A lethal ignorance: We could make drugs safer. We choose not to

Deaths from PMA, a more toxic form of ecstasy, are rising in the UK, but are almost unknown in countries that take a more pragmatic approach

Could we be doing more to prevent deaths caused by drug use?

The story of paramethoxyamphetamine, or PMA, is a neat parable of the war on drugs: a story of unintended consequences, a problem with viable solutions that are being ignored. Fixing this problem will not fix everything else. It is a relatively small part of the picture. But the logic that drives our response to it stands as a bottomlessly depressing symbol of the whole.

PMA has been around since the 1970s. It has some similar effects to MDMA (ecstasy), and it really came to prominence when efforts to crack down on that drug began to succeed in the mid-1990s. “It is a classic example,” says David Nutt, the former government adviser who now chairs the Independent Scientific Committee on Drugs. “Prohibition has led to the attempt to avoid prohibition, and therefore the production of more toxic substances.”

The purity of ecstasy tablets is often higher now than it was a few years ago. But unscrupulous dealers like the fact that PMA is cheaper, and it appears to be more prevalent than ever. There were no recorded deaths caused by PMA in the UK in 2009 or 2010; in 2011, there were five; in 2012, there were at least 17. The total for 2013 will be higher again. And yet, no one is using it on purpose. “There’s a gulf between what people are buying and what they think they are buying,” says Fiona Measham, a professor of criminology at Durham University and a leading authority on drug trends. “That gulf is growing.”

PMA is often described in newspaper headlines as “stronger” than MDMA. But it doesn’t get you higher. It’s just more toxic. What’s more, the effects of PMA take longer to come on, and a small increase can turn a relatively safe dose into a dangerous one. So people take a pill, think it’s poor quality ecstasy when they don’t feel anything after an hour, and take more to catch up. And then things go wrong.

Nicole Tomlinson was one of those who died in 2012. She had taken what she believed to be ecstasy when she was given it by her boyfriend, James Meaney; when nothing happened, they each took another two doses. Tomlinson was 19 years’ old. The couple’s child was two when she died. Last week, Meaney, 22, was sentenced to seven months in prison.

There is no question that Meaney bears a terrible responsibility for the fact that his child will grow up without a mother. But ultimately, his story is one of haplessness; on the other side of the equation is an approach so negligent that it is hard to distinguish from deliberate malice. The truth is, one simple step might have considerably reduced the chances of Nicole Tomlinson’s death, and that of many other victims of PMA: the provision of drug-testing facilities at clubs, so that researchers can find out which varieties of pill are not what they are said to be, and let people know.

This sort of scheme could be instituted this week without any legal difficulty. It is, of course, impossible to test every pill: you’d do well to operate in one or two big clubs in a particular city. But proper testing reshapes the market. It gives people the knowledge they need to make better decisions. Every headline on the Tomlinson story features the word “ecstasy”. But it wasn’t ecstasy that killed her. It was ignorance. If she had taken ecstasy, she would have been fine.

Such testing regimes run in Austria and the Netherlands. And to those involved, Britain’s resistance to a protocol with real evidence behind it seems perverse. “If we are not there, there is no information,” argues Rainer Schmid, a toxicologist and founder of Vienna’s “checkit!” project. “In Britain, it is a cynical approach, if you ask me. You know what is happening, and you say, no, we don’t want to solve it.”

The Home Office sees things differently. “We have no plans to introduce testing centres for illegal drugs,” it says. “Drugs are illegal because they are dangerous.”

This piercing insight didn’t do much good for Nick Bonnie, a 30-year-old youth worker who took a dodgy pill on a night out at Manchester’s The Warehouse Project last year. Bonnie and four of his friends were hospitalised. Bonnie died. The batch of pills they took is suspected to have contained PMA.

The Warehouse Project already went to admirable lengths to protect people; now it goes even further. It has sniffer dogs, a hefty security presence, amnesty boxes, and a boss vehemently opposed to drug use. “I’ve seen so many people fall by the wayside,” says Sacha Lord. “But everyone has to understand that drugs are going to be taken into a venue. If there was something we could do to prevent these tragedies, of course we would endorse it.”

Lord, for his part, is unconvinced about the benefits of on-the-spot testing. But he did let the Home Office run a scheme at The Warehouse Project which analysed samples from the club’s amnesty bins in the hope of getting better information for researchers. After the death of Nick Bonnie, Lord, who was devastated, decided that if that analysis revealed the presence of PMA, that information should be circulated in the club. “Information on its own doesn’t necessarily change behaviour,” says Fiona Measham, who ran the project. “There’s a complex relationship between information and behaviour change. But it’s certainly a useful piece in the jigsaw.”

As Measham suggests, a service like checkit! is not a panacea. John Ramsey, a toxicologist who runs the commercial drugs database, TicTac, says: “Most people who die on the club scene die from taking perfectly normal MDMA tablets. If I test their pills they’re going to take them and they’re going to die. There are better casualty avoidance strategies.”

If so, though, their deployment is not obvious at the moment. At the moment, the strategy for this particular skirmish in the wider war appears to consist of telling people that a drug they don’t want to take anyway is bad for them without giving them any means of identifying it. You might as well tell people to avoid the plane with the faulty engine. Besides, the European testing units would disagree that their strategy is ineffective: in both the Netherlands and Austria, deaths from PMA are vanishingly rare. In 2012, the same year in which 17 PMA-related deaths were reported in Britain, the Netherlands did not record a single such fatality.

In Britain, successive governments have turned down the opportunity to act. It is hard to see any reason for this failure other than the exigencies of electoral politics. “We were trying to bring it in, we were desperate to,” says David Nutt, of his time as chairman of the government’s Advisory Council on the Misuse of Drugs. “We had informal discussions with the Dutch testers years ago, but home secretaries always said no.”

According to Nutt, when Jacqui Smith was at the Home Office, she refused to let him use government money even to bring the head of the Dutch programme to the UK for a meeting. (Smith declined to be interviewed at length for this article, but she did vehemently deny this.)

Luckily, not everyone in power is so resistant. Last year, the Welsh government instituted the Wedinos testing scheme. Wedinos does not operate in clubs. Instead, anyone can send in an anonymous sample, identified only by post code, and find the results online a few weeks later.

Wedinos launched to predictable headlines about helping drug dealers ensure the quality of their supply. In fact, according to Mark Drakeford, the Labour Health Minister responsible, the vast majority of data comes from paramedics and police officers. For £100,000 a year, the information provided is saving lives. “In January, for instance,” says Drakeford, “four young men came into an A&E in North Wales. They had lost their sight, and they had begun to lose the use of their limbs as well. They didn’t know exactly what they had taken. But through the system we were able to identify what they had taken and let the people on the spot know the pharmacology. So they were able to provide effective treatment.”

What about the claims that such an approach seems to endorse dangerous behaviour? Drakeford sighs wearily, like a man who knows that the opinions of a 59-year-old politician are unlikely to affect what a 19-year-old does for fun. “Our first message is not to put yourself in harm’s way,” he says. “But we recognise that however you promote that message there still will be people who find themselves in those circumstances. Our view is that you have got to do the two things at the same time.”

You are probably tired of reading about the “war on drugs”. I know I am. The arguments never seem to go anywhere, and with every new death that ridiculous shorthand comes to seem still more absurd. Today, when I think of the “war on drugs”, I don’t think of a just struggle with a wicked opponent. I think of footsoldiers, and something a little more like the Somme. The people who take drugs aren’t being looked after. Instead, without understanding why, they are being dispatched to the frontlines and sent over the top – by a class of leaders more concerned with their own prospects than with the wellbeing of the very people they have sworn to defend. If this really is a war, why can’t we give them some protection?