The basic aim is to enable recreational drug users to make informed decisions about what substances they take.

Pill testing is part of the Netherlands national drug policy – it was introduced there in 1992. Government-sanctioned services have been in Austria since 1997, Belgium since 1993 and Switzerland since 2001. Pill testing is also available in Portugal, France and Spain. Not-for-profit organisations have been testing in the US and Canada since 1999 and in the UK since 2013.

In New Zealand, pill testing is offered at festivals by the volunteer group KnowYourStuffNZ, which is independent but supported by the New Zealand Drug Foundation.

Australia’s first professionally administered pill-testing outfit was in a mobile laboratory at Canberra’s Groovin’ the Moo festival in April. The testers used an infrared spectrometer to identify substances in a sample of each pill.

(Commercially available “do it yourself” pill-testing kits have been used by some festival-goers for years. Each kit contains a solution which, dropped onto a grounded-up sample of a pill, will change colours to show the presence or absence of a substance such as MDMA. But these kits cannot confirm dose levels of a particular drug and do not provide information on other potentially dangerous cutting agents.)

How does pill testing work?

Based on the Canberra’s Groovin’ the Moo festival, the process works like this:

• Attendees queue outside a tent in the medical precinct of a festival.
• Once inside, they sign a waiver releasing the testers from liability.
• They also speak to a peer educator to ensure they understand that the test does not guarantee the safety of the drugs. “We’re quite explicit in telling people that this test doesn't tell you if your drug is safe,” says Dr David Caldicott, an emergency medicine consultant at Calvary Hospital in Canberra and a leader at the Groovin’ the Moo trial. “It just tells you what we’re able to find in your sample.”
• Each attendee provides a sample of their drug to a licensed chemist who photographs and weighs it before putting it under an infrared spectrometer where it is mounted on a piece of diamond and shot with laser light. Through the light reflected, the chemist can tell what is in the sample.
• The attendee then has a consultation with another peer educator to discuss their options now they know what’s in their drug.

In Canberra, of the 83 samples tested in April, just 42 contained mostly MDMA, the active ingredient in the drug known as ecstasy – even though 70 people thought they had bought ecstasy pills. Seventeen of the samples had “fillers” or cutting agents as their main ingredient.

Other substances found included antihistamine, caffeine, dietary supplements, oil, “foodstuff” and toothpaste.

One man discovered that the main ingredient in what he thought was “meth” was actually N-Ethylpentylone, a stimulant that had been responsible for the hospitalisations of 13 people in New Zealand.

Does pill testing change people’s drug-taking?

There are people at music festivals who’ll never take drugs and those who will take drugs no matter what, says Dr Caldicott. But the biggest group using drugs at music festivals are those whose behaviour pill testers aim to change. “I would say perhaps 80 per cent of people at music festivals are prepared to modify their behaviour if they’re provided information that allows them to do so – and that’s the group we’re targeting.”

Similarly, when people discover that the drugs they have are not the substances they thought they were, about half say they won’t take them, according to Know YourStuffNZ’s Dr Jez Weston. He says his group’s non-judgmental stance is one of the factors in changing behaviour as are the trust and reciprocity involved in the process, the attendees’ involvement in testing and the immediacy of the results.

“Our approach acknowledges the agency of the user,” Dr Weston wrote on scientific blog Sciblogs, “and therefore encourages mature decision-making''.

A recently-published US-Australian study which surveyed ecstasy users at dance parties in New York found a similar percentage of participants reporting they would be less likely to use drugs found to contain unexpected substances.

What do the politicians say?

NSW Premier Gladys Berejiklian has said pill testing gives drug users "a false sense of security" and her job as Premier was to keep the community safe.

But following the recent deaths, Ms Berejiklian appears to have softened her stance. "If there was a way in which we could ensure that lives were saved through pill testing we would consider it - but there is no evidence provided to the government on that,” she said.

NSW Opposition Leader Michael Daley recently signalled that pill testing “should not be off the table”.

Former Australian Federal Police commissioner Mick Palmer has urged NSW to consider allowing pill testing. “How a government which presides in a jurisdiction in which a medically-supervised injecting centre has operated successfully and with indisputable success in Kings Cross over 18 years, can be so vehemently opposed to trialling – or even discussing or considering – pill testing is difficult, almost impossible, to understand,” he wrote in The Sydney Morning Herald.

In Victoria, pill-testing supporters include the Greens and the Reason Party but the Victorian government is not in favour. “We have no plans to allow for pill-testing at events in Victoria,” Mental Health Minister Martin Foley said in December. “Advice from Victoria Police tells us it can give people a false, and potentially fatal, sense of security about illicit drugs.”

However, Dr Caldicott says, “I can’t fathom how anyone who is in regular contact with young people would believe, ever, that turning up with a shipping container, with some of the most-advanced technology available, with a team of doctors and chemists who, at the very get-go, tell the people presenting to the pill tester that they could die if they use drugs today – it’s beyond me how that encourages drug use.”

Who else is in favour of pill-testing trials?

The Australian Medical Association. And Professor Alison Ritter, from the National Drug and Alcohol Research Centre, lists several reasons to pilot pill testing. They include that pills exposed as dangerous have been found to leave the black market; ingredients of tested pills start to correspond to the expected ingredients over time; pill testing changes behaviour once the ingredients are exposed; and pill-testing booths offer support and information over and above the actual testing.

“As an emergency doctor,” Dr Caldicott says, “when we give news about somebody being unwell and go, ‘I’m sorry I can’t tell you whether they’ll survive or not’, there is not a parent I’ve ever spoken to who is prepared to turn around and say; ‘Do you know what? As long as their death serves a lesson to others I’m OK with it'.”