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Observed Benefits to On-site Medical Services during an Annual 5-day Electronic Dance Music Event with Harm Reduction Services

Published online by Cambridge University Press:  02 February 2016

Matthew Brendan Munn*
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Adam Lund
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Riley Golby
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Sheila A. Turris
Affiliation:
Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
*
Correspondence: Matthew Brendan Munn, MPhil, MD, CCFP(EM), DA(SA) Department of Emergency Medicine Kelowna General Hospital 2268 Pandosy Street Kelowna, British Columbia, Canada, V1Y 1T2 E-mail: brendan.munn@mgmcanada.ca

Abstract

Background

With increasing attendance and media attention, large-scale electronic dance music events (EDMEs) are a subset of mass gatherings that have a unique risk profile for attendees and promoters. Shambhala Music Festival (Canada) is a multi-day event in a rural setting with a recognized history of providing harm reduction (HR) services alongside medical care.

Study/Objective

This manuscript describes the medical response at a multi-day electronic music festival where on-site HR interventions and dedicated medical care are delivered as parallel public health measures.

Methods

This study was a descriptive case report. Medical encounters and event-related data were documented prospectively using an established event registry database.

Results

In 2014, Shambhala Music Festival had 67,120 cumulative attendees over a 7-day period, with a peak daily attendance of 15,380 people. There were 1,393 patient encounters and the patient presentation rate (PPR) was 20.8 per one thousand. The majority of these (90.9%) were for non-urgent complaints. The ambulance transfer rate (ATR) was 0.194 per one thousand and 0.93% of patient encounters were transferred by ambulance. No patients required intubation and there were no fatalities.

Harm reduction services included mobile outreach teams, distribution of educational materials, pill checking facilities, a dedicated women’s space, and a “Sanctuary” area that provided non-medical peer support for overwhelmed guests. More than 10,000 encounters were recorded by mobile and booth-based preventive and educational services, and 2,786 pills were checked on-site with a seven percent discard rate.

Conclusion

Dedicated medical and HR services represent two complementary public health strategies to minimize risk at a multi-day electronic music festival. The specific extent to which HR strategies reduce the need for medical care is not well understood. Incorporation of HR practices when planning on-site medical care has the potential to inform patient management, reduce presentation rates and acuity, and decrease utilization and cost for local, community-based health services.

MunnMB , LundA , GolbyR , TurrisSA . Observed Benefits to On-site Medical Services during an Annual 5-day Electronic Dance Music Event with Harm Reduction Services. Prehosp Disaster Med. 2016;31(2):228–234.

Type
Case Report
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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References

1. Shambhala Music Festival. About. SMF Web site. http://www.shambhalamusicfestival.com/about/. Accessed December 15, 2014.Google Scholar
2. Podsadzki, A. Taking a trip to a different kind of music festival, for safety’s sake. Globe and Mail [online]. http://www.theglobeandmail.com/news/british-columbia/taking-a-trip-to-a-different-kind-of-music-festival/article20081824/. Accessed October 19, 2014.Google Scholar
3. Euringer, A. Shambhala’s farm-to-turntable party. Maclean’s [online]. http://www.macleans.ca/culture/shambhalas-farm-to-turntable-party/. Accessed October 19, 2014.Google Scholar
4. Penner, D. Rave safety, metaphysical Moby, and life changing moments at BC’s Shambhala’s Music Festival. The Huffington Post [online]. http://www.huffingtonpost.ca/drew-penner/shambhala-music-festival_b_5697417.html. Accessed October 19, 2014.Google Scholar
5. Lund, A, Turris, SA. Mass gathering medicine: risks and patient presentations at a 2-day electronic dance music event. AJEM. In Review.Google Scholar
6. CBC. Veld Music Festival deaths linked to party drugs, police say. CBC [online]. http://www.cbc.ca/news/canada/toronto/veld-music-festival-deaths-linked-to-party-drugs-police-say-1.2727358. Accessed October 30, 2014.Google Scholar
7. Broughton, D. Mystery surrounds death of 21-year old man at Pemberton Music Festival. Vancouver Sun [online]. http://www.vancouversun.com/entertainment/Mystery+surrounds+death+year+Pemberton+Music+Festival+with+video/10043690/story.html. Accessed October 30, 2014.Google Scholar
8. Leger, D. Death at Electric Zoo Music Fest brings drug charges. USA Today [online]. http://www.usatoday.com/story/news/nation/2014/07/30/man-charged-with-drug-trafficking-tied-to-electric-zoo-deaths/13370549/. Accessed October 30, 2014.Google Scholar
9. MacPherson, D. Preventing music festival drug deaths must go beyond ‘just say no’. National Post [online]. http://fullcomment.nationalpost.com/2014/08/20/donald-macpherson-preventing-music-festival-drug-deaths-must-go-beyond-saying-just-say-no/. Accessed October 19, 2014.Google Scholar
10. Arbon, P. Mass-gathering medicine: a review of the evidence and future directions for research. Prehosp Disaster Med. 2007;22(2):131-135.CrossRefGoogle ScholarPubMed
11. Memish, Z, Zumla, A, McCloskey, B, et al. Mass gatherings medicine: international cooperation and progress. Lancet. 2014;383(9934):2030-2032.Google Scholar
12. Lund, A, Turris, SA, Bowles, R. Conceptualizing the impact of special events on community health service levels: an operational analysis. Prehosp Disaster Med. 2014;29(5):525-531.CrossRefGoogle ScholarPubMed
13. Sanders, AB, Criss, E, Steckl, P, Meislin, HW, Raife, J, Allen, D. An analysis of medical care at mass gatherings. Ann Emerg Med. 1986;15(5):515-519.Google Scholar
14. Meites, E, Brown, JF. Ambulance need at mass gatherings. Prehosp Disaster Med. 2010;25(6):511-514.Google Scholar
15. World Health Organization. WHO definition of public health. WHO Web site. http://www.who.int/trade/glossary/story076/en/. Accessed January 18, 2015.Google Scholar
16. World Health Organization. WHO definition of health promotion. WHO Web site. http://www.who.int/topics/health_promotion/en. Accessed January 18, 2015.Google Scholar
17. Breslow, L. From disease prevention to health promotion. JAMA. 1999;281(11):1030-1033.Google ScholarPubMed
18. Centre for Addiction and Mental Health. CAMH and harm reduction: a background paper on its meaning and application for substance use issues. http://www.camh.ca/en/hospital/about_camh/influencing_public_policy/public_policy_submissions/harm_reduction/Pages/harmreductionbackground.aspx. Published May 2002. Accessed February 21, 2015.Google Scholar
19. Single, E. Defining harm reduction. Drug Alcohol Rev. 1995;14(3):287-290.Google Scholar
20. Akram, G, Galt, M. A profile of harm-reduction practices and co-use of illicit and licit drugs amongst users of dance drugs. Drugs Educ Prev Policy. 1999;6(2):215-225.Google Scholar
21. Henricksen, K. Harm reduction in the rave community. Focus. 2000;15(4):1-7.Google Scholar
22. Frei, M. Party drugs: use and harm reduction. Aust Fam Physician. 2010;39(8):558-561.Google Scholar
23. Peters, GJ, Kok, G, Schaalma, HP. Careers in ecstasy use: do ecstasy users cease of their own accord? Implications for intervention development. BMC Public Health. 2008;8:376-386.Google Scholar
24. Bellis, MA, Hughes, K, Lowey, H. Healthy nightclubs and recreational substance use. From a harm minimization to a healthy settings approach. Addict Behav. 2002;27(6):1025-1035.Google Scholar
25. Akbar, T, Baldacchino, A, Cecil, J, Riglietta, M, Sommer, B, Humphris, G. Poly-substance use and related harms: a systematic review of harm reduction strategies implemented in recreational settings. Neurosci Biobehav Rev. 2011;35(5):1186-1202.Google Scholar
26. Calafat, A, Juan, M, Duch, MA. Preventive interventions in nightlife: a review. Adicciones. 2009;21(4):387-413.Google Scholar
27. Van Havere, T, Vanderplasschen, W, Lammertyn, J, Broekaert, E, Bellis, M. Drug use and nightlife: more than just dance music. Subst Abuse Treat Prev Policy. 2011;6:18.Google Scholar
28. European Monitoring Centre for Drugs and Drug Addiction. European Monitoring Centre for Drugs and Drug Addiction Annual Report 2006. EMCDDA Web site. http://www.emcdda.europa.eu/publications/annual-report/2006. Accessed January 2, 2014.Google Scholar
29. Chinet, L, Stéphan, P, Zobel, F, Halfon, O. Party drug use in techno nights: a field survey among French-speaking Swiss attendees. Pharm Biochem Behav. 2007;86(2):284-289.CrossRefGoogle ScholarPubMed
30. Environment Canada. Weather for Salmo, British Columbia. https://weather.gc.ca. Accessed December 20, 2014.Google Scholar
31. Turris, SA, Lund, A. Triage during mass gatherings. Prehosp Disaster Med. 2012;27(6):531-535.Google Scholar
32. Lund, A, Turris, SA, Amiri, N, Lewis, K, Carson, M. Mass-gathering medicine: creation of an online event and patient registry. Prehosp Disaster Med. 2012;27(6):601-611.CrossRefGoogle ScholarPubMed
33. Mass Gathering Medicine Interest Group. Encounter Forms. MGMIG Web site. http://mgm.med.ubc.ca/research/projects-active/mgm-regisrty/. Accessed January 20, 2016.Google Scholar
34. Shambhala Music Festival. Shambhala alcohol policy. SMF Web site. http://www.shambhalamusicfestival.com/banned-items-faq/. Accessed October 10, 2014.Google Scholar
35. Shambhala 2014 Harm Reduction Statistics. Stacey Lock, Personal Communication. October 22, 2014.Google Scholar
36. ANKORS Unpublished Shambhala 2014 Data. Chloe Sage, Personal Communication. October 6, 2014.Google Scholar
37. Krul, J, Blankers, M, Girbes, AR. Substance-related health problems during rave parties in the Netherlands (1997-2008). PLoS One. 2011;6(12):e29620.CrossRefGoogle ScholarPubMed
38. Krul, J, Sanou, B, Swart, E, Girbes, AR. Medical care at mass gatherings: Emergency Medical Services at large-scale rave events. Prehosp Disaster Med. 2012;27(1):71-74.Google Scholar
39. Weir, E. Raves: a review of the culture, the drugs and the prevention of harm. CMAJ. 2000;162(13):1843-1848.Google Scholar
40. Winstock, AR, Wolff, K, Ramsey, J. Ecstasy pill testing: harm minimization gone too far? Addiction. 200;96(8):1139-1148.Google Scholar
41. 108th US Congress Bill 226: Illicit Drug Anti-Proliferation Act. https://www.congress.gov/bill/108th-congress/senate-bill/226. Accessed January 10, 2014.Google Scholar
42. Wood, DM, Greene, SL, Alldus, G, et al. Improvement in the prehospital care of recreational drug users through the development of club specific ambulance referral guidelines. Subst Abuse Treat Prev Policy. 2008;3:14.Google Scholar
43. Dutch, MJ, Austin, KB. Hospital in the field: prehospital management of GHB intoxication by medical assistance teams. Prehosp Disaster Med. 2012;27(5):463-467.CrossRefGoogle ScholarPubMed
44. Kelleher, S. Health care professionals' knowledge and attitudes regarding substance use and substance users. Accid Emerg Nurs. 2007;15(3):161-165.CrossRefGoogle ScholarPubMed
45. Van Boekel, LC, Brouwers, EP, van Weeghel, J, Garretsen, HF. Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: systematic review. Drug Alcohol Depend. 2013;131(1-2):23-35.Google Scholar
46. Giandinoto, JA, Edward, KL. Challenges in acute care of people with co-morbid mental illness. Br J Nurs. 2014;23(13):728-732.Google Scholar
47. Ritter, A, Cameron, J. A review of the efficacy and effectiveness of harm reduction strategies for alcohol, tobacco, and illicit drugs. Drug Alcohol Rev. 2006;25(6):611-624.Google Scholar