Across 2018 and 2019 there have been a series of drug-related deaths at Australian music festivals. These tragedies have highlighted a lack of current and localised information about the circumstances surrounding acute harm events following drug use among Australian festivalgoers.
This report analyses data from the Global Drug Survey from 2018, at the onset of the last Australian summer music festival season. We recruited a large sample of Australian festivalgoers (N = 4,391), all of whom (a) reported being residents of Australia, (b) reported attending one or more festivals in the last 12 months, and (c) answered at least one question about seeking emergency medical treatment (EMT) in the last 12 months. This report provides information to assist the 2019 NSW Coronial Inquest into the drug-related deaths of music festival attendees pertaining to EMT seeking, including rates of EMT by drug type among Australian festivalgoers, and descriptions of the circumstances surrounding EMT, including symptoms and hospitalisations.
280 respondents reported seeking EMT at least once in the last 12 months; this equates to 6.4% of our respondents. But rates of EMT seeking varied according to the last drug consumed. For example, alcohol ranked highest with 4.302 per 100 last-year consumers reporting seeking EMT after alcohol use, followed by MDMA (2.50), LSD (1.48), cannabis (0.96) and cocaine (0.67).
Females aged 16-20 were the most likely to report seeking EMT, followed by males 16-20, whereas older respondents of both genders reported seeking EMT at a comparatively lower rate. This trend held for alcohol, MDMA and LSD, but not for cocaine (where males and females aged 21 plus reported higher rates of EMT) or for cannabis (with similar rates across all ages/genders).
A broad array of information was gathered about the circumstances surrounding EMT. For example, for those seeking EMT following alcohol consumption the median reported standard alcoholic drinks consumed was 15 (range 1-72), with 60% reporting either consuming only alcohol or combining alcohol and tobacco only. The most commonly mentioned symptoms here were nausea/vomiting (45%), accident/trauma (40%) and passing out/unconscious (37%), with 65% reporting being admitted to hospital as part of their last EMT following alcohol.
For those seeking EMT following MDMA consumption, the median quantity consumed during the session was 3 pills (range 0.5 to >10) or 0.4g (range 0.1 to 1.5g). Most (81%) reporting combining MDMA with another psychoactive substance (alcohol and/or other illicit drugs). The most common symptoms experienced were confusion (40%), anxiety/ panic (40%) and very low mood in the days afterwards (40%), with 48% reporting being admitted to hospital as part of their last EMT following MDMA.
Comparing symptoms across drug types indicates some differences. For example, more anxiety and confusion post LSD, more nausea/vomiting and passing out post alcohol, and more palpitations, extreme sweating and overheating post MDMA, while hospitalisation was more likely to follow the use of LSD and alcohol than MDMA.
The analyses show that circumstances of seeking EMT following alcohol and other drug use are complex and unlikely to be attributable to one factor alone. But the analyses refute some potential explanations. For example, greater frequency of festival attendance (i.e., increased exposure) is unlikely to be a driver of increased reporting of EMT needs, and so any harm-reduction messages need to target both frequent and sporadic attendees of music festivals. In contrast, being both young and female may elevate the risk of acute drug-related harms. That said, we do not know for certain why being young and female is associated with elevated risk, although differences in body mass, consumption patterns and hormones that moderate stimulant drug sensitivity may play a role.
Profiling Australian festivalgoers requiring emergency medical attendance identified behavioural risk factors that tailored interventions could target, such as polydrug use, taking large doses, and not knowing the content/purity of drug(s) consumed. Having said that, people’s capacity to modify their behaviour depends to an extent on whether they have accurate knowledge about the drugs they are taking. Expanded access to peer-run harm-reduction services like DanceWize may help better educate festivalgoers who take illegal drugs. These services would ideally be informed by, or work alongside, on-site forensic analysis of drugs (drug checking). Brief interventions that engage festivalgoers to reconsider their drinking practices are also warranted, given that in this dataset, the most prevalent substance resulting in the need for emergency services was alcohol. Attention to the broader risk environment, particularly policing and criminal statute of the laws surrounding drug taking at Australian festivals, is also warranted.