Drug checking works, so why do some governments still treat it like it’s an experiment?
We’ve now got clear evidence that drug checking changes behaviour in real time. People discard their drugs. They use less. They avoid risky combinations. They have conversations about drugs with a health professional for the first time.
So why are we still treating it like an experiment?
The short answer isn’t evidence. It’s politics.
Because drug checking sits in an uncomfortable space. It prevents harm without preventing use. And that’s where our system starts to struggle.
We’ve built a system for crisis, not prevention
Across alcohol and other drugs, we’ve designed services around the pointy end. Dependence. Acute harm. Treatment.
But most harm doesn’t start (or end) there. It builds slowly, often in people who don’t need help and won’t engage with traditional services.
Drug checking sits in that middle. It reaches people earlier. It creates a pause point. It opens the door to a conversation that otherwise wouldn’t happen. Drug checking is playing a long game.
In the ACT, more than 7,000 brief interventions have already been delivered through CanTEST.
Seventy two percent of people had never previously talked to a healthcare worker for alcohol and other drug advice.
That’s not a marginal group. That’s the majority.
In Victoria, early data shows that more than one in ten samples contained unexpected psychoactive substances. That’s one in ten people who were about to take something different from what they thought.
And in the ACT, around one in ten people choose to discard their drugs after testing.
These are real time behaviour changes. Not just intentions or attitudes. Decisions.
There aren’t that many interventions in this space with that kind of immediate impact.
So what’s holding us back?
If this were purely about evidence, drug checking would already be widely available.
Instead, access across Australia remains patchy and inconsistent.
The ACT has had ongoing services since 2022.
Victoria is currently trialling both fixed and mobile models.
New South Wales has completed trials and is evaluating next steps.
Queensland ran trials with positive outcomes and then banned services down entirely.
Same evidence. Different decisions.
This isn’t about what works. It’s about what’s politically tolerable.
Drug checking challenges a long standing tension in drug policy. The idea that acknowledging use might be seen as condoning it.
For governments, that creates risk. Not clinical risk, political risk.
A single negative headline can outweigh thousands of prevented harms. Prevention doesn’t make the news because absence of harm is invisible.
That leads to a deeper problem.
The prevention paradox in action
When prevention works, nothing happens.
No overdose. No ambulance callout. No hospital presentation.
But those “non events” are hard to count and even harder to communicate.
We can see that more than 16,000 people died from overdose between 2017 and 2023.
We can’t easily see how many deaths were avoided because someone decided not to take a substance after it was tested.
So we end up in a situation where the interventions that work earliest and most effectively are also the hardest to justify in a political cycle.
The better drug checking works, the harder it is to prove its value in ways that resonate outside public health.
Policy is being shaped by values, not just evidence
There’s another layer here we don’t talk about enough.
Some of the resistance to drug checking isn’t about uncertainty. It’s about discomfort. And that discomfort creates stigma.
The idea that people shouldn’t be using drugs at all still shapes how decisions are made, even when the evidence shows that people will use drugs regardless.
We’ve known for decades that drug use occurs across the community, not just in marginalised groups. In fact the wealthier you are the more likely you are to have tried an illicit drug. We also know that most people who experience harm are not in treatment and don’t need it.
Drug checking doesn’t fit neatly into our system. A system that prefers clear categories of abstinence or dependence. It sits in the middle. And drug policy has never been very comfortable in the grey.
This is what inconsistent access really means
Right now, whether someone can access drug checking depends on where they live - not on their level of risk; not on need; not on evidence but on postcode.
That means two people making the same decision in different states have different access to information, support and opportunities to reduce harm. In most other areas of health, that would be hard to justify.
Where to from here?
History tells us that people will use drugs. If we have an intervention that reduces harm, changes behaviour and connects people with health professionals, then the question isn’t whether drug checking should exist. It’s whether we’re prepared to back prevention, even when it’s politically uncomfortable. Because until we do, access won’t be determined by evidence. It will be determined by who is willing to take the risk. And that’s not a public health decision. It’s a political one.
