Intended for healthcare professionals


Testing of illicit drugs in the Netherlands could be a model for the UK

BMJ 2019; 365 doi: (Published 18 April 2019) Cite this as: BMJ 2019;365:l1784
  1. Tony Sheldon, freelance journalist
  1. Utrecht
  1. tonysheldon5{at}

As the UK Home Office issues its first licence for a pill testing scheme based in Weston-super-Mare, Tony Sheldon considers two decades of Dutch experience in offering such services, which aim to reduce harm among people who take illegal drugs

Nearly five years ago Daan van der Gouwe, a drug researcher at the Dutch Institute of Mental Health and Addiction (Trimbos), received laboratory test results on a “Pink Superman” ecstasy tablet that had been submitted for testing by an anonymous drug user.1

The tablet contained no MDMA (3,4 methylenedioxymethamphetamine). Instead, it held a lethal dose (173 mg) of para-methoxy-N-methylamphetamine (PMMA). Van der Gouwe remembers it well: it was Thursday 18 December 2014, and tourists were about to descend on Amsterdam for the holidays.

One sample is not normally enough to recommend a red alert by the Ministry of Health, but the risk was too great. “We already had intelligence of a very large batch with the same composition elsewhere,” says Van der Gouwe. A mass media campaign with the message “Please don’t take this tablet” went out to television and radio stations, newspapers, the internet, and mobile phones.

No incidents of illness or death were related to the fake ecstasy in the Netherlands. But in the UK, where no testing was available, several people died after taking these tablets over the next two weeks.

In what has now become standard public health practice in some parts of the world, people who use illegal drugs can bring samples of drugs—mostly ecstasy, cocaine, amphetamines, or ketamine—to a network of local government funded testing services, without fear of prosecution. The drugs can be checked for their content, contaminants, and strength. This offers a window on to a hard-to-reach client group, providing an opportunity to advise users on harm reduction or to …

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