A nationwide survey on substance use

This summer I got an email from a concerned nurse. In June, the Canadian Centre for Substance Abuse, and UBC’s Mass Gathering Medicine Interest Group released their recommendations for Preventing Drug- and Alcohol-related Harms at Music Festivals. As a nurse who works with live music events, she was encouraged to see that many of the recommendations were already being implemented locally, but wanted to talk about strategies to reducing barriers that some festivals were encountering when seeking to offer substance testing at events.

This nurse was looking to start conversations with communities and event holders about how to standardize access to recommendations on this list, with full support of police and stakeholders to create safer events, leading to less drain on the emergency services in the communities they are held. But where do we even start?

Shambhala Music Festival has set the bar for harm reduction. For many years, the Shambhala music festival has provided a safe space where attendees can bring unidentified substances to volunteer care providers, where they are tested using a chemical testing kit. The goal is one of harm reduction, aiming to reduce consumption of dangerous contaminated substances, as well as create better education and dialogue surrounding substance use at big events.

However, this isn’t so easy at many large events. Earlier this summer, the Evolve Festival, another electronic music event in Halifax, experienced a challenge. Similar to Shambhala, Evolve had planned to offer substance testing at the festival. However, days before the event, insurance providers threatened to shut down the festival if drug testing was offered. Despite evidence that substance testing in festival settings may help reduce overdoses and improve education for substance users, there are still legal barriers surrounding the use of testing kits. In response to testing kit use at festivals, the Nova Scotia RCMP stated that “The RCMP is all about public safety. However, we don’t support any initiatives that will condone illicit drug use, and these kits do condone illicit drug use”.

Fear of losing insurance coverage, concern about RCMP support and legal barriers surrounding the use of testing kits, as well as a lack of clear policy about this harm reduction measure, make it difficult for festivals and events to offer harm reductions services that include substance testing.

Enter the conversation with my concerned nurse colleague. Together, we struggled to think about potential solutions. Anyone who has worked at, or attended, large music events can tell you that substance use is common, and, promising harm reduction strategies are not always present. So, how do we bridge the gap demonstrating a need for better access to testing sites and improved education systems surrounding drugs? It seems that one of the barriers preventing change is a lack of good data demonstrating the patterns of use, perspectives and knowledge of young people surrounding illicit substances.

Together, we decided to address this problem. We created a nation-wide survey designed to assess the understanding, use, and opinions of young people concerning drugs. Our aim is to examine the perspectives of younger substance users, and determine whether there is the potential for better testing and education opportunities at large gatherings. It is our hope that this survey will result in data that event and festival organizers can use in conversations with community stake-holders, agencies, insurance providers, security teams and patrons to help maximize opportunities for event safety. We also hope the findings will be of benefit to harm reduction organizations and educators who are looking to address gaps in young people’s knowledge of substance use.

You can take the survey HERE. It’s completely anonymous, and your identity will never be linked to your data. Your input could help improve the safety of recreational substance users both in festival settings and in other situations in the future.

There’s a real need for better harm reduction and education for young people surrounding substances. Let’s start talking about it.

Authors:

kimberly-girling

Kimberly Girling is a Ph.D. candidate in Neuroscience at UBC with a strong interest in global health and accessible medicine. She has done extensive work with the Student Biotechnology Network in BC, and currently volunteers with the Canadian Drug Policy Coalition in Vancouver.

stacey-forrester

Stacey Forrester is a harm reduction nurse from Vancouver BC. She is involved in many projects aimed at creating health and increasing access to safer spaces, via education, feminism, and urban planning.

 **Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC

Finding common ground to prevent drug and alcohol-related harms at music festivals

A photo of the Shambhala music festival

The summer of 2014 was a troubling season for music festivals in Canada, with five young people dying and dozens more admitted to hospitals at a number of festivals for harms associated with alcohol and other drug use. At the Canadian Centre on Substance Abuse (CCSA), we started asking why this was happening and what more could be done to prevent such tragedies.

Can safety be standardized?

We took a look at whether anyone had developed national guidelines to reduce alcohol- and other drug-related harms at music festivals. Discovering there were none, we contacted our network of partners within the Canadian Community Epidemiology Network on Drug Use (CCENDU) and issued a bulletin about harms at music festivals. This led us to connect with Dr. Adam Lund and Sheila Turris at the University of British Columbia mass gathering medicine group, who have been working on music festival safety for a while.

It was clear that true impact could not be achieved without multi-stakeholder collaboration from all implicated sectors. To support this, CCSA funded the first-ever gathering of a group of stakeholders from all major sectors responsible for safety at music festivals — event organizers, concert promoters, police and security guards, paramedics, emergency physicians, and those working in health promotion and harm reduction — to discuss what could be done to prevent these deaths and other harms.

Overwhelming support

Interest and commitment was far greater than we had ever imagined! We had to expand our meeting space, and many of our nearly 50 participants paid their own way and travelled great distances to attend the January 2015 meeting in Vancouver. Particularly striking was how these stakeholder groups had never had the opportunity to sit down together to share and reflect upon their objectives, the way they operate and the pressures they face. Given the opportunity, they quickly discovered that everyone shared similar goals: to support a fun environment and prevent harms to festivalgoers.

Capitalizing on the collective enthusiasm in the room, the group brainstormed key elements involved in safety planning at music festivals and identified areas for improvement. CCSA took the lead in assembling these recommendations into a report that was released in June 2015 — just ahead of summer festival season.

Recommendations to reduce drug- and alcohol-related harms at music festivals

The recommendations outlined in the report covered all aspects of music festival design and execution, and applied to event organizers, staff, security services, first responders and those working in health promotion and harm reduction. The report called upon organizers to ensure reliable access to free drinking water, as well as training for all on-site personnel to recognize and respond to signs of someone experiencing harms from drug or alcohol use, among other recommendations. It also highlighted the need for chill spaces where festival attendees can seek shade and shelter and get away from the noise and activity, and recommended having drug- and alcohol-free zones. The report also raised the need for evidence-based substance use prevention messaging, including using social media to draw attention to potential risks and harms.

Another important finding was learning about the diversity of environments in which those working in health promotion and harm reduction operate in across Canada. At the time of the meeting, the kinds of strategies or interventions that were possible in one area of the country, such as drug checking, were simply not possible in others. In contrast other strategies, such as the support of peer outreach workers, were readily accepted and embraced without controversy.

Collaboration is key

The report saw immediate interest and uptake, with more than 130 downloads within the first month and close to 100 media mentions (print, broadcast and online) within the first week alone. But the biggest indicator of success was seeing uptake and endorsement of recommendations from event organizers with music festivals such as Pemberton, Digital Dreams and Veld publicly indicating they were following recommendations from the report. In addition to festival organizers other groups such as the U.S.-based harm reduction organization DanceSafe also promoted the report via their networks and organizations such as BC-based ANKORS indicated that the report became valuable in helping them to connect with new groups of stakeholders that they had not previously engaged with.

The challenge: how do we as a community move things forward?

At the heart of this project is a vision to collaboratively develop a set of voluntary, evidence-based standards that event promoters and other stakeholders can strive toward, giving credibility to the event and permitting attendees and other interested groups (e.g., parents, law enforcement, municipal officials) to feel confident that all efforts to make the festival as fun and safe as possible are being taken.

To achieve this goal, we need to collect and synthesize the evidence supporting the recommendations and advance the priority areas for action outlined in the initial report. CCSA is prepared to focus on drug and alcohol harms, but music festival safety is much broader than this. We will need others to join us in collective action and lead other aspects of a comprehensive approach.

For more information, view Drugs at Music Festivals or email info@ccsa.ca to get involved.

dr matthew young  barton-tina

Authors: Dr. Matthew Young and Tina Barton, Canadian Centre on Substance Abuse

Featured image: Photo of the Shambhala Music Festival. Photo by Flickr user Coen Halmans, Creative Common License

 **Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC