Pill testing as harm minimisation
Three weeks after the first pill-testing trial on the Canberra leg of the Groovin the Moo music festival, Matt Noffs, one of its most vocal advocates, found himself confronted by a ghost from his past. Long, lean and covered in spots, Harold was hanging outside the gates of Noffs’ daughter’s school in a bus.
“I was born the same year as Happy Harold [aka Healthy Harold] – 1979,” Noffs says cheerfully. He’s talking about the giraffe puppet that his grandfather, Reverend Ted Noffs, created as a drug-education tool. Harold still travels the country as part of the Life Education program, which has also been adopted in Britain, the United States, Hong Kong, Finland, Cyprus and Barbados, in a bus rigged up with stars on the ceiling and a female mannequin with light-up organs to demonstrate the dangers of drugs. Its gentle scare tactics are starkly at odds with the harm-minimisation principles around which Noffs jnr bases his work. Harm minimisation – which has underpinned Australia’s National Drug Strategy since 1985 – acknowledges that drug use plays an inevitable role in society, and so reducing harms should be the priority.
“My grandparents came up with some really incredible things – Freedom Rides, Aboriginal Affairs association, Lifeline, The Wayside Chapel and the first drug crisis centre,” he says, not to mention Noffs, a foundation of which he is chief executive. “But Happy Harold was hardly evidence-based. I adore the principle of Life Education, but I can’t bear it saying it’s drug education, because what really matters now in drug education is to work with people who are at the age of experimenting with drugs, and to be pragmatic with them.”
Noffs’ second book, Addicted?: How Addiction Affects Every One of Us and What We Can Do About It, is co-written with psychologist Kieran Palmer. When writing about real characters, Noffs looked to The Grapes of Wrath and Steinbeck’s idea of using realist fiction to create empathy for the people of the Dust Bowl. Noffs wasn’t short of inspiration. He and his wife, Naomi, co-founded the Street University program, which provides practical support to 12- to 25-year-olds in communities where drug use is already rife.
But Noffs isn’t particularly permissive about drug use. It was Naomi who pointed out that their own kids would be better encouraged to use a pill-testing service overseen by medical professionals than be too wary to confide in their parents.
Pill testing is now practised in more than 20 countries, and as part of the STA-SAFE consortium, Noffs has been campaigning for four years for its initiation in Australia. The night before Groovin the Moo, held on April 29, he had one nightmare after another in his Canberra hotel room, dreaming that the pill-testing tent would be empty. The next morning, it seemed his worst fears were realised. No sign was allowed on the tent, and for the first hour, nobody walked in. By midnight, the team had seen 128 people.
It was a grim victory, in that the potentially deadly stimulant ephylone was detected in two samples. Testing those pills might have saved lives, but it also marks the first time this substance has been spotted in Australia. Noffs points out that sniffer dogs won’t give police that kind of information, and in the worst-case scenario, a punter who spots the dogs may immediately swallow their stash.
Not everyone is in agreement with pill testing. ACT shadow attorney-general Jeremy Hanson has argued, “I’m very concerned about the young people who are now going to be taking drugs under the misapprehension that these drugs are safe.” This was echoed by Tony Wood, whose daughter Anna died in 1995 of water intoxication after overhydrating while on MDMA (ecstasy).
Noffs points out that the STA-SAFE team warned Groovin the Moo punters whose pills were not contaminated that, “ ‘Just because you’re about to take pure MDMA, you could still end up in hospital. Instead of taking it all at once, would you reduce that?’ And everyone was told that the safest way to take a drug was not to take it at all.”
The next trial will likely take place at Spilt Milk in Canberra in November, says Noffs. “Then I’d like to start campaigning in other states.” In the meantime, his other focus, along with Dr Alex Wodak, the president of the Australian Drug Law Reform Foundation, is to continue his campaigning for medically supervised drug consumption centres – in a model that includes a ventilated room for drug inhalation.
“Alex and I went to look at drug-monitoring rooms in Europe, and in Germany they had nearly 30,” he says. “It meant they were able to get people off the street and into a health setting. What we were interested in was the notion that an inhalation room captured a cohort that was previously uncapturable, in that they haven’t moved to injecting yet. It’s a win for them and a win for the community, because you reduce the spread of HIV and hepatitis by stopping them going to the needle and having a clean ice pipe exchange.”
Noffs rejects the idea that having the inhaling cohort mingling with the injecting cohort would simply expedite a move into injecting. “That would be happening anyway, on the street or in a lounge room,” he says. “In a health setting you mitigate that by having health practitioners there giving you information.”
According to data from the 2016 National Drug Strategy Household Survey, overall rates of ice use have remained stable or declined in recent years, but Noffs says history tells us we might now be due an opioid crisis, such as that gripping the US.
“Sometimes, following a stimulant crisis, you can have an opioid crisis because people use opioids to come down off a stimulant,” he says. “We do need to be strategic about this. Our governments are tactical, only ever dealing with the drug that’s in front of them, never strategically thinking five, 10 years ahead. The federal and state governments could start developing an opioid strategy tomorrow: ‘If it’s a prescription issue, these are some of the regulations we’re going to put in place. Here are some of the things we’re going to set up in terms of NSP [needle and syringe programs]. We’re going to have this for treatment’, and so on. We were 10 years behind with ice. We could have dealt with it in 2006.”
Still, he says, progress with harm-minimisation ventures and drug-law reform are speeding up. “We had a period in the 1990s of amazing success – needle and syringe programs, and the first medically supervised injecting centre,” he says. “Then there was a gap between the New South Wales Drug Summit of 1999 and Mike Baird calling for medicinal cannabis in the last couple of years.”
Now we have the pill-testing trial and a two-year trial for Australia’s second medically supervised injecting centre.
Even though legalisation for recreational use is so far limited to cannabis in Uruguay, Alaska, California, Washington and Colorado, Noffs thinks there will be a domino effect. “It’s inevitable, partly because big pharma and those behind the recreational cannabis push in the US are going for it, so there’s a market force there, but also, people are starting to see it comes down to control: how much control do we want over drugs, and how much control do we want the black market to have over us? You’ll never completely get rid of the black market. However, if you look at the tobacco black market in Australia, it’s tiny, and it’s easy for the police to shut down.”
Though he was always pro-decriminalisation, Noffs says he was vehemently against legalisation until Alex Wodak – who prefers the term “regulation” – walked him through case studies such as New Zealand’s legalisation of synthetic drugs, before it was overturned on the grounds of animal testing ethics, to persuade him. Still, he thought, “My grandfather started Life Education Centre. If he were alive today, what would he say to me?”
A rummage through his father’s archives gave him the answer. “I opened up an Australian Penthouse from 1985 and there was my grandfather calling for the regulation of drugs. I thought, ‘You’re kidding me.’ Then I found a book he’d written in 1975 called Drugs and People, and in that he’d also said that we need to regulate all substances. It’s just, if you look at all the different things he did, it got missed in a lot of that.”
Noffs can’t hide his admiration. “If you can imagine how unpopular it is today, calling for the regulation of all drugs, you can only imagine how unpopular it was in 1975.”
This article was first published in the print edition of The Saturday Paper on Jun 2, 2018 as "A better pill to swallow". Subscribe here.