Novel harm reduction measures at music festivals in Australia: Pilot implementation of the Emerging Drugs Network of Australia–Victoria toxicosurveillance methodology

Abstract

Introduction: Harm reduction strategies at music festivals seek to create a safer environment for patrons. The Emerging Drugs Network of Australia–Victoria (EDNAV) project is a state-wide toxicosurveillance network that derives drug intelligence from a sample of patients presenting to hospital with illicit drug-related toxicity. This publication describes the preliminary outcomes of conducting toxicosurveillance for critically unwell festival patrons within on-site medical facilities. Methods: Blood samples were collected from patrons who presented with severe illicit drug-related toxicity across three festivals (2022/2023). Blood samples were analysed via liquid chromatography–tandem mass spectrometry for over 700 pharmaceutical and illicit drugs. Results: There were 1603 individual medical encounters across the festivals, 228 of which were illicit drug related. A blood sample was collected for 24 patients, with a median age of 22 years (range 18–39 years). A median of two drugs (range 1–5 drugs) were reported and four drugs (range 0–8 drugs) were analytically confirmed per patient. The most frequently reported exposures were congruent with analytical results, 3,4-methylenedioxymethamphetamine (reported n = 17, detected n = 20), ketamine (reported n = 9, detected n = 13) and cocaine (reported n = 9, detected n = 12). An unreported illicit drug and/or new psychoactive substance (NPS) was detected in 18 patients, including methylamphetamine (n = 10), a cathinone (n = 7), benzodiazepine-type NPS (n = 6), N-ethylamphetamine (n = 1), 3-hydroxyphencyclidine (n = 1) and/or 4-hydroxy-N-methyl-N-isopropyltryptamine (n = 1). Discussion and Conclusions: EDNAV toxicosurveillance serves as an additional tool within a multi-faceted approach to harm reduction at festivals. Continued data collection will allow for the characterisation of high-risk drug use patterns to provide evidence-based messaging to festival patrons and key stakeholders.