Party night, poison pill

In a state first, the Victorian coroner has recommended illicit drug testing be made available to the public, in a bid to combat drug related deaths. Picture: UNSPLASH

By Andrew Cantwell

Jeremy* was your ordinary 22-year-old male, a labourer at a family firm, who liked to kick up his heels on weekends … as many young men do.

His death was horrible – brought about by a toxic mix of chemicals packaged up as the popular ‘party’ drug MDMA – pinned to the ground by his besties, who were restraining him from doing himself further harm.

The Pakenham man had taken the supposed MDMA in preparation for a night out at a Narre Warren nightclub with friends.

Instead, he soon lapsed into unconsciousness and his breathing stopped until resuscitated by ambulance. Rushed to The Alfred, he rapidly deteriorated and was pronounced brain dead three days later, his body kept on support to aid the harvesting of his organs with his family’s consent.

The drug he took actually belonged to a new class of ‘designer’ drugs increasingly coming to the attention of authorities, known as ‘novel psychoactive substances’ or NPS. In Jeremy’s case it was a mix of 25c-NBOMe and 4-Fluoroamphetamine.

Because the drugs are new, nobody knows the potency or toxicity of the concentrations or combination.

What authorities do know is that this new class of drug is killing young people.

Jeremy was one of a cluster of five deaths in 2016-17 identified by the State Coroner Paresa Spanos involving NPS drugs being marketed around Melbourne’s nightclubs as MDMA or magic mushrooms. It should be noted that no-one has suggested local nightclubs were involved in the sale or distribution of the pills.

But the Coroner this week has taken the unusual stand of recommending organised and regular testing so that authorities – and users – can get early warning of new drugs and better understand the risks.

The Coroner also ordered the publishing of the findings of the inquest into the cluster.

A coroner’s report into Jeremy’s last night out accompanied the inquest findings, and makes disturbing reading.

Disturbing because Jeremy’s story is so ordinary – and is no doubt even now repeated weekly in suburbs across the city.

Disturbing also because it clinically details the moments a planned night of fun became unhinged from a single, fateful decision.

Jeremy had grown up around Pakenham, had been in a stable relationship and was reported to have been fit and healthy with an active lifestyle.

His parents were unaware of his drugtaking, but friends reported to the coroner he had a taste for pills, cocaine, speed and ketamine when out drinking. They reported he was a social drinker at weekends, not drinking during the week.

So the Thursday night out, 22 December 2016, was something out of the ordinary. Perhaps, so close to Christmas, he had been enjoying a holiday break.

After a session at some local pubs in the afternoon, Jeremy and a number of friends had gathered at a house to prepare for the night out at the nightclub.

Jeremy had earlier flashed a bag of pills at a local pub.

With two mates, and while other friends had gone briefly, Jeremy apparently popped one or more of the pills, sometime after 7.45pm.

When the friends returned after about 20 minutes, they immediately noticed a difference in the three young men.

Agitated, babbling and unable to be calmed, police were eventually called.

Restrained on the ground by his friends, Jeremy had stopped breathing and was being given CPR when police arrived about 10.50pm. Ambulance officers arrived at 11.05 and took over CPR, working on Jeremy for another 10 minutes until they could sustain a pulse.

At The Alfred, it was apparent early that Jeremy’s brain had been without oxygen too long. Over the next 24 hours, his pupils became fixed and dilated, and brain scans showed increasing signs of the damage caused by oxygen starvation. He eventually stopped responding to treatment.

A specialist made the call that Sunday that Jeremy’s life had effectively ended – it was mid-morning on Christmas day 2016.

The fates of Jeremy’s two mates are, thankfully, not recorded in the coroner’s report.

But four other men – Anson, Ilker, Jason and James – were also part of the fatal NPS cluster investigated. Four other young men who’d rolled the dice on a chemically assisted good night out and had paid the price.

The Coroner’s investigation found in Jeremy’s case that his friends’ efforts to save him by restraining him had not contributed to his death. The medical efforts to save him had probably been futile. And that Jeremy hadn’t had the chance to save himself, having been sold a lie in a handful of pills dressed up as a familiar good time.

The illicit, or ‘unregulated’, drug market offers a promise of good times. The illegal trade’s dirty little secret is that there are no guarantees of quality, content, purity, potency or survivability.

For the new designer drugs, the early customers are actually the crash-test dummies.

The Coroner directly addressed this in her findings, while calling for a dedicated drug testing service to be established in Victoria.

As part of the investigation, the Coroner had asked for expert advice from drug harm minimisation experts, health authorities and police.

Unsurprisingly, these were neatly divided between those advocating testing and informed decisions, and those backing ‘buyer beware’.

The Department of Health was open to the idea of drug testing, but as an agency of State Government had no plans for implementation; while Victoria Police were firmly against pill testing, reasoning that for there was an implicit endorsement for illicit drugs if the State was behind a testing service.

The harm reduction experts argued for better knowledge of what was actually being bought by young party-goers, especially experimental mixes wrongly marketed as known pill types.

The Coroner had no hesitations backing the pill testing option, in order to give the best possible chance of survival to people like Jeremy, Anson, Ilker, Jason and James – people who have heard all about the risks, but buy anyway.

This puts her at odds with the current position of the State, in opposing pill testing.

The State appears content that the ‘don’t take drugs’ message is sufficient.

They also appear content with the knowledge that those who won’t be told, won’t be saved either.

*The Gazette has chosen not to name the Pakenham overdose victim. Jeremy is not his real name.