’re high. </p>
<p>MDMA is a unique drug. Despite being a Schedule I drug in the U.S. (meaning in part, with no current approved medical uses), last year the <a href="https://maps.org/news/media/6786-press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd,-agrees-on-special-protocol-assessment-for-phase-3-trials">Food and Drug Administration</a> granted breakthrough therapy designation for the drug, as it appears to be highly effective in treating <a href="https://www.ncbi.nlm.nih.gov/pubmed/29728331">post-traumatic stress disorder</a>. </p>
<p>The drug is not typically very dangerous when used in a controlled manner, but recreational use can increase risk of harm. For example, many ecstasy pills throughout <a href="https://www.theguardian.com/society/2017/jul/22/friends-out-ecstasy-deaths-highest-level-pills">Europe</a> have been found to have very high, potentially lethal doses, and ecstasy in the U.S., often called “<a href="https://www.ncbi.nlm.nih.gov/pubmed/27925866">Molly</a>” when in powder form, is often cut with other dangerous drugs like “<a href="https://www.vice.com/en_us/article/3deky8/mdma-molly-bath-salts-nyu-study">bath salts</a>.” </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/247368/original/file-20181126-140531-x02ene.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/247368/original/file-20181126-140531-x02ene.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/247368/original/file-20181126-140531-x02ene.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/247368/original/file-20181126-140531-x02ene.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/247368/original/file-20181126-140531-x02ene.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/247368/original/file-20181126-140531-x02ene.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/247368/original/file-20181126-140531-x02ene.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Ecstasy, or MDMA, is a popular drug at electronic dance parties.</span>
<span class="attribution"><a class="source" href="https://www.healthline.com/health-news/why-needle-exchange-programs-are-important">serpeblu/Shutterstock.com</a></span>
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<p>About <a href="https://www.ncbi.nlm.nih.gov/pubmed/29028555">2 percent</a> of the U.S. population aged 12 to 34 is estimated to have used ecstasy in the past year, but prevalence of use is much higher among those who attend dance parties. For example, recent estimates suggest a <a href="https://www.ncbi.nlm.nih.gov/pubmed/29128711">quarter</a> of those who attend electronic dance music parties in New York City have used ecstasy in the past year. </p>
<h2>Harm reduction</h2>
<p>So one may ask – given the high popularity of use, how do people who use ecstasy ensure they have a safe experience? Often, something called “harm reduction” is practiced. </p>
<p>Harm reduction is the recognition that treatment for people who use substances sometimes is best focused on reducing potential harm from the drug or drugs used, rather than trying to eliminate use altogether. <a href="https://www.healthline.com/health-news/why-needle-exchange-programs-are-important">Needle exchange programs</a> are an example. Harm reduction is used when certain behaviors are applied, or avoided, to reduce or prevent adverse outcomes that may result from using a drug. </p>
<p>Ecstasy users, for example, are commonly <a href="https://dancesafe.org/heatstroke/">taught</a> to stay hydrated and take rest breaks from dancing while high. Many ecstasy users also <a href="https://www.ncbi.nlm.nih.gov/pubmed/28635057">test</a> their drugs to ensure they are using real MDMA and not adulterants such as “bath salts.”</p>
<p>But these are just basic measures to help prevent direct adverse health outcomes. What is largely missing from the discussion is reducing potential adverse social effects associated with use. </p>
<p>Kardashian West implied that use of the drug ecstasy was at least partially responsible for her decisions to get married and to make a sex tape. It is unknown whether Kardashian West was in fact high on ecstasy during these occasions, and it is unknown whether she would have made the decision to partake in these activities if she were not high. However, similar to <a href="https://www.ncbi.nlm.nih.gov/pubmed/29430277">alcohol</a>, drugs like ecstasy can increase risk of engaging in socially regrettable behavior. </p>
<p>People high on a drug like ecstasy may let their guard down, place too much trust in others, and engage in actions they may later regret. And technology further complicates things.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/247369/original/file-20181126-140522-imai3d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/247369/original/file-20181126-140522-imai3d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/247369/original/file-20181126-140522-imai3d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/247369/original/file-20181126-140522-imai3d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/247369/original/file-20181126-140522-imai3d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/247369/original/file-20181126-140522-imai3d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/247369/original/file-20181126-140522-imai3d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Everybody is a star on their cellphones, but recording risky behavior has its downsides.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/attractive-girls-trendy-sunglasses-taking-selfie-656072725?src=kikbmDlt330hNMA09J5yCA-1-9">Pressmaster/Shutterstock.com</a></span>
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<p>Mobile phones, which are virtually all now capable of recording, can further facilitate or exacerbate social risk. Mobile phones already provide us with the opportunity to leave regretful texts, phone calls, social media posts, or take or post regretful photos or videos. But introducing mind-altering drugs into the mix can increase risk of such regretful behavior. </p>
<p>Once a post or image is posted or shared with someone, it can remain perpetually available. Alarmingly, “sexting” is already common among young individuals, with almost a <a href="https://www.ncbi.nlm.nih.gov/pubmed/29399839">third</a> estimated to have ever consensually sexted. A drug like ecstasy that makes you feel sensual and empathetic may further increase risk for engaging in such behavior –consensually or non-consensually. </p>
<p>And social risks are by no means limited to sexting. You may post or say something to someone while high you didn’t intend to share. And if you happen to be in a photo or video while high, you likely wouldn’t want your parent or boss to see it. When drug use is included into the mix of everyday communication, there is increased risk of social harm. </p>
<h2>What partiers need to keep in mind</h2>
<p>Those who decide to use any drug, legal or illegal, need to keep potential social risks in mind when using. You might not make a sex tape or decide to get married that day, but it’s worth preventing any potential social harm that can result from being high on a drug. If you decide to use a drug like ecstasy, educate yourself on the effects of the drug and how to prevent potential harm. And lay off of social media until you’re no longer inebriated.</p><img src="https://counter.theconversation.com/content/107671/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joseph Palamar receives funding from the National Institutes of Health. </span></em></p>Many brides are ecstatic when they marry, but few use the drug ecstasy on the big day. Kim Kardashian West recently divulged that she did. A drug expert explains the big risks of the party drug.Joseph Palamar, Associate Professor of Population Health, New York UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/939782018-04-01T20:28:40Z2018-04-01T20:28:40ZDrug use can have social benefits, and acknowledging this could improve rehabilitation<figure><img src="https://images.theconversation.com/files/212413/original/file-20180328-109207-i3y096.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Young people have reported cultural gains from drug use, such as strengthening social ties and gaining access to social networks.</span> <span class="attribution"><span class="source">from www.shutterstock.com</span></span></figcaption></figure><p>Illicit drug use is <a href="http://www.ijdp.org/article/S0955-3959(11)00089-2/fulltext">often framed</a> in terms of risk and antisocial or criminal behaviour. But drug use is often a highly social activity. For many people, the pleasure of using drugs is about social connection as much as it is about the physical effects. </p>
<p><a href="http://www.publish.csiro.au/sh/Fulltext/SH17151">A new study</a> aiming to understanding the social benefits of drug use may help us to improve responses to risky or harmful drug taking.</p>
<h2>Pleasure is not just physical</h2>
<p>Pleasure is an obvious part of drug use and the <a href="https://adf.org.au/insights/why-do-people-use-alcohol-and-other-drugs/">short-term physical benefits</a> are well known. Drugs can produce a “high”, give people energy, make them feel good, reduce stress and aid sleep.</p>
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Read more:
<a href="https://theconversation.com/weekly-dose-ghb-a-party-drug-thats-easy-to-overdose-on-but-was-once-used-in-childbirth-73266">Weekly Dose: GHB, a party drug that's easy to overdose on but was once used in childbirth</a>
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<p>The social benefits of drug use are more complex to quantify. But there are now numerous studies showing people use <a href="https://www.psychologicalscience.org/news/alcohol-is-a-social-lubricant-study-confirms.html">alcohol</a> or <a href="http://journals.sagepub.com/doi/abs/10.1177/009145090903600109">other drugs</a> in social settings such as bars, clubs and parties to enhance their interactions with others through increased confidence, greater sociability and less anxiety. For some people this leads to <a href="https://www.tandfonline.com/doi/pdf/10.1080/13676260600983668?needAccess=true">longer-term benefits</a> such as stronger bonds with friends.</p>
<p>This was shown in <a href="https://theconversation.com/what-do-young-people-gain-from-drug-use-18878">recent Australian studies</a> where young people reported cultural gains from drug use, such as strengthening social ties and gaining access to social networks that offered a form of cultural capital.</p>
<h2>The social benefits of drug use</h2>
<p>“<a href="https://www.racgp.org.au/download/documents/AFP/2010/August/201008frei_partydrugs.pdf">Party drugs</a>” are those which, as the name suggests, are generally used in a dance party or nightclub setting. This set of drugs often includes MDMA (ecstasy), cocaine, ketamine, gamma hydroxybutyrate (GHB), methamphetamine (speed) or crystal methamphetamine (crystal meth or ice). </p>
<p><a href="https://www.tandfonline.com/doi/abs/10.1080/16066350801983681">Studies</a> have shown people generally use party drugs to give them energy, help them socialise and have fun. </p>
<p>At La Trobe University, we recently conducted a <a href="http://www.publish.csiro.au/sh/Fulltext/SH17151">study</a> which explored party drug use – including use of crystal meth – among Australian gay and bisexual men who are living with HIV. Consistent with what we know about <a href="http://europepmc.org/abstract/med/12717048">party-drug use</a>, we found the men in our study almost always used party drugs socially – at nightclubs and dance parties or to facilitate sexual pleasure. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/212414/original/file-20180328-109175-mceyeq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/212414/original/file-20180328-109175-mceyeq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/212414/original/file-20180328-109175-mceyeq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/212414/original/file-20180328-109175-mceyeq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/212414/original/file-20180328-109175-mceyeq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/212414/original/file-20180328-109175-mceyeq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/212414/original/file-20180328-109175-mceyeq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/212414/original/file-20180328-109175-mceyeq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">People generally use party drugs to give them energy, help them socialise and have fun.</span>
<span class="attribution"><span class="source">Stephen Arnold Unsplash</span></span>
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<p>More surprisingly, we also found men who were occasional or regular users of party drugs reported significantly better social outcomes than non-users on a range of measures including a higher level of resilience, less experience of HIV-related stigma, and a greater sense of support from other people living with HIV as well as from their gay and bisexual friends. </p>
<p>This is important because all of these outcomes are strongly associated with <a href="https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-016-0154-z">greater emotional well-being</a> among people living with HIV. </p>
<p>We are not claiming this study shows drug-use (in any form) has a direct impact on longer-term well-being. It’s also possible people who are resilient and <a href="http://journals.sagepub.com/doi/abs/10.1177/0022146510395026">socially connected</a> are more likely than others to be part of social circles in which drug use is common. </p>
<p>But this study does encourage us to consider the social losses some people might encounter if they stop drug use. <a href="http://psycnet.apa.org/buy/1995-29052-001">Friendship, connection, intimacy</a> and sex are fundamental to humanity. If these are strongly tied to the social circles in which a person consumes drugs, their social and emotional well-being may suffer if they cease drug use. </p>
<p>For people living with HIV, who may have experienced <a href="https://www.tandfonline.com/doi/abs/10.1080/09540121.2011.613910">HIV-related stigma</a> or rejection by sexual partners, access to social and sexual networks in which they feel accepted may be part of the appeal of party drugs. </p>
<h2>How this can help responses to drug use</h2>
<p>Research that explores people’s social experiences of drug use can usefully inform harm minimisation or drug cessation programs. </p>
<p>While the physical effects of a drug may pose risks, the social settings in which drugs are consumed are not necessarily damaging or dangerous. In fact, they may be quite the opposite, providing a source of friendship, support and happiness for users.</p>
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Read more:
<a href="https://theconversation.com/weekly-dose-ecstasy-the-party-drug-that-could-be-used-to-treat-ptsd-55149">Weekly Dose: ecstasy, the party drug that could be used to treat PTSD</a>
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<p>It might be tempting to denounce this with the assertion that the potential health risks undermine any claims to benefit – or that friendships generated through drug use are not genuine. But sense of community and friendship has been successfully harnessed in drug and alcohol harm minimisation campaigns such as the “<a href="https://www.smh.com.au/lifestyle/life-and-relationships/schoolies-urged-to-look-after-their-mates-20171118-p4yx2r.html">Take Care of Your Mates</a>” campaigns directed toward young people. </p>
<p>Focusing on <a href="https://www.tandfonline.com/doi/pdf/10.1080/13691050600783320?needAccess=true">the social settings in which drug use occurs</a> may also be useful for strategies to reduce other risks. For example, <a href="http://www.starobserver.com.au/features/in-depth-features/heat-moment-chemsex-sex-venues/154631">campaigns</a> to promote safer sex among gay men who use crystal meth have focused on venues and parties where “sex on drugs” is common. </p>
<p>Understanding the potential social benefits of drug use may also enhance drug rehabilitation programs. Strategies to help people rebuild social ties, friendships and support networks could be important in supporting long term cessation of drug use.</p><img src="https://counter.theconversation.com/content/93978/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer Power receives funding for research from The Australian Department of Health and ViiV Healthcare. She has previously received funding from the Australian Research Council. Jennifer's research cited in this article was wholly funded by the Australian Department of Health. </span></em></p>A new study among gay and bisexual men living with HIV found those who were occasional or regular users of party drugs reported significantly better social outcomes than non-users.Jennifer Power, Senior Research Fellow at the Australian Research Centre in Sex, Health and Society, La Trobe UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/941052018-03-29T01:33:21Z2018-03-29T01:33:21ZIs psychiatry ready for medical MDMA?<p>Within five years, science will likely have answered a controversial question: can methylenedioxymethamphetamine (MDMA) treat psychiatric disorders? </p>
<p>After some <a href="https://www.ncbi.nlm.nih.gov/pubmed/20643699">studies</a> showing a positive effect, MDMA-assisted psychotherapy is entering <a href="https://www.maps.org/news/media/6786-press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd,-agrees-on-special-protocol-assessment-for-phase-3-trials">final clinical trials</a> as a treatment for post-traumatic stress disorder (PTSD). If these trials show positive results, MDMA will go from an illegal drug to a prescription medicine in the United States by 2021, potentially prompting movement in this space in Australia and Europe.</p>
<p>MDMA would move from the fringes to mainstream psychiatry, becoming recognised as a mainstream treatment option. What remains less clear is how psychiatry will deal with questions arising from this new treatment approach. </p>
<h2>MDMA in medicine: a brief history</h2>
<p>German pharmaceutical company <a href="https://upload.wikimedia.org/wikipedia/commons/1/12/Merck_MDMA_Synthesis_Patent.pdf">Merck</a> patented MDMA in 1912. However, it appears not to have been used in humans <a href="https://www.ncbi.nlm.nih.gov/pubmed/17152992">until later that century</a>.</p>
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<p>Better known as a street drug in the rave scene of the 1980s and ’90s, MDMA was used in the 1970s by a small band of <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=grinspoon+mdma">US psychiatrists and therapists</a>. This group believed it enhanced the therapeutic bond and improved treatment for ailments ranging from marital distress to, potentially, <a href="http://inch.com/%7Ejholland/julie/jhchapter.htm">schizophrenia</a>. </p>
<p>Following rebranding as “ecstasy”, large-scale recreational use of MDMA led to its 1985 listing as an illegal drug in the USA (Australia followed in 1986). The <a href="http://www.cognitiveliberty.org/dll/mdma_scheduling_history.htm">MDMA-therapy community</a> unsuccessfully protested against this designation. </p>
<p>Advocates for MDMA-assisted psychotherapy have been playing the long game ever since, undertaking a painstaking process of research and advocacy, which has culminated in the upcoming trials. </p>
<h2>MDMA versus ecstasy</h2>
<p>Advocates for MDMA-assisted psychotherapy have been at pains to distinguish the street drug ecstasy from MDMA the medicine. Ecstasy can contain a range of substances as well as varying doses of MDMA. </p>
<p>This is unsurprising given early <a href="https://www.ncbi.nlm.nih.gov/pubmed/1379014">evidence</a> that high repeated MDMA doses – more relevant for recreational than therapeutic use – damage serotonergic neurons in animals. </p>
<p>Catastrophic predictions of a lost generation of ecstasy users, however, <a href="https://www.ncbi.nlm.nih.gov/pubmed/24830185">failed to materialise</a>. Indeed, numerous people have received MDMA doses similar to those proposed for therapy in <a href="https://www.ncbi.nlm.nih.gov/pubmed/28443695">laboratory studies</a>. This shows that MDMA can be safely administered under controlled conditions to well-screened healthy adults. </p>
<p>It remains unknown whether the same is true of groups excluded from most studies. This includes children and older people, and those with psychiatric or physical illnesses. Studies to date do, however, suggest acceptable safety in <a href="https://www.ncbi.nlm.nih.gov/pubmed/20643699">adults with PTSD</a>. </p>
<h2>Pharmacologically enhanced treatment</h2>
<p>One aspect of MDMA therapy attracting less attention is that it involves a fundamental shift in psychiatric medication. All currently approved psychiatric medications treat symptoms rather than the disease itself. Relapse is common after stopping treatment.</p>
<p>MDMA-assisted psychotherapy, by comparison, involves limited MDMA doses over two or three sessions of eight to ten hours. The aim is to “fast-track” psychotherapy to produce long-lasting changes. </p>
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<a href="https://theconversation.com/human-testing-of-illicit-drugs-the-highs-and-lows-8155">Human testing of illicit drugs – the highs and lows</a>
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<p>Possible mechanisms of such an effect are unclear. One suggestion is that the effects of MDMA, such as feelings of empathy, openness and reduced fear, might allow people to reprocess traumatic memories during <a href="http://www.maps.org/news-letters/v23n1/v23n1_p10-14.pdf">psychotherapy</a>. </p>
<p>Other medications are also being considered as adjuncts for psychotherapy. These include potent psychoactives like LSD and psilocybin, or drugs thought to enhance psychotherapy via mechanisms other than psychoactive effects (e.g. <a href="https://www.ncbi.nlm.nih.gov/pubmed/27314661">d-cycloserine</a>). </p>
<p>It is possible, however, that a broader range of pharmaceuticals could be used in this way. Thus, a potential benefit of MDMA’s approval could be to spur further research in this area. </p>
<h2>The challenges of regulation</h2>
<p>The potential approval of MDMA for prescription gives rise to pressing questions about regulation. For instance, should prescribing be limited to physicians with specific qualifications? What training should be required for those conducting the psychotherapy? How should the drug be handled and stored by pharmacists? </p>
<p>The combination of a drug-affected patient with non-drug-affected therapists could make patients vulnerable during psychotherapy. This suggests a need for stringent training and oversight of MDMA-assisted therapy. </p>
<p>Approval of MDMA will also lead to off-label prescribing, with doctors prescribing the drug for conditions other than PTSD. This could include a range of conditions, such as depression and substance use disorders, and various patient groups. </p>
<p>A particular issue is prescribing to children/adolescents. To date no controlled studies have assessed the safety of MDMA in young people. Planned studies in adolescents with PTSD will thus be important. </p>
<h2>Is anything ‘penicillin for the soul’?</h2>
<p>The slow progression of MDMA-assisted psychotherapy from the subcultural margins towards approval has been driven by the belief of those advocating for it.</p>
<p>Without this motivated community, MDMA would likely not have been developed as a medication, as it is off patent. The downside of this robust advocacy base is that it can lead to rather extreme claims (e.g. <a href="http://www.azquotes.com/quote/769126">“penicillin for the soul”</a>) and experimenter bias. </p>
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Read more:
<a href="https://theconversation.com/weekly-dose-ecstasy-the-party-drug-that-could-be-used-to-treat-ptsd-55149">Weekly Dose: ecstasy, the party drug that could be used to treat PTSD</a>
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<p>In addition to well-designed studies that control for experimenter bias, there is a need for researchers and clinicians outside the MDMA-advocacy community to be involved in the ongoing development of this research direction. </p>
<p>If MDMA is to become a part of mainstream psychiatry’s armamentarium, many questions will need to be answered. The next few years will be critical to see if MDMA joins the ranks of failed psychiatric treatments, or offers new hope to people suffering from PTSD.</p><img src="https://counter.theconversation.com/content/94105/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gillinder Bedi receives funding from the US National Institute of Drug Abuse. </span></em></p>Current trials suggest MDMA could used to treat psychiatric disorders as a prescription medicine by 2021. But there remain a number of unresolved patient / doctor issues to be considered.Gillinder Bedi, Assistant Professor of Clinical Psychology (in Psychiatry) University of Melbourne and Orygen National Centre of Excellent in Youth Mental Health, The University of MelbourneLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/907362018-01-26T00:43:57Z2018-01-26T00:43:57ZThe comeback and dangers of the drug GHB<figure><img src="https://images.theconversation.com/files/203476/original/file-20180125-100896-1v5ijhp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The drug GHB gained notoriety during raves decades ago, but it is resurfacing again. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/hands-air-rave-smoke-machine-laser-94782199?src=Fzblek3t6VqYJnWlF6IUxA-1-9">Anthony Mooney/Shutterstock.com</a></span></figcaption></figure><p>A highly potent drug called GHB is making a comeback in nightlife scenes, along with overdoses and even death. On Jan. 23, 2018, “Storm Chaser” star Joel Taylor <a href="http://abcnews.go.com/Entertainment/joel-taylor-storm-chasers-died-cruise/story?id=52606692">died</a> on a cruise ship. Celebrity news site TMZ reported that Taylor may have used <a href="https://www.dea.gov/druginfo/drug_data_sheets/GHB.pdf">GHB</a> in the hours before his death. </p>
<p>GHB, or gamma-hydroxybutyrate, has been referred to as a “date rape drug” by the media for decades, as it has been involved in instances of sexual predators spiking unsuspecting womens’ drinks to take advantage of them while unconscious. However, much of the public is unaware that most of use of this highly potent drug is actually intentional. </p>
<p>I am a public health researcher who studies party drug use in the nightclub scene. I have learned a great deal through my research and through what I have witnessed firsthand in my years in this scene. Use of this drug largely disappeared from the scene, but it appears to be emerging again in popularity. </p>
<h2>Initially, a sleep aid</h2>
<p>GHB gained popularity in the 1990s, when it was sold over-the-counter in vitamin supplement stores as a sleep aid and growth hormone enhancer. In <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00001847.htm">1990</a>, at least 100 people were reportedly poisoned using GHB, and the Food Drug Administration banned sales of the substance. However, availability continued, as did <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00047106.htm">outbreaks</a> of poisonings. </p>
<p>Use can lead to a <a href="https://www.cdc.gov/mmwr/preview/mmwrhtml/00001847.htm">range</a> of adverse effects ranging from nausea and vomiting to seizures, repressed breathing, and even death. Despite the ban, GHB use increased throughout the 1990s, and the drug was made <a href="http://www.projectghb.org/content/gamma-hydroxy-butyrate-ghb">illegal to possess </a>in March 2000. Recreational use eventually decreased, but there appears to be a recent uptick in use — especially in the <a href="https://www.vice.com/en_us/article/8x5kbp/heres-how-queer-nightlife-is-addressing-a-rise-in-ghb-use">gay</a> party scene. </p>
<iframe src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2FDiscovery%2Fposts%2F10156207760958586&width=500" width="100%" height="486" style="border:none;overflow:hidden" scrolling="no" frameborder="0" allowtransparency="true"></iframe>
<p>While GHB induces sleep, the drug causes users to feel high before falling unconscious. Therefore, in my observation, most users of GHB attempt to take small doses in order to experience the high without falling unconscious. This practice of using GHB to get high began in the 1990s and led to GHB’s popularity in nightclubs. </p>
<p>However, doses of GHB are difficult to calibrate as it is highly potent with a steep dose-response curve, and co-using GHB with alcohol increases its effects. Higher than intended doses or combining it with drugs like alcohol can easily render someone unconscious. </p>
<h2>The party scene</h2>
<p>What is particularly unique about GHB is that onset of unconsciousness can occur quickly. A user can be dancing and talking with friends, yet a few seconds later fall on the floor unconscious and temporarily unwakeable. In fact, <a href="https://www.ncbi.nlm.nih.gov/pubmed/12534425">most</a> users expect to “overdose” at some point and fall unconscious. </p>
<p>Witnessing the problems associated with GHB use so often in nightclubs was the main reason I became a drug researcher. I was deeply immersed in the after-hours New York City nightclub scene in the late 1990s and early 2000s, when GHB popularity was at its peak. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/203475/original/file-20180125-100912-1a651gi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">GHB was especially popular in dance clubs, where dancers could get a quick high.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-p…">KK Tan/Shutterstock.com</a></span>
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</figure>
<p>By 2001, almost every week I witnessed multiple overdoses. I’ve helped carry unconscious bodies from dance floors, I’ve had good friends of mine die after using GHB, and I had even witnessed some of the infamous hidden <a href="http://www.nydailynews.com/archives/news/detail-chilling-dance-death-night-twilo-ends-er-article-1.913461">rooms</a> in some nightclubs that held bodies of unconscious users where nightclub staff waited for them to gain consciousness hours later. Some New York City nightclubs even had their own private <a href="http://www.nytimes.com/2001/05/07/nyregion/city-closes-dance-club-over-problems-with-permits.html">ambulance</a> services in order to not alert authorities about the GHB problem in their venues. </p>
<p>GHB use declined in response to the abundance of overdoses and increased <a href="http://www.ijdp.org/article/S0955-3959(05)00183-0/fulltext">stigma</a> toward use. In New York City, some <a href="http://www.nytimes.com/2001/05/07/nyregion/city-closes-dance-club-over-problems-with-permits.html">major venues</a> closed, largely in response to so many GHB overdoses. </p>
<h2>The popularity of GHB</h2>
<p>GHB is by no means a popular drug in the general population. Only about 3 out of 1,000 young adults (age 18-25) in the U.S. are <a href="https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.htm#tab7-22a">estimated</a> to have ever knowingly used the drug. </p>
<p>But things are much different in the nightclub scene. My colleagues and I, for example, found that among electronic dance music attendees in New York City in <a href="http://www.tandfonline.com/doi/full/10.1080/10826084.2016.1219373">2015</a>, nearly 1 out of 10 attendees reported ever using GHB. However, most of the individuals we surveyed identified as heterosexual. </p>
<p>Use is more prevalent among gay men and men who have sex with men (MSM) in party scenes. For example, a recent <a href="https://www.ncbi.nlm.nih.gov/pubmed/26440912">study</a> of MSM nightclub attendees in South London found that more than half reported GHB use in the past year. </p>
<p>But GHB is not only popular in the nightclub scene for dancing and socializing; it is a leading “ChemSex” drug — meaning it is often used intentionally to intensify sex. This is particularly prevalent among <a href="https://www.ncbi.nlm.nih.gov/pubmed/29268075">MSM</a>.</p>
<h2>What can be done to prevent more deaths?</h2>
<p>GHB, due to its high likelihood of leading to overdose, is one of the most deleterious drugs to ever reach the party scene. Stigma toward users was a leading method of reducing prevalence in the early 2000s, and anti-GHB campaigns in the nightclub scene have already begun in <a href="https://thump.vice.com/en_ca/article/bma7xm/canada-clubs-ghb-guide">Canada</a> in response to recent overdoses. However, while stigma might prevent some people from using, this will lead others to resort to hiding their use. And hidden use is riskier. </p>
<p>The new generation of partiers needs to learn from the past. Yes, there are plenty of partiers who use GHB “safely,” and harm reduction techniques should be used among those who insist on using. But GHB commonly results in overdoses, and as is shown by the death of Joel Taylor who is suspected of taking GHB, sometimes use can lead to fatal outcomes.</p><img src="https://counter.theconversation.com/content/90736/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joseph Palamar receives funding from the National Institutes of Health (grant K01DA038800)</span></em></p>The recent death of ‘Storm Chaser’ star Joel Taylor, reportedly because of his use of the GHB, is a tragic reminder of the drug’s dangerous impact.Joseph Palamar, Associate Professor of Population Health, New York UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/732662017-02-26T19:04:40Z2017-02-26T19:04:40ZWeekly Dose: GHB, a party drug that’s easy to overdose on but was once used in childbirth<figure><img src="https://images.theconversation.com/files/157830/original/image-20170222-1340-1uyzyjt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">People who take GHB at dance parties say it makes them feel euphoric and less inhibited. But the drug is easy to overdose on.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/573004459?src=HX483FdrXw1-JTtOy5jcIg-1-11&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p><a href="http://www.drugwise.org.uk/ghb/">GHB</a> stands for gamma-hydroxybutyric acid (also known as 4-hydroxybutanoic acid) and is a naturally occurring neurotransmitter. It’s also a recreational drug.</p>
<p>People take it at dance parties and to enhance sex. Although it’s a depressant, like alcohol, in small doses people find it stimulates them.</p>
<p>It’s in the news in Australia because <a href="http://www.abc.net.au/news/2017-02-19/electric-parade-festival-more-than-20-overdose-hospital/8283828">at least 20 people</a> were taken to hospital recently with suspected GHB overdoses after attending a recent music festival in Melbourne.</p>
<p>Overdoses can happen easily because people do not know the strength of the drug they are taking. Also, the amount needed for the desired effect is not much less than the amount that <a href="http://europepmc.org/abstract/med/10869868">can cause an overdose</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=717&fit=crop&dpr=1 600w, https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=717&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=717&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=901&fit=crop&dpr=1 754w, https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=901&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/158238/original/image-20170224-32729-126myhq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=901&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<h2>How is it used?</h2>
<p>GHB has many street or slang names including G, fantasy, grievous bodily harm (GBH), juice, liquid ecstasy, liquid E, liquid X, Georgia Home Boy, soap, scoop, cherry meth and blue nitro. It is also called fishies because it is sometimes sold in the small fish-shaped soy sauce containers sold with sushi.</p>
<p>It’s generally made in small batches in people’s homes rather than <a href="http://europepmc.org/abstract/med/10869868">illicit drug labs</a> and <a href="http://www.australiandoctor.com.au/cmspages/getfile.aspx?guid=9be78a1b-dc64-4f9e-a191-15aeb295ba78">comes as a clear liquid</a> with no smell that often <a href="http://europepmc.org/abstract/med/10869868">tastes salty</a>. </p>
<p>It’s often sold in a small plastic container, or sometimes as a white powder, for about A$10 a dose. People usually swallow it, but can inject it or insert it anally.</p>
<h2>Who uses it</h2>
<p>A major 2013 drug survey found only <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549848">0.1% or 24,000</a> Australians aged over 14 had used GHB in the past year.</p>
<p>People most likely to use GHB usually use other drugs as well. GHB use has recently increased among regular ecstasy and methamphetamine users but is still infrequent. Of those who reported using it in 2016, most said they had used it <a href="https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/EDRS%20October%202016_FINAL.pdf">two or three times</a> that year.</p>
<h2>What are its effects?</h2>
<p>No-one is certain what naturally-occurring GHB does in the body. But we do know it increases levels of <a href="http://www.who.int/medicines/areas/quality_safety/4.1GHBcritical_review.pdf">dopamine in the brain</a>, a neurotransmitter that helps control the brain’s reward and pleasure centres.</p>
<p>Its effects on the body start within five to 20 minutes of taking the drug and last three to four hours. GHB causes a loss of inhibition, relaxes people, boosts their sex drive and promotes feelings of euphoria.</p>
<p>But side-effects include memory lapses, drowsiness, clumsiness, dizziness or headache, lowered temperature, tremors, nausea and diarrhoea.</p>
<p>The effects of the drug vary according to how much people take (usually 0.5-3g), their body weight, if they are used to taking it, and if they have taken other drugs, including alcohol.</p>
<p><a href="http://www.ajemjournal.com/article/S0735-6757(09)00553-1/abstract">Symptoms of a GHB overdose</a> include vomiting, sweating, shallow breathing, confusion, agitation, hallucinations, seizures, blackouts and unconsciousness for several hours.</p>
<p>Some people have died from GHB because they appear to have gone to sleep but are actually unconscious and have stopped breathing.</p>
<p>Children have also <a href="http://www.theage.com.au/news/national/recall-for-toy-that-turns-into-drug/2007/11/06/1194329225773.html">accidentally overdosed</a> on GHB after swallowing beads from a children’s toy called Bindeez. In 2007, three children were hospitalised after swallowing the beads, made using an incorrect chemical, which turned into GHB in the stomach.</p>
<h2>The date rape drug?</h2>
<p>GHB has been linked to drink spiking and sexual assault. This was the case for <a href="http://www.smh.com.au/national/three-face-charges-over-brimble-cruiseship-death-20080911-4ekv.html">Dianne Brimble</a>, who died on a cruise ship in 2002 after being given GHB and alcohol. So GHB is sometimes called the date rape drug.</p>
<p>Some campaigns about the dangers of drink spiking reported GHB makes people unable to <a href="https://web.archive.org/web/20120510151441/http://www.justice.gov/dea//ongoing/daterapep.html">resist sexual advances</a>.</p>
<p>GHB can only be detected in urine samples for <a href="https://pdfs.semanticscholar.org/a4a3/d2fce99c40bf3e3d3acb5632eac7c3bc7914.pdf">four hours</a> after the drug has been taken. This suggests GHB could have been used when people were drugged and sexually assaulted but it would have left their system by the time they sought help.</p>
<p>But more recent studies <a href="http://www.sciencedirect.com/science/article/pii/S1353113106000393">in Australia</a>, <a href="http://www.24housing.co.uk/news/no-evidence-to-suggest-widespread-date-rape-drug-use/">Netherlands</a> and elsewhere show alcohol is the drug most common in drink spiking, not GHB or other sedatives.</p>
<h2>Is GHB illegal?</h2>
<p>GHB is a chemical that occurs naturally in the body and helps messages travel to the brain. You can also find GHB in some <a href="http://europepmc.org/abstract/med/15939164">meats, fruit and wine</a>.</p>
<p>But as a synthesised chemical, its classification in Australia changed in 2014 from a prohibited drug to a controlled drug (a schedule 8 drug).</p>
<p>This is so doctors could prescribe it for the sleeping disorder <a href="https://theconversation.com/the-big-sleep-science-is-waking-up-to-the-curious-story-of-narcolepsy-45040">narcolepsy</a> under the brand name <a href="http://sleephub.com.au/xyrem-in-australia/">Xyrem</a>. Doctors can only access the drug by special request to the <a href="https://www.tga.gov.au/">Therapeutic Goods Administration</a>.</p>
<h2>An interesting history</h2>
<p>GHB has an <a href="http://www.who.int/medicines/areas/quality_safety/4.1GHBcritical_review.pdf">interesting history</a>.
Russian chemist Alexander Zaytsev synthesised it in 1874 but there are no reports about how it was used at the time. </p>
<p>It was not until 1964 when French doctor Dr Henri Laborit used GHB to drop people’s temperature during surgery, trying to reverse the symptoms of shock caused by their injuries and the operation.</p>
<p>GHB was widely used in Europe for several decades as an anaesthetic in childbirth because it helped the cervix dilate. It was also used to help people sleep. But the development of newer drugs has superseded it.</p>
<p>Reports of GHB use and overdose have been recorded internationally by the <a href="http://www.who.int/medicines/areas/quality_safety/4.1GHBcritical_review.pdf">World Health Organization</a> since 1990. Most reports are from the USA, western Europe and Australia, with spikes at different time periods indicating changes in availability.</p>
<p>Low price, easy administration and limited information about the risks of GHB can cause serious problems for people who try it.</p><img src="https://counter.theconversation.com/content/73266/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julaine Allan has received funding from the NHMRC, ARC, RIRDC, NSW Health and the Ian Potter Foundation to undertake research related to drug and alcohol use.</span></em></p>It’s easy to overdose on the recreational drug GHB, as recent cases in Melbourne show.Julaine Allan, Senior Research Fellow, Charles Sturt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/645502016-09-21T05:35:23Z2016-09-21T05:35:23ZWeekly Dose: LSD – dangerous, mystical or therapeutic?<figure><img src="https://images.theconversation.com/files/137514/original/image-20160913-19269-rtw2nj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">LSD causes euphoria, increased body temperature and hallucinations where some or all of the senses are distorted.</span> <span class="attribution"><span class="source">from shutterstock.com</span></span></figcaption></figure><p>Lysergic acid diethylamide (LSD) is a synthetic chemical made from a substance found in a fungus that grows on rye and other grains, called <a href="https://en.wikipedia.org/wiki/Ergot">ergot</a>.</p>
<p>In 1943, Swiss scientist Albert Hofmann – who was interested in the medicinal properties of plants – <a href="http://www.drugscience.org.uk/drugs-info/lsd/">altered a molecule in the fungus</a> hoping to create something that would stimulate blood circulation. But by testing the compound on himself, he discovered <a href="http://www.maps.org/news-letters/v06n3/06346hof.html">he had created a hallucinogen</a> instead.</p>
<p>Today, LSD is an illicit substance used recreationally for its hallucinogenic effects.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/137902/original/image-20160915-30608-1574br2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/137902/original/image-20160915-30608-1574br2.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=870&fit=crop&dpr=1 600w, https://images.theconversation.com/files/137902/original/image-20160915-30608-1574br2.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=870&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/137902/original/image-20160915-30608-1574br2.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=870&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/137902/original/image-20160915-30608-1574br2.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1093&fit=crop&dpr=1 754w, https://images.theconversation.com/files/137902/original/image-20160915-30608-1574br2.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1093&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/137902/original/image-20160915-30608-1574br2.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1093&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<h2>How is it used?</h2>
<p>LSD is a white powder with no smell. A <a href="http://www.drugscience.org.uk/drugs-info/lsd/">tiny amount is mixed with liquid</a> and soaked into blotting paper, sugar cubes, gelatine squares and tiny pills called microdots; or squeezed out of a dropper and swallowed; or held under the tongue.</p>
<p>LSD takes 30 to 60 minutes <a href="http://www.druginfo.adf.org.au/drug-facts/lsd#references">to have an effect</a>, which is called a trip. A trip can last from four to 12 hours and is characterised by feelings of euphoria, increased body temperature and hallucinations, where some or all of the senses are distorted. Time may seem to pass slowly or quickly, colours are enhanced, smells are stronger and <a href="https://www.drugabuse.gov/publications/drugfacts/hallucinogens">thoughts are intense</a>. </p>
<p>A trip can be positive or negative. A bad trip can include overwhelming memories of traumatic experiences, increased anxiety, or fear of people or things in the environment. A person’s mood, the setting and the dose <a href="http://csp.org/psilocybin/HopkinsHallucinogenSafety2008.pdf">will influence the experience</a> of LSD.</p>
<h2>History of use</h2>
<p>During the 1950s and 1960s, LSD was used more for psychotherapy than recreation. Between 1950 and 1965, <a href="https://www.erowid.org/archive/rhodium/chemistry/lsdpatent.html">40,000 people were treated with LSD</a> (under the brand name Delysid) for alcoholism, depression, schizophrenia, autism and homosexuality.</p>
<p>In the United States, psychotherapists <a href="http://www.ncbi.nlm.nih.gov/pubmed/19040555">used low doses of LSD</a> to enhance the standard therapeutic process. In Europe, psychologists used higher doses to induce a mystical experience and emotional release, believing this would reduce anxiety and depression. </p>
<p>Scientific reports on the <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4086777/">effectiveness of either approach</a> are limited. </p>
<p>Most LSD-assisted psychotherapy stopped when increased recreational use led to it being made <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4086777/">illegal in the United States</a> in 1966. In <a href="https://extranet.who.int/iris/restricted/bitstream/10665/89509/1/WHA20.42_eng.pdf">1967, the World Health Organisation recommended</a> LSD become a controlled substance.</p>
<h2>How does it work?</h2>
<p>Limited research has been conducted into how LSD produces its psychoactive effects. One <a href="http://www.pnas.org/content/109/6/2138.full">study on psilocybin</a>, the hallucinogenic substance in magic mushrooms, found it led to decreased activity and connections in the brain, as well as causing changes in blood flow. The link to blood flow suggests Hofman’s theory about LSD affecting circulation could be true.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/138563/original/image-20160921-12483-1cq5cia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/138563/original/image-20160921-12483-1cq5cia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/138563/original/image-20160921-12483-1cq5cia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=347&fit=crop&dpr=1 600w, https://images.theconversation.com/files/138563/original/image-20160921-12483-1cq5cia.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=347&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/138563/original/image-20160921-12483-1cq5cia.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=347&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/138563/original/image-20160921-12483-1cq5cia.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=436&fit=crop&dpr=1 754w, https://images.theconversation.com/files/138563/original/image-20160921-12483-1cq5cia.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=436&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/138563/original/image-20160921-12483-1cq5cia.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=436&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Limited research has been conducted into how LSD produces its psychoactive effects.</span>
<span class="attribution"><a class="source" href="https://pixabay.com/en/forest-abstract-colorful-forest-764924/#_=_">Pixabay</a></span>
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<p>Other scientists have suggested LSD <a href="http://www.nature.com/npp/journal/v21/n1s/full/1395318a.html">affects the brain’s serotonin receptors</a> that regulate moods, appetite, sex drive and perception.</p>
<h2>It it dangerous?</h2>
<p>LSD is not <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0030437">physically addictive</a>. Tripping on a regular basis, and therefore relying on the drug to have a good time, can lead to psychological dependence.</p>
<p>There have been many reports of phenomena termed <a href="https://askthepsych.com/atp/2009/07/13/dealing-with-lsd-flashbacks/">acid flashbacks</a> – bouts of psychedelic-like perception long after the drug’s effects have work off. Although the flashback is frequently described by people who have used LSD, it has not been well researched or understood. </p>
<p>Except in the case of a pre-existing mental illness, there is <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0063972">little evidence of LSD having a negative</a>, long-term impact on mental health. </p>
<p>The biggest risks associated with LSD are accidents and injuries during trips because of distorted perceptions and feelings of immortality that can lead to risk-taking behaviour.</p>
<p>Reports of overdose are rare. In 1973, <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1129381/">eight people were taken to hospital</a> after snorting several milligrams of a powder they thought was cocaine but was actually LSD. They passed out and were hospitalised with high temperatures, internal bleeding and vomiting; although all recovered within 12 hours.</p>
<p>However, a more powerful hallucinogenic sometimes sold as LSD – called 251-NBOMe, 251 or N-bomb – has caused a number of deaths around the world including in <a href="http://www.adelaidenow.com.au/news/south-australia/new-hallucinogenic-drug-25b-nbome-and-25i-nbome-led-to-south-australian-mans-bizarre-death/story-e6frea83-1226472672220">Australia</a>, both from overdose as well as <a href="https://theconversation.com/explainer-what-is-nbome-16950">accidents and injuries</a>. </p>
<h2>How many people use it?</h2>
<p>A <a href="http://www.aihw.gov.au/alcohol-and-other-drugs/ndshs/">survey found that in 2013</a>, around 1.3% of the Australian population, or 299,000 people over 14 years of age, had used a hallucinogen in the previous 12 months. This includes LSD and other drugs that cause hallucinations such as magic mushrooms. </p>
<p>The rate of use has not changed much over time, although it was <a href="http://www.aihw.gov.au/alcohol-and-other-drugs/ndshs/2013/data-and-references/">recorded as 3% of the population</a> in 1998.</p>
<h2>How much does it cost?</h2>
<p>The <a href="https://www.reddit.com/r/Drugs/comments/1dt26w/lsd_prices/?st=isjp00o3&sh=b2609aab">price of a single dose varies</a> between A$5 and A$25. An average dose is thought to be 0.001 of a gram, althoough 20 to 30 micrograms (a millionth of a gram) can produce an <a href="https://www.erowid.org/psychoactives/guides/handbook_lsd25.shtml#11">effect</a>.
Like most illicit drugs, the amount of LSD in a purchased dose is unknown.</p>
<h2>Other points of interest</h2>
<p>A controversial psychologist Timothy Leary was sacked from Harvard University for using LSD in experiments, and recreationally with students. </p>
<p>In response to supply restrictions, in 1967, Leary founded The League for Spiritual Discovery, a religion that claimed LSD as a holy sacrament that should be legal as a religious freedom. United States president at the time, Richard Nixon, <a href="http://www.nytimes.com/1996/06/01/us/timothy-leary-pied-piper-of-psychedelic-60-s-dies-at-75.html">called Leary the most dangerous man</a> in America. </p>
<p>Leary <a href="http://www.csp.org/chrestomathy/realms_of3.html">wasn’t the only one who believed</a> LSD caused religious or mystical experiences. Many people in the 1960s sought such experiences from LSD, and were sometimes called psychonauts.</p>
<p>Aldous Huxley, author of the dystopian novel Brave New World, regularly used and wrote about psychoactive substances such as LSD and mescaline, a cactus-obtained hallucinogen. He thought LSD was <a href="http://www.maps.org/news-letters/v06n3/06346hof.html">valuable for those who didn’t have a talent</a> for visionary experiences; the kinds necessary to produce great works of art.</p>
<p>Indeed, great artists such as The Beatles did a lot to popularise LSD; with their song Tomorrow Never Knows <a href="http://time.com/4435236/revolver-released-50-years-ago/">quoting directly from a book</a> co-authored by Timothy Leary.</p>
<p>Interest in the medical uses of hallucinogens continues. A 2014 study in Switzerland <a href="http://www.maps.org/research-archive/lsd/Gasser-2014-JMND-4March14.pdf">reported</a> participants’ anxiety was reduced following two LSD-assisted psychotherapy sessions.</p>
<p>In Australia, an anaesthetic called ketamine – which causes hallucinations – is being trialled to see if it helps people with <a href="http://www.blackdoginstitute.org.au/public/research/Usingketamineasanantidepressantwaysandmeans.cfm">depression</a>.</p><img src="https://counter.theconversation.com/content/64550/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julaine Allan has received funding from the NHMRC, ARC and RIRDC for the various research projects she has been involved with.</span></em></p>During the 1950s and 1960s, LSD was used more for psychotherapy than recreation. Between 1950 and 1965, many were treated with LSD for alcoholism, depression, schizophrenia, autism and homosexuality.Julaine Allan, Senior Research Fellow, Charles Sturt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/551492016-04-06T06:43:19Z2016-04-06T06:43:19ZWeekly Dose: ecstasy, the party drug that could be used to treat PTSD<p>Ecstasy is the street name for 3,4-methylenedioxymethamphetamine, or MDMA, an illicit party drug that speeds up messages to and from the brain and alters the user’s perception of reality. Other street names include eckies, E, XTC, pills, pingers and molly.</p>
<p>Pills sold as ecstasy contain variable amounts of MDMA, sometimes none, and may also include other fillers. The pills come in a variety of shapes, sizes and colours, and often have <a href="https://www.erowid.org/chemicals/show_image.php?i=mdma/ecstasy_pill_collage__i2007h0004.jpg">designs</a> stamped on them such as rabbits, hearts and smiley faces.</p>
<p>While pills are the most common form of ecstasy, it is also sold as powder and, more recently (and rarely), in a crystal form. All forms are typically swallowed, but are sometimes crushed and snorted, injected or smoked.</p>
<p>Ecstasy <a href="https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/National_EDRS_2013.pdf">costs</a> around A$25 per tablet, ranging from A$20 in South Australia to A$40 in the Northern Territory. A capsule sells for around A$30. Powder and crystal sell for around A$250 and A$260 per gram.</p>
<p>MDMA is illegal in Australia, which means possession, use, manufacture and trafficking are criminal offences. The <a href="http://www.aic.gov.au/publications/current%20series/tandi/461-480/tandi467.html">threshold for drug trafficking</a> in Australia ranges from half a gram in the NT to ten grams in Tasmania.</p>
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<img alt="" src="https://images.theconversation.com/files/117588/original/image-20160406-29002-1kl312i.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/117588/original/image-20160406-29002-1kl312i.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=595&fit=crop&dpr=1 600w, https://images.theconversation.com/files/117588/original/image-20160406-29002-1kl312i.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=595&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/117588/original/image-20160406-29002-1kl312i.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=595&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/117588/original/image-20160406-29002-1kl312i.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=748&fit=crop&dpr=1 754w, https://images.theconversation.com/files/117588/original/image-20160406-29002-1kl312i.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=748&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/117588/original/image-20160406-29002-1kl312i.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=748&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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<h2>History</h2>
<p>MDMA was <a href="http://www.ncbi.nlm.nih.gov/pubmed/17152992">first manufactured</a> in Germany in the early 1900s as a precursor chemical for a pharmaceutical drug to stop bleeding. It was not considered significant at the time and only appears to be patented as part of the synthesis process.</p>
<p>It was not until <a href="http://www.ncbi.nlm.nih.gov/pubmed/16911722">much later</a> (in 1927 and 1959) that the basic pharmacology of MDMA was tested, but not in humans.</p>
<p>In the 1960s, <a href="https://en.wikipedia.org/wiki/Alexander_Shulgin">Alex Shulgin</a>, sometimes referred to as the “Godfather of ecstasy”, rediscovered it and created a new and easier way to make the drug, which he personally tested along with many other psychedelic compounds he created.</p>
<p>It was used in the 1970s and early 80s for a range of experimental therapeutic purposes, including in psychotherapy for couples. MDMA is in the early stages of being tested for safety as a <a href="http://jop.sagepub.com/content/25/4/439.short">possible treatment for post-traumatic stress disorder</a> in conjunction with psychotherapy, but there are no currently endorsed therapeutic uses of MDMA. </p>
<p>The idea behind using MDMA to treat PTSD is that people with this disorder often avoid their emotions and MDMA may be able to assist them to be more expressive during psychotherapy.</p>
<p>In the mid to late 1980s, ecstasy became a dance party favourite in Australia and other parts of the world. </p>
<h2>Effects of ecstasy</h2>
<p>MDMA is an <a href="http://www.who.int/substance_abuse/facts/ATS/en/">amphetamine-type stimulant</a>, with hallucinogenic effects. </p>
<p>MDMA’s main effects are through the release of <a href="https://en.wikipedia.org/wiki/Serotonin">serotonin</a>, unlike its cousins the amphetamines, which work mainly through the <a href="https://en.wikipedia.org/wiki/Dopamine">dopamine</a> system. Too little serotonin and dopamine are both associated with depression.</p>
<p>Serotonin helps regulate mood, sexual desire and sexual function, as well as other bodily processes such as appetite, sleep and temperature. MDMA releases large amounts of serotonin artificially, increasing the effects of serotonin in the brain, such as significantly improved mood. </p>
<p>People who use ecstasy report a range of positive <a href="https://www.betterhealth.vic.gov.au/health/healthyliving/ecstasy">effects</a> including increased confidence, well-being, happiness, empathy and sex drive. MDMA enhances <a href="http://scan.oxfordjournals.org/content/early/2013/10/28/scan.nst161.short">social behaviour and empathy towards others</a>.</p>
<p>Some of the less desirable effects include nausea, jaw clenching, and increased heart rate and blood pressure.</p>
<h2>Who uses ecstasy?</h2>
<p><a href="http://www.unodc.org/wdr2014/en/interactive-map.html">Australians</a> are the biggest users of ecstasy in the world, with 3% of the population reporting they have used it at least once in the last year.</p>
<p>Ecstasy is mostly used relatively infrequently by recreational drug users at dance parties, music festivals and social events. Even among people who regularly use ecstasy, the average <a href="https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/National_EDRS_2014.pdf">frequency of use</a> is less than twice a month.</p>
<p>It is most commonly used by <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549848">people in their 20s</a> – around 9% of that age group have used in the past year. The average age that people first try ecstasy is around 22 years.</p>
<p>Very few people report use by the time they are in their 40s (only around 0.5%).</p>
<p>Men use ecstasy at nearly twice the rate as women. </p>
<p>Although the <a href="https://www.crimecommission.gov.au/sites/default/files/290414-IDDR-2012-13.pdf">number of detections</a> and seizures of the drug increased by nearly 330%, and the weight of those seizures by over 1,100%, between 2011 and 2013, there was no reported increase in the rate of use. </p>
<p>But the best available population data suggests a relatively <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549848">high proportion of new users</a>.</p>
<h2>How dangerous is ecstasy?</h2>
<p>Unlike other stimulants, MDMA does not appear to be <a href="http://www.ncbi.nlm.nih.gov/pubmed/1354992">at high risk of overuse</a> because the positive effects decrease and negative effects increase quickly with use. It has been described as a “self-limiting” drug, with most people using irregularly, for a relatively short period of time.</p>
<p>Dependence is uncommon and <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129551454">the proportion of people presenting to treatment centres</a> for ecstasy as a primary drug of concern is very low at about 1% of cases.</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497800/">Animal studies</a> show changes to brain chemistry, especially in the serotonin system, after long-term use of MDMA. </p>
<p>Cognitive deficits in mice include learning and memory problems. But this does not seem to translate consistently to major cognitive problems in humans if they primarily <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.03252.x/abstract;jsessionid=07D363C59F8DAA66F940A8BAB89B7B17.f04t02?userIsAuthenticated=false&deniedAccessCustomisedMessage=">only use ecstasy</a>.</p>
<p>There is some limited evidence that long-term use of ecstasy, particularly by adolescents, may <a href="http://www.tandfonline.com/doi/abs/10.1080/hrp.10.4.212.220">increase vulnerability</a> to mental health problems.</p>
<p>While long-term problems with the drug are rare, acute harms due to toxicity and overdose are more common, and may be on the rise. <a href="http://www.australianprescriber.com/magazine/26/3/62/3">Serotonin syndrome</a> can occur as a result of the release of stored serotonin and may result in a range of symptoms including confusion, loss of coordination, increased heart rate and agitation. </p>
<p>Releasing large amounts of serotonin can also deplete natural levels in the brain resulting in feeling flat and unmotivated the next day after taking MDMA.</p>
<p><a href="http://www.abc.net.au/news/2015-12-07/drugs-mar-stereosonic-music-festival-as-two-die/7005862">Media</a> have reported large numbers of overdoses, including deaths, at festivals around the country over summer.</p>
<p><a href="http://www.turningpoint.org.au/site/DefaultSite/filesystem/documents/Ambo%20Report%20-%20trends%20in%20alcohol%20and%20drug%20related%20ambulance%20attendances%202013-14%281%29.pdf">Ambulance callouts</a> for ecstasy in Victoria increased by around 10% between 2013 and 2014. Although they still remain the fourth lowest of all illicit drugs.</p>
<p>One of the main dangers of pills sold as ecstasy is the unknown contents. In addition, the relatively large proportion of first-time users may be at higher risk of problems because they are unfamiliar with the drug, its effects and the risks.</p>
<p>Often pills sold as ecstasy are a combination of other stimulants, hallucinogens and various other drugs, increasing the risk of adverse reactions and toxicity. </p>
<p>One of the common substitute drugs is paramethoxyamphetamine (PMA), which is <a href="http://www.theguardian.com/commentisfree/2015/jan/05/superman-pill-ecstasy-pma-deaths-drugs-policy">significantly more toxic</a> than MDMA. It is up to ten times more potent; it works more slowly so people sometimes take a second dose thinking the first hasn’t worked; and it is more likely to increase serotonin in the brain to toxic levels.</p>
<p>In an article in the prestigious journal Lancet, researchers ranked 20 common legal and illegal drugs by their potential for harm. Ecstasy <a href="http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2807%2960464-4.pdf">ranked</a> third lowest.</p><img src="https://counter.theconversation.com/content/55149/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee works as a consultant to health services to support best practice implementation of drug responses. She has previously been awarded funding by the Australian and state governments, NHMRC and other bodies for evaluation and research into drug treatment.</span></em></p>Ecstasy is the street name for 3,4-methylenedioxymethamphetamine, or MDMA, an illicit party drug that speeds up messages to and from the brain and alters the user’s perception of reality.Nicole Lee, Associate Professor at the National Drug Research Institute, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/554932016-03-01T19:05:42Z2016-03-01T19:05:42ZAustralia’s recreational drug policies aren’t working, so what are the options for reform?<figure><img src="https://images.theconversation.com/files/113308/original/image-20160301-4090-1110xx1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Decriminalisation removes criminal penalties for drug use or possession.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-153850529/stock-photo-man-addicted-to-marijuana-or-cannabis-rolling-himself-a-joint-sitting-outdoors-in-the-shade-close.html?src=9eK7lHT6li5nSX1SfEgStQ-1-79">Viacheslav Nikolaenko/Shutterstock</a></span></figcaption></figure><p>Some of the greatest harms from using illicit drugs are because they are illegal. </p>
<p>Illegal drug production is unregulated and many drugs are manufactured in backyard labs. Users cannot be sure what’s in them or how potent they are, so the risk of adverse reactions, including overdose and death, is high. </p>
<p>A large proportion of the work of the <a href="http://www.aic.gov.au/media_library/publications/tandi_pdf/tandi439.pdf">justice system</a> – police, courts and prisons – is occupied with drug-related offences. Many people have a criminal record for possessing drugs intended for personal use, which can affect their work prospects. </p>
<p><a href="http://www.bocsar.nsw.gov.au/Documents/r38.pdf">Drug busts</a> have little impact on the availability of drugs and, as we continue to see more harms including overdoses and deaths, it is clear we need a new approach to illicit drugs.</p>
<p>This week, a parliamentary drug summit, convened by the Australian Parliamentary Group on Drug Policy and Law Reform, is debating drug policy reform in Australia. This includes the options for reform: depenalisation, decriminalisation and legalisation. </p>
<h2>The options</h2>
<p>There are many different legal frameworks governing the use and supply of drugs:</p>
<ul>
<li><p><strong>Full prohibition</strong>: drug use, possession and supply are <a href="https://www.legalaid.vic.gov.au/find-legal-answers/criminal-offences">criminal offences</a> and result in a criminal record and sometimes prison sentence</p></li>
<li><p><strong>Depenalisation</strong>: drug use and possession are still criminal offences but with lighter penalties (referral for assessment, education and/or treatment); drug supply remains a criminal offence</p></li>
<li><p><strong>Decriminalisation</strong>: the removal of criminal penalties for drug use or possession. Illicit drugs remain illegal but criminal penalties are replaced with civil penalties (such as fines). People who use or possess drugs can still be charged, especially if they do not comply with paying the fine or attending the assessment. Drug supply remains a criminal offence</p></li>
<li><p><strong>Legalisation</strong>: use of a drug is legal as is drug supply.</p></li>
</ul>
<h2>What legal frameworks apply in Australia?</h2>
<p>In Australia, legislation is state-based. Different penalties apply to different drugs in different states.</p>
<p>South Australia, the ACT and Northern Territory have decriminalised cannabis by applying civil penalties, if a person meets certain eligibility criteria. All other states have no decriminalisation options for any illicit drugs.</p>
<p>All Australian states have depenalisation systems in place for cannabis, through diversion to education, assessment or treatment for those who meet eligibility criteria. Non-attendance at education, assessment or treatment can still lead to criminal charges. </p>
<p>All states, except NSW and Queensland, have depenalisation options for drugs other than cannabis.</p>
<h2>How does decriminalisation affect drug supply and use?</h2>
<p>Most research on decriminalisation is based on cannabis and has shown a number of consequences of decriminalisation.</p>
<p>One negative effect of decriminialisation is <a href="http://www.ncbi.nlm.nih.gov/pubmed/25959525">net-widening</a>: an increase in the number of people arrested or charged. The way decriminalisation is implemented can affect the extent of net-widening.</p>
<p>On the other hand, several studies <a href="http://bjc.oxfordjournals.org/content/50/6/999.abstract">have shown</a> that decriminalisation does not increase drug use among existing or new users. It reduces demand on, and the cost of, the <a href="http://www.parl.gc.ca/content/sen/committee/371/ille/presentation/single-e.htm">criminal justice system</a>. </p>
<p>Portugal <a href="http://bjc.oxfordjournals.org/content/50/6/999.abstract">decriminalised the use and possession</a> of all illicit drugs in 2001. At the same time, it expanded investment in drug treatment, harm reduction and social reintegration. <a href="https://www.drugpolicy.org/sites/default/files/DPA_Fact_Sheet_Portugal_Decriminalization_Feb2015.pdf">Impacts of this reform included</a> a reduced burden on the criminal justice system, reductions in problematic drug use, reductions in drug-related HIV and AIDS, reductions in drug-related deaths, and reduced social costs of responding to drugs.</p>
<h2>What about legalisation?</h2>
<p>There are few jurisdictions where drugs are legalised. Uruguay has recently legalised cannabis use and production, and is in the process of implementing that legislation.</p>
<p>Some states in the US have legalised possession and sale of small amounts of cannabis for personal use, including Colorado, Washington, Oregon, Alaska and Washington DC. So far, this move <a href="http://www.medicinalgenomics.com/wp-content/uploads/2011/12/Assessing-the-pub-health-impacts-of-legalizing-recreational-cannabis-use-in-the-USA.pdf">does not seem to have led</a> to an increase in use of cannabis or an increase in harms in those states but further monitoring is needed.</p>
<p>Some of the arguments for legalisation are that it would reduce the black market and criminal networks associated with the drug trade, and shift responses and funding from police and the criminal justice system towards health and treatment programs. Taxes raised could be collected to benefit the community.</p>
<p>One of the arguments against legalisation is that it could result in a significant increase in drug use, based on the harms and costs associated with legal drugs, alcohol and tobacco.</p>
<h2>What does the Australian public think?</h2>
<p>There has been a clear shift towards viewing drug use as a health and human rights issue. Former Victorian police commissioner Ken Lay, head of the federal government’s Ice Taskforce, <a href="http://www.theaustralian.com.au/national-affairs/ice-a-crisis-for-all-to-tackle-says-new-tsar-ken-lay/news-story/92fdf9dd9895dc8a011a6b1b32abcb70">has explained</a> that “you can’t arrest your way out of this problem”, while Mick Palmer, former AFP Commissioner, <a href="http://www.smh.com.au/it-pro/after-33-years-i-can-no-longer-ignore-the-evidence-on-drugs-20120606-1zwpr.html">notes</a> that “drug law enforcement has had little impact on the Australian drug market”. </p>
<p>Most Australians support some form of decriminalisation (caution, civil penalty or diversion) for all drugs. Only <a href="http://www.aihw.gov.au/alcohol-and-other-drugs/ndshs/">5% of Australians support</a> a prison sentence for cannabis possession, with support for prison for ecstasy (14%), methamphetamine (21%) and heroin (24%) also relatively low.</p>
<p>One in four Australians (26%) <a href="http://www.aihw.gov.au/alcohol-and-other-drugs/ndshs/">believe that personal use</a> of cannabis should be legal and 69% support a change in legislation to allow the use of cannabis for medical purposes. Some 42% believe that a caution, warning or no action would be appropriate for possession of small amounts of cannabis. Between 5% and 7% of Australians support legalisation of other drugs.</p>
<p>It’s becoming increasing clear that the illegal status of drugs causes significant harms to users and the community. There is increasing recognition that a new approach is needed. </p>
<p>Decriminalisation of illegal drugs has the support of Australians and does not appear to increase use, but can substantially reduce harms. Further research in countries that have legalised some drugs is needed to identify any benefits and consequences.</p><img src="https://counter.theconversation.com/content/55493/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee works as a consultant to health services to support best practice implementation of methamphetamine and other drug treatment and is the President of the Australian Association for Cognitive and Behaviour Therapy. She has previously been awarded grants by the Australian Government for research into methamphetamine treatment options.</span></em></p><p class="fine-print"><em><span>Professor Alison Ritter is an NHMRC Senior Research Fellow and Director of the Drug Policy Modelling Program, NDARC, UNSW. She has received research funding form the NHMRC, the ARC, philanthropic organisations and state and federal governments.</span></em></p>Some of the greatest harms from using illicit drugs are because they are illegal.Nicole Lee, Associate Professor at the National Drug Research Institute, Curtin UniversityAlison Ritter, Professor & Specialist in Drug Policy, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/546362016-02-16T04:30:10Z2016-02-16T04:30:10ZWe can’t eradicate drugs, but we can stop people dying from them<figure><img src="https://images.theconversation.com/files/111595/original/image-20160216-22547-h6wl23.png?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Drug checking would make music festivals safer.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/mixtribe/11488079996/">Mixtribe/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><blockquote>
<p>There is something very special about illicit drugs. If they don’t always make the drug user behave irrationally, they certainly cause many non-users to behave that way.
– Harvard Professor of Psychiatry Lester Grinspoon</p>
</blockquote>
<p>Last night’s <a href="http://www.abc.net.au/4corners/stories/2016/02/15/4404734.htm">Four Corners</a> focused on party drugs and the policies Australia is implementing to combat their use. Not only is what we’re doing not working, we’re falling behind the rest of the world and what evidence says is best to ensure we have fewer deaths from illicit drugs.</p>
<p>Going back a few decades in global attitudes, drugs were bad, users were evil and the deaths of consumers were proof of the inherent danger of drugs and an inevitable outcome if people continued to insist on breaking the law.</p>
<p>Now, if we look at the drug policies in place in other countries, medical and recreational cannabis are being <a href="https://theconversation.com/could-iran-be-the-next-country-to-legalise-cannabis-and-opium-49183">embraced</a>, as well as safe <a href="https://theconversation.com/why-australia-needs-drug-consumption-rooms-53215">injecting and consumption</a> rooms.</p>
<p>The European Union continues to roll out <a href="https://theconversation.com/what-is-drug-checking-and-why-do-we-need-it-in-australia-51578">drug-checking programs</a> (where party drugs are tested for strength at music festivals and other sites where they’re consumed). In April, the <a href="http://www.unodc.org/ungass2016/">United Nations General Assembly special session on drugs policy</a> is considering decriminalising personal drug use. </p>
<p>In the midst of this, Australia plods on with its punitive and prohibitionist ideals, despite the rest of the world moving on. Whether it’s the use of sniffer dogs at music festivals (which an <a href="https://www.ombo.nsw.gov.au/__data/assets/pdf_file/0020/4457/Review-of-the-Police-Powers-Drug-Detection-Dogs-Part-1_October-2006.pdf">ombudsman’s report</a> found was ineffective in detecting drug dealers), or roadside drug testing (for which there is <a href="http://www.smh.com.au/national/health/hundred-thousand-nsw-residents-to-be-targeted-for-wasteful-unfair-roadside-drug-testing-20151003-gk0gyo.html">no evidence</a> it prevents crashes), we seem happy to adopt interventions that have little evidence behind them, instead of those that do.</p>
<p>The most fundamental shift on drugs policy worldwide has been from moralising about use to focusing on keeping young people safe. More people are beginning accept that nowhere will ever be “drug free”. Now over a decade old, US drug policy expert Marsha Rosenbaum’s “<a href="https://www.unodc.org/documents/ungass2016//Contributions/Civil/DrugPolicyAlliance/DPA_SafetyFirst_2014_0.pdf">Safety First</a>” tells parents to replace “Just Say No” with “Just Say Know”.</p>
<h2>The global war on drugs</h2>
<p>While it may now be touted as a public health initiative, the birth of the global war on drugs was largely ideological. This has been well described both in <a href="http://dulwichcentre.com.au/articles-about-narrative-therapy/deconstructing-addiction/from-mr-sin-to-mr-big/">Australia</a> and the <a href="http://www.amazon.com/Chasing-Scream-First-Last-Drugs/dp/1620408902">rest of the world</a>.</p>
<p>The National Commission on Marijuana and Drug Abuse, also known as <a href="http://www.iowamedicalmarijuana.org/documents/nc1contents.aspx">The Shafer Report</a> of 1972, was shelved because it concluded there was “little proven danger of physical or psychological harm from the experimental or intermittent use of the natural preparations of cannabis”. That was not what US President Richard Nixon wanted to hear. </p>
<p>When MDMA was banned, the professor of psychiatry at Harvard University <a href="https://dash.harvard.edu/bitstream/handle/1/8889454/Lewis,_Donald_00.pdf?sequence=1">successfully argued</a> it had utility as a medicine, until US President Ronald Reagan forced the ban through executive action. And so politics continues to trump science.</p>
<p>Since the war on drugs began, the entire market has changed. Drugs are now researched online, ordered from industrial chemists producing them to pharmaceutical purity, paid for using cryptocurrencies and delivered by the postie. The latest have never been identified and are undetectable either by sniffer dogs or routine toxicological tests. </p>
<p>That is not to say that the market is any safer – far from it. But drugs are now easier to get and many can’t be detected.</p>
<h2>Why we’re not moving on</h2>
<p>There is some suggestion that in NSW, at least, all of the political capital there is to spend on drugs has already been spent on medical cannabis, so there just isn’t the appetite to open another front in the growing war on the War on Drugs.</p>
<p>More broadly, Australian politicians are afraid for their political careers – they fear that a perceived back-flip on drugs policy might raise questions about their judgement. </p>
<p>However, with significant changes likely to emerge out of the UN General Assembly’s special session on drugs in April 2016, difficult questions are likely to be asked of those who have historically pursued, against all the evidence to the contrary, the global war on drugs.</p>
<p>Perhaps the most likely and disappointingly mundane reason that Australian politicians shy away from any debate on drugs policy is the multi-billion-dollar “sunk cost” of the global war on drugs to date. So much has been invested in our current and failing approach that they are pressured to keep the status quo, no matter what evidence is brought to the table.</p>
<p>Sniffer dogs at music festivals – which the NSW Ombudsman dismissed as a waste of money and even potentially dangerous – cost just shy of A$1 million a year per jurisdiction. For that sort of money, ten drug checking programs could be rolled out across Australia within weeks and to far greater effect than has ever been observed in the history of the use of sniffer dogs.</p>
<p>If our political counterparts wish to continue with a modicum of credibility on drugs policy, now would be an excellent and potentially politically rewarding time to start listening to the evidence.</p><img src="https://counter.theconversation.com/content/54636/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Caldicott is a member of Harm Reduction Australia and ATODA, and has offered bipartisan academic advice in the development of medical cannabis legislation in Australia. He has no political affiliations or financial disclosures to make.</span></em></p>Not only are our drug policies not working, we’re falling behind the rest of the world and what evidence says is best to ensure we have fewer deaths from illicit drugs.David Caldicott, Emergency Medicine Consultant, Australian National UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/515782015-12-01T05:22:57Z2015-12-01T05:22:57ZWhat is ‘drug checking’ and why do we need it in Australia?<figure><img src="https://images.theconversation.com/files/103834/original/image-20151201-26568-1pugw5h.png?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">This has been one of the worst starts to the music festival season ever, in terms of harm from overdoses.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/mixtribe/14251730514/">mixtribe/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>This weekend saw the tragic death of a <a href="http://www.smh.com.au/nsw/woman-dies-at-stereosonic-music-festival-as-dozens-charged-with-drug-offenses-20151128-glam35.html">young woman</a> after she took an unidentified tablet at the Stereosonic music festival. Drug-related deaths of this type are not uncommon in Australia, and this raises the question of whether our approach to harm minimisation needs reform.</p>
<p>Ten years ago the Australian Medical Association passed a resolution backing research on testing illicit drugs in Australia to see what they actually contained, in an attempt to reduce consumption, overdose and death.</p>
<p>Previously called “pill testing”, “drug checking” gives a consumer the opportunity to know what is in their product prior to consuming it. It also allows alcohol and drug researchers to access what is largely an invisible cohort of functional consumers.</p>
<p>Its origins lie in the European dance music scene, with the emergence of counterfeit and contaminated pills. Consumers often feared something in the products they were consuming could be dangerous to them. But with no regulation, there was no way to find out. </p>
<p>A decade ago, when we <a href="http://www.ncbi.nlm.nih.gov/pubmed/15935943">conducted research</a> at the Enchanted Forest “raves” in South Australia, that was what we were concerned with too. But a decade is a lifetime in drug-market years. We are now faced with the most dangerous drug market in years. </p>
<p>Novel compounds previously undescribed in human toxicology, and MDMA (methylenedioxy-methamphetamine, or, ecstasy) of a purity and dose never seen before, are all available through the internet and untraceable cryptocurrencies. From what I’ve observed as an emergency physician, this has been one of the worst starts to the music festival season ever, in terms of harm from overdoses.</p>
<h2>Drug checking as process and intervention</h2>
<p>One of the best examples of a drug-checking program is in Zurich, under the banner of “<a href="http://www.lapresse.ca/videos/actualites/201309/12/46-1-faire-tester-sa-drogue-en-vingt-minutes.php/c2e6226bdc9c4b828f029c8f9f123800">Saferparty</a>”. In conjunction with University of Bern, researchers bring a shipping container of state-of-the-art forensic equipment to one of the largest dance festivals in Europe, Street Parade.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/103835/original/image-20151201-26559-lpuami.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/103835/original/image-20151201-26559-lpuami.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/103835/original/image-20151201-26559-lpuami.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=388&fit=crop&dpr=1 600w, https://images.theconversation.com/files/103835/original/image-20151201-26559-lpuami.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=388&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/103835/original/image-20151201-26559-lpuami.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=388&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/103835/original/image-20151201-26559-lpuami.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=487&fit=crop&dpr=1 754w, https://images.theconversation.com/files/103835/original/image-20151201-26559-lpuami.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=487&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/103835/original/image-20151201-26559-lpuami.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=487&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Knowing what’s in the drugs is just as important as talking to the people taking them.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/extra_chrisb/4175811208/in/photolist-8S8Fa7-8S8DEm-dnd4f9-9fFg6Z-aADGLJ-aADGr9-6EKeq-9cjyXc-9cjzzK-9cnATW-9cjCp8-4ZRoZX-4ZU9uj-a2Ym31-9cnFyw-9cjyjt-9cjBEV-9cnCsq-9cjEbx-9cjAgv-9cnKc9-9cjDCP-9cnLgw-9cjFge-9cjvJM-jb9xz-jb9Wk-8VwEgr-7n18bY">Chris Breikss/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Setting up in the early hours of the event, forensic chemists, doctors and teams of experts are ready to test drugs in their mobile laboratory. Chemists are looking for drugs they know to be particularly dangerous, or drugs in dangerous doses.</p>
<p>Patrons queue up from the time the doors open to submit a scraping of what they intend to consume during the day. Law enforcement are aware and tolerate the program, acknowledging its benefits to public, and the fact that they will also have access to a de-identified data source that would have otherwise been unavailable to them.</p>
<p>Festival-goers are provided with a unique code that corresponds to their submission, and then wait for their results. This can take 20-40 minutes, in which time there is ample opportunity for a dialogue between consumer and tester.</p>
<p>Attendees are frequently functional users, meaning their drug use is not problematic and does not prevent them from leading a normal life. This means they’re otherwise invisible to routine survey techniques. While many might think establishing the identity of the drugs is reason enough to conduct drug checking at music festivals, it is this opportunity for dialogue that presents one of the most compelling justifications for this sort of program on-site.</p>
<p>At venues where drug checking occurs, we see patrons modify their behaviour, and mitigate potentially more dangerous behaviour that might result in harm. In our on-site labs from the early 2000s, as many as two-thirds of those surveyed wouldn’t take their drugs if they found them to contain something other than what they were expecting. There are few other interventions that demonstrate this strength of effect in this environment.</p>
<p>This has now been rolled out across dozens of European countries, and has its own <a href="http://www.emcdda.europa.eu/attachements.cfm/att_231074_EN_INT15_NEWIP_Drug%20checking_standards-final_20.12-A4.pdf">best-practice guidelines</a>.</p>
<h2>Why not in Australia?</h2>
<p>There have been many opponents to drug checking in Australia over the last decade, largely from conservatives from the Howard-era “tough on drugs” movement.</p>
<p>Some arguments are philosophical, such as the charge that it sends “the wrong message” to users or wider society. This was articulated in the mid-2000s by then Minister for Ageing Christopher Pyne, <a href="http://www.adelaidenow.com.au/news/south-australia/pynes-pain/story-e6frea83-1111113660298">who stated at the time</a> that I, along with other supporters, were part of:</p>
<blockquote>
<p>… a long line of medical people who treat drugs as a health issue, rather than the self-harm and criminal offences that they are …</p>
</blockquote>
<p>and that pill testing represented:</p>
<blockquote>
<p>… dangerous views, which if allowed to become mainstream, would undermine the government’s policy of being tough on drugs.</p>
</blockquote>
<p>There are those who feel the process underscores some sort of capitulation in an already failed War On Drugs. On the contrary – by providing a medical and toxicological context, we can “nudge” the behaviour of consumers in a far more persuasive manner than by the mere threat of criminalisation. In their eyes, the law is something to be eluded; death and permanent impairment is a much more serious prospect.</p>
<p>Against the charge that it might encourage drug consumption, we would agree – if it was our plan to deploy the intervention outside supermarkets, or primary schools. But the intervention deliberately targets the highest of the high risk, the venues where patrons have already chosen to consume illicit drugs. It’s not possible to encourage them any more - only to persuade them to moderate their ways. </p>
<p>At no stage are users ever advised that what has been tested is “safe” – the only way to be completely safe from drug-related harm is to not take drugs.</p>
<p>Prime Minister Malcolm Turnbull <a href="http://www.malcolmturnbull.com.au/media/Ministry">has called for</a> a “nimble”, “imaginative” and “innovative” Australia. We applaud this, as it’s precisely what we will need if we are to stop more avoidable deaths at dance festivals this season.</p><img src="https://counter.theconversation.com/content/51578/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>David Caldicott is a member of Harm Reduction Australia and ATODA, and has offered bipartisan academic advice in the development of medical cannabis legislation in Australia. He has no political affiliations or
financial disclosures to make.</span></em></p>Testing drugs at music festivals not only means we can assess whether they contain anything unexpected, but it’s an opportunity to try to change the behaviour of users.David Caldicott, Emergency Medicine Consultant, Australian National UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/340732014-11-11T19:31:24Z2014-11-11T19:31:24ZSix reasons Australia should pilot ‘pill testing’ party drugs<figure><img src="https://images.theconversation.com/files/225831/original/file-20180702-116132-1m66t5y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Young people want better information about illicit drugs so they can make informed choices. </span> <span class="attribution"><span class="source">from www.shutterstock.com</span></span></figcaption></figure><p>The death of 19-year-old Georgina Bartter at a music festival on the weekend from a <a href="http://www.smh.com.au/nsw/teenager-dies-after-taking-pills-at-music-festival-20141109-11jby1.html">suspected ecstasy overdose</a> could possibly have been avoided with a simple harm-minimisation intervention. Pill testing, or drug checking as it’s known in Europe, provides feedback to users on the content of illegal drugs, allowing them to make informed choices. </p>
<p>Taking illicit drugs, especially ecstasy, is not particularly unusual for someone of Bartter’s age. <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737421314">A 2010 survey</a> found more than 11% of 20- to 29-year-olds and 7% of 18- to 19-year-olds had taken the drug in the previous 12 months. According to annual <a href="https://ndarc.med.unsw.edu.au/resource/key-findings-2014-edrs-drug-trends-conference-handoutWe">research among 1,000 ecstasy users</a>, 70% of these pills are taken at clubs, festivals and dance parties. </p>
<p>Australia is internationally applauded for our harm-minimisation approach to drugs but we have failed to introduce pill testing, even though it is an intuitively appealing strategy.</p>
<h2>Wide support</h2>
<p>Pill-testing kits or booths at venues where pills are known to be consumed could inform users about the content of illicit drugs. As we have equipment that can test drugs in real time, people intending to take them could have them checked beforehand.</p>
<p>Research shows young people are <a href="http://www.ancd.org.au/images/PDF/Researchpapers/RP27-young-peoples-opinions.pdf">highly supportive of pill testing</a>; more than 82% of the 2,300 young Australians aged between 16 and 25 years surveyed for the Australian National Council on Drugs in 2013 supported its introduction. The finding is consistent with young people’s overall views about drugs: they want better information in order to make informed choices. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/64227/original/6vnbg8hw-1415688012.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/64227/original/6vnbg8hw-1415688012.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=388&fit=crop&dpr=1 600w, https://images.theconversation.com/files/64227/original/6vnbg8hw-1415688012.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=388&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/64227/original/6vnbg8hw-1415688012.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=388&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/64227/original/6vnbg8hw-1415688012.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=487&fit=crop&dpr=1 754w, https://images.theconversation.com/files/64227/original/6vnbg8hw-1415688012.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=487&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/64227/original/6vnbg8hw-1415688012.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=487&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">We have equipment that can test drugs in real time, so people intending to take them could have them checked beforehand.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/extra_chrisb/4175811208">Chris Breikss/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Pill testing is not a radical idea. As a harm-reduction intervention provided by community and local governments, it’s available in several European countries including the Netherlands, Switzerland, Austria, Belgium, Germany, Spain and France. But the legal status of the service is unclear and there is no formal government endorsement of the measure.</p>
<p>Nonetheless, its effectiveness is strongly grounded in evidence. There are good reasons why this country should introduce the measure.</p>
<h2>Five good reasons</h2>
<p>First, pill testing has been shown to <a href="http://informahealthcare.com/doi/abs/10.1081/JA-100000227">change the black market</a>. Products identified as particularly dangerous that subsequently became the subject of warning campaigns were found to leave the market.</p>
<p><a href="http://www.emcdda.europa.eu/attachements.cfm/att_2878_EN_pill_testing_report.pdf">Research also shows</a> the ingredients of tested pills started to correspond to the expected components over time. This suggests pill testing might be able to change the black market in positive ways.</p>
<p>Third, pill testing changes behaviour: <a href="http://www.emcdda.europa.eu/html.cfm/index1577EN.html">research from Austria</a> shows 50% of those who had their drugs tested said the results affected their consumption choices. Two-thirds said they wouldn’t consume the drug and would warn friends in cases of negative results. </p>
<p>Visits to pill-testing booths create an important opportunity for providing support and information over and above the testing itself. They enable drug services to contact a population that is otherwise difficult to reach because these people are not experiencing acute drug problems. Indeed, the intervention has been <a href="http://www.harmreductionjournal.com/content/8/1/16">used to establish contact</a> and as the basis for follow-up work with members of not-yet-problematic, but nevertheless high-risk, groups of recreational drug users. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/64228/original/8d688xzr-1415688159.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/64228/original/8d688xzr-1415688159.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=378&fit=crop&dpr=1 600w, https://images.theconversation.com/files/64228/original/8d688xzr-1415688159.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=378&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/64228/original/8d688xzr-1415688159.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=378&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/64228/original/8d688xzr-1415688159.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=475&fit=crop&dpr=1 754w, https://images.theconversation.com/files/64228/original/8d688xzr-1415688159.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=475&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/64228/original/8d688xzr-1415688159.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=475&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Pill-testing kits or booths at venues where pills are known to be consumed could inform users about the content of illicit drugs.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/vegas/526372413">Mark Vegas/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
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<p>Finally, pill testing means we can <a href="http://jop.sagepub.com/content/25/11/1543.short">capture long-term data</a> about the actual substances present in the drug scene. And it creates the potential for <a href="http://www.tandfonline.com/doi/abs/10.1080/08897077.2013.792760#.VGGkEmS1aRk">an early warning system</a> beyond immediate users. This is becoming all the more important as new psychoactive substances that may be used as adulterants are appearing more frequently. </p>
<h2>Not a panacea</h2>
<p>A harm-reduction approach to drugs is always a balance between benefits and risks: the availability of pill testing reduces harm, but it may increase risks for some. Not everyone will use the service and some may ignore the results and risk being subject to potentially harmful drugs. </p>
<p>It may also lend the appearance of safety when, in reality, the pills remain illegal and potentially harmful. What’s more, we will need to ensure that pill-testing results are accurate by researching the <a href="http://bitnest.ca/external.php?id=%257DbxUgY%255CC%2540%251BR%252B8%253CW%255C%250E%2505%2515%251CVIwy%257E%2515RwxGC">effectiveness of testing kits</a>. </p>
<p>Of course, critics will argue the measure will “send the wrong message”. But the messages we’re currently sending are that we don’t want informed consumers and we don’t want to reduce harm from illicit drug use. They’re clearly not quite right either.</p>
<p>Australia should run a trial of pill testing and assess its benefits and harms so we can then make an informed choice about this intervention.</p>
<p>The growth in new psychoactive substances and the ever-evolving chemical composition of drugs, coupled with the need to reduce the harms from pill use, means this is an idea whose time has come. And although the coroner has yet to confirm the exact cause of her death, the final reason for introducing pill testing is that it may help avoid the needless loss of young lives like that of Georgina Bartter.</p><img src="https://counter.theconversation.com/content/34073/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alison Ritter receives funding from Australian National Council on Drugs, which funded the youth survey mentioned in this article.</span></em></p>The death of 19-year-old Georgina Bartter at a music festival on the weekend from a suspected ecstasy overdose could possibly have been avoided with a simple harm-minimisation intervention. Pill testing…Alison Ritter, Professor & Specialist in Drug Policy, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.