Monash University study finds festival drug-checking services could reduce deaths

An analysis of all drug-related deaths at music festivals across Australia over the past decade has revealed that most incidents are related to young people and the use of MDMA mixed with other substances - including alcohol - and that more stringent drug-checking services could help prevent these deaths.

Significantly, the Monash University study found that most deaths were a result of unintentional overdoses and could potentially have been prevented through the implementation of harm reduction strategies including drug checking services.

Using Coronial reports, the first ever national study found drug use among music festival attendees is disproportionally high compared with the general population - referencing a recent survey of 2305 participants at 23 festivals in Victoria which found that almost half (48%) had recently used drugs and 24% intended to take illicit drugs at the next festival.

Published this month in the International Journal of Drug Policy, the review, led by Associate Professor Jennifer Schumann, from Monash University’s Department of Forensic Medicine, looked at drug-related deaths at music festivals throughout Australia between 1st July 2000 (Queensland from 1st January 2001) and 31st December 2019, using the National Coronial Information System.

During the study period there were 64 deaths, mostly of males (73.4%) aged in their mid-20s (range 15-50 years).

The study revealed that:

• Drug toxicity was the most common primary cause of death (46.9%) followed by external injuries in the setting of drug use (37.5%).

• The drug most commonly detected or reported as being used was MDMA (65.6%), followed by alcohol (46.9%) and cannabis (17.2%)

• Most cases involved the use of two or more drugs (including alcohol)

• Most deaths were unintentional

• Clinical intervention was involved in 64.1% of cases and most festivals occurred in inner city locations (59.4%).

The authors, who also include colleagues at the University of Melbourne and ANU, note that while law enforcement-centred strategies intended to deter drug use and supply at these mass gatherings have been implemented throughout Australia, according to Associate Professor Schumann, “many have been criticised for their lack of effectiveness, with evidence suggesting that they can inadvertently increase the risk of drug harm”.

A wide range of illicit substances are consumed at music festivals in Australia, with alcohol, stimulants, and cannabis most common. Toxicity can occur with seizures, hyperthermia and cardiovascular collapse associated with stimulant use or cardiorespiratory depression with the use of central nervous system depressants including alcohol and GHB.

Associate Professor Schumann went on to advise that illicit drugs may also interact with pharmaceutical medications or non-illicit substances such as herbal supplements, making polysubstance use an added risk for drug toxicity.

Drug detection dogs have been used at festivals throughout Australia for over two decades, contrary to studies demonstrating that their presence may increase the risk of drug-related harm, citing emotional impacts as well as internal concealment or consumption of drugs to avoid arrest.

Following a 2019 inquest into six music festival deaths, the NSW Coroner found compelling evidence to discontinue the use of drug detection dogs. Further, recommendations were made to reduce the number of strip searches, redefine drug use as a health rather than law-enforcement issue, improve drug education, hold a summit for the development of evidence-based drug policy, and introduce drug checking.

Drug checking, or pill testing, allows the general public to submit drugs for toxicological analysis indicating the contents, dose and purity of pills and powders, which may reveal potentially dangerous substances, promoting drug disposal and safer drug use while also enabling community toxico-surveillance.

Countries such as the Netherlands have used drug checking for over three decades to understand the dynamic recreational drug market, providing toxico-surveillance data to the European Union Early Warning System as part of the Drug Information and Monitoring System.

Australia currently has one drug checking service in the Australian Capital Territory (CANTest) and Queensland have announced they will also introduce a drug checking service.

According to the Monash-led study, while critics argue that pill testing “condones drug use or providing patrons with a false sense of security over the contents of their drugs … research demonstrates that people who both have and never used ecstasy report being no more likely to use it at a festival when drug checking is provided than when it is not.

“The importance of drug counsellors on-site as part of the drug checking operation, to provide context to the results provided and to counsel consumers on how to avoid harm from drug use, is integral to reducing harm.”

Images used for illustrative purposes only.