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IN THE MATTER OF THE SPECIAL COMMISSION OF INQUIRY INTO THE DRUG “ICE” ALESSANDRO PIRONA (PORTUGAL) HARM REDUCTION – VIDEO PRESENTATION MONDAY, 9 SEPTEMBER 2019 TRANSCRIBED BUT NOT RECORDED BY AUSCRIPT AUSTRALASIA PTY LIMITED SCII.013.022.0065
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MR A. PIRONA: My name is Alessandro Pirona. I’m a Principal Scientific Analyst at the European Monitoring Centre for Drugs and Drug Addiction. I’ve been asked to give this presentation to be used as evidence by the Special Commission of Inquiry into the Drug Ice and the date today is the, I believe, it’s the 9th of September
- 2019. So my professional background is I have a PhD in Psychopharmacology from
5 Sussex University in the UK. I have long experience in monitoring public health responses in the drugs field. I’ve joined the European Monitoring Centre for Drugs and Drug Addiction in 2007. And my research interest is the monitoring of new drug trends, responses and interventions in the public health field. And also I have a range
- f publications in my name in this area, whether in peer reviewed journals or
10 EMCDDA publications. I’ve been asked to provide evidence on drug checking services. So starting with the first question, where I’ve been asked to “Describe the drug checking services currently in place across Europe, including the different modalities?” So we have, in 15 Europe, we have about 14 or more drug checking services. Which are, primarily, in the west – in Western Europe and Southern Europe, that’s where they are located. And, basically, the modalities, there are primarily two to three modalities that exist in
- Europe. One modality is onsite drug checking. The second modality is offsite drug
- checking. And the third modality is where, actually, a drug checking service
20 provides onsite and offsite drug checking. Onsite modalities are where the drug testing or the drug checking takes place at an event, a festival or a club. Offsite is where the drug checking takes place in a drop in centre, for example, or in an office. And where we have both modalities, where the 25 service provides both onsite at a festival, for example, and has also a drop in centre where users bring their drugs to the drop in centre to get their test – their drugs tested. B, the next question, I’ve been asked to “Describe the outcomes that drug checking 30 services are seeking to achieve and the conditions or partnerships required to enable effective operation?” So probably, there’s three main objectives that drug checking services try to achieve. Is, the first one is an individual harm reduction service, to the
- user. So provide harm reduction advice based on the results of the drug check. A
second one is public health intervention, so service, which is more systemic. Which 35 is, for example, also early warning system – being part of the early warning system would fall under that. And also market monitoring objective where you can use, just like we do at the EMCDDA, with the drug checking data, actually monitor trends, be alerted by 40 changing trends based on drug checking data, which is actually data tested, analytical data at user level. One particular aspect that is important from the objectives of drug checking services is, really, understanding why they were developed, also, and in the first instance it was that recreational drug users were a particularly hard to reach population for health services. And drug checking services, actually, through their 45 SCII.013.022.0066
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drug checking intervention have this objective, also, to reach this population, this target population. Providing not only the drug checking service, so the analytical test, but also counselling with interventions and motivational interviewing. So providing this 5 aspect of harm reduction besides the – just the results of an analytical test of the
- drugs. So how effective – so I’ve been asked in the third question to, “Discuss how
effective drug checking services have been, to date, in achieving these outcomes?” The scientific literature still remains relatively limited in terms of very specific
- bjectives in regards to the outcomes of particular outcomes of drug checking.
10 Primarily because it’s actually very difficult to – boil down the – impact of just the drug checking on particular outcomes like harm reduction outcomes. Which would be, reducing risk behaviours, reducing mortality in this setting. Because there are a number of factors that actually influence these outcomes. The first one being 15 individual factors from the drug user, and the – because we need to understand that drug taking involves a risk, in itself. So drug checking is not – the objective is not to get the user to stop using the drug and therefore making that risk go away, but is actually to provide, to provide information necessary to make an informed choice about the risks that the user is going to take. 20 A second point, also, is in order to increase the effectiveness of drug checking services and this brings me to one of the points that was asked to me in these questions was, “What partnerships are necessary to make this service effective?” And this is – crucial in terms of providing a sound drug checking service is 25 partnership, first and foremost with the local authorities and lawmakers. Because there are a number of legal aspects associated with drug checking that need to be taken into consideration when setting up drug checking. For example, every time a user provides a sample to be tested to a worker, a professional worker in the drug checking service, the drug checking worker might incur the risk of being arrested for 30 possession. If a sample of a drug needs to be transported to another lab, this will also have an effect, legal impact, in terms of trafficking. So lawmakers need to be involved in the setting up of drug checking. Another point that is also important in terms of 35 partnership is, obviously, with other health authorities like emergency services, they are crucial. And, obviously, law enforcement and, as we seen in Europe also, promoters of events. These are all partners that need to be involved in a drug checking service, especially offsite – or onsite, I mean, in festivals and clubs, but also in drop in centres when it’s onsite. 40 Another point that is important is also understanding the impact of the technology when that is used to provide the drug checking. And this will also have an impact on the effectiveness of the drug checking service in achieving certain goals, which is to provide the most reliable information to the drug user. So you can have – and this 45 will also then impact, subsequently, where the drug checking takes place, whether it’s at an event or in a drop in centre. So more advanced technology will allow you SCII.013.022.0067
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to actually have better quantitative information about the content of the drug samples while – but this would only be available in drop in centres or in specific labs. So the time between the test of the drug and the, providing the result of this information to the user, is much longer. While at the festival, the technology might 5 be more limited and would provide you more qualitative information about the presence of the expected drug that the user bought and expects to be contained within the drug samples or a range of drugs contained in that sample. But more advanced to know, actually, the quantity of each of these components, of adulterants within the sample requires more advanced technology. So in this respect, funding plays a 10 crucial role in having an effective drug checking service. The next question I’ve been asked to, “Describe how the monitoring and surveillance data that is obtained from drug checking services is utilised, including for public health and law enforcement responses.” This is very crucial data that, the drug 15 checking data is very crucial for monitoring aspects. But primarily for early warning system function. At a European level, drug checking services are part of the European Early Warning System and also the National Early Warning System. When new psychoactive substances are detected or toxic substances, or high purity substances are detected through drug checking services, this information is 20 immediately relayed to the national authorities who inform the European Monitoring Centre for Drugs and Drug Addiction which can then do a European Alert. But at national level, law enforcement authorities are informed and the Government is also informed. And, jointly, they will decide whether a public alert is necessary. 25 As we’ve seen in the Netherlands when cocaine was sold but contained heroin, where a national alert was initiated. And this was based on drug checking data. To finish, the last question is, I’ve been asked to “Describe, with reference to any recent research conducted by the EMCDDA, the risks associated with drug checking 30 services and whether or not this has been observed in relation to services provided in Europe.” The EMCDDA hasn’t actually carried out research on specific risks associated with drug checking services. However, we’ve done overviews which are available online on our public website and in our latest European Response Guide published in 2017 where we give the overview – there are some aspects about us or 35 criticisms that are associated with drug checking that are reported by policymakers. Or that are just general criticisms or question marks, rather than criticisms, around drug checking. For example, there is a question whether drug checking doesn’t actually provide a 40 false sense of security to drug users by giving information and making them feel that they can actually take the drug? But this is not the objective. This is not how the information from the drug checking service to the user is actually conveyed. It’s not about giving them, giving them safety about what they’re going to take. But it’s about informing them with factual information about the content of the substance. 45 And if possible, and obviously, this is associated with brief intervention and information about risk taking and about overall safer partying and safer use of drugs. SCII.013.022.0068
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Another criticism or question mark is associated with the fact that, it is claimed, that drug checking actually encourages drug use. And what we are seeing – what we are not observing is, for example, this is actually very difficult to measure, to research. But the few studies that have looked into it have not seen people who are not intending to take drugs in settings where drug checking was available, that they 5 actually did take drugs. And also more at a systemic level or national level, countries with drug checking services do not necessarily show a higher prevalence of specific drugs associated with party settings. 10 RECORDING CONCLUDED SCII.013.022.0069
