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Medical Emergencies Related to Ethanol and Illicit Drugs at an Annual, Nocturnal, Indoor, Electronic Dance Music Event

Published online by Cambridge University Press:  29 December 2017

Paul Calle ,
Nora Sundahl ,
Kristof Maudens ,
Sarah MR Wille ,
Diederik Van Sassenbroeck ,
Koen De Graeve ,
Stefan Gogaert ,
Peter De Paepe ,
Dieter Devriese  and
Geert Arno
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Paul Calle*
Affiliation:
Ghent University, Ghent, Belgium Emergency Department, General Hospital Maria Middelares, Ghent, Belgium
Nora Sundahl
Affiliation:
Ghent University, Ghent, Belgium
Kristof Maudens
Affiliation:
Toxicological Centre, University of Antwerp, Antwerp, Belgium
Sarah MR Wille
Affiliation:
National Institute of Criminalistics and Criminology, Brussels, Belgium
Diederik Van Sassenbroeck
Affiliation:
Emergency Department, General Hospital Maria Middelares, Ghent, Belgium
Koen De Graeve
Affiliation:
Emergency Department, General Hospital Jan Palfijn, Ghent, Belgium
Stefan Gogaert
Affiliation:
Belgian Red Cross, Mechelen, Belgium
Peter De Paepe
Affiliation:
Ghent University, Ghent, Belgium Emergency Department, University Hospital, Ghent, Belgium
Dieter Devriese
Affiliation:
Emergency Department, General Hospital Saint Lucas, Ghent, Belgium
Geert Arno
Affiliation:
Federal Public Service Health, Food Chain Safety and Environment, Brussels, Belgium
Peter Blanckaert
Affiliation:
Belgian Early Warning System on Drugs, Scientific Institute of Public Health, Brussels, Belgium
*
Correspondence: Paul Calle, PhD General Hospital Maria Middelares Emergency Department Ghent, Belgium E-mail: paul.calle@ugent.be
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Abstract

Introduction

Medical problems are frequently encountered during electronic dance music (EDM) events.

Problem

There are uncertainties about the frequencies and severity of intoxications with different types of recreational drugs: ethanol, “classical” illicit party drugs, and new psychoactive substances (NPS).

Methods

Statistical data on the medical problems encountered during two editions of an indoor electronic dance event with around 30,000 attendants were retrieved from the Belgian Red Cross (Mechelen, Belgium) database. Data on drug use were prospectively collected from the patient (or a bystander), the clinical presentation, and/or toxicological screening.

Results

In the on-site medical station, 487 patients were treated (265 in 2013 and 222 in 2014). The most frequent reasons were trauma (n=171), headache (n=36), gastro-intestinal problems (n=44), and intoxication (n=160). Sixty-nine patients were transferred to a hospital, including 53 with severe drug-related symptoms. Analysis of blood samples from 106 intoxicated patients detected ethanol in 91.5%, 3,4-methylenedioxymethamphetamine (MDMA) in 34.0%, cannabis in 30.2%, cocaine in 7.5%, amphetamine in 2.8%, and gamma-hydroxybutyric acid (GHB) in 0.9% of patients (alone or in combination). In only six of the MDMA-positive cases, MDMA was the sole substance found. In 2014, the neuroleptic drug clozapine was found in three cases and ketamine in one. Additional analyses for NPS were performed in 20 cases. Only in one agitated patient, the psychedelic phenethylamines 25B-NBOMe and 25C-NBOMe were found.

Conclusions

At this particular event, recreational drug abuse necessitated on-site medical treatment in one out of 350 attendants and a hospital transfer in one out of 1,000. Ethanol remains the most frequently abused (legal) drug, yet classical illicit recreational drugs are also frequently (co-) ingested. The most worrying observation was high-risk poly-drug use, especially among MDMA users. Regarding NPS, the number of cases was low and the clinical presentations were rather mild. It should be stressed that these observations only apply to this particular event and cannot be generalized to other EDM events.

CalleP, SundahlN, MaudensK, WilleSMR, Van SassenbroeckD, De GraeveK, GogaertS, De PaepeP, DevrieseD, ArnoG, BlanckaertP. Medical Emergencies Related to Ethanol and Illicit Drugs at an Annual, Nocturnal, Indoor, Electronic Dance Music Event. Prehosp Disaster Med. 2018;33(1):71–76.

Keywords

3,4-methylenedioxymethamphetamine (MDMA)ethanolillicit drugsmass gatheringsrave party
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 33 , Issue 1 , February 2018 , pp. 71 - 76
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest: none

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