Harm Reduction at Raves

Although it is an odd thing to say about something that has always been based around loud music, drugs and sex—raves used to be rather innocent. Back in the day, hundreds of people would meet in “secret locations” (which were often abandoned warehouses on the outskirts of cities) and dance all night to music that was then called techno. There were lots of drugs around, of course—there always are at these things. While acid was used by some, MDMA, also known as ecstasy, or Molly, quickly became the drug of choice.

And why not? This truly was a drug made for raves. Take Molly while at one of these events, and a lot of things happen. You feel euphoric, you’re sociable, you have a blissful sense of inner peace, you love everyone all around you. You even hallucinate a bit, but in a mellow way. For rave attendees, MDMA truly seemed to be a miracle drug.

But things are not so innocent these days. Raves are now ridiculously popular. There are dozens of enormous outdoor raves all over the world, some with over 100,000 attendees. What was then called techno is now known as EDM, short for Electronic Dance Music. The one thing similar to the old days is that people at raves are still using MDMA. While ketamine, LSD, and mushrooms are still viable options for rave-goers seeking to get messed up, MDMA is by far the rave drug of choice.

The only problem with all of this, is that some of those people have been dying. While there is no reliable national data on MDMA-related deaths, it is common knowledge that compared to other drugs, there are very few fatalities related to its use. But when more than one death happens at the same festival, people start to notice.

MDMA combines the effects of both amphetamines and hallucinogens. Using this drug can increase serotonin, raise body temperatures and reduce sodium levels. This, combined with the fact that the rave attendee is surrounded by a crush of people in all directions in the midst of a hot outdoor music festival, makes the risk of hyperthermia and dehydration very real.

When two women died of suspected overdoses at last summer's HARD Music festival in Pomona, it put the entire industry in the hot seat. Many politicians and medical professionals have called for a ban on raves in LA County, calling the rave operators “irresponsible for failing to keep rave-goers safe.”

When it comes to keeping people safe at raves, there are organizations out there that exist to do just that. While some attempt to operate under the traditional medical and security model, others attempt to meet the rave-goers where they are at.

The most well known of them all is probably DanceSafe, a non-profit organization which has been around for 15 years. Its goal is to provide safe spaces for rave-goers to talk about their health and drug use. They also provide condoms, as well as free water and electrolytes to prevent dehydration and heatstroke, and perhaps most controversially, they test substances to make sure festival attendees are taking pure drugs that don’t contain unknown or dangerous adulterants that are often found in street drugs.

While some might find what they do to be nothing more than enabling drug use at raves, Missi Wooldridge, the executive director of DanceSafe, says there is an ever-growing need for what they do.

“There's a general lack of knowledge about substances. There's an ever-changing drug market, impurity issues, potency issues, and no widespread tools, messaging, or services to help people make informed decisions. There's also a growing electronic music industry, so we've evolved from underground rave and warehouse subculture to a mainstream electronic music culture—making these events a place where at-risk youth are experimenting with alcohol and other drugs.

"There's also an issue around safe settings. As these events have grown, there's no standard for managing drug use at events. There's become an emphasis on restrictions, heightened security measures, and arrests rather than health promotion and drug education. If we can't keep drugs out of prisons, we absolutely can't keep them out of nightlife districts and music festivals."

To those that think DanceSafe tacitly encourages drug use, Wooldridge has this to say: “People will use drugs regardless of the law or what services are or aren't put in place. Abstinence-only education is ineffective. We've never had a drug-free society, so it's unrealistic to think that's attainable. We need to meet people where they are at because it is morally and medically negligent to not provide a person with resources and services that could potentially save their life.”

Another group that uses harm-reduction principles in working with rave attendees is The Zendo Project, which focuses specifically on psychedelics—with an emphasis not just on harm reduction, but also on helping people change their experiences into learning opportunities. Its goals are to reduce the number of psychiatric hospitalizations and arrests, and to demonstrate that safe, productive psychedelic experiences are possible without the need for law enforcement-based policies.

Sara Gael, MAPS Harm Reduction Coordinator for The Zendo Project, says that providing psychedelic harm reduction services at raves decreases the number of unnecessary hospitalizations and arrests. "Festival producers, emergency service personnel, and the public are increasingly recognizing the necessity for psychedelic harm reduction spaces and education. The Zendo Project provides compassionate care for individuals experiencing psychological or emotional overwhelm or difficulty, drug related or otherwise. Unless an individual is engaging in destructive or harmful behavior or is physically endangered, there is most often no need for medical or law enforcement intervention including restraint, sedation, or arrest. Harm reduction services free up medical, security, and law enforcement resources so that these departments can focus on where they are most needed, dealing with crime and physical illness and injury."

But what about those who feel that what The Zendo Project is doing (and harm reduction in general) just encourages people to use drugs that might be harmful to them? Gael says, “It’s a given that there are possible risks to substance use. We do not condone or condemn drug use, we rather admit the reality that despite laws and policies, people use them. Educating the public on the actual potential risks of substance use allows people to make informed decisions. One could make the argument that if people are properly informed about drug risks, they may be less, and not more, likely to use a substance than if they are uneducated about the effects. No matter the subject, it is always safer to err on the side of more education, more information, and increased safety precautions. A punitive, 'just say no' approach to substance use is not only harmful but denies the reality that humans have long used, and will continue to use substances. Failing to provide harm reduction services is the equivalent to not providing first aid at an event out of the fear that people will engage in more physically risky behavior if you do.”

Harm reduction organizations are not the only way that people at raves and festivals can receive help. There are organizations out there that provide doctors, EMTs, ambulances and paramedics on-site to help those with conditions such as hyperthermia get medical help quickly.

One of the most successful of these organizations is CrowdRX, whose chairman, Dr. Andrew Bazos, had this to say about what they do:

“There is a huge need for high-quality, advanced medical care at large events ... Because we are bringing a higher level of care to the festival, sick patrons who didn’t intend on getting sick in the first place, can potentially remain at the festival longer and receive proper medical care faster. Our transport rates are lower because of the on-site physicians, which keeps local hospitals from being burdened by an influx of patients. We strive to make events as safe as possible through physician-led, on-site advanced medical care. When you think of it, a promoter is essentially throwing a party at 'their house' so they want to take good care of their guests. Promoters are held responsible for their attendees' conduct, health, and safety. Be it alcohol, drugs, or maybe falling down a stairway, we’re ready to step in and provide quality, rapid on-site medical care. Studies have clearly shown that more rapid medical response leads to greatly improved outcomes.”

Despite the recent deaths at raves, they, and other huge music festivals won't be going away anytime soon. They are way too popular. While hiring competent medical staff such as the ones provided by CrowdRx to help with any emergencies is paramount, having organizations around like DanceSafe and The Zendo Project does nothing but help those in need when they are experiencing a medical issue, or if they are having a bad trip.