TY  - JOUR
PY  - 2020//
TI  - Toxicological analysis of serious drug-related harm among electronic dance music festival attendees in New South Wales, Australia: a consecutive case series
JO  - Drug and alcohol dependence
A1  - Black, Eleanor
A1  - Govindasamy, Laksmi
A1  - Auld, Robin
A1  - McArdle, Kylie
A1  - Sharpe, Caroline
A1  - Dawson, Andrew
A1  - Vazquez, Santiago
A1  - Brett, Jonathan
A1  - Friend, Caren
A1  - Shaw, Vanessa
A1  - Tyner, Sophie
A1  - McDonald, Catherine
A1  - Koop, David
A1  - Tall, Gary
A1  - Welsby, Deb
A1  - Habig, Karel
A1  - Madeddu, Daniel
A1  - Cretikos, Michelle
SP  - e108070
EP  - e108070
VL  - 213
IS  - 
N2  - BACKGROUND: A substantial increase in drug-related harm was observed during the 2018-2019 music festival season in New South Wales, Australia, including the deaths of five young people. As part of a rapid public health response, the New South Wales Ministry of Health referred samples from patients with suspected severe drug-related illness for forensic toxicological testing to identify the type and concentration of substances associated with the presentations. <br><br>METHODS: Cases were identified through a variety of active and passive surveillance systems, and selected consecutively based on indicators of clinical severity. Comprehensive toxicology testing of blood and urine samples was expedited for all cases. Demographic and clinical characteristics were collated, together with quantitative toxicology results. <br><br>RESULTS were analysed using descriptive statistics. <br><br>RESULTS: Forty cases from eleven different music festivals were included. The majority of cases (80.0%) were aged 25 years and under. There were five fatalities, and 62.5% of cases were admitted to intensive care units. MDMA was the most frequent substance, detected in 87.5% of cases. In 82.9% of cases with MDMA, blood concentrations were above thresholds that have been associated with toxicity. Multiple substances were detected in 60.0% of cases. Novel psychoactive substances were not detected. <br><br>CONCLUSIONS: Our findings strongly suggest that MDMA-related toxicity was a major factor in the severity of the clinical presentations among these cases. Other substances may have enhanced MDMA toxicity but appear unlikely to have caused severe toxicity in isolation. These findings have important implications for harm reduction strategies targeted to music festival settings.<br><br>Copyright © 2020 Elsevier B.V. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0376-8716
UR  - http://dx.doi.org/10.1016/j.drugalcdep.2020.108070
ID  - ref1
ER  -