While the future of UK drug testing hangs in the balance after new licensing requirements for on-site testing at festivals (also called back-of-house testing), the HSE has confirmed to Hot Press that its drug checking programme will continue at Irish festivals this summer, including the upcoming Electric Picnic.

The HSE's preliminary report following this year's Life Festival read: "We issued three alerts in relation to high strength ketamine, MDMA and cocaine in circulation. The MDMA we tested ranged from 50mg to 246mg in products showing the diversity of MDMA available on the Irish market. This confirms that the public can’t be sure of the purity and how they will react."

During a pilot programme at the Electric Picnic festival last summer, the HSE found 12 New Psychoactive Substances and four drug compounds that had not been identified in Ireland before.

Parklife festival last year found eight new forms of ecstasy in circulation, and tablets ranging in concentration from 118 to 223 milligrams. The average dose in confiscated MDMA was 1.5 times the normal average dose.

The HSE launched their Safer Nightlife initiative in May, a harm-reduction campaign that centres on reaching people who use illicit drugs to provide education and safeguards, like on-site drug testing, which minimise the danger involved in drug use. Festivals and other outdoor events like block parties are more common during the summer, meaning the HSE's Safer Nightlife Programme is kicking into high gear.

Welcoming that news, Tony Duffin, CEO of the Ana Liffey Drug Project, says: "Drug checking is a tried and tested, no pun intended, Harm Reduction intervention. Varying versions are available across Europe providing information to people who use drugs and helping them to make informed decisions about their drug use.

"At Electric Picnic in 2017, Ana Liffey Drug Project made its festival debut providing drug Harm Reduction advice and support to people. That year lots of people asked us about drug checking, they wanted to know why we didn’t have it available.

"Fast forward to 2022," Duffin continues, "and the HSE, and their partners, introduced back of house drug checking at Electric Picnic. A very welcome development which proved to be a success. 2023 has already seen further roll out of this service and we look forward to further developments in the future."

The HSE'S National Clinic Lead, Professor Eamon Keenan said in a statement, "While the HSE recognises that it is safer not to use drugs at all and there is always risk, the campaign has been developed in response to a changing drug landscape in Ireland and aims to offer people who use drugs practical harm-reduction information on how they can reduce health harms if they choose to use."

UK Home Office Issues Changes

The HSE's policy on harm reduction stands in contrast to recent changes from the UK's Home Office. Changes to the law require any organisation doing on-site drug testing to apply for a testing permit through the Home Office rather than using a standing agreement with local law enforcement.

Any changes made by the UK Home Office would affect events held in Northern Ireland, complicating public health coordination across the Irish border.

The change requires any organisation performing drug testing in the UK to apply for a separate license through the Home Office, adding both a financial and time component to the process. Some festival organisers report the permit can take up to three months to be approved and cost up to £3,000.

The restriction of drug testing services marks a shift away from the strategies centred on harm reduction rather than enforcement that led in the past to the UK having internationally low rates of HIV and Hepatitis C among people who inject drugs.

New rules would also mandate the creation of a permanent structure for testing, and the Home Office would likely want to inspect the site weeks before the event. These demands are difficult for organisers to comply with, as many outdoor festivals are set up days in advance rather than weeks and rely on temporary structures like tents or mobile cabins.

The move came just days before the popular Parklife festival in Manchester. As these permits can take months to be approved, the organisers of Parklife were forced to forgo on-site drug testing for the first time in nearly a decade. Greater Manchester Police estimate the Parklife festival drew as many as 70,000 attendees each day of the two-day event.

Usually, organisers partner with local charities and law enforcement to set up temporary structures where substances can be tested on-site. If anything dangerous is discovered, attendees will receive push notifications alerting them to the threat.

In the past, this system has alerted EMTs to drugs with dangerously high concentrations that could put lives at risk. Because many of these substances are illegal, tracing where they came from is difficult and can mean identical-looking tablets or powders can have varying doses.

Drug Use and Public Health in the UK

Of particular concern to the HSE and public health agencies across the UK are the emergence of New Psychoactive Substances (NPSs) being sold as MDMA. These new substances, some of which are appearing for the very first time in Ireland and the UK, can have a wide range of side-effects not known to local EMTs and health professionals.

A report from the UK's Office of National Statistics in 2021 cited an increase in the appearance of NPSs, as well as a continued increase in the number of Cocaine, Opiate, and Methadone deaths. Opiates continue to be the leading cause of death when comparing substance deaths by type, with 39 confirmed deaths per million people in 2021.

Almost half of all drug poisonings in the UK last year involved an opiate. The overall number of drug deaths is 6.5 percent higher than last year, and at an all time high since record-keeping began in 1993.

The report cited a significant increase in deaths involving methadone and an increase in cocaine deaths for the tenth consecutive year.

A new report from Ireland's HRB found cocaine is now the most common drug reported for people seeking treatment, accounting for more than a third of all cases, and a 25% increase over 2021.

From Harm to Hope: UK's Ten Year Plan

Last year, the UK Home Office announced an increase in funding for drug testing sites to combat the issue. In 2021, the UK government unveiled a ten-year drug strategy 'From Harm to Hope' which included more funding for drug testing, treatment, and research complete with an additional £421 million in funding through 2025.

The recent change requiring licenses from the Home Office for all drug testing marks a shift away from harm reduction and back towards an enforcement approach to illicit drugs. Critics of this approach include Adam Holland and a team of 20 researchers who published an analysis of the Harm to Hope strategy last October.

"The assumption that the threat of punishment will reduce demand is not supported by evidence, with no clear relationship between the stringency of drug laws and drug use prevalence," reads the report. "The Home Office previously concluded ‘levels of drug use are influenced by factors more complex and nuanced than legislation and enforcement alone’." 

"Unevidenced and harmful measures to deter drug use by means of punishment continue to be promoted, which will have deleterious impacts on people who use drugs. An effective public health approach to drugs should tackle population-level risk factors... and institute evidence-based measures to mitigate drug-related harm. This would likely be more effective, and just, than the continuation of policies rooted in enforcement. A more dramatic re-orientation of UK drug policy than that offered by the [From Harm to Hope] strategy is overdue," the report continues.