Pitchfork explains how the implementation of harm reduction services at large-scale music events can help reduce the risks of recreational drug use. The article interviews harm reduction advocates about the various ways that music events can improve safety for attendees, placing an emphasis on the elimination of zero tolerance policies, offering fact-based drug education, and repositioning drug use as a public health issue instead of a criminal issue. “Ultimately, harm reduction is about spreading awareness and destigmatizing an issue that is taboo despite its ubiquity,” explains Molly Beauchemin of Pitchfork. “Promoting awareness is not an endorsement of recklessness: it’s a courtesy that saves lives.”
Originally appearing here.
I called Missi Wooldridge, the Executive Director of a nonprofit drug testing and harm reduction agency called Dance Safe, because I was curious about the surge in ecstasy-related deaths at music festivals in the last few months despite a social history of drug use that predates the 1960s. Ecstasy, the common name for 3.4-methylenedioxymethamphetamine or “MDMA”, is a synthetic amphetamine-based drug that induces euphoria by causing a flood of serotonin and other feel-good neurotransmitters to the brain. MDMA was first synthesized in 1914 for use in appetite suppression, but ultimately found use as a recreational drug in the 1970s, until the U.S. Drug Enforcement Agency put MDMA on their list of controlled substances in 1985. Since that time, ecstasy has earned a reputation as a party drug, and has been associated with recent deaths atCoachella, Glastonbury, Electric Zoo, Ultra, Bonnaroo, Electric Daisy, Electric Forest, Future Music Festival Asia, Veld, and countless other festivals and nightclubs. In the argot of music culture, it is often referred to as “Molly”, which is simply ecstasy in powdered form. (MDMA can be powder or crystal.) Contrary to popular belief, Molly isn’t any more pure than ecstasy; it earned that reputation because common parlance suggested powder was harder to contaminate than pills, which is not true. Purity is impossible to track because the production of ecstasy isn’t regulated.
Dance Safe is a harm reduction organization that works to promote safety and health within the electronic music community; Wooldridge and her team provide non-judgmental adulterant screening (aka “pill testing” or “drug checking”) on site at music festivals and nightlife venues in the U.S. They also distribute unbiased educational literature describing the effects and risks associated with drug use.
A few days before Wooldridge and I speak, Dance Safe published a response to LA Weekly’s recent story that blamed an Electric Daisy Carnival Vegas raver’s death on an “ecstasy overdose”. Their article, titled “MDMA-Related Deaths: Stop Calling Them Overdoses”, obviated a critical aspect of the unspoken drug shaming that goes on at so many mainstream music festivals: media coverage of drug-related deaths tends to imply recklessness on behalf of the user rather than to focus on the circumstances associated with their death, like heat stroke, hyponaetremia (aka water-toxicity, also known as water retention in the brain), or ill-fated combinations of drugs that stem from a lack of public education about mixing substances.
MDMA-related deaths, it turns out, are rarely the result of an overdose: “The association of the word ‘overdose’ with ‘drug-related death’,” Wooldridge writes, “is primarily reflective of heroin and opiate-related deaths, where the majority of fatalities are in fact the result of overdosing. MDMA-related deaths are rarely—if ever—the result of an overdose, and calling them overdoses is dangerous and negligent. In the vast majority of cases of MDMA-related deaths, where no other drugs were found in the person’s bloodstream, the deceased had taken a dose within the normal range for appropriate therapeutic or recreational use.” Most often, its environmental conditions—like heat, limited access to water, pre-existing health conditions like high blood pressure or heart disease, as well as a zero-tolerance policy that drives drug exchange underground—that leads to unexpected fatalities.
Some reporters, however, have refuted this argument. Dennis Romero, writing for LA Weeklyshortly after the Molly deaths at Electric Zoo last year, claims that the notion that MDMA can be consumed safely is a myth, that “evidence proves time and again that ecstasy can kill all by itself.” While Romero’s work is well-researched, including coroners reports that cite “overheating” and “kidney failure” as the "consequences of multiple drug toxicity"—there are few claims about ecstasy use alone. (“The drugs listed,” to quote the report, “were MDMA and methamphetamine.”) According to a report published by the American Society of Nephrology, the risk for death from ecstasy in first-time users has been estimated as between “one in 2000 and one in 50,000”. This is between a 0.05% and 0.002% chance. Emergency room physician Dr. Robert Glatter, meanwhile, told The New York Times in 2013 that MDMA, when taken by itself, rarely leads to death. While official mortality figures are not available, the same Times article reports a study by New York City’s deputy chief medical examiner that looked into ecstasy-related death over a three-year period in the late 90s. From 1997 to 2000, only two people died solely because of MDMA. Reporters, it turns out, are correct in suggesting that ecstasy alone can kill—but you are more likely to get struck by lightning.
The vagaries of reporting this kind of death—including the heavy-handed use of buzzwords like “overdose”—compound public ignorance about the neurological properties of party drugs like ecstasy, which may do more harm than good. The scientific community, meanwhile, struggles internally with how to make claims about the effects of drug use. Brad Burge of the Multidisciplinary Association for Psychedelic Studies points out that pure MDMA and ecstasy, which can be contaminated with other substances, are not the same thing. Further, as he writes in the Chronicle of Higher Education: “There are big differences between two years and forever, between changed serotonin levels and brain damage, between Ecstasy and MDMA, and between recreational and clinical use. Studies have to be designed carefully enough that they actually measure what they claim to be measuring.” Sensational headlines are designed to evoke fear, he points out, which in turn makes it harder for people to accept research without bias.
All of this is compounded by a social tendency to shame drug users. Obscuring the link between environment and consequence by using words like “overdose” places the onus on the victim—e.g.he OD’ed because he’s irresponsible—rather than a festival whose promoters have created an atmosphere of repudiation, opacity, and denial. Even the pictures included in news stories about ecstasy-related deaths are suggestive: EDM listeners are usually depicted wearing flamboyant costumes or makeup, covered in glitter, holding drinks, wearing little clothing, or screaming. The effect is to imply excess and inhibition, which perpetuates stereotypes about the dance community’s ignominious history with drugs despite the fact that people have died from drug-related complications at non-electronic festivals like Coachella and Glastonbury. The “othering” of victims, moreover, distances festivals from moral culpability while compounding stereotypes about dance music. Meanwhile, the premise of “increased security” to prevent drug use allows festival promoters to stick to the status quo; really what they’re doing is putting up a wall. Security measures have become a placeholder for an uncomfortable dialogue about the reality of drug use that nobody in the music community wants to address. In the meantime, most Americans never receive formal drug education, and the public remains wholly uneducated about how to mitigate their own risk.
“Part of this is because the public doesn’t look at a difference between addiction and non-problematic drug use,” Wooldridge says. “80 percent of people who use drugs do so recreationally, but most are hit with a stigma that recreational drug users make bad decisions and are bad for society, which isn’t always true.” (Similar stigmas are currently being addressed in the movement to decriminalize marijuana.) “Instead, we’re choosing to blame an 18-year-old rather than addressing this larger environmental and health problem that won’t be fixed with increased security.”
When we discuss the fact that Electric Zoo’s response to last year’s Molly deaths was to maximize security, Wooldridge points out that increased security doesn’t stop people from doing drugs, as the frequent reports of ecstasy-related festival deaths make clear. “If you think about it, people manage to get drugs into prisons”—institutions that by definition imply maximum security—“so there’s no way you’ll be able to keep them out of festivals just because you do a thorough bag check.” Electric Zoo also recently mandated that its ticket holders watch what Consequence of Sound called “an anti-Molly PSA”, which contains no information about health risk or what to do in a drug-related emergency. Instead, the video shows one user alienating his hookup with off-putting, drug-induced behavior, and reduces the argument to the PSA’s final message of “Don’t Miss The Moment—Be Present”. Were it not for the final words, “Avoid Risks”, scrawled across the screen, “Be Present” might as well have been an anti-Smart Phone PSA.
A friend of mine who has been involved with Electric Forest and All Good music festival points out that part of the appeal of drug use at festivals comes from the assumption that festival-goers might be more open to recreational drug use than others. “Most of the recreational drugs I’ve tried—the list of which reads like the Erowid Index minus the Trainspotting-level scary ones,” she says, “were ones that I tried first at a festival.” In this discussion she acknowledges something that Wooldridge also touches on, a point that most concert promoters fail to address publicly: drug use has become a ubiquitous aspect of festival culture that’s no longer confined to niche or the underground rave scene, regardless of whether promoters choose to acknowledge it. The war on drugs, it turns out, fails to prevent drug-related deaths in the same way that abstinence-only sex education has proven to increase teen pregnancy: the "just say no" movement impedes safe experimentation with something that people may inevitably try. “Humans are curious by nature,” my contact points out, “and festivals are an ideal kind of micro-society where people feel safe to try them.” But without providing honest information about how drugs actually work, there will always be potential for abuse.
This isn’t to say that festival environments are safe, or that people should try drugs, but festivals looking to mitigate bad publicity would benefit from promoting an open dialogue about drug use rather than pretending it doesn’t exist. The notion that handing out drug testing kits at festivals will “encourage” people to do drugs is analogous to the fear that handing out condoms will “encourage” people to have sex: its an anachronism that fails to educate would-be users about risk. Providing resources like drug testing kits, which allow the user to test if their psychostimulants contain harmful, potentially-lethal chemicals, is a tactic that’s long been embraced in Europe, but one that meets a lot of resistance in the ultra-conservative United States.
Drug testing kits typically use four chemical solutions that change color in the presence of contaminated drug samples. (Dance Safe sells them on their website, and the European-based EZ Test is also reliable.) Most festivals, however, a
pproach this har
m reduction measure with a degree of wariness. Dance Safe has worked with Electric Forest, Detroit Electronic Festival, Lightning In A Bottle, and other American music festivals, but often promoters are uncomfortable with the idea of hosting drug testing services on site—likely for fear that it would look like an endorsement. In Europe, where drug use is viewed as a health issue rather than a political one, secure drug testing services are more readily available. As a result, our European counterparts typically know more about how drugs work—for example, that you shouldn’t mix alcohol and Molly—because the lack of stigma begets better public outreach and education. “Festival promoters in the U.S. don’t understand that ‘harm reduction’ doesn’t mean promoting drugs,” Wooldridge tells me, “but it’s morally and medically negligent not to have education about how they work.”
Stefanie Jones, the Nightlife Community Engagement Manager at the Drug Policy Alliance in New York, also suggests that the criminalization of drugs has contributed to the increase in ecstasy-related deaths over the past few years. Jones and the DPA work to promote drug policies that are grounded in science, compassion, health, and human rights. The criminalization of party drugs, she points out, “makes it impossible or very difficult to have an honest, straightforward conversation about drug use in our society, [and] it criminalizes event producers for the behavior of their attendees by making them resistant to addressing the drug use issue in any way other than through zero tolerance and enforcement.”
Prohibition, it turns out, makes substances more dangerous: in order to circumvent drug laws, she says, “producers are inventing myriad new synthetic drugs to bring to market. The effects of these new synthetic drugs are unknown and can be even more dangerous than the ‘classics’ they are meant to imitate.” Wooldridge and her staff at Dance Safe have seen the effects of this shift first hand in the drugs that they’ve tested at festivals. According to what she suggests is a conservative estimate, around 40% of the Molly that they test is so contaminated that it “doesn’t even contain MDMA.”
A black market of new, under-tested psychoactive drugs are also the result of increased supply and demand—there’s pressure to produce more Molly, which increases the likelihood of cheap substitutes. The Wall Street Journal recently reported that a 23-year-old man was arrested for allegedly supplying a synthetic drug that led to the fatalities at last year’s Electric Zoo. Since ecstasy isn’t legalized, there’s no way for us to regulate it—meanwhile, a zero-tolerance policy that fosters a community of willful blindness at festivals ups the likelihood of death. “[EDM in particular] has shifted from underground to a mainstream market that has crossed over to fill stadiums,” Wooldridge points out. “This has increased exposure to hot sun, and users are also mixing substances. We’re seeing more adulterants in drugs, and new psychoactive chemicals pop up on the drug market each day. People don’t know enough about them and they may react differently than they think, especially when the wrong conditions can make them deadly.” There’s no one molecular culprit, she concludes, but the lack of education can be egregious, especially for “once and a while” users who don’t educate themselves about drugs because they don’t do them regularly. “Zero-tolerance events don’t provide any information on drug use or drug mixing, yet [promoters] wonder why there are still medical emergencies.”
There is, of course, a persistent moral argument that people simply shouldn’t do drugs. It’s a fair argument, albeit one that sidesteps the real issue: drug use at festivals is no longer a matter of niche or genre, and the rising toll of Molly-related deaths consistently proves the inadequacy of prohibition alone.
Woolridge and Jones, therefore, suggest a three-fold approach to improving safety at festivals. First, we need to amend zero tolerance policies to protect people who call 911 or seek medical assistance in the event of a drug emergency. Often, people neglect to help themselves for fear of being arrested or charged with drug offenses that go on a permanent record. Secondly, we need to educate the populace about the reality of drug use, which includes advising them on the dangers of combining drugs and alcohol, remembering to stay hydrated, testing drugs for purity, and the risks of mixing drugs. This information—and the kind of drug-testing services that Dance Safe can provide—should be used to protect and inform, rather than condemn. Finally, we need to stop pursuing drug use as a criminal issue and start addressing it as the public health issue that it is. “Drug checking kits, like the kind that DanceSafe uses to check for adulterants, should no longer be considered drug paraphernalia since they are public health tools that can save people’s lives,” Jones says. Dance Safe also suggests establishing safe settings protocols for EDM events, which includes reducing ambient temperatures, offering chill rooms, and providing free and easily-accessible water and electrolytes that ultimately reduce the risk of heatstroke emergencies, regardless of whether or not people are using drugs.
Ultimately, harm reduction is about spreading awareness and destigmatizing an issue that is taboo despite its ubiquity. Denying people tools and information that could save their lives by stopping the spread of adulterated pills only increases the chances of people dying from them—a phenomenon that’s become all too common in recent months. Pretending that people don’t do drugs at music festivals limits the public’s awareness about risk and the festival’s ability to mitigate danger. And blaming the victims of drug-related deaths denies our shared integrity. When it comes to the big business of music festivals, a climate of denial isn’t safe for anyone. Promoting awareness is not an endorsement of recklessness: it’s a courtesy that saves lives.