Closing the Gap

Closing the Gap

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High-dose MDMA drug warning for NSW

High-dose MDMA drug warning for NSW

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NSW Health is warning the public of multiple high-dose MDMA (ecstasy) tablets currently circulating in the state.

NSW Health Pathology’s Foren­sic & Ana­lyt­i­cal Sci­ence Ser­vice (FASS) has played a key role in test­ing three types of high dose MDMA tablet that have been recent­ly found in NSW.

The tablets are described as:
• blue dia­mond shaped tablet with ‘pun­ish­er’ logo con­tain­ing 216 mg MDMA
• blue skull shaped tablet with ‘MYBRAND’ logo and text con­tain­ing 216 mg MDMA
• yel­low square tablet with ‘Sponge­Bob’ smi­ley face mark­ings con­tain­ing 160 mg MDMA.

These tablets con­tain up to twice the aver­age amount of MDMA usu­al­ly con­tained in tablets cir­cu­lat­ing in NSW.

Oth­er drugs includ­ing cathi­nones, ket­a­mine and ket­a­mine ana­logues have recent­ly been detect­ed in some MDMA tablets and capsules.

Med­ical Direc­tor of the NSW Poi­sons Infor­ma­tion Cen­tre, Dr Dar­ren Roberts, said con­sum­ing high dos­es of MDMA has been linked to recent cas­es of seri­ous ill­ness and death in NSW.

“MDMA can cause severe agi­ta­tion, raised body tem­per­a­ture, seizures or fits, irreg­u­lar heart rhythm and death,” Dr Roberts said.

“The amount of MDMA in a tablet or cap­sule can vary a lot, even with­in the same batch. The health risks from MDMA are great­ly increased if high amounts (includ­ing mul­ti­ple dos­es) are con­sumed over a short peri­od. Oth­er risks include tak­ing MDMA in com­bi­na­tion with oth­er stim­u­lants, such as amphet­a­mines, cocaine or cathinones.

“Hot envi­ron­ments, such as at music fes­ti­vals, increase the risk of harm from MDMA. Tak­ing a break from danc­ing, seek­ing shade, and drink­ing water are impor­tant mea­sures to reduce the risk of over­heat­ing,” Dr Roberts said.

NSW Health reg­u­lar­ly informs the pub­lic of known high risk drugs in cir­cu­la­tion at Pub­lic drug alerts.

NSW Health Pathology’s Illic­it Drugs Analy­sis Unit works every day to keep the com­mu­ni­ty safe by con­duct­ing tests on drugs seized by police. Their work sup­ports the health and jus­tice sys­tems and con­tributes to pub­lic health alerts and drug warnings.

For more infor­ma­tion about stay­ing safe at fes­ti­vals, includ­ing the warn­ing signs to seek help, see: stayok.nsw.gov.au

What goes on inside a pathology laboratory?

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International Pathology Day is on 8 November 2023. To celebrate, we’ve given some budding young scientists access to one of our newest laboratories to find out what happens behind the lab doors!

Inter­na­tion­al Pathol­o­gy Day is all about cel­e­brat­ing the impor­tance of pathol­o­gy in our health­care system.

Pathol­o­gy plays an invalu­able role in the detec­tion, diag­no­sis, and treat­ment of dis­ease.  As Australia’s largest pub­lic pathol­o­gy provider, we’re proud that our net­work of over 60 lab­o­ra­to­ries and 150+ col­lec­tion cen­tres is keep­ing our com­mu­ni­ty safe and healthy.

This year, we’ve opened our doors to some future sci­en­tists – Spencer and Emil­ia (both aged 7) – to tour our Nepean lab­o­ra­to­ry which was offi­cial­ly opened in August and inter­view some of the staff who work there.

Cather­ine Jan­to is Spencer’s aunt and is the A/Senior Hos­pi­tal Sci­en­tist in Charge of Micro­bi­ol­o­gy at the Nepean laboratory.

She began work­ing in micro­bi­ol­o­gy 13 years ago and says she loves that the job is all about help­ing patients.

A woman wearing a white lab coat sits at a laboratory desk talking to a young boy in a lab coat.
Spencer’s aunt Cather­ine talks him through a day in the life of Nepean pathol­o­gy laboratory.

“We play a big role in diag­nos­ing infec­tions. We grow bac­te­ria, detect virus­es, par­a­sites and fun­gi to work out why some­one is sick, and what kind of infec­tion they may have,” she explained.

“In the lab we don’t see patients face-to-face, we are focused on our agar plates and PCR ampli­fi­ca­tion curves, so it’s good to remind our­selves there are patients who we’re help­ing behind every result.

“It’s a reward­ing feel­ing to be able to work in this brand-new lab­o­ra­to­ry that we designed and got up and run­ning, essen­tial­ly for the future of Nepean Hos­pi­tal and sur­round­ing community.”

A woman in a white lab coat stands next to a young girl in a lab coat holding a microphone.
Michelle Bas­nett explains to her niece Emil­ia why she loves work­ing in pathology.

Michelle Bas­nett, Emilia’s aunt, is a tech­ni­cal offi­cer in the lab and told her niece that even though her job involves study­ing poo – she loves work­ing in pathology!

“We receive all sorts of sam­ples here at the lab, like urine, we look at stools or poo, tis­sue or flesh from the body, swabs, we also look at blood and oth­er flu­id com­ing from the body,” she said.

“I chose to work in pathol­o­gy because I real­ly liked sci­ence at school and I was inter­est­ed in how the body works.

“It’s very hands on and I’m a very visu­al per­son, so I like to use my obser­va­tion­al skills, for exam­ple using the micro­scope to look for organ­isms, I find it all quite interesting.”

Thanks Spencer and Emil­ia for check­ing out the lab and we hope to see you back in front of a micro­scope again one day!

Challenges of testing urine for drugs of abuse

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Testing urine for drugs is a well-accepted scientific process, providing verifiable and reliable results. But testing whether the urine is real and not synthetic or adulterated has been more difficult, until now.

Dr Ashraf Mina is a prin­ci­pal sci­en­tist at NSW Health Pathology’s Foren­sic & Ana­lyt­i­cal Sci­ence Ser­vice, based at the Drug Tox­i­col­o­gy Unit, which tests urine sam­ples for evi­dence of drugs, both drugs of abuse and therapeutic.

He says a chance con­ver­sa­tion a cou­ple of years ago got him won­der­ing why there are no defin­i­tive tests to deter­mine that a urine sam­ple is actu­al­ly real human urine.

“There is no stan­dard for it world­wide, there are some attempts to test for the most com­mon para­me­ters in urine, but they can be exact­ly mim­ic­ked in syn­thet­ic urine,” Dr Mina said.

So, he got to work and has devel­oped a nov­el approach to sam­ple valid­i­ty test­ing and he recent­ly pre­sent­ed his find­ings to a research sym­po­sium at West­mead Hospital.

“We’ve designed the test on two lev­els,” Dr Mina explained.

“Lev­el one we test for four para­me­ters – cre­a­ti­nine, pH, spe­cif­ic grav­i­ty, and oxi­dant assay – and they are basi­cal­ly test­ing for both sam­ple dilu­tion and some oth­er iterations.

“If we pick up any­thing, we go to sam­ple valid­i­ty test­ing lev­el two which is this new­ly devel­oped method in which we can analyse 23 dif­fer­ent para­me­ters that are always present in human urine and should be there in a sample.”

Two graphs showing a biological urine sample with many peaks indicating its components, versus a graph of a synthetic urine with far fewer peaks.
No com­par­i­son: the real thing ver­sus syn­thet­ic urine samples.

He says the method is already help­ing to detect cas­es where urine sam­ples have been tam­pered with to avoid drug detection.

“We had a case recent­ly where we found a par­ent drug in a urine sam­ple but not its metabo­lites. When the sam­ple was test­ed by the new method, it seemed to be water spiked with a drug and was not a bio­log­i­cal sample.

“So that’s telling us that some­one topped the water up with some drugs to show that they are tak­ing their med­ica­tion because we didn’t find the drug metabo­lites or any of the 23 mark­ers we iden­ti­fied for urine.”

Dr Mina says the test­ing is done at the same time as the sam­ple is analysed for more than 70 drugs so there is no loss of effi­cien­cy for the laboratory.

“In devel­op­ing this test we asked is it syn­thet­ic urine? Is it sub­sti­tut­ed urine? Is there an added adul­ter­ant to the urine? This method answers all those ques­tions, and we are the only lab in Aus­tralia, and pos­si­bly the world, cur­rent­ly able to do this.”

Dr Mina will also be pre­sent­ing his research at the upcom­ing IAFS con­fer­ence in Syd­ney in Novem­ber 2023.

Collaborating with a global technology leader to deliver better patient care

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NSW Health has appointed health technology provider Epic to work with eHealth NSW and NSW Health Pathology to deliver a Single Digital Patient Record (SDPR) that will enhance the care patients receive at NSW public hospitals.

NSW Min­is­ter for Health the Hon. Ryan Park, MP announced the SDPR on 19 Octo­ber 2023, giv­ing the green light to uni­fy­ing health care tech­nolo­gies across NSW to pro­vide patients with improved hos­pi­tal care and pro­vide greater sup­port for busy health care providers.

Cre­at­ing a sin­gle statewide pathol­o­gy lab­o­ra­to­ry infor­ma­tion sys­tem is an impor­tant part of the SDPR that will pro­vide health pro­fes­sion­als with secure real-time access to pathol­o­gy results for their patients, no mat­ter which NSW pub­lic hos­pi­tal they are treat­ed in.

“This excit­ing trans­for­ma­tion pro­gram will improve patient care across NSW by enabling a high­ly secure, holis­tic and inte­grat­ed view of the care a patient receives across the NSW pub­lic health sys­tem,” said Vanes­sa Janis­sen, Chief Exec­u­tive of NSW Health Pathology.

“This means that if some­one from Dub­bo, for exam­ple, needs urgent hos­pi­tal care in Syd­ney, the treat­ing doc­tors will have imme­di­ate access to their med­ical his­to­ry and diag­nos­tic results and can make fast, informed deci­sions about their care”, she said.

SDPR will also enhance impor­tant dig­i­tal inte­gra­tions between our Foren­sic and Ana­lyt­i­cal Sci­ence Ser­vice, NSW Police, and the Coro­ner as well as across our pathol­o­gy net­work to help improve time­li­ness, informed deci­sion mak­ing and out­comes for the jus­tice system.

NSW Health Pathol­o­gy Chief Med­ical Infor­ma­tion Offi­cer Dr Stephen Braye said pathol­o­gy plays a vital role in the clin­i­cal diag­no­sis and treat­ment of patients and hav­ing this infor­ma­tion on hand fast is important.

“It’s why a sin­gle pathol­o­gy lab­o­ra­to­ry infor­ma­tion sys­tem is a core fea­ture of the SDPR ini­tia­tive – to ensure doc­tors can secure­ly access real-time pathol­o­gy results for patients no mat­ter which NSW pub­lic hos­pi­tal they’re being treat­ed in,” Dr Braye said.

Epic is a world leader in dig­i­tal health tech­nol­o­gy and will work with us to devel­op the SDPR, which will also include a sin­gle elec­tron­ic med­ical record (eMR) and one patient admin­is­tra­tion sys­tem (PAS).

Work on the design and build of the SDPR will soon begin and is sched­uled to go live at Hunter New Eng­land Local Health Dis­trict. It is then planned to be rolled out across the state in phases.

New Chief Executive at NSW Health Pathology

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Australia’s largest public pathology provider and world-class forensic service, NSW Health Pathology has a new Chief Executive, with the appointment of Vanessa Janissen to the role.

A for­mer senior exec­u­tive at the organ­i­sa­tion, Ms Janis­sen brings a wealth of expe­ri­ence and a proven track record in pub­lic and pri­vate health services.

“I am excit­ed to be back at NSW Health Pathol­o­gy and am par­tic­u­lar­ly look­ing for­ward to guid­ing the organ­i­sa­tion through its next stage of evo­lu­tion, which will see us work close­ly with our lead­ers and high­ly skilled sci­en­tif­ic and med­ical teams to con­tin­ue to dri­ve improved out­comes and expe­ri­ences,” Ms Janis­sen said.

“Togeth­er we will be mak­ing the most of the advances in dig­i­tal, sci­ence and tech­nol­o­gy for our cus­tomers, part­ners and community.”

Ms Janissen’s arrival fol­lows the depar­ture ear­li­er this year of found­ing Chief Exec­u­tive Tracey McCosker PSM, who was appoint­ed Chief Exec­u­tive at Hunter New Eng­land Local Health District.

“I would like to pay trib­ute to the 10 years of ser­vice for­mer Chief Exec­u­tive Tracey McCosker gave to NSW Health Pathol­o­gy, over­see­ing its estab­lish­ment as a tru­ly statewide pathol­o­gy and foren­sic ser­vice in 2012.

“Her inspi­ra­tional lead­er­ship and patient-focused, strate­gic think­ing has helped cement NSW Health Pathol­o­gy as a trust­ed part­ner and leader in pathol­o­gy and forensics.”

“I also want to extend my thanks to Pro­fes­sor Rob Lin­de­man for act­ing in the Chief Exec­u­tive role for much of the year to date.

“Rob has ably led NSW Health Pathol­o­gy with his strong clin­i­cal exper­tise and lead­er­ship expe­ri­ence. I look for­ward to work­ing along­side him and the rest of the Strate­gic Lead­er­ship Team as we chart our next course.”

Ms Janis­sen held a num­ber of lead­er­ship posi­tions at Cal­vary Health­care, most recent­ly as the Nation­al Direc­tor, Strat­e­gy and Ser­vice Devel­op­ment lead­ing their growth strat­e­gy across hos­pi­tal, aged care, com­mu­ni­ty and vir­tu­al care services.

She was also NSW Health Pathology’s Exec­u­tive Direc­tor Strat­e­gy and Clin­i­cal Ser­vices Trans­for­ma­tion between 2013 and 2019. Pri­or to that she held mul­ti­ple oper­a­tional roles in Hunter New Eng­land Local Health District.

Her exper­tise in strat­e­gy, plan­ning, dig­i­tal trans­for­ma­tion, and ded­i­ca­tion to enhanc­ing human-cen­tered care will fur­ther strength­en NSW Health Pathol­o­gy’s posi­tion as a lead­ing pathol­o­gy and foren­sic ser­vice provider for the peo­ple of NSW.

“This organ­i­sa­tion tru­ly demon­strat­ed its exper­tise and val­ue as a con­nect­ed statewide net­work through­out the response to the COVID-19 pan­dem­ic when it played an instru­men­tal role in help­ing keep our com­mu­ni­ties safe.

“While this new era comes with its own chal­lenges, I’m con­fi­dent we will again rise to these, find­ing more new and inno­v­a­tive ways to enhance our ser­vices and the com­mu­ni­ties we serve.

“We will need to col­lab­o­rate even more close­ly with our part­ners in the health and jus­tice sys­tems to deliv­er more mod­ern, sus­tain­able ser­vices that meet the evolv­ing needs of our cus­tomers and communities.

“One of my ini­tial goals is to vis­it as many of our 5,000 plus staff in our 50 plus accred­it­ed lab­o­ra­to­ries, along with our key health and jus­tice part­ners, to bet­ter under­stand the chal­lenges and oppor­tu­ni­ties ahead so we can explore new and bet­ter ways of work­ing together.”

From emergency nursing to collections

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Lee Wakeman has been a registered nurse blood collector for NSW Health Pathology for just over a year and is enjoying a welcome change of pace from her previous role in emergency nursing.

After nine years in nurs­ing, Lee Wake­man brings a wealth of expe­ri­ence to her role at NSW Health Pathology’s col­lec­tion ser­vice at Newcastle’s John Hunter Hospital.

“I worked in men­tal health and foren­sics as a new grad for the first 18 months of my career, where I gained expe­ri­ence that would help me tran­si­tion into my new role as an emer­gency nurse,” she said.

“I worked in emer­gency for six years, gain­ing lots of expe­ri­ence and many skills over the years, like triage and resus­ci­ta­tion skills.”

Lee says her work at NSW Health Pathol­o­gy allows her to col­lab­o­rate with doc­tors, oth­er nurs­es, and staff with­in the laboratory.

“My role now is to be a team leader and col­lect and coor­di­nate the pathol­o­gy col­lec­tions through­out John Hunter Hos­pi­tal, includ­ing the pae­di­atric wards,” she explains.

“I real­ly enjoy work­ing in pathol­o­gy, the hours are great, work­ing autonomous­ly and with­in a team, meet­ing lots of new peo­ple, mak­ing new friend­ships and you get the oppor­tu­ni­ty to get to know the patients.”

Lee also keeps her clin­i­cal skills up to date by work­ing casu­al­ly in a Post Anaes­the­sia Care Unit (PACU), oth­er­wise known as the recov­ery unit, in a local pri­vate hospital.

“I love that you can work in so many dif­fer­ent areas with­in nurs­ing and there is so many oppor­tu­ni­ties to learn and progress.”

Lee enjoys help­ing peo­ple and mak­ing a dif­fer­ence in their lives, no mat­ter how big or small, dur­ing a time that is dif­fi­cult in theirs.

“It’s a very dynam­ic and chal­leng­ing field to work in. But even the bad times have helped me improve my prac­tices and made me a bet­ter nurse.

“I have also made some of the best friends of my life whilst work­ing as a nurse.

“Out­side of work I love to trav­el, go out for nice food and wine, see my friends and family.”

Lee says she’s still learn­ing new skills all the time and would rec­om­mend a career in collections.

Keen to find out more? Check out the careers page on our web­site.

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NSW Health Pathology acknowledges the Traditional Custodians of the land across NSW whose cultures and customs have nurtured and continue to nurture this land. We would like to pay our respects to the Elders past, present and emerging, for they hold the memories, the traditions, the culture and hopes of Aboriginal and Torres Strait Islander peoples across the state.

Aboriginal Workforce Development Closing the Gap

NSW Health Pathology acknowledges the Traditional Custodians of the land across NSW whose cultures and customs have nurtured and continue to nurture this land. We would like to pay our respects to the Elders past, present and emerging, for they hold the memories, the traditions, the culture and hopes of Aboriginal and Torres Strait Islander peoples across the state.

Aboriginal Workforce Development Closing the Gap
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