Southeast Asian countries particularly Thailand, where drug use remains a serious problem, should learn a lesson and apply a drug checking service model from Australia following the launch of its first fixed-site health and drug checking service -- CanTEST -- in Canberra nearly nine months ago.
CanTEST health and drug checking service is operated on a harm-reduction basis that aims to help drug users stay safe and not suffer an adverse reaction from taking drugs. It is a strictly confidential service and it is free. Drug users who would like their drugs tested, are asked to sign a waiver that says that they understand that no drug taking is safe. Their ID is not requested.
The waiver is stored securely in a separate database that cannot be accessed by anyone outside the service. All information obtained from the testing is completely deidentified and stored in a different database, according to CanTEST.
However, CanTEST not only provides drug checking but also health professionals or peer educators who give appropriate information counselling and advice to drug users based on their specific test results, keeping them informed about their health, said Stephanie Stephens, services manager at CanTEST, health and drug checking service.
"We want to help them stay safe. We do not tell them that they must not do this or should not do this. But we will give them recommendations and advice that they can decide on about their drug use," she told the Bangkok Post during a visit to the service.
Six journalists from Southeast Asian countries: Thailand, Vietnam, Singapore, Malaysia, the Philippines and Indonesia, were invited to attend the Harm Reduction International Conference 2023 (HR23) in Melbourne, Australia, that ends today and visiting CanTEST is part of the programme which promotes harm-reduction services.
"Southeast Asian countries, including Thailand, can learn and apply our model. It is actually cheaper than managing overdoses in hospital," Ms Stephens said.
Caldicott: We are telling the truth
When asked about community participation, she said local people in the community understood well the objectives of CanTEST. There has never been opposition from them.
"We know that the Canberra community believes and wants us here and Australia wants us here and wants drug checking centres in other cities as well,'' she said.
The service centre itself is located in the centre of Canberra, close to public transport, which is convenient for drug users who want to have their pills or drugs tested there. It is open in the evenings on Fridays from 6pm-9pm and on Thursdays from 10am-1pm.
"There is only one CanTEST in Australia. We work only six hours a week for now," Ms Stephens said.
Since CanTEST opened nine months ago, over 800 drug users have used the service so far, having learned of the service through word of mouth, social media, mainstream media and friends.
How are the drugs tested?
The drugs have to come with the drug users. They bring the drugs with them for checking by staff licensed to handle the drugs. All kinds of drugs can be tested. Drug users will be provided with the results and harm reduction information they should know.
"We have never had any issues with people interacting with police," she said. Police are very supportive of us. The government has an MoU between health officials and the police to support our centre. It is amazing," Ms Stephens said.
"Since CanTEST was established, we have never faced any opposition from local communities in Canberra. I think people here are supporting us. They understand what we are really doing or why we are here. We are doing a good job and helping keep people safer."
Red Alert
Dr David Caldicott, the clinical lead for Pill Testing Australia and CanTEST, told the Bangkok Post that when adults tell teenagers to refrain from using drugs, they must inform them properly of the consequences of not doing so.
"If you generally want to change a behaviour, you have to think about what changes people's behaviour. When we tell kids not to use drugs, we think it's enough for them to change their behaviour. However, now in 2023 it does not work anymore."
He said from a public health perspective, facilities like CanTEST could control what messages to give and how to communicate those messages to drug users after they have their drugs tested and are told the results.
Stephens: Centre gives sound advice
"This is terrible [if we say] you should not use drugs, we are careful about the messaging. It is only the very worst situation when we say 'no, this is something you should not use at all. It will hurt you.' We are not exaggerating. We are telling the truth. So we have data. We have got chemists analysing it," Dr Caldicott said.
"There is an idea in some parts of society that all drugs are created equal. That's not true," he said.
"Actually, some drugs are much more dangerous than others. We spend a lot of time looking for the most dangerous drugs. Whenever we find them, we have two levels of warnings,'' he said.
First, he said, CanTEST has a yellow warning. Most of the yellow warnings the centre gives are the consequences of somebody turning up with drugs that aren't what they thought they were.
They turn up with drugs that they think are MDMA, and it turns out to be ketamine, which means when they take that drug, it will have different effects, and those effects could be dangerous for them.
"When my colleagues in the lab here find something that is very dangerous. I will be called, if it is agreed it's a 'yellow', I will issue the warning to that drug user.
"If it is a 'red' [warning], we have one hour to tell the government what we have discovered that makes us very nervous. At the same time, the government will decide whether to inform the media to alert members of the public or not.
"A red alert involves a very quick turnaround. We are very quick in getting messages out. Messages about very dangerous drugs go to the government within an hour of testing. We signed an agreement to do that. We have issued two such warnings [since the centre was opened],'' Dr Caldicott said.
One was for metonitazene, which is a synthetic opioid, and the other one is a combination involving amphetamine.
It has killed a number of young people in Melbourne.
"From the government, it will issue a public alert to let the community know. We also put out our warnings as well on social media and on Instagram. We know people are paying attention not only in the ACT [Australian Capital Territory]. Internationally, our colleagues in Canada said it was interesting. We regularly get asked for information so there is dialogue among drug checking centres around the world to help inform us as well," he said.
Voice of a drug user
A 21-year-old drug user who called herself Rosie said she started taking drugs at 14 when she went to parties. She first tried cannabis and then moved on to other drugs.
"It's good to have this health and drug testing centre in my local community. It is free for everyone.
"CanTEST will give choices as to whether you will use a type of drug and how much you can use safely, and not overdose on it," she said.
