Drugs of Abuse and Novel Psychoactive Substances at Outdoor Music Festivals in Colorado

ABSTRACT

Background: Drugs of abuse (DOA) are widely used in the United States and are ubiquitous at outdoor music festivals. Attendees at music festivals are at high-risk for novel psychoactive substance (NPS) use, which is becoming more prevalent worldwide. No U.S. studies have employed an qualitative approach to investigate the etiologies of both traditional DOA and NPS use amongst music festival attendees. Objectives: The objective of this study was to improve understanding of the knowledge, attitudes, beliefs, and practices of festival attendees using NPS and DOA. Methods: We conducted semi-structured interviews of 171 attendees during the Sonic Bloom and Arise music festivals in Colorado in 2015 and 2016. Discrete variables were summarized with descriptive statistics. The anonymous, multi-domain interview documented the knowledge, attitudes beliefs, and practices underlying DOA use, which were analyzed with qualitative methods. Results: We enrolled 171 participants that endorsed DOA use at the festivals. Most were experienced DOA users, who perceived minimal risks associated with DOA and NPS use. Nearly all unanimously reported normalization of DOA at music festivals. Participants popularly cited empathogenic, entactogenic, and entheogenic effects of DOA as their primary motivations for use. NPS use was endorsed by 39.8% (n = 68) of respondents, all of whom identified as being experienced DOA users. Conclusions: This population of novel psychoactive substance users is primarily composed of experienced drug users that endorsed use because of low cost, minimal perceived risk, accessibility, and normalization of drug use at music festivals.

KEYWORDS:

• Novel psychoactive substance
• ethnography
• drugs of abuse
• music festival
• harm reduction
• festival medicine
• substance abuse
• synthetic cannabinoid
• 2C
• kratom
• synthetic opioid, qualitative

Acknowledgements

We are grateful to Groove Medical Services and their volunteers for accommodating our investigators and interviews in their medical tents at Sonic Bloom and Arise music festivals.

Declaration of interests

Dr. Cushing is the volunteer Medical Director of Groove Medical Services, a Colorado non-profit that receives donations for operating medical tents at the contracted events. Dr. Monte receives support from NIGMS K23 GM110516 and NIH CTSI UL1 TR001082. Dr. Monte has a patent pending for a synthetic cannabinoid clinical assay. The contents of this work are the sole responsibility of the authors and do not necessarily represent the views of the National Institutes of Health (NIH).

Author contributions

JF and AS enrolled subjects at the festivals in 2016 and drafted the manuscript. AY, CC, and EA enrolled subjects in 2015, were responsible for data management, and critically edited the manuscript. TC provided the opportunity to run this study at these festivals, supervised the research assistants on site, and critically edited the manuscript. AAM conceived the study, coordinated the study, provided critical guidance on data analyses, and edited the manuscript throughout its development.