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Drug experiences may be harmful at EDM parties, Rutgers study says

<p>Many people who use drugs such as alcohol, marijuana and molly do not reach out to hospitals for medical care because they are familiar with the effects of these drugs, said Lewis Nelson, an emergency medicine professor at Rutgers New Jersey Medical School.</p>

Many people who use drugs such as alcohol, marijuana and molly do not reach out to hospitals for medical care because they are familiar with the effects of these drugs, said Lewis Nelson, an emergency medicine professor at Rutgers New Jersey Medical School.

Rutgers researchers recently studied the adverse effects of drug experiences of electronic dance music (EDM) party and music festival attendees. 

 Dr. Lewis Nelson, professor and chair of the Department of Emergency Medicine at Rutgers New Jersey Medical School , and his team partnered with researchers from New York University to conduct the study, which was published in the International Journal of Drug Policy.

Using electronic tablets provided outside concert venues or nightclubs, the team anonymously surveyed more than 1,000 partygoers in New York City, Nelson said. The individuals were asked about their harmful or unpleasant experiences with drugs — including alcohol, as well as opioids, marijuana and other illegal drugs — in the past year and whether these experiences led them to the emergency department.

"We weren't actually looking at how many people used drugs, but at how many people who used these drugs also experienced adverse effects that they talked to others about or that made them go or consider going to the hospital,” Nelson said. “The average student on a college campus, I imagine, wouldn't know what DMT or the 2C series are. But this population (EDM partygoers) does because there's a very high prevalence of drug use. This is a very highly knowledgeable group, one willing to take relatively high risks in their drug use."

The study found that a third of the surveyed individuals had an unpleasant experience with drugs in the past year. While many of the adverse effects the participants cited were related to the use of a single drug, many were also due to the use of a combination of drugs.

“It’s hard enough to predict the effect of one drug, but when you start to combine things, unexpected effects start to occur,” Nelson said.

The results of the study cannot be applied to college campuses or other demographics because it was designed to look at a very specific, high-risk group, he said.

With common drugs like alcohol, marijuana and MDMA, a third of people reached out to others for help and many did not go to the hospital for medical care. This is because people are generally very familiar with the effects of alcohol and marijuana, Nelson said.

In contrast, the study found that individuals who use drugs such as bath salts or hallucinogens, like dimethyltryptamine, often end up in the hospital. When using these drugs and others, people do not often know the content or potency of the drugs they are taking, Nelson said. This market landscape of recreational drugs is much different now than it was 20 years ago.

Take marijuana, for example. Twenty years ago, the active component of marijuana, or tetrahydrocannabinol (THC), was present in smaller doses of 3 to 4%. Today, marijuana strains often contain 15 to 20% THC, Nelson said.

While marijuana also used to only be found as a joint, it is now found as edibles, extracts, oils and potent smokeables, Nelson said. Each form, based on kinetics or different pathways and movement of the drug through the body, causes different effects.

“When you smoke a joint and you get high, you can feel it within 1 to 3 minutes. When you eat it, you don't feel anything for 45 to 60 minutes. If you don't wait and you take a second or third or fourth dose, they're all going catch up to you. That’s how a lot of people who use marijuana get sick,” Nelson said.

These issues come from poor messaging and lack of communication, especially regarding harms of mixing drugs, using drugs of unknown concentration and harm-reduction methods such as Supervised Injection Sites or tester shots.

The results of the study could also lead to improved response to and treatment of drug-related emergencies. Nightclubs could stock naloxone, a medication that counters the effects of an opioid overdose, and music festivals could have more cooling stations to prevent adverse effects related to drug use in hot, crowded environment, Nelson said.

“Even in the hospital, understanding what people are using and what adverse effects they're having makes a difference. There are a lot of drugs that cause symptoms that mimic medical diseases. Being able to differentiate between the two is very important because the treatments are often very different,” he said.

Abstinence is not a rational endpoint and people just have to explore drugs safely, thoughtfully and moderately, Nelson said. Yet some drugs, like opioids or drugs of unknown quality, should be off-limits, he said.

“For college students, obviously, I have to say don't use drugs. But, if you're willing to take the risk, you should use it in moderation and in a safe setting,” Nelson said.

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