It’s already fairly well known that music festivals tend to come with plenty of illicit drug use. The activity is so common at festivals, and in dance scenes as a whole, that organizers and attendees alike are becoming increasingly more equipped to combat potential overdoses through a variety of measures.

A new study published in the International Journal of Drug Policy underscores the impact of these harm reduction strategies and consciously incorporating them into events, looking at the amount of drug-related deaths at Australian music festivals, the common trends and what may have helped to prevent them.

Moreover, the researchers ultimately confirmed that mobile medical care, drug testing and increased consumer education and awareness could have prevented these largely unintentional deaths.

Examining Modern-Day, Drug-Related Deaths at Australian Festivals

Researchers note the high prevalence of drug use among festival attendees compared to the general population, citing a study finding that 44% of over 5,200 surveyed Australian music festival attendees reported past-month use of illicit drugs. That said, it’s no surprise that more instances of drug use often result in increased cases of drug-related harm.

To examine the prevalence of drug-related deaths at Australian music festivals, researchers conducted a descriptive case series study using the National Coronial Information System (NCIS) looking at relevant data between July 2000 and December 2019.

The study noted a total of 64 deaths, predominantly males (73.4%) aged in their mid-20s (ranging 15-50 years old). MDMA and alcohol were the most common substances across the study period, reported respectively in 42 (65.6%) and 30 (46.9%) cases and with alcohol co-detected with MDMA in 14 (33.3%) cases. 

Deaths were primarily associated with toxicity from MDMA and other stimulants (19 cases), toxicity from other drugs or drug combinations (11 cases) and either natural causes (10 cases) or external injuries (24 cases) in the setting of drug use, like those involving motor vehicle or train collisions or a passenger or driver using drugs. The majority of cases involved unintended harm, with 11 deaths (17.2%) related to intentional self-harm.

Drug-Related Harm Reduction at Music Festivals

So, what exactly are the ways to prevent a drug overdose at these events?

Authors note that there is limited evidence surrounding the efficacy of specific law enforcement-related approaches. While drug detection dogs have been utilized in Australian festivals for more than two decades, researchers note some research showing this can actually increase risk of drug-related harm. They also mention that this method may “paradoxically increase the risk of overdose,” with attendees potentially leading to festival goers hiding drugs internally or quickly consuming drugs to avoid arrest.

There’s drug checking and testing, which allows members of the public to analyze drugs to confirm if they contain any potentially dangerous or unexpected substances and how much of a substance is actually in a given powder, pill, tablet and so on. 

Researchers note the body of research finding that this option indeed demonstrates a reduction in drug use and related harm. Combating the notion that people may be more inclined to use drugs with the ability to test them, researchers cite a recent study finding that festival attendees are no more likely to use drugs at festivals whether drug testing is provided or not.

Music festivals also tend to have mobile paramedics, peer harm reduction workers, chill-out spaces and may even incorporate specific physical design elements to reduce the risk of drug-related harm.

Preventing Overdose Through Drug Testing and Other Measures

Authors note that in these 64 cases, the most common cause of death was MDMA toxicity. While there are a variety of factors associated with increased risk of adverse effects surrounding MDMA usage, researchers highlight the variability in dose amounts as a key factor. For this study, the average MDMA concentration among the deaths was above a range usually associated with toxicity, showing an opportunity for harm reduction by drug checking and testing.

“Drug checking is not merely an analytical process; counsellors are available on-site to discuss analytical results and provide important harm reduction interventions,” researchers write. “This approach is favoured by festival patrons and has resulted in positive outcomes including changing dosing patterns, trust of health providers, and increased drug harm reduction knowledge.”

However these services are still in their infancy in Australia, despite being available throughout Europe and North America for a number of decades.

“Harm reduction strategies such as roving first aid volunteers, mobile medical care, spaces to rest, hydration stations, and drug checking services, may best address some of the risks associated with illicit drug use at festivals, in addition to increased consumer education and awareness,” authors conclude. “It is important to understand the factors involved in these incidents in order to inform policies around harm reduction and law enforcement at music festivals in future to prevent further deaths.”

In an interview with online music magazine and community platform Resident Advisor, co-author Dr. Jennifer Schumann underscored the findings around harm reduction, citing that two in three Austalians support drug checking services along with recommendations from coroners throughout the region to implement these services.

“It’s possible that information about the drugs these people were taking, along with harm-reduction advice from drug-checking service counsellors, may have prevented death in some cases in our study,” Schumann said.

It’s a particularly relevant topic Down Under, with renewed calls for more safety measures after nine people were hospitalized in January from suspected MDMA overdoses at Melbourne’s Hardmission Festival.

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