Two more coronial inquests call for pill testing. How many more will it take?

Seven coronial inquiries into drug overdose deaths in the last three years have called for the Victorian government to implement drug testing.

Two separate independent coronial inquests have this week urged the Victorian government to investigate the launch of drug checks to provide potentially life-saving services.

Seven coroners have now made the same recommendation to the Victorian government since 2021, but their calls are yet to be heeded.

Acknowledging that the Victorian government has rejected these calls before, the latest two coronial reports have called for a trial of a drug checking service rather than a full implementation from the outset, with hopes the government will finally adopt the policy.

Both coronal inquiries found that the presence of a drug checking service had the potential to save the lives of individuals who ingested illegal drugs containing dangerous substances that were not known to them.

The inquest into an 18-year-old man who died after a drug overdose at the Dreamstate music festival at Flemington Racecourse in April 2023 found that he had died from an unintentional overdose of MDMA and methylone, a synthetic cathinone drug with stimulant effects.

Coroner Simon McGregor found that this synthetic drug had been implicated in at least 17 overdose deaths in Victoria since 2013. He found it was also possible that the MDMA capsules contained a higher dose than the man had expected, and that he likely did not know they contained the methylone.

The other coronial inquest was looking into the death of a 38-year-old man who died from mixed drug toxicity in late 2022. Coroner Ingrid Giles said that a testing had found the presence of several prescription drugs and methamphetamine, but not heroin.

There was a positive result for metonitazene, a member of the nitazene drug family, a group of highly potent novel synthetic opioids which can be 300 times stronger than morphine. This synthetic drug is often sold as heroin, oxycodone or MDMA.

These synthetic drugs have been involved in the overdose deaths of at least 16 Victorians since the start of 2021, with many cases having direct evidence that the deceased believed they were consuming other substances.

Coroner Giles said the man likely believed he was injecting heroin rather than the dangerous synthetic opioid.

Both Coroners concluded that although there was no guarantee that either individuals would have utilised a drug checking service or changed their behaviour if they did, the presence of such a service would have given them an opportunity to learn more about the drugs they were planning to use, and make an informed choice about the risks involved.

“Staff at a drug checking service could have advised [him] of the capsules’ contents and the potential risks of ingesting them, as well as how to recognise and respond to these risks, giving [him] information he needed to make better informed and safer choices about his drug use,” Coroner McGregor said.

Coroner Giles pointed to the success of the ACT’s CanTEST pilot, which has been extended twice and given valuable insights into future drug testing in the territory.

“A similar pilot in Victoria would assist in building the evidence base for drug-checking services in this state, and build on learnings from other jurisdictions,” she said.

“The risk of further deaths in similar circumstances could be reduced if a drug checking service was introduced in Victoria.

“He would have at least had the option to do so and could also have been given vital hrm reduction information from such a service - in this case, by informing him that he was not in possession of heroin, but rather an extremely potent drug called metonitazene that poses a serious risk if consumed.

“Whilst such information may not have prompted [him] to act differently, the lack of a drug checking service at the time meant that changing his drug consumption behaviour did not exist as a possible outcome.”

Calls for a pill testing service in Victoria have intensified following a suspected overdose death at the Pitch music festival over the weekend.

Victorian Premier Jacinta Allan has said earlier this year that she was seeking further advice on pill testing, signalling a slight shift in posture from the state government after former Premier Daniel Andrews repeatedly rejected the concept entirely.

The ACT and Queensland are the only Australian jurisdictions to have given the greenlight for some legalised drug checking.