Pill testing is proven. I Am Hardstyle shows how much we need it

The hospitalisation of multiple people at the I Am Hardstyle rave in Melbourne over the weekend after consuming what they probably believed were ecstasy pills has caused understandable concern, and reports that the pills may have contained the dangerous compound paramethoxyamphetamine or PMA have reignited the debate around pill testing at nightclubs and festivals.

Sadly, this is not new territory; last year pill-related overdoses in Melbourne led to three deaths and there have been many other lives lost in similar circumstances. This sense of familiarity merely adds to the frustration for those of us who take a scientific approach to this problem – because if pill testing was available at the event, perhaps this disaster could have been avoided.

The recent debacle with Spilt Milk festival shows how challenging it is to implement any sensible policy in this area. Safety Testing and Advisory Service at Festivals and Events (STA-Safe) were ready to conduct the first trial of pill testing at the Canberra event but the organisers backed out at the last minute – claiming they had failed to provide the necessary paperwork. STA-Safe vehemently refuted this allegation while the (curiously-titled) Liberal party claimed this as a victory for their hardline stance on drug taking. Further evidence, if any was required, that the battle lines remain clearly delineated in the longstanding, and ultimately futile, “war” on drugs.

The benefits of pill testing are well-documented; as well as alerting consumers when they contain dangerous substances, it facilitates a subtle process of quality improvement and provides an opportunity for education. These benefits have also been borne out in real world examples where dangerous substances have been identified and lives have undoubtedly been saved. So why are we exposing party-goers to unnecessary risks?

Opponents of pill testing argue that it “sends the wrong message”, ie people should not be taking pills at all so the government cannot allow testing as it might suggest a degree of flexibility. However, thousands of festival attendees and clubbers take ecstasy and MDMA powder (the active component in ecstasy pills) each week around the country and will continue to do so, even in the absence of testing facilities. And the most recent National Drug Strategy Household Survey found that about one in nine people have used in their lifetime, which is most likely an underestimate since people are generally unlikely to disclose information on an illegal act. So whatever message the government is trying to deliver, it is clearly not connecting.

The validity of this message is also worth questioning – in a seminal study conducted by the addictions psychiatrist David Nutt, a group of experts scored the relative harm inflicted by various drugs on individuals and others. Alcohol was found to be the most harmful overall followed by heroin and crack cocaine, with ecstasy featuring much lower down the list (17th out of 20).

MDMA is less addictive than many other drugs – you won’t catch people taking frequent breaks from work to consume it in the way that people take cigarette breaks, nor do the feelings of euphoria and love precipitated by it lend themselves to violent crime in the way that the effects of alcohol might. And although any death is of course a tragedy, there are very few in relation to the numbers of people using actual MDMA. In fact Professor Nutt once famously noted that taking MDMA was statistically safer than horse riding.

Although pill testing is most definitely a step in the right direction, it is in some respects a legal and scientific half-way house. If MDMA was legalised, its quality could be controlled and the number of deaths from contamination could potentially be reduced even further. Funds raised from taxation could be used for public education programmes about how to consume these drugs safely and the police would have more time and resource to focus on harder drugs like ice and heroin.

The comparison with alcohol is a good one – during the Prohibition era in the US, manufacture was pushed underground which led to numerous deaths from contaminated, poor quality moonshine. Legalisation led to quality control and people stopped dying from drinking wood alcohol.

Drug policy is of course far from simple – with so many drugs out there, how do we determine which ones should be illegal? An evidence-based approach would make sense; criminalising any addiction (which is a medical illness) is draconian, but the manufacture and supply of drugs which are highly addictive or highly dangerous even in small quantities, should be restricted. MDMA is neither of those – the gravest danger is from contamination.

This debate has been raging for decades, but the time to act is now. Festival season is in full swing and although the police presence usually verges on the military, with vigorous searches and barking police dogs greeting revellers as they enter, at every festival young people will be taking ecstasy pills and MDMA to enhance their experience. So rather than risking more lives, we should implement pill testing in clubs and festivals immediately and start a serious conversation about the legalisation of MDMA.

• Kamran Ahmed is a psychiatrist and filmmaker