Inside NSW’s first drug trial: Advice and hope
Thursday, 15 August, 2024.
Chemist Dr Richard Kevin testing drugs as part of the pilot program.
Drug testing is available for registered clients at the Uniting Medically-Supervised Injecting Centre (MSIC) in Kings Cross on Mondays between 1 and 5 PM. It’s a temporary trial which runs until Monday 9 September this year.
You only need submit a small portion of your drugs to find out what is in them but you won’t get back the portion used. You hand over 0.01g if you just want to know what drug or drugs are in your gear. You hand over 0.1g if you want to know the percentage break down of each substance in the sample.
The service can test almost any illicit drug, except for plant materials (weed and magic mushrooms, for example), edibles (gummies, for instance) and peptides/steroids.
You are paid for the time it takes you to participate in the drug testing trial, the first time you do it. Participation is entirely voluntary.
A drug and alcohol clinician will explain the results to you and offer advice about harm reduction practices and testing for blood-borne viruses.
Since the beginning of April, staff from The Loop Australia have a run a drug checking trial at the Uniting Medically-Supervised Injecting Centre (MSIC) in Kings Cross for service users there.
With the number of public drug alerts in NSW at an all-time high and increasing detections of nitazenes across the nation – lab-made drugs with heroin-like effects but far far stronger – the pilot program is a timely endeavour. The trial follows on from the success of other local fixed-site drug testing facilities, such as CanTEST in Canberra, which evidence shows is changing user behaviours, ensuring safer drug usage and reaching audiences who have never discussed their drug usage with a health professional.
From 1 to 5 PM each Monday Dr Robert Page, a drug and alcohol expert from The Loop, and chemist Dr Richard Kevin attend the Uniting MSIC to provide this service. They will be there every Monday until 9 September this year. So, whether you’re an MSIC regular or you’re interested in giving the safe injecting room a go for the first time, it’s worth talking to the staff there about getting your drugs tested. You never know what unexpected substances could be hidden in your gear. Better safe than sorry, we say!
To get an overview of the service on offer, who can participate and why this ground-breaking trial is important, Users News has chatted to Dr Page.
Dr Robert Page, a drug and alcohol specialist, yarning with an MSIC visitor.
Users News (UN): What was the inspiration for running a drug testing pilot at the Uniting MSIC in Kings Cross?
Dr Robert Page: It’s something that people who use drugs in NSW have been requesting for a long time. In addition, many organisations, including Uniting, NUAA, Unharm and the Royal Australian Colleges of GPs and Physicians, think that drug checking should be trialled, so we wanted to see if we could make it happen. Discussion with MSIC’s Consumer Action Group (CAG) proved that we were on the right track with our plans. There’s been lots of interest and keen engagement on this project from CAG! CAG is a paid group of people who are clients of MSIC. Representing the views of MSIC clients, they have input into many aspects of the service, and they helped with the co-design and feedback phases of this project. A major aim of the project is to find out whether MSIC clients themselves actually want access to drug checking, and what they find good or bad about it.
UN: What makes the MSIC drug checking service unique?
Dr Page: It’s the first time that people have been able to access a drug checking service in NSW! Often people think of drug checking as “pill testing”. That is: testing people’s drugs at festivals, which evidence suggests is a valuable thing to do. But it’s important to remember there are highly varied populations of people who use drugs. Other communities (in this case people who inject drugs) may also want more information about their drugs, so they can make more informed drug use decisions and keep themselves safer.
UN: In light of recent drug alerts – for example, alerts indicating the increasing presence of nitazenes in local drug markets – how important is this drug testing service?
Dr Page: Without drug checking, people are left with an unpredictable and often dangerous unregulated illicit drug market. There is little ability for people to access accurate information about the drugs they obtain and use. As we’ve seen, this sometimes leads to people consuming drugs they didn’t intend to consume, suffering harms, and even dying. There are, of course, a number of systems already in place which publicise information about illicit drug supplies. NSW Health and NUAA often release important alerts and advice about drugs they detect, hear about or investigate. This project provides an additional opportunity for people to find out what’s in their drugs before they take them. It means we can help people make even more informed choices. In the case of nitazene detection, this may mean people choose to not take that drug, or they decide to use MSIC for all their substance use, or at the very least make sure that they have naloxone on hand and use with someone else around, or they tell their mates what they found in their drugs. All these things likely help people keep themselves and others around them safer.
UN: In terms of bureaucratic and legal hurdles, was it difficult introducing this drug checking service in NSW? Why/why not?
Dr Page: It has been a challenge at times. This is the first time this has been done in NSW, so we had to do a lot of background research, build partnerships with lots of experts in this field and get all the relevant approvals to make sure we’re doing everything “by the book”. In addition to this we have faced hurdles and delays in getting and maintaining insurance, issues related to project funding, issues with equipment breaking down… It hasn’t been easy! Thankfully things are running along pretty smoothly now.
UN: Can you run me through the process by which visitors get their drugs tested? How long is the wait for a result?
Dr Page: This drug testing service is only available to registered MSIC clients and it is entirely voluntary for anyone who visits the centre. If someone wants to participate, they come and speak with me, and I describe the project to them. I have to make sure they understand what it’s all about, so I can get informed consent from them to participate, as this is a research project. They then submit a small amount of their drug to the chemist for analysis – 0.01g if they want qualitative analysis (that is, what’s in their drugs) or 0.1g if they want quantitative analysis (that is, what percentage of each substance makes up their sample). The drug is analysed in front of them using Fourier Transform Infrared Spectroscopy (FTIR) and a fentanyl test strip, while we do a short survey. We then discuss the results and what people can do to keep themselves safer while using that drug. We also make sure people have take-home naloxone, that they’re up to date with their blood-borne virus testing, and we can even help get people referred in for treatment if that’s what they want. All participants are compensated for the time that it takes to complete the survey, the first time they attend. And if people want to come back to participate another time with different drugs to get tested, they’re very welcome to.
UN: Are MSIC service users able to get drugs tested which they are not using on-site? Is the trial focused on heroin and ice or all drugs?
Dr Page: MSIC service users can come and get almost any illicit drug tested, be it in powder, crystal, pressed pill or liquid form. We can’t test plants (e.g. cannabis or mushrooms), edibles (e.g. gummies), or peptides/steroids, due to some limitations of the tech we’re using for this study. It’s up to clients whether they then proceed to use that drug on site.
UN: What can you tell me about the reaction of service users who use the facilities to the news that they can now have their drugs tested?
Dr Page: So far we’ve had mostly positive (and often surprised) reactions from people when we tell them that we can test their drugs. There’s been a lot of “I’ve been wanting this for years!” So it’s nice to be able to provide this service to people. But there will be lots more info on this coming after we’ve finished data collection and had a chance to review people’s responses in more detail.
UN: What reasons do MSIC users give when they refuse drug testing? Is there a financial barrier that means visitors to the centre don’t always want to give up a portion of their drugs for testing or a social barrier that means people don’t want to wait?
Dr Page: Some people are more or less interested in participating, which is fine. The main goal of this project is to find out whether it’s feasible and acceptable. In other words, can we do it? And do people want it? Unfortunately we don’t have much data on the people who decline to participate. Since they don’t consent to take part in the study, we can’t talk about their responses. When we spoke with MSIC’s Consumer Action Group before launching the project, it was flagged that some people may not want to participate because of having to give up a small amount of their drugs (about a tenth of a point, or 10mg), so it’s possible that this is why some people don’t want to participate. But of the people who’ve participated so far, only a small minority have indicated that this is an issue for them.
Sometimes people have expressed interest but have then had to wait a while because we’ve been busy with other participants, and then they haven’t hung around to participate themselves. It’s a pity but people have other priorities that they need to attend to. Of course we’re there every Monday for the next little while, so they can always come back the following week
UN: Do you have data available that you can publicly share on the number of MSIC visitors who choose to have their drugs tested? What are you able to tell Users News about the results already accumulated from drug testing?
Dr Page: We’ve had fairly consistent uptake week by week with people coming to see us to have their drugs tested. We’re unable to talk in much detail about the results so far, but thankfully we haven’t seen anything of specific concern. Of course if anything concerning was found we would raise this with health authorities to make sure relevant drug alerts can be sent out to the public.
UN: What is the next step for the drug testing pilot? Is there hope or intention to expand the service over time?
Dr Page: For now we want to complete the project – which is time limited and finishing up shortly – look at the data, talk with MSIC clients about it, hopefully publish, and then we’ll look at next steps. We have the upcoming NSW Drug Summit later in 2024, and we hope that we’ll get a chance to speak with folks there about some of the findings from our project. Going forward, The Loop Australia would love to be able to deliver a more accessible service in NSW, ideally in partnership with NUAA or ACON or other community organisations, but we’ll have to see how things go!
UN: Any last comments?
Dr Page: Thanks for chatting with me about this, It’s been a passion project of mine for years now so it’s good to be getting it done and spreading the word about the potential value of approaches such as drug checking! And huge thanks to the participants so far, to the MSIC Consumer Action Group, to UNSW for their support, and to Uniting for their partnership that has allowed us to deliver this project at MSIC.