“I studied social sciences in college and have always been very interested in the sociocultural impact of drug use. There were head shops in Ireland when I was a student and it was a really fascinating time for behavior change in people who used different types of substances.
I was interested in both how our drug landscape was changing and harm reduction approaches, so I pursued a masters in addiction research.
I started working with the HSE just before the 2019 festival season. We have worked with festivals on a much smaller scale, partnering with three events and a series of concerts for third year students. We also did a small study with Trinity College on drug use at festivals and then formed a group on emerging drug trends.
We really just wanted to validate the types of substances people are using, age, gender and see if they would engage in new services.
Alcohol is obviously the most common drug [used by people at festivals] But what is unique to Ireland, and possibly Britain, is the polydrug pattern, using alcohol with other substances. When you drink alcohol it increases the risk of any particular drug in the sense that it can mask the effects of other substances that could cause a person to take more.
In our festival study with Trinity College we found that the most commonly used controlled substances were MDMA powder, cannabis, cocaine, MDMA pills followed by ketamine and I would say that reflects very well what we are seeing [at festivals] this year. Many people will use MDMA mixed with cocaine and ketamine, and maybe alcohol as well.
We’ve found that ketamine, a dissociative hallucinogen and anesthetic, has become one of the most popular drugs at all festivals. Ketamine was pretty popular on the dance scene a few years ago, but it was a smaller user community. I think what’s happened now with substances like ketamine and psychedelics like 2CB is that they’re starting to move from the fringes into the mainstream so we’re starting to see more user groups.
Our studies at Trinity College was really the first time we acknowledged the festival setting – and not to stigmatize that setting. We need to learn how to implement interventions. While we recognize that there are risks, we also see that there are tremendous benefits for healthcare professionals to work on festival grounds.
Work has been postponed due to Covid but when events reopened this year we have partnered with three festivals: Life, Indiependence and Electric Picnic.
It is a multi-component campaign and the idea is that at the event we are a really accessible, non-judgmental point of contact for people to engage with and help them understand substances and take practical steps do to protect yourself. We also have a training program for people who want to volunteer with us to provide drug education at festivals.
We sent teams of volunteers and HSE managers to this year’s Life Festival. We had an information tent where we gave out bottled water to encourage people to hydrate and lip balm when people’s lips got parched over the weekend, along with resources and information.
We wore safety vests that said ‘drugs.ie‘ on the back and we had badges that said ‘Drugs: no judgement, no stigma’. Our materials, developed by Irish illustrator Jacky Sheridan, are quite colorful and our tent was really alive, so people were curious as to what it was all about. It was circulating at the festival that we were dealing with people, and soon people were coming to us rather than going to them.
We found that festival goers really wanted to engage with health services and really wanted to know how to take care of themselves. They wanted to know what was in the substances they were taking, but of course we couldn’t tell them. And they wanted to know what would happen if they went to the paramedics.
One of our big tasks was to allay people’s concerns about medical help. We found in our research with Trinity that young people who use drugs at festivals are afraid to seek medical help when things go wrong.
They think they’ll be convicted or prosecuted, so a big part of our job at Life Festival was getting around the campsite to make sure people understood the signs when something went wrong. Sometimes overconsumption can start as a headache or muscle ache that people may not be aware of.
We also let them know that the medical tent is a safe space. At the point where you present yourself after eating something, your well-being is the top priority and law enforcement will not be involved. The key message is: when in doubt, check with the medics rather than procrastinate or leave it too late.
“Start low and go slow” is another of our key messages. There was a point in Irish culture where there was a trend to ‘double drop’ and people would do a number of substances in one night.
But the drug market has changed a lot. In the 1990s, ecstasy pills contained a maximum of 60-90 mg MDMA. Now the pills have evolved and we are seeing pills containing 120 to 300mg of MDMA. The highest ecstasy pill ever recorded was found in Manchester last year – it contained 477mg of pure MDMA.
Therefore, it is very difficult to prescribe how much of this pill you should take if we do not know how much is in it. The harm reduction message a few years ago would have been take half a pill and wait, now it’s take a quarter pill and wait
We also highlight how drugs can negatively interact with some medications. For example, MDMA might interact negatively with selective serotonin reuptake inhibitor (SSRI) antidepressants. MDMA affects the serotonin in your body, as do SSRIs. The so-called serotonin syndrome can occur anyway when people take MDMA and stimulants, but the risk could increase if they take medication. Serotonin syndrome is extremely rare, but if left untreated it can be extremely risky and life-threatening. A really common symptom is pain in the arms and legs.
Substances like tramadol could also be risky when used with MDMA. Our advice is not to stop taking the drug, but to think about the interaction.
Another concern we have right now is that MDMA and cocaine may contain powerful cathinone substances similar to those sold in head shops.
Cathinones can feel less empathetic than MDMA, making people feel like they have a dud product and take more to get an effect when there is actually something in the substance. Similarly, cathinones can lead to compulsive behavior, so people may take more of the substance without realizing it is in their MDMA or cocaine.
Our goal is to educate people on how to minimize harm to health, including overdose prevention. Obviously, our general message is that it’s always safer not to use drugs at all. But we have to recognize that festivals can be risk-taking environments where people can try new types of drugs or try drugs for the first time.”
As Katie Byrne was told
https://www.independent.ie/life/music-festivals-and-substance-abuse-the-medical-tent-is-a-safe-space-law-enforcement-wont-be-involved-41831943.html Music festivals and drug abuse: ‘The medical tent is a safe place…law enforcement won’t be involved’