One highly visible facet of the global pandemic over the past 18 months has been the spotlight on public health officials. Moving in a sort of triage atmosphere, scientists dredge the data and aim for the greatest public good. Discussions can often be contentious and driven by opinion rather than hard facts.
Such is the case with the conversation around drug-testing and safety measures to prevent harm at events and festivals. The discussion is tainted by the stigma around the use of drugs, like the notion that testing services promote illegal use, or the idea that drug overdoses are the biggest concern.
But the public conversation is shifting, as harm reduction advocates can point to a growing body of evidence that most harm and fatalities derive from preventable circumstances like adulterants present in drugs, and a combination of environmental factors like heat exhaustion, dehydration, and over-hydration overtaking drug users.
Dr. Carl Hart, a neuroscientist who specializes in how humans respond to psychoactive drugs, has some thoughts about drug testing and safety at events and within communities in the general population. Chair of the Department of Psychology at Columbia University, as well as the Ziff Professor of Psychology in the Departments of Psychology and Psychiatry, Hart’s commonsense outlook regarding drug use for adults is focused on keeping people safe, happy, and healthy. In the absence of legal and regulated drug markets, that means education and testing for toxins.
“These conversations about drug testing increasing drug use, that’s a dead-end street designed to basically stop this conversation,” says Dr. Hart. “Our role as public health authorities is to keep people from getting sick, not to tell them what to do.” He uses the example of a typical breakfast and the basic assurance people have that they won’t get sick from store-bought food. “I can be comfortable knowing that there are no contaminants in the breakfast I had this morning because we have quality control for our food,” he says. “And so, when people are out at festivals, all of that quality control goes away, which increases the likelihood that people might have contaminated substances.”
Mitchell Gomez, executive director of DanceSafe — a nonprofit providing adulterant screening and unbiased educational literature detailing the effects and risks associated with the use of various drugs — cites a particularly onerous piece of U.S. legislation presented in 2002 that greatly exacerbated the situation. The “Reducing America’s Vulnerability to Ecstasy Act” (or the RAVE Act) first introduced by then-Senator Joseph Biden, expanded prior crack-house punishments to include commercial venues where drugs were in use. Passed in 2003 and renamed the “Illicit Drug Anti-Proliferation Act,” it was slyly piggybacked as a rider to the child abduction Amber Alert Bill.
The law meant that event promoters could be prosecuted for cultivating drug-involved premises. First conceived to discourage those who were knowingly and intentionally promoting or distributing drugs at venues, for years since its creation the reading has served to intimidate concert and festival organizers who might provide safety measures to protect patrons. Gomez notes the liability issues where many risk-averse organizers fear to tread. While some local police turn a blind eye to safety efforts, essentially giving a wink-and-a-nod, threats have been made by law enforcement for something as innocuous as providing free water and cooldown areas for distressed individuals. Some promoters believe that police may interpret such actions as an admission that people are, for instance, using MDMA.
“Drunk people don’t generally need water and a sit down area,” says Gomez, noting that in his experience there are police who understand the need for harm reduction services, like needle exchanges that reduce injury to intravenous drug users. “I wish law enforcement would come right out and say they agree with harm reduction efforts like testing and safety standards and that they are trying to end drug deaths,” says Gomez.
In his new book Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear, Dr. Hart describes some of the more effective testing and safety methods employed around the world, including services at Boom Festival in Portugal. A biennial international music and cultural celebration started in 1997 (akin to Burning Man in the U.S.), the event has pioneered useful safety protocols where drugs are concerned. The organization Kosmicare — a collective that promotes safer drug use patterns and works to implement more humane and evidence-based drug policies and practices — has been part of the effort at Boom.
Helena Valente, a psychologist and founding member of Kosmicare, describes their services, which include a psychedelic emergency space to help people undergoing crisis episodes related to the use of drugs, and a drug checking and info hub. The emergency space is run by experienced volunteers and technicians, many with medical training and experience in crisis situations. “The team is usually around 30 members and two coordinators, depending on the size of the event,” says Valente. “All members have experience in intervention in nightlife settings and are given specific training in first aid, drug effects, and harm reduction strategies, new psychoactive substances, collecting drug checking samples, and providing results, evaluation, working rules, and ethics.”
Whereas harm reduction efforts like Boom’s do not present a significant liability for promoters in Portugal, where in 1999 all drugs were decriminalized as a national strategy to combat drugs and drug addiction, such progressive federal laws do not yet exist in many parts of the world, including the U.S. and the United Kingdom. The Loop, a nonprofit established in 2013 in the U.K., provides harm reduction services at nightclubs, festivals and other events — but their drug safety examination is confined to surrendered substances left in amnesty bins. During events, The Loop evaluates some of the substances in the bins and posts flyers online describing what those substances truly contain.
“If we think about Boom versus what happens in the U.K. with a group like The Loop, at Boom you have Energy Control from Spain,” says Dr. Hart, speaking of services offered by Kosmicare right on festival grounds using high-performance liquid chromatography (HPLC) and UV-Vis spectrophotometer equipment. “You can stand in line with your substance — they just need about 10 milligrams of it —they test it and you get the results right back. You get a nice chemical printout of all of your stuff, everything that is contained in the substance.”
While organizations like the Loop, Energy Control, and Kosmicare are certainly making a difference and reducing harm, there’s also a need to help keep people healthy and happy who are not attending festivals. Dr. Hart says he wants to see this drug safety and testing mentality trickle out to the general public, protecting local communities, too. Gomez shares that mindset, saying DanceSafe is currently working on that. “In terms of diversity, equity and inclusion,” says Gomez, “we are working with a group of consultants on increasing access to our harm reduction services and are in talks with multiple public health departments about the possibility of offering public drop-in drug checking days at community health clinics.”
Allowing people who are not attending paid music events to access services is a big step forward for the greater good.
Valente notes that there is another positive impact that community-based drug checking is having. Evidence is showing that a fringe of people, particularly young users in the beginning of their experimentation with drugs, “who haven’t had contact with any other drug counselling services are interested in drug checking,” she says, “which also corroborates its potential as an interesting harm reduction tool.”
Correction: An earlier version of this article stated that some police believe free water and cooldown areas at venues is an admission that people are using MDMA. The language has been updated for accuracy.
Main Image: Eva Rinaldi