Drug use, harm-reduction practices and attitudes toward the utilisation of drug safety testing services in an Irish cohort of festival-goers

Abstract

Background Festival drug-related deaths are a growing public health concern. Aim To examine drug use and related harm-reduction practices and attitudes towards utilisation of drug safety testing services. Methods Data collection took place over the 2019 festival season (June–October). The questionnaire was self-reported. Data was gathered via the online survey, which was promoted through online and social media platforms and outlets. Social media communication methods were used to reach the targeted population more effectively. Results A total of 1193 Irish festival attendees over the age of 18 completed an anonymous online survey. Alcohol, MDMA powder/crystals, ecstasy pills and cocaine were the highest reported drugs used by Irish festival attendees. The vast majority of participants reported polysubstance use (86.8%/n = 1036). Forty percent of participants (39.98%/n = 477) reported having had sex following the use of a drug at a festival; of these, 66% (n = 316) said that the sex was unprotected. Most participants (84.0%/n = 1003) engaged in some form of harm reduction when taking drugs at festivals. Overwhelmingly, participants reported a willingness to engage with drug-checking services. The vast majority (96.3%; n = 1149) and would use drug checking services more than three-quarters (75.1%/n = 897) reported that they would use an ‘amnesty bin’ for drugs if it were part of an alert system to notify if dangerous drugs are in circulation. A chi-square test of Independence was conducted to examine whether age and utilisation of drug safety testing service a festival were independent. Moreover, when all cases are taken together, the difference between testing modalities (onsite, offsite and amnesty bin) shows a significant difference p < 001 between those who would use onsite and offsite drug testing facilities. Conclusion The evidence from this survey indicates that those young people who use drugs at festivals would be prepared to utilise drug checking services and amnesty bins should help inform the public health response to this important area.

Insights from Drug Checking Programs: Practicing Bootstrap Public Health Whilst Tailoring to Local Drug User Needs

“…Overall, providers' depictions of the illicit drug market highlight the need for drug checking as a key mechanism to reduce risks to PWUDs while emphasizing the 'bootstrap' nature of the implementation of these programs. In addition to providing individuals with vital information about potential drug risks, drug checking data can provide both formal and informal (word of mouth) warnings about contaminants and/or drug variants that may pose risks to the larger community [11,12,14,15]. In Canada, drug checking is increasingly used as a monitoring and surveillance tool, while other forms of drug supply surveillance have been suggested elsewhere [34,68].…”

“…Without such assurance, not only will PWUDs and providers be left in legal limbo, but it will remain difficult to find funding to pay for the necessary equipment and training investments without being able to plan for the future. Overall, if the legal status of drug checking remains as it is, drug checking services will continue to operate through temporary exemption orders and gray areas in the law, neither of which are compatible with meeting the long-term harm reduction objectives which encompass these initiatives [2,6,12,17,73].…”

“…Drug checking was initiated in the 1960s with psychedelic drugs in California [5]. In the 1990s, the emergence of the rave/festival scene in Europe and the associated ecstasy and amphetamine use led to concerns that non-injection drug users needed to have access to drug checking in order to reduce the likelihood of contaminants causing adverse health reactions or potential mortality [11][12][13][14][15][16]. Drug checking in the festival and event context has continued throughout the 2000s [17], and programs have emerged sporadically in North America over the last decade [5].…”

“…Mobile drug checking has the advantage of reaching more people but may be technically more challenging and costly [37,47,50]. Drug checking may provide additional channels to spread warnings about contaminants by word of mouth among communities of PWUDs [11,12,14,15]. Willingness to use services is complicated by social factors, including trust, stigma, and fears of police [48,50,51].…”

Patrones De Policonsumo Simultáneo De Sustancias: Efectos Positivos Y Negativos Experimentados Y Estrategias De Reducción De Daños Empleadas

“…Quienes asisten a contextos recreativos y deciden consumir sustancias psicoactivas ponen en práctica numerosas estrategias con el objetivo de protegerse frente a los potenciales daños de las sustancias (Brache et al, 2012;Ivers et al, 2021;Rigg, 2017;Rigg & Sharp, 2018). El uso de algunas estrategias de reducción de daños, tales como alimentarse e hidratarse bien antes, durante y después del consumo (Ivers et al, 2021;Van Havere et al, 2011;White et al, 2006) o, reducir o dosificar el consumo de alguna de las sustancias cuando ésta se mezcla con otra/s simultáneamente (Vera et al, 2020) parece ser común a las diferentes sustancias consumidas. Sin embargo, algunas otras estrategias sólo se ponen en práctica ante el consumo de sustancias específicas.…”