Blood tests of sick festival goers show concerning results

Ahead of pill testing being introduced in Victoria in time for the music festival season over the summer, the first study examining patients presenting to medical services at Victoria's music festivals has been published—revealing that a large proportion of people reporting using drugs and feeling unwell, when tested, have been impacted by drugs they were unaware of taking. Three-quarters of those tested had an unreported illicit or new synthetic drug in their blood.

The pilot study looked at data from the Emerging Drugs Network of Australia—Victoria (EDNAV) project, an initiative led by the Victorian Poisons Information Center (Austin Health), in collaboration with the Victorian Institute of Forensic Medicine and the Victorian Department of Health.

The EDNAV project operated as a state-wide toxicosurveillance network that derives drug intelligence from a sample of patients presenting to 17 public hospitals with illicit drug-related toxicity—in this case pertaining to critically unwell festival patrons within on-site medical facilities serviced by St John Ambulance Victoria.

The study, published in the journal Drug and Alcohol Review, was led by Rebekka Syrianen, a Ph.D. student at Monash University and Associate Professors Jennifer Schumann and Shaun Greene from Monash University's Department of Forensic Medicine. The paper is titled "Novel harm reduction measures at music festivals in Australia: Pilot implementation of the Emerging Drugs Network of Australia-Victoria toxicosurveillance methodology."

There were 1,603 individual medical encounters across two multi-day electronic dance music (EDM) festival events in regional Victoria, and one single day festival in metropolitan Melbourne in 2022 and 2023, 228 of which were illicit drug related. EDNAV blood samples were collected from 24 patients who presented with severe illicit drug-related toxicity across the three festivals.

EDM festivals are considered high risk due to high levels of stimulant/poly-stimulant use, frequent re-dosing, high levels of physical activity and increased crowd density. Stimulant drug exposure can potentially lead to the development of severe hyperthermia and multi-organ dysfunction. This can be further exacerbated by environmental factors such as high ambient temperatures, high relative humidity and physical crowding.

The patients reported having used between one and five drugs each, and up to four known drugs were confirmed by screening.

The study found that—in the 24 seriously unwell cases (with eight going to hospital) tested:

• 17 reported using MDMA/ ecstasy, while 20 tested positive for the drug
• 9 reported using ketamine while 13 tested positive for it
• nine reported using cocaine while it was detected in 12 patients
• an unreported illicit drug and/or new psychoactive substance (NPS) was detected in 18 patients, including methamphetamine, synthetic stimulants and/or benzodiazepines.

According to Ms. Syrianen, the mixing of multiple drugs was common and consistent with previous studies: "polydrug use was the rule, rather than the exception, being both commonly reported to staff and confirmed analytically," she said.

"What was alarming was that new psychoactive substances were detected in just under half of the sampled cohort, despite not being reported as intentionally used by any patient."

According to Associate Professor Schumann, "polydrug use is common among those requiring emergency medical care at festivals, particularly those experiencing severe drug toxicity."

"What is concerning about these findings, is the discordance between reported illicit drug use and corresponding analytical confirmation was identified in 18 patients, with some of the unreported drugs potentially indicative of drug adulteration or substitution."