Building the evidence base on drug checking services in Australia: Past, present and future

I am delighted to be returning to work at the National Drug Research Institute to complete a 5-year NHMRC Investigator Grant that will continue to expand the evidence base on how drug checking services can reduce drug-related harms in Australia, in a context of an increasingly unpredictable unregulated drug supply. I’ll continue to live in Victoria, working at NDRI’s Melbourne office co-located with the Burnet Institute.

The changing landscape

I was first employed at NDRI in 2002 as a research assistant working with Professor Wendy Loxley on a large review project known as The Prevention Monograph – this was my first academic job. This work led to a collaboration with Professor Simon Lenton, who supervised my Honours and PhD at NDRI. I recall in 2006, when determining which project to pursue for my PhD, I presented Simon with two worked-up proposals. One of them, which we decided to pursue, asked how emerging digital and networked technologies were impacting drug use and harms. This decision led to me leading a research program about digitally facilitated drug markets, responding in particular to the emergence of darknet markets from 2011, when Silk Road was first launched.

However, the alternate proposal that I wrote up 20 years ago was titled: “Pill testing as a harm reduction initiative and drug market monitoring system”. At the time, I had recently volunteered for Enlighten, a harm reduction group who had been conducting (unauthorised) testing of pills believed to be MDMA or ‘Ecstasy’ using reagent test kits. However, Enlighten was also exploring more advanced technology for testing drugs in party or festival settings. Dated from August 2005, my proposal sought to understand how people who used the drugs tested by Enlighten may adjust their behaviours to reduce drug-related harms, how its presence onsite may influence drug use prevalence and frequency, the effects of sharing this information with the public both on-site and via online databases, and the influence of pill testing upon different parts of local drug markets (in particular, whether markets may become safer over time in response to the wider availability of information about the composition of drugs). On reflection, it was entirely reasonable that we did not pursue this research project 20 years ago; these harm-reduction activities were not legally endorsed and therefore posed significant feasibility concerns.

Despite not pursuing this as my PhD, my interest in pill testing, now known as drug checking, continued and expanded over the following two decades. My interest has now broadened beyond testing ‘ecstasy’ at festivals to testing any and all unregulated psychoactive drugs, for any people who may use those drugs, and in any setting best suited to reach such populations. I came to understand the deep history of drug checking, which started as a community-led response to drug criminalisation. The earliest known instances of drug checking – where substances submitted by community members were chemically analysed and individual results provided back to the submitter for the purposes of harm reduction – can be traced back to the Summer of Love in San Francisco in 1967, not long after the first UN Conventions criminalising drug use and supply were enacted, although drug checking has emerged in various forms across many drug-using communities globally. The past decade in Australia has seen a significant shift in the availability and acceptance of drug checking, although we still have a long way to go.

My fellowship at the Drug Policy Modelling Program (2014-2019) had the mandate of addressing emerging use of new psychoactive substances in Australia. In this time, I led a survey of Australian festival and nightlife attendees about acceptability of service design features for drug checking services, in an era where no such services had been launched in this country. My team also conducted the first global review of drug checking services, to identify where they were operating and with what design features, also aiming to inform future Australian service offerings. We used these findings to advocate for drug checking in Australia, for example, at the Victorian parliamentary inquiry into drug law reform and the NSW Coronial Inquest in music festival deaths. Following my move to RMIT, the Coroner’s Court of Victoria invited me to write an expert report as part of an inquest into five deaths that resulted from the unintended consumption of new psychoactive substances – all consumed outside of festival settings. The report, published in 2021, was the first time Victoria’s coroner had formally recommended that the Victorian government support and fund drug checking in efforts to prevent future drug-related deaths. They repeated this recommendation six times before the government announced that they had adopted the policy in June 2024.

The story of drug checking policy and implementation in Australia is a tumultuous one. Government sanctioned services began operating in Australia at Canberra festivals pre-pandemic (2018 and 2019), the result of much advocacy in that region. The pandemic then halted this progress, as music festivals were shut down. After the pandemic, the ACT opened its fixed site, CanTEST, in July 2022, which is now permanent. CheQpoint, in Brisbane and the Gold Coast, was open for a year from April 2024 to April 2025, and festival drug checking has taken place in Queensland since March 2024. Due to a change of government, drug checking has now ceased in Queensland following legislation to criminalise its provision. Victoria launched festival drug checking in December 2024, followed by a fixed site in August 2025. NSW launched festival drug checking in March 2025, while research-led projects have conducted drug checking at Sydney’s Medically Supervised Injecting Centre. Other Australian states and territories, as well as regional, rural and remote communities, do not currently have access to drug checking. Furthermore, all drug checking services in Australia currently require in-person attendance, reducing accessibility for many diverse sub-populations.

Responding to emerging challenges

In the time that drug checking has increasingly been taken up in Australia, new health threats have emerged in unregulated drug markets, with potent synthetic opioids, in particular from the nitazene family, and potent novel benzodiazepines, being associated with non-fatal and fatal overdose. Higher-than-anticipated doses of MDMA in pills and capsules have also led to harms, and in combination with high temperatures in festival contexts, MDMA overdoses (e.g. in Victoria) have prompted drug checking as a policy response.

When criminal organisations supply drugs to make profit, the quality of the drugs is not guaranteed. Ultimately, the harms caused by not knowing the contents and the concentrations and doses of criminalised drugs could be solved by regulating their supply, as we do with psychoactive medicines via pharmaceutical supply, or allowing people to grow and use their own plants (e.g. as traditional plant medicines). However, in the absence of accessible safer supply and where drug prohibition continues to operate (which is the current situation in Australia), robust, accessible, and impactful drug checking operations that innovate to address these drug market harms are urgently needed.

Within this context, two decades after my first ideas about enhancing the evidence base for drug checking, I feel privileged to have the opportunity to build out a team to address the most critical knowledge gaps in this field. The work we will do over the coming five years aims to:

• Determine the medium-to-long-term effectiveness of drug checking on reducing drug harms
• Innovate public outputs from these services to reduce drug harms
• Understand how best to leverage community experiences of drug practices, substances and markets to mitigate toxic drug outbreaks
• Learn how best to engage with and serve diverse populations with drug checking, and
• Drive innovation in local service delivery through conducting global mapping of drug checking services and working with diverse interest groups.

But further than these aims, we will continue to frame drug checking as a response to government criminalisation of drugs. Drug checking will not solve the root cause of unknown and variable drug content and purity. Moving the conversation towards critiquing the policies that create the conditions for these increasingly dangerous drug markets needs to continue to frame our work. Investigating safer supply options is a natural extension of this research agenda. As drug checking enjoys increasing public acceptance, we are looking to the future to see what might come next to rapidly respond to contemporary drug markets and associated harms.

We will take mixed-methods participatory approaches to these studies, honouring principles of community self-determination. True partnerships and allyships with people currently affected by drug-related harms are critical, to ensure this work is meaningful and can positively impact people’s health and wellbeing. I have learned that it is possible to acknowledge and draw on my own lived-living experience of drug use in my research role, but that these self-reflections are no substitute for engaging widely with different communities. While my research role is my central focus, this learning has prompted me in the past decade to devote significant energy to taking up operational and governance roles in a variety of community non-profit organisations that complement my research agenda. These include The Loop Australia (a provider of and advocate for drug checking services), Bluelight Communities (a global digital community advancing the health and wellbeing of people who use drugs), Students for Sensible Drug Policy Australia and the Australian Psychedelic Society. Working in partnership with community organisations in Victoria, including Harm Reduction Victoria and the Victorian Alcohol and Drug Association, has been essential for my more recent projects that sought to better understand how drug checking services communicate their findings, to inform service design and utility for communities of people who use drugs and the related service sector.

Since my earliest days working as a research assistant, I have been concerned with how to better include people with lived-living experience in the production of research knowledge, so that the voices of those directly affected by policies could be louder and have more impact. While I don’t have all the answers yet, my current position is that researchers must continue to make more room for community members in our processes of generating new knowledge. Community partnerships where researchers facilitate the empowerment and training of community members to lead their own research, under their own agendas, is a worthy goal, as reflected in AIVL’s emerging national research strategy. At the very least, researchers need to avoid extractive and tokenistic practices when engaging in research. Through this next stage of my research, I will endeavour to facilitate opportunities for the relevant personal experiences of researchers to be acknowledged more openly and explicitly – so that researchers with relevant lived-living experience can bring their whole self into the workplace.  

I’d like to thank NDRI for welcoming me back, and I’m looking forward to working with you all (alongside many community partners) to advance this research agenda.

To find out more about Monica Barratt’s Investigator Grant, see the New Project summary.

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