novel/new psychoactive substances seminar -dr david caldicott
TRANSCRIPT
From Pill Testing to Drug Checking
-& why it’s more relevant than ever
Associate Professor David Caldicott, B.Sc.(Hons), FCEM, Dip. Clin. Tox.
Emergency Specialist, Calvary Hospital, Canberra; Coordinator, ACTINOS Group.
Today we’re going to chat about...
• Reminiscences
• Evolution
• Revolution
Evangelist?
Harm Minimization
Reluctant Evangelist
Harm Minimization
Reluctant Evangelist
26th August 2001
PMA
PMA
Harm Minimisation For The Dance Community? • What was the clubbers equivalent to…– NSPs– Naloxone– Injecting rooms
• Not a lot out there…– Drink enough water– Chill out–Moderate use
?
Over 5 years of data…13 events…Over 5000 interviews…
Enchanted 2003 (n=235)
Enchanted 2004 (n=413)
• Victorian Premier’s, 2004• Club Health Sydney, 2005• Club Health Ibiza, 2007• NDARC Drug Trends, 2008
• And countless meetings and presentations with SAPOL, SA Health, DASSA etc…
Everybody Knew.
Very few spoke out…
Dr. Cameron Duff Prof. Margaret Hamilton
• Reaches the parts others can’t…
• Pertinent to those already using drugs
• Alters behaviour
• Sentinel warning for contaminated products
• Sentinel warning for novel products
Why Bother?
Why Not?
• ‘It’s illegal’
• ‘It encourages drug use’
• ‘It’s not accurate’
• ‘It sends the ‘wrong message’’
Why Not?
“He has some dangerous views, which if allowed to become mainstream, would undermine the Governments policy of being tough on drugs”
Why Not?
“Dr Caldicott is one of a long line of medical people who treat drugs as a health issue, rather than the self-harm and criminal offences that they are”
• Smith & Nephew agreed to supply tech
• ‘Interference’ from federal sources
• MCDS blocked progress
• FOI blocked on MCDS decision!
Nearly got there…
“…The AMA recognise that there is no data from Australia on the usefulness of ecstasy pill testing at large events such as raves, as a harm minimisation strategy although there is evidence from Europe that it might reduce consumption, morbidity and mortality
Therefore, the AMA supports in principle targeted, ethically approved, medically supervised research to clarify if there is a role for pill testing within the Australian context”
A decade ago...
Federal Council of the AMA, November 2005
• RAHBIT– Never got off the ground
• WEDINOS
• ACTINOS
Hybrid Models
• Europeans have continued on…
• Attempts to get it off the ground in the UK
In the meantime…
Nomenclature…
“Pill Testing”
Nomenclature…
“Drug Checking”
Testing ModelsVoluntary
Involuntary
On-Site Off-Site
LawEnforcement
Peers
Testing ModelsVoluntary
Involuntary
On-Site Off-Site
Peers
ColourimetricTests
HPLC/GCMS/NMR
Moral Range of Testing Initiatives
Police Seizures
Peer Testing
Hospital Testing
Community Submissions
Full disclosureof all results
Disclosureof all results
Disclosureof potentially
dangerousresults
No Disclosure
QuantitativeProportional
Qualitative
It’s important to be yourself…
Unless you can be Batman.
Always be Batman.
‘Ajax and Cassandra’, 1886Solomon J. Solomon,
Art Gallery of Ballarat
• Nothing has happened
• Until recently…
What about Oz?
• What is needed?
– No appetite from a European type model (yet)
– Need to move incrementally
– Needs advocacy beyond that of peer groups
What about Oz?
• What is needed?
– Team of knowledgeable volunteers– Technical support– Off-site back up– Acute medical support– University ethics– Law enforcement support– Political will
What about Oz?
• DanceWize
• ACTINOS
• Victorian Politics
• Law enforcement
Alignment of the planets
Welcome to the battle…
