A Harm Reduction Guide on Drug Use at Music Festivals: How to Stay Safe

Drug use is common among people who attend music festivals and raves. Festival drugs, such as MDMA, marijuana, LSD, and psilocybin (“magic mushrooms”), are a large part of the music festival experience for many festival-goers. However, drug use at music festivals can be dangerous and even lead to life-threatening consequences, such as an overdose or medical emergencies like hyperthermia or extreme dehydration. Knowing the risks of Coachella drug use, signs of overdose, and harm reduction practices can help attendees stay safe.

In this article:

Music Festivals and Drug Use

Since Woodstock, music festivals have been a communal gathering place for people to not only listen to their favorite musicians, but also dance, create and appreciate art, and camp. Unfortunately, drug use is also a major component of festival culture. This is especially true for festivals that include electronic dance music (EDM) since DJs tend to integrate lights and art into their shows and many people will use drugs like MDMA or ecstasy to enhance their experience.

Common music festivals where people engage in alcohol and drug use include:

  • Coachella
  • Lollapalooza
  • South By SouthWest
  • Pitchfork
  • Electric Daisy Carnival
  • Ultra Music Festival
  • Burning Man
  • Bonnaroo
  • Firefly Music Festival

Research varies on the prevalence of drug use as well as drug preferences among festival attendees, but the general consensus seems to be that drug use is higher among people who attend music festivals than the general population.

Some research indicates that nearly 50% of festival-goers reported doing something at a music festival they wouldn’t normally do, and that may include drugs, given that 21% reported using illegal drugs at a music festival. Additionally, only 45% of participants reported attending festivals for the music, which demonstrates how much drug use has become synonymous with festival culture.1

One Australian study of festival-goers found that just over 73% of participants had used illicit drugs in the past year, most commonly ecstasy and marijuana. Another study of adolescents at a music festival found 52% had used illegal drugs at least once and 25% had engaged in past-month drug use.2

The most commonly used drugs at music festivals include:

  • Alcohol
  • Marijuana
  • MDMA/ecstasy
  • Cocaine
  • LSD
  • Psilocybin
  • Ketamine
  • DMT
  • Opioids
  • Inhalants
  • Synthetic cannabinoids, like Spice and K2

A Danish study, which analyzed urine from a music festival, found 77 drugs in 44 urine samples, with the most common drugs including:3

  • Cocaine
  • Ecstasy/MDMA
  • Amphetamine
  • Ketamine
  • Marijuana
  • Methamphetamine
  • Spice
  • Methylphenidate (Ritalin, Concerta)

Some drugs may be more popular at specific music festivals. For example, Coachella attendees are more likely to use cocaine whereas Burning Man attendees may opt for hallucinogens like DMT, LSD, and psilocybin. Many festival-goers report using drugs to increase their connectedness and emotional openness (such as with MDMA), enhance the music, and alter perception and mood.4

Dangers of Drug Use at Music Festivals

Between 1999 and 2014, drug overdoses accounted for 75% of all non-trauma-related deaths at music festivals and 13% of all festival deaths.5

Drugs are also responsible for non-fatal medical emergencies. For instance, at a 2017 Australian music festival, 21 attendees were hospitalized after taking what they believed to be GHB, a central nervous system depressant that’s common in the party scene. An additional seven people received medical care after collapsing in the street or park after the event.6

An Australian study related to drug toxicity in electronic dance music festival attendees revealed that 13% of cases were fatalities while 62.5% of cases were admitted to the hospital. MDMA/ecstasy was the most common substance, found in nearly 88% of cases. About 60% of cases involved multiple substances, with the other drugs likely contributing to MDMA toxicity.7

Although the dangers and risks vary between substances, some harmful effects of drug use at music festivals include:8,9,10,11,12

  • Irregular heart rhythm
  • Heart attack
  • Stroke
  • Seizures
  • Hyperthermia (dangerously high body temperature)
  • Liver and kidney failure
  • Heatstroke
  • Dehydration
  • Paranoia
  • Anxiety and severe panic attacks
  • Psychosis
  • Confusion
  • Nausea and vomiting
  • Trouble breathing
  • Increased risk of accidents and injuries
  • “Bad trips” or an unpleasant and often terrifying experience after taking hallucinogens
  • Suicidal thoughts or behaviors
  • Coma

Adulterants: You May Not Be Taking What You Think

Illicit drugs are hardly ever 100% “pure.” Dealers often cut their drugs with other substances to increase their profits or increase drug potency—and they do this without informing those they are selling these drugs to. Chances are, whatever drug you’ve bought is cut with other substances, many of which are extremely dangerous.

For example, MDMA/ecstasy may contain little to no MDMA. Instead, it may contain adulterants, such as:13

  • Ketamine
  • Heroin
  • Phencyclidine (PCP)
  • Dextromethorphan (DXM)
  • Cocaine
  • Methamphetamine
  • Caffeine
  • Ephedrine, a diet drug
  • Bath salts

Additionally, drugs you believe to be MDMA or LSD may actually be synthetic drugs or designer drugs, many of which can be bought online for much cheaper than the drugs they’re sold as. Synthetic drugs, like illegal and street drugs, are unregulated and can produce unpredictable and life-threatening effects.

Many Drugs are Cut with Fentanyl

Fentanyl is an extremely potent synthetic opioid, estimated to be 50 to 100 times more potent than morphine, an opioid painkiller. Synthetic opioids like fentanyl are the most common substance involved in overdose deaths in the United States.14

Many drugs, including opioids and non-opioids, are cut with fentanyl because of its potency and cost-effectiveness, including but not limited to:9,14

  • Cocaine
  • Heroin
  • MDMA
  • Methamphetamine
  • Marijuana

Furthermore, illicit drug manufacturers are mass-producing counterfeit pills that are pressed with fentanyl and marketing them as legal prescription drugs. It’s extremely dangerous to take pills that weren’t bought through a pharmacy. Prescription pills are regulated so that you know what’s in them, but counterfeit pills often contain fentanyl as well as other harmful drugs. You can’t even go by appearance either because they often are able to make counterfeit pills look like the real thing.15

Some common counterfeit pills containing fentanyl include:15</sup.

  • Alprazolam (Xanax)
  • Hydrocodone (Vicodin, Norco)
  • Oxycodone (OxyContin, Percocet)
  • Adderall

Most of these pills contain a lethal amount of fentanyl, which can lead to overdose and death.

Carry Naloxone (Narcan) with You, if Permitted

Naloxone is a life-saving medication that rapidly reverses the effects of an overdose on opioids like fentanyl, heroin, oxycodone, and hydrocodone. If someone has overdosed and stopped breathing or their breathing has slowed dramatically, naloxone can restore normal breathing. Naloxone cannot be used for an overdose on substances that aren’t opioids.16

Narcan is the brand name for the prepackaged nasal spray that is easiest for the lay person to use. It requires no assembly and is sprayed into a person’s nostril while they lie on their back.16

If you are planning on going to a music festival, you should plan to bring Narcan with you. Naloxone access laws are different in every state, but every state has some sort of law allowing you to purchase it at pharmacies like CVS. Some will allow you to buy it through the pharmacist without a prescription. However, before packing your Narcan, you’ll want to check festival guidelines before or contact the venue as some venues may consider it drug paraphernalia and confiscate it.

Safety and Harm Reduction Measures for Drug Use at Music Festivals

Harm reduction is a set of practices to prevent negative consequences and deaths related to drug and alcohol use. Harm reduction can help mitigate the dangers of substance use at music festivals and keep attendees safe.

Music festivals may implement a range of harm reduction strategies, such as:

  • Amnesty boxes where people can discard illegal drugs without legal consequences
  • Drug education information on flyers
  • Medical services
  • Additional security and staff
  • Free water to prevent dehydration
  • Plenty of food options
  • Limited number of alcohol sales
  • Reduced festival hours to encourage rest
  • Organizations handing out free earplugs, drug information, condoms, and water

Drug Testing Services

Some music festivals offer free drug testing services on-site. People can bring a small sample of their drugs to the station and professionals will use drug-testing kits to determine the purity of the sample and what other substances it may contain.

Free drug testing allows festival attendees to make informed decisions about their substance use. Individuals who find out that their MDMA is cut with heroin or those who find out their “prescription” Xanax is actually comprised of fentanyl may choose to discard their drugs. Of course, some people may choose to use their drugs anyway, but they at least know what they’re putting in their body.

While proponents of drug testing understand the value of harm reduction, some people criticize pill testing because they think it encourages drug use. However, research indicates that the opposite is true. One study related to drug use behavior in festival-goers found that people reported they would not take drugs if contained ketamine, methamphetamine, or para-methoxyamphetamine (a drug similar to MDMA).2

This same study found that festival-goers believed drug checking services could help keep people safe and that these services should be combined with harm reduction advice.2

Historically, organizations like Bunk Police and DanceSafe conducted free drug testing services at music festivals throughout the U.S., but in recent years, they have been forbidden from certain festivals like Coachella. Still, some organizations find ways to help keep people safe within the festivals. For example, Bunk Police has urged people to text a certain number in order to receive updates about drugs testing positive for fentanyl or to be able to find stealth testing sites.

Other Precautions

Besides using drug testing kits and carrying Narcan (if permitted), there are some other things you can do to stay safe at music festivals like Coachella this season, including:

  • Stay hydrated by making sure you know where you can get free water and setting aside time to drink throughout the day
  • Schedule plenty of breaks throughout the day to rest, eat food, and drink water
  • Get to know your surroundings, such as where medical tents are located, where you get free where, where food is available, and where you can find drug testing kits
  • Use the buddy system and establish a meet-up spot if anyone gets separated
  • Keep your phone on you at all times
  • Educate yourself on substance use, including the signs of dehydration or an overdose

Signs of a Drug Overdose or Medical Emergency

Different drugs have different overdose signs and symptoms. It’s important to be aware of the myriad of drug overdose signs so you can seek help for yourself or someone else.

Opioid Overdose

Signs and symptoms of an opioid overdose include:17

  • Loss of consciousness
  • Gurgling sounds
  • Vomiting
  • Slow or stopped heartbeat
  • Slow or stopped breathing
  • Unresponsiveness
  • Limp body
  • Pale face
  • Blue-ish lips and fingertips

Sedative Overdose

Sedatives may include benzodiazepines like Klonopin, Ativan, and Xanax, as well as barbiturates such as phenobarbital. Signs and symptoms of a sedative overdose include:18,19

  • Slurred speech
  • Slowed or stopped breathing
  • Confusion
  • Impaired mental status
  • Coma

Alcohol Poisoning or Overdose

Someone may be experiencing alcohol poisoning if they are experiencing the following:20

  • Vomiting
  • Stupor
  • Trouble maintaining consciousness
  • Clammy skin
  • Slow or stopped breathing
  • Slow heart rate
  • Seizures
  • Blue-ish skin color
  • Low body temperature
  • No gag reflex

Stimulant Overdose

Unlike opioids, alcohol, and sedatives, which are all central nervous system (CNS) depressants, stimulant overdose does not result in slowed breathing and heart rate, which can lead to coma. This is because stimulants like cocaine, methamphetamine, and amphetamines speed up the effects of the central nervous system. They have their own host of detrimental effects, which can occur even at relatively low doses.

Signs and symptoms of a stimulant overdose include:21

  • Fever
  • Hallucinations
  • Dangerously high body temperature
  • Heart attack
  • Seizure
  • Convulsions
  • Coma
  • Aggression
  • Tremors

MDMA/Ecstasy Overdose

Signs and symptmos of MDMA toxicity or overdose may include:22

  • Faintness
  • Hyperthermia
  • Panic attacks
  • High blood pressure
  • Unconsciousness
  • Seizures

Hallucinogens Overdose

Hallucinogens like LSD and magic mushrooms rarely result in fatalities or overdose. However, individuals may experience a “bad trip,” which may involve frightening hallucinations or horrifying experiences.

Bath Salts Overdose

Some drugs like MDMA may be cut with bath salts, unbeknownst to the person taking the drug. Bath salts, also known as synthetic cathinones, are dangerous synthetic drugs that can cause a host of harmful effects, including overdose. Signs and symptoms of a bath salts overdose may include:23

  • Heart palpitations
  • Irregular heartbeat
  • Kidney failure
  • Paranoia
  • Agitation
  • Delusions and hallucinations
  • Profound sweating

What to Do if Someone Overdoses

If you suspect someone near you has overdosed or is experiencing dangerous side effects of drug use, seek medical attention immediately. If the person is conscious and able to move, help them over to the medical tent, where they can receive emergency medical care. Inform the medical team as to what drugs the person took and how much, if known.

In the case of someone losing consciousness, send someone to get help while you stay beside the person who has overdosed. You can roll them onto their side into recovery position to prevent them from choking on or asphyxiating their vomit. You can also call 911 if you are unable to find medical staff on-site.

You can also administer Narcan, the opioid overdose medication, in the event of an opioid overdose. Even if the person was not using opioids, you can still use it in case their drugs were cut with fentanyl or other opioids. It won’t hurt them if it turns out they don’t have opioids in their system.

How to Help Someone Through a Bad Trip

Bad trips are likely to occur at a music festival setting due to use of psychedelics like LSD and psilocybin. Bad trips may involve extreme panic attacks, severe paranoia, scary hallucinations, or emotionally distressing experiences.

If someone around you is having a bad trip, here are some things you can do to help:

  • First, determine if they want your help by approaching them, asking how they’re doing, and if they need your assistance
  • Act as a guide that helps them through the process instead of trying to talk them down
  • Offer to move them to a quiet, calm, and comfortable environment
  • Seek additional help, if needed, such as in the event of a medical emergency, potential aggression or violence, or severe mental health symptoms you aren’t equipped to handle
  • Take care of yourself, especially if you have taken psychedelics as well
  • Help them integrate back into their social circle after their trip begins to resolve

Some music festivals may have tents set up specifically for those who are experiencing bad trips. You can seek one out for yourself or someone else. Typically, these tents have counselors at them who can help individuals through a bad trip.

Addiction Treatment as Drug Overdose Prevention

Professional addiction treatment can decrease the risk of overdose and help people stop using drugs or alcohol by equipping them with adaptive coping skills, relapse prevention strategies, drug refusal skills, and beyond. Behavioral therapies and psychotherapy can help address the underlying factors that contributed to a person’s substance misuse in the first place, as well as address any previously undiagnosed mental health conditions, such as co-occurring depression, bipolar disorder, or schizophrenia.

For help finding a rehab that’s right for you or a loved one, call our helpline at 800-662-4357. One of our knowledgeable treatment support specialists can assist you, 24 hours per day, 7 days per week.

Resources

  1. National Institute on Drug Abuse. (2013). Summer Music Festivals: More About Partying Than Music?
  2. Day, N., Criss, J., Griffiths, B. et al.(2018). Music festival attendees’ illicit drug use, knowledge and practices regarding drug content and purity: a cross-sectional surveyHarm Reduction Journal 15(1).
  3. Hoegberg, L., Christiansen, C., Soe, J., Telving, R., Andreasen, M. F., Staerk, D., Christrup, L. L., & Kongstad, K. T. (2018). Recreational drug use at a major music festival: trend analysis of anonymised pooled urineClinical toxicology (Philadelphia, Pa.)56(4), 245–255.
  4. Jacob Fox, Alexis Smith, Alexander Yale, Christopher Chow, Elsa Alaswad, Tracy Cushing & Andrew A. Monte. (2017). Drugs of Abuse and Novel Psychoactive Substances at Outdoor Music Festivals in ColoradoSubstance Use & Misuse 53(7): 1203-1211.
  5. Turris, S. and Lund, A. (2016). Mortality at Music Festivals: Academic and Grey Literature for Case Finding. Prehospital and disaster medicine 32(1): 1-6.
  6. ABC News Australia. (2017). GHB Suspected Drug Behind Overdoses at Melbourne Dance Party that Saw 21 People Hospitalised.
  7. Black, E., Govindasamy, L., Auld, R., McArdle, K., Sharpe, C., Dawson, A., Vazquez, S., Brett, J., Friend, C., Shaw, V., Tyner, S., McDonald, C., Koop, D., Tall, G., Welsby, D., Habig, K., Madeddu, D., & Cretikos, M. (2020). Toxicological analysis of serious drug-related harm among electronic dance music festival attendees in New South Wales, Australia: A consecutive case seriesDrug and alcohol dependence213, 108070. Advance online publication.
  8. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  9. Drug Enforcement Administration. (2020). Ecstasy/MDMA.
  10. National Institute on Drug Abuse. (2019). Cannabis (Marijuana) DrugFacts.
  11. National Institute on Drug Abuse. (2021). Cocaine DrugFacts.
  12. National Institute on Drug Abuse. (2020). Synthetic Cannabinoids (K2/Spice) DrugFacts.
  13. National Institute on Drug Abuse. (2017). MDMA (Ecstasy) Abuse.
  14. National Institute on Drug Abuse. (2021). Fentanyl DrugFacts.
  15. Drug Enforcement Administration. (2021, September 27). Sharp Increase in Fake Prescription Pills Containing Fentanyl and Meth.
  16. National Institute on Drug Abuse. (2022). Naloxone DrugFacts.
  17. American Psychological Association. (2018). Recognizing and Responding to Opioid Overdose.
  18. Centers for Disease Control and Prevention. (2021, August 20). A day to remember: international overdose awareness day.
  19. Kang, M., Galuska, M.A., & Ghassemzadeh, S. (2021). Benzodiazepine toxicity. Treasure Island, FL: StatPearls Publishing.
  20. National Institute on Alcohol Abuse and Alcoholism. (2021, May). Understanding the dangers of alcohol overdose.
  21. National Institute on Drug Abuse. (2018, June). Prescription stimulants DrugFacts.
  22. National Institute on Drug Abuse. (2017). MDMA (Ecstasy) Abuse: What are the effects of MDMA?
  23. Weaver, M. F., Hopper, J. A., & Gunderson, E. W. (2015). Designer drugs 2015: assessment and managementAddiction Science & Clinical Practice, 10(1), 8.

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