Hard News by Russell Brown

25

What's in the pills? It matters.

Earlier this year, I spoke at some length to someone who had done something interesting at a New Zealand summer festival, and it's probably not what you're thinking. This person had, with a small team, tested the recreational drugs people had brought with them to the festival. And the results were alarming.

The large majority of festival-goers had not bought the drug they thought they had. In the case of substances bought as LSD, the situation was particularly troubling. Fully 80% of people who thought they had LSD in fact had NBOMe drugs, which are far more risky than LSD – they have a scary dose-response curve and overdoses can be very harmful and even fatal.

Later, I became aware that some people in my wider social circle were buying pills whose ingredients had been obtained – as such party drugs increasingly are – via the "dark web". People liked the speckled blue pills and believed they contained MDMA. I watched people who'd taken them and I had my doubts.

I proposed a story to my editors at Matters of Substance, the magazine of the New Zealand Drug Foundation. Could, I asked, a budget be found to have ESR test one of these pills? It could, we made the arrangements and one afternoon I drove over to ESR with the pill. (I passed three police cars on the way and I confess part of me wanted to be pulled over and searched so I could honestly say "It's for WORK!")

The meeting there was fascinating and informative. I started to get an idea of how the party drug scene had evolved in the past few years, and of how much of a problem it is becoming that we don't know what's in the pills.

I spoke to a number of other people, including Wellington emergency doctor Paul Quigley, who has to deal with the consequences. He was remarkably frank:

“Quite frankly, there’s growing evidence that MDMA is a safe form of intoxication – especially when you compare it to alcohol and so on – but that’s not what you get. You look at the recent hauls in Wellington of alpha-PVP, which is a highly stimulating hallucinogenic. So not only do you hallucinate, but you get the tachycardia and hypertension. That is not an enactogenic effect.

“Even the dealers know this, so they’re mixing things like benzos into these tablets. The high from the amphetamine effect is almost too high, so they try and balance that by putting in a benzodiazepine. Now we’re talking really dangerous, because benzos are addictive – they’re enough of a problem in prescription medicines, let alone the recreational ones.”

It turned out the the blue pills contained a mix of chemicals people like Dr Quigley had not encountered. Chemicals that were not the most harmful thing that can turn up in an "E", but chemicals that have some important caveats associated with their use. In certain circumstances, people have died from taking them.

I readily shared the information with Dr Quigley and a couple of other specialists in advance of publication, because in the end that's the point of the story itself. The problem with our present drug laws is that they force out well-understood drugs whose place is taken by new drugs, which are less well understood and often much riskier. And people like Dr Quigley don't even know what's coming in the door when something goes wrong.

There are various solutions, including permitted onsite testing. But that's a politically alarming step. Dr Quigley would like to see MDMA licensed and regulated for sale. More within reach right now is a risk register – which should be public. That saves lives.

But that's a problem for politicians too. At the least, medical staff should be as well informed as possible about what's in the market, so they know how to respond when they have to. And, mercifully, that small step is beginning to happen. It's a step.

My feature has just been published online by Matters of Substance as If it’s not true to label, then what are people taking? I think it's pretty important.

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