Urine screening before concerts? Drug policy advocates explain why that may do more harm than good

• Urine screening proposed by the Selangor government to combat drug use at festivals has been criticised as ineffective, costly, and potentially harmful.

• Advocates suggest on-site pill or drug testing as a safer alternative, proven to prevent fatal overdoses in countries like Australia.

• Malaysia’s punitive drug laws hinder harm reduction efforts, with calls to decriminalise drug use gaining momentum among policy experts.

KUALA LUMPUR, Jan 20 — Selangor’s Local Government and Tourism Committee chairman Datuk Ng Suee Lim recently proposed urine screening to detect drug use among ravers or concert-goers.

The proposal followed the deaths of four people who attended the New Year's Eve Pinkfish Festival in Sunway here.

Post-mortem reports indicated they died from complications caused by the drugs they consumed, likely to be ecstasy in pill form. Three other attendees were also hospitalised because they were suspected of taking the same pills.

There were mixed reactions to the proposal. Drug policy advocates suggested urine screening may not be effective at all, and could actually do more harm. The National Anti-Drug Agency, meanwhile, said the idea was impractical.

Why is urine screening may not be a good idea?

Palani Narayanan, Director of Drug Policy Program Malaysia, said urine screening is inherently defective as a solution to drug use problems

“Firstly, urine screening can only tell you if someone used a drug in the short past, say three weeks before, so someone who hasn’t taken a drug in six months will likely test negative,” he said.

“Now when they consume a drug at the music festival after having not taken anything in the last six months, just a small dose of drugs can be fatal because their tolerance level is lower than someone who takes drugs regularly,” he added.

“This person has a higher chance of fatal overdose and urine tests are useless to identify this.”

Then there is the cost factor. Urine screening is expensive. In the US, urine drug screening costs billions of dollars annually. Between 2011 and 2014, the cost of urine tests were reported to be around US$8.5 billion.

There is no available data on how much enforcement agencies spent on urine screening, but drug policy advocates believe it could reach hundreds of millions in the past ten years.

Palani said it makes little sense to pour money into a defective system that could be better spent on harm reduction measures like the health care workers who can advise people on the safety of the drugs they take.

Is there a better alternative?

Countries like Australia and the UK have long advocated for on-site pill or drug testing instead, with the focus being safety and harm-prevention instead of catching and punishing drug users.

It’s a policy that is based on the “practical and realistic” view that the authorities have never succeeded in curbing drug inflows, as evident in the continued announcement of large drug busts every year. Since these drugs will reach the hands of users no matter what, it’s better to put in place measures to prevent greater harm from use.

This is more crucial given the growing preference for synthetic narcotics, which syndicates adulterate with unsafe substances as they try to manoeuvre around tight controls of supplies used to cook these drugs.

“Pill/drug testing is a service where a health unit (like a mobile van) is set up at music festivals where punters/users can go and get their drugs checked for its content.

“In the van there will be health workers who will scrape a little of the drug and check for its content including adulterants and other dangerous mixtures,” Palani explained.

“Then the health workers can advise the user — about the content and warn them of any dangerous adulterants. They can provide safe and life-saving advice to the users. This service has shown to avoid fatal overdose and save lives in all the places it has been implemented in — most recently in Victoria, Australia.”

Is there a pill or drug testing service in Malaysia?

In Malaysia, the National Poison Centre conducts most of the testing, but it does not provide services as mentioned above. The reason for this is drug use is still a criminal offence, and pro-punitive drug laws think drug testing acts as a form of “encouragement” for more drug use.

Palani is one of thousands of progressive drug policy advocates, including those in the World Health Organisation, who call such a view archaic with little supportive evidence.

They argue that the best way to prevent overdoses or harm from drug use is by encouraging people to come forward and seek help, and to do that will entail removing laws that treat people who use drugs as a crime.

“Decriminalise, decriminalise, decriminalise. Decriminalisation will allow for services such as drug checking to exist and we can provide life-saving harm reduction programs. Decriminalisation will take the fear of incarceration away from your people and encourage them to come forward to receive help,” he said.

What does the National Anti-Drug Agency (AADK) think?

AADK director-general Datuk Ruslin Jusoh was reported to have opposed the idea, saying urine tests at concert venues are impractical and difficult to carry, since urine screening can be delicate and takes time.

Jia Vern Tham, a researcher who works with family members of women caught as trafficked drug couriers, echoed Ruslin’s view and said it would only add more strain to a legal justice system already overwhelmed with small drug offences.

“This would also be an important test for the new drug treatment law. Will concert-goers caught with positive urine tests be treated as ‘misusers’ or ‘dependents’?” She asked.

“Will their record of affirming traits such as stable employment be considered in deciding that? Performing such invasive checks does nothing to alleviate the burden on our criminal justice system, and neither does it help concert-goers to make safer choices in consuming substances.”