Electronic Dance Music Party Attendees Research Articles

Shifting awareness among electronic dance music party attendees that drugs may contain fentanyl or other adulterants.

Drugs like ecstasy, cocaine, and counterfeit prescription pills can contain fentanyl. We examined knowledge about potential adulteration/contamination of such drugs among people attending electronic dance music (EDM) parties. Adults in New York City were surveyed entering randomly selected EDM parties during the summers of 2018 (n=1,029) and 2019 (n=559). Surveys assessed perceptions that: 1) ecstasy/Molly can contain adulterants more dangerous than MDMA, 2) cocaine can contain fentanyl, and 3) prescription pills from non-pharmacy sources can contain fentanyl. We compared prevalence of perceptions between 2018 and 2019. Prevalence of agreeing that cocaine can contain fentanyl increased from 42.1% to 58.6%, a 39.2% increase (p=.003). Increases in agreement were not significant regarding ecstasy potentially containing adulterants (55.0% vs. 59.0%) and non-pharmacy prescription drugs potentially containing fentanyl (46.8% vs. 52.9%). Those reporting past-year ecstasy use in particular reported increased agreement that ecstasy can be adulterated (from 52.9% to 80.0%, a 51.2% increase; p<.001) and those reporting past-year cocaine use reported increased agreement that cocaine can be adulterated (from 48.2% to 70.7%, a 46.7% increase; p=.016). Knowledge of potential adulteration or contamination of commonly used drugs in this high-risk scene is increasing. Continued education about possible drug contents is needed.

Underreporting of drug use among electronic dance music party attendees

Background and Objectives Electronic dance music (EDM) party attendees are at high risk for drug use. However, little is known regarding the extent of underreporting of drug use in this population, in part, because use of synthetic drugs is often associated with unknown exposure to adulterant drugs. We estimated the extent of underreported drug use in this population by comparing self-reported use to hair toxicology results. Methods Time-space sampling was used to survey adults entering EDM events at nightclubs and dance festivals in New York City from January through August of 2019. Seven hundred ninety-four adults were surveyed and 141 provided analyzable hair samples. We queried past-year use of >90 drugs and tested hair samples using ultra-high performance liquid chromatography–tandem mass spectrometry. We compared hair test results to past-year self-reported use and adjusted prevalence estimates by defining use as reporting use or testing positive. Correlates of discordant reporting, defined as testing positive after not reporting use, were estimated. Results Prevalence of drug use increased when considering positive hair tests in estimates, with 43.8% of participants testing positive for at least one drug after not reporting use. For example, based on self-report, cocaine use prevalence was 51.1%, and increased by a factor of 1.6 to a prevalence of 80.0% when adding hair test results to self-report. Younger adults (ages 18–25), black and other/mixed race participants, those reporting “other” sexuality, and those with a college degree were at significantly higher risk for testing positive for drugs not reportedly used. Those who self-reported using more types of drugs were less likely to test positive after not reporting use (adjusted prevalence ratio = 0.53, 95% confidence interval = 0.41-0.68). Conclusions We detected underreporting of drug use, particularly cocaine and ketamine. More research is needed to determine whether this is driven by intentional underreporting or unknown exposure through adulterants.

Increasing Willingness to Use Synthetic Drugs if Offered among Electronic Dance Music Party Attendees, 2017–2019

ABSTRACT Intention and willingness to use drugs are proximal predictors of drug use; however, willingness to use requires more research to inform prevention efforts. This study examines willingness to use drugs among electronic dance music (EDM) party attendees, a population at high risk for drug use. Data were examined from a repeated cross-sectional study of 2,426 adult EDM party attendees surveyed entering nightclubs and festivals in New York City from 2017 to 2019 using time-space sampling. Trends and correlates of reporting whether participants would use ten different synthetic drugs if offered by a friend in the next thirty days were examined. Ecstasy (31.9%), powder cocaine (25.5%), LSD (20.0%), and opioids (16.4%) were most likely to be used if offered. Willingness to use powder cocaine, LSD, ketamine, amphetamine, tryptamines, and 2C series drugs significantly increased from 2017 to 2019, particularly powder cocaine (increasing from 19.1% to 34.2%, p <.001). Any or more recent use of each drug was associated with increases in willingness to use. Past drug use is a consistent predictor of willingness to use if offered, and willingness to use is increasing in this population. Findings can inform prevention efforts by allowing better targeting of those at risk for use.

High Prevalence of Tobacco Product and E-Cigarette Use among Electronic Dance Music Party Attendees

Background: Electronic dance music (EDM) party attendees are at high risk for use of various illegal drugs; however, little is known about their tobacco use. Understanding tobacco use patterns in this population at high risk for illegal drug use can inform multi-product interventions. Objectives: 954 EDM party attendees (ages 18–40) were surveyed in New York City in 2017. We estimated prevalence of use of cigarettes, hookah, cigars, other tobacco, and e-cigarettes and delineated correlates of current (past-month) use using bivariable and multivariable models. Results: Past-month use of cigarettes (36.2%), e-cigarettes (15.6%), cigars (12.5%), and hookah (11.7%) in particular was prevalent. In multivariable models, females were less likely to use e-cigarettes than males (adjusted prevalence ratio [aPR] = 0.63, p = .030), and those who attended graduate school were less likely to use cigarettes (aPR = 0.55, p = .003) and/or e-cigarettes (aPR = 0.33, p = .026). Past-year ecstasy/MDMA/Molly use was a risk factor for past-month use of cigarettes (aPR = 1.38, p = .013) and/or cigars (aPR = 1.61, p = .032), and past-year cocaine use was a risk factor for past-month use of cigarettes (aPR = 1.80, p < .001), cigars (aPR = 1.80, p = .013), other tobacco products (aPR = 3.05, p = .003), and/or e-cigarettes (aPR = 2.39, p = .003). 55.4% of ecstasy users and 60.3% of cocaine users were current cigarette smokers, but use of other products among users of these drugs was less prevalent (9.8–27.9%). Conclusions: Results suggest that current tobacco use is prevalent in this population who is also at high risk for use of drugs such as ecstasy and cocaine. Prevention and cessation efforts need to target tobacco users in this scene while incorporating components addressing illegal drug use.

Trends in drug use among electronic dance music party attendees in New York City, 2016–2019

ObjectiveElectronic dance music (EDM) party attendees are a high-risk population for drug use and associated adverse effects. We examined trends in past-year drug use within this population to better inform prevention and harm reduction efforts. MethodsEach summer from 2016 through 2019, we used time-space sampling to survey a cross-section of adults entering EDM parties at randomly selected nightclubs and at dance festivals in New York City. Ns ranged from 504 (2019) to 1,087 (2016). We estimated log-linear trends in past-year use of 16 different synthetic drugs or drug classes. ResultsBetween 2016 and 2019, estimated past-year prevalence of use of ketamine increased from 5.9% to 15.3% (a 157.6% relative increase; P = .007), LSD use increased from 9.9% to 16.6% (a 67.7% relative increase, P < .001), powder cocaine use increased from 17.3% to 35.2% (a 103.5% relative increase, P < .001), and GHB use increased from 1.0% to 4.2% (a 311.8% relative increase; P = .002). Past-year use of >3 drugs increased from 12.7% to 20.5% (a 61.4% relative increase; P = .013); however, estimated past-year use of unknown powders decreased from 2.0% to 1.1% (a relative 44.7% decrease; P = .038) and ecstasy/MDMA/Molly use was stable across years (at 25.0 to 28.5 %; P = .687). ConclusionsReports of powder cocaine, LSD, ketamine, and GHB are becoming more prevalent among EDM party attendees. Prevention and harm reduction efforts are needed to address increasing use. Research is also needed to examine whether increasing media coverage of medical use of ketamine and other psychedelics affects prevalence of recreational use.

Extensive Underreported Exposure to Ketamine Among Electronic Dance Music Party Attendees.

Extensive Underreported Exposure to Ketamine Among Electronic Dance Music Party Attendees.

Non-Consensual Sexual Contact at Electronic Dance Music Parties.

Non-consensual sexual contact in bars is common, but few studies have focused on the extent of this problem at electronic dance music (EDM) parties, which are growing in popularity. We aimed to estimate prevalence and correlates of non-consensual sexual contact among individuals who attend EDM parties in New York City (NYC). Adults (ages 18-40 years) entering EDM parties in NYC were surveyed in 2018 using time-space sampling. Participants (n = 1005) were asked whether they had experienced unwanted or uninvited sexual contact including unwanted groping, kissing, or touching at an EDM party. We estimate that 15.2% of EDM party attendees in NYC have experienced non-consensual sexual contact at such parties. The majority (62.5%) of those reported that it occurred 1-2 times and 49.1% were usually or always drunk or high during the encounter(s). Almost all women experiencing non-consensual contact (99.5%) were all or mostly touched by men; 38.6% of men were all or mostly touched by other men. Women were at more than twice the odds of reporting non-consensual sexual contact than men (aOR = 2.38, p < .05) with 21.8% of women reporting experiencing non-consensual sexual contact compared to 11.0% of men. Among women, those ages 18-24 were at over twice the odds (aOR = 2.75, p < .05) of experiencing non-consensual sexual contact than those ages 25-40. EDM party environments can increase susceptibility to non-consensual sexual contact. Prevention needs to be geared toward those at risk, and education is needed for those likely to commit non-consensual sexual contact.

Differential Risk for Drug Use by Sexual Minority Status among Electronic Dance Music Party Attendees in New York City

Background: Drug use among electronic dance music (EDM) party attendees is common; however, studies are needed to examine associations between drug use and sexual orientation as this can inform prevention and harm reduction efforts in the lesbian, gay, and bisexual (LGB) community. Methods: Data were examined from a repeated cross-sectional study of 3066 young adult EDM party attendees surveyed entering nightclubs and dance festivals in New York City between 2016 and 2018. Of these participants, 277 identified as gay/lesbian, 293 identified as bisexual, and 83 identified as other sexuality. We examined how sexual orientation relates to past-year use of various ‘traditional’ drugs (e.g., ecstasy/MDMA/Molly) and new psychoactive substances (NPS; e.g., “bath salts”) in a bivariable and multivariable manner, stratified by sex. Results: Compared to heterosexual males, gay males were at higher odds for use of ecstasy, GHB, and methamphetamine; bisexual males were at higher odds for use of LSD and unknown powders, and males identifying as “other” sexuality were at higher odds for use of mushrooms and 2C drugs. Compared to heterosexual females, lesbians were at higher odds for use of mushrooms and GHB; bisexual females were at higher odds for use of cocaine, LSD, mushrooms, and tryptamines, and females identifying as “other” sexuality were at higher odds for use of cocaine and tryptamines. Conclusions: We determined differential risk of use of different drugs among those who attend EDM parties according to sexual orientation. Findings can be used to tailor prevention messaging to specific groups within the LGB community.

Consistency of self-reported drug use among electronic dance music party attendees.

Longitudinal studies have found that recanting of drug use is common. We investigate the extent to which individuals in a high-risk population-electronic dance music (EDM) party attendees-provide inconsistent reports of drug use. Nine hundred and thirty-three EDM party attendees were intercept-surveyed before entering randomly selected parties in 2017. A quarter (n = 236) completed the optional follow-up survey (63.1% of those providing an email address to be contacted for follow up). We compared self-reported past-year drug use on baseline and follow-up surveys (mean = 3.6 days post-baseline) among those who completed both. Predictors for providing discordant responses were also examined. About 42.4% provided a discordant response between surveys, but discord regarding reported use of individual drugs (measured in changes in absolute percentage) ranged from 0.0% to 5.1%. At follow up, prevalence of reported use of LSD decreased (by 3.8%, P = 0.013) and prevalence of reported use of shrooms also decreased (by 5.1%, P = 0.005); however, test-retest reliability was strong or almost perfect for all 17 drugs (κ range: 0.88-1.00). Those reporting the use of a higher number of drugs at baseline were at increased risk of providing discordant responses. Those surveyed outside of festivals were less likely to provide more discordant responses than those surveyed outside of nightclubs. Although reporting of drug use was very reliable in this high-risk population, inconsistent self-reported use of some drugs was still common. Research is needed to determine how to acquire more accurate responses in this population at the point of recruitment without relying on follow-up surveys.

Underreporting of drug use on a survey of electronic dance music party attendees

Objectives: Skip-logic is commonly used on electronic surveys in which programs provide follow-up questions to affirmative responses and skip to the next topic in response to non-affirmative responses. While skip-logic helps produce data without contradictory responses, erroneous non-affirmative reports can lead to loss of accurate information. We examined the extent to which type-in drug use responses contradict unreported use in a survey of a high-risk population—electronic dance music (EDM) party attendees.Design: We surveyed 1029 EDM party-attending adults (ages 18–40) using time-spacing sampling in 2018. We examined the extent to which reporting of recent drug use via type-in responses occurred after past-year use of the same drugs were unreported earlier on the same survey. Changes in prevalence of use and predictors of providing discordant responses were examined.Results: 3.6% of participants typed in names of drugs they had used that they did not report using earlier on the survey. Changes in prevalence were not significant when correcting contradictory responses, but prevalence of past-year cocaine use increased from 23.3% to 24.3%. Those with a college degree were at lower odds for providing a discordant response (aOR = 0.13, p = .019). Females (aOR = 2.82, p = .022), those earning ≥$1000 per week (aOR = 11.03, p = .011), and those identifying as gay/lesbian (aOR = 5.20, p = .032) or bisexual or other sexuality (aOR = 15.12, p < .001) were at higher odds of providing a discordant response.Conclusions: Electronic surveys that query drug use can benefit from follow-up (e.g. open-ended) questions not dependent on previous responses, as they may elicit affirmative responses underreported earlier in the survey.

Adverse drug-related effects among electronic dance music party attendees

BackgroundDrug use is prevalent among electronic dance music (EDM) party attendees, but research is needed to determine the extent of adverse drug-related outcomes in this population in order to better inform prevention and harm reduction efforts. Method1029 adults were surveyed entering EDM parties in New York City in 2018. Those reporting past-year use of a drug were asked if they experienced a harmful or very unpleasant effect after use in which they were concerned about their immediate safety. They were also asked about co-use of other drugs and whether they sought help. ResultsWe estimate that a third (33.5%) of EDM party attendees have experienced a drug-related adverse effect in the past year. Two-thirds (67.8%) of adverse effects involved use of alcohol. Relative to use, adverse effects most commonly resulted from use of opioids (e.g., prescription opioid misuse, 41.2%) or alcohol (33.9%). Among those reporting an adverse effect, concomitant use of other drugs was common, particularly among users of LSD (56.5%), ketamine (56.3%), cocaine (55.7%), and ecstasy/MDMA/Molly (47.7%). Adverse effects resulting from synthetic cathinone (“bath salt”) use were most likely to result in a hospital visit (57.1%). ConclusionAdverse effects from drug use are common among those in the EDM party scene and polydrug use appears to be a common risk factor. More research is needed, however, to determine the extent of event-specific adverse outcomes. Results can inform prevention and harm reduction efforts in this population.

Use of "Lean" Among Electronic Dance Music Party Attendees.

Lean (a.k.a.: Sizzurp, Purple Drank) is a recreational beverage that commonly contains codeine cough syrup. Despite its popularization in the hip-hop music scene, few epidemiologic studies have examined use. This study examined prevalence and correlates of use among a population at high-risk for drug use-electronic dance music (EDM) party attendees. A total of 1029 EDM party attendees (ages 18-40) were surveyed in New York City in 2018 using time-space sampling. Prevalence and correlates of use of Lean were estimated. An estimated 15.5% of attendees have ever used Lean, and 3.4% of attendees have used in the past year. Only an estimated 0.2% have used in the past month, but 14.2% would use in the next month if offered by a friend. Three-quarters (75.4%) of users believed their Lean ever contained codeine and 32.4% believed it always or usually contained codeine. Past-year use was strongly associated with past-year nonmedical prescription opioid use (adjusted odds ratio = 10.77, P = 0.003), but not past-year use of other illegal drugs. Attendees who are black or bisexual are at higher odds for past-year use, and those with a college degree or higher are at lower odds for past-year use. While use of Lean is not as prevalent as use of various other drugs (eg, ecstasy) in this high-risk population, over a tenth have tried it and/or are willing to use it if offered. Prevention efforts need to target potential users as frequent use of beverages containing codeine products can lead to dependence. (Am J Addict 2019;28:347-352).

Willingness to provide a hair sample for drug testing among electronic dance music party attendees

Background: Nondisclosure of drug use on surveys is common, and many drug users unknowingly ingest adulterant or replacement drugs, which leads to underreporting of use of these drugs. Biological testing can complement survey research, and hair testing is an appealing method, as many drugs are detectable for months post-use. We examined willingness to donate a hair sample to be tested among those surveyed in a population at high risk for consuming adulterated drugs—electronic dance music (EDM) party attendees. Methods: We surveyed 933 adults entering EDM parties in New York City in 2017. Hair donation response rates and reasons for refusal were examined from this cross-sectional study. Results: A third (n = 312; 33.4%) provided a hair sample. Lack of interest (21.0%), lack of time (19.8%), not wanting a lock of hair cut (17.7%), and disinterest in having hair cut in public (13.8%) were the main reported reasons for refusal; 4.7% refused because they could not receive results. Past-year drug users were more likely to fear identification than nonusers (P < .001). Asian participants were at lower odds of providing a hair sample (adjusted odds ratio [aOR] = 0.53, 95% confidence interval [CI] = 0.32–0.87), and those reporting past-year use of LSD (aOR = 1.62, 95% CI = 1.11–2.35), opioids (nonmedical; aOR = 1.93, 95% CI = 1.25–2.99), and/or methamphetamine (aOR = 3.43, 95% CI = 1.36–8.62) were at higher odds of providing a sample than nonusers of these drugs. Conclusions: Only a third of participants provided a hair sample, and we found individual-level differences regarding willingness to provide a sample. Factors contributing to refusal should be considered to increase response rates and generalizability of results.

Nonmedical opioid use among electronic dance music party attendees in New York City

BackgroundNonmedical opioid use remains an epidemic in the United States. Electronic dance music (EDM) party attendees have been found to be at high risk for the use of drugs such as ecstasy, but little is known about nonmedical opioid use in this population. MethodsUsing time-space sampling, we surveyed 954 individuals (ages 18–40) attending randomly selected EDM parties in New York City in 2017. Participants were asked about the use of 18 different opioids and about willingness to use if offered by a friend in the next 30 days. We estimated the prevalence of use in this population and examined correlates of past-year and past-month use. ResultsAlmost a quarter (23.9%) of EDM party attendees are estimated to have used opioids non-medically in their lifetime, and one out of ten (9.8%) in the past year. 5% are estimated to be current users (reporting past-month use), and 16.4% are willing to use opioids non-medically if offered by a friend in the next 30 days. Past-year nonmedical benzodiazepine users were at high odds for reporting current nonmedical opioid use (aOR = 10.11, p < 0.001) and, on average, report using more different opioid drugs in the past year than non-past-year-users (p = 0.012). Nearly three-quarters (73.6%) of those who have used in the past year indicated that they would use again if offered by a friend in the next 30 days. ConclusionNonmedical opioid use is prevalent in the EDM scene and many attendees are willing to use if offered. Prevention efforts are needed in this high-risk population.

Polysubstance use profiles among electronic dance music party attendees in New York City and their relation to use of new psychoactive substances

BackgroundElectronic Dance Music (EDM) party attendees are often polysubstance users and are at high risk for use of new psychoactive substances (NPS). We sought to identify patterns of use of common illegal drugs among EDM party attendees, sociodemographic correlates, and use of NPS as a function of patterns of use of more common drugs to inform prevention and harm reduction. MethodUsing time-space-sampling, 1045 individuals aged 18–40 were surveyed entering EDM parties in New York City. We queried past-year use of common illegal drugs and 98 NPS. We conducted latent class analysis to identify polysubstance use profiles of use of eight common drugs (i.e., ecstasy, ketamine, LSD, mushrooms, powder cocaine, marijuana, amphetamine, benzodiazepines). Relationships between drug classification membership and sociodemographics and use of drugs within six NPS categories were examined. ResultsWe identified four profiles of use of common drugs: non-polysubstance use (61.1%), extensive polysubstance use (19.2%), moderate polysubstance use/stimulants (12.8%), and moderate polysubstance use/psychedelics (6.7%). Those in the moderate/psychedelic group were at higher odds of using NPS with psychedelic-type effects (2C, tryptamines, and other “new” psychedelics; Ps<0.05). Extensive polysubstance users were at increased odds of reporting use of 2C drugs, synthetic cathinones (“bath salts”), tryptamines, other new (non-phenethylamine) psychedelics, new dissociatives, and synthetic cannabinoids (Ps<0.05). ConclusionNPS preference is linked to the profile of use of common drugs among individuals in the EDM scene. Most participants were identified as non-polysubstance users, but findings may help inform preventive and harm reduction interventions among those at risk in this scene.

Hair testing to assess both known and unknown use of drugs amongst ecstasy users in the electronic dance music scene

BackgroundData on both known and unknown drug use in the electronic dance music (EDM) scene is important to inform prevention and harm reduction. While surveys are the most common method of querying drug use, additional biological data can help validate use and detect unknown/unintentional use of drugs such as new psychoactive substances (NPS). We sought to determine the extent of both known and unknown use of various substances in this high-risk scene. MethodsWe hair-tested 90 self-reported past-year ecstasy/MDMA/Molly users attending EDM parties in New York City during the summer of 2016 using UHPLC–MS/MS. Results were compared to self-reported past-year use. ResultsThree quarters (74.4%) tested positive for MDMA, a third (33.3%) tested positive for an NPS, and 27.8% tested positive specifically for one or more synthetic cathinones (e.g., butylone, ethylone, pentylone, methylone, alpha-PVP). Half (51.1%) of participants tested positive for a drug not self-reported, with most testing positive for synthetic cathinones (72.0%), methamphetamine (69.0%), other NPS stimulants (e.g., 4-FA, 5/6-APB; 66.7%), or new dissociatives (e.g., methoxetamine, diphenidine; 60.0%). Attending parties every other week or more often, reporting higher-frequency ecstasy pill use, having tested one’s ecstasy, and having found out one’s ecstasy was adulterated, were risk factors for testing positive for synthetic cathinones and NPS in general. ConclusionHair testing appears to be a valuable addition to drug epidemiology studies. Many EDM party attendees—even those who test their ecstasy—are unknowingly using NPS and/or other drugs. Prevention information and harm reduction may help reduce unknown/unintentional use.

Attitudes and Beliefs About New Psychoactive Substance Use Among Electronic Dance Music Party Attendees

ABSTRACTBackground: Attitudes and beliefs about drug use have been shown to be robust correlates of use of drugs such as alcohol, marijuana, and cocaine; however, little is known regarding attitudes or beliefs about new psychoactive substances (NPS). We sought to examine attitudes and beliefs about NPS and how they relate to self-reported use in a high-risk population—electronic dance music (EDM) party attendees. Method: 1,048 individuals (age 18–40) were surveyed entering EDM parties in New York City in 2016. We queried lifetime use and attitudes and beliefs specific to NBOMe, 2C series drugs, “bath salts” (synthetic cathinones), tryptamines, dissociative NPS, and synthetic cannabinoids.Results: More than half the sample reported being unfamiliar with NPS other than “bath salts” and synthetic cannabinoids. “Bath salts” received the highest ratings of strong disapproval (34.3%), followed by synthetic cannabinoids (23.3%), compared to other NPS (10–14%). “Bath salts” were perceived to be a great risk by 43.1% of the sample, followed by synthetic cannabinoids (27.0%), and other NPS (12–16%). “Bath salts” were reportedly least likely to be used if offered (2.9%). In multivariable models, reporting no disapproval towards use was associated with increased odds of reporting use of 2C drugs, “bath salts”, and tryptamines. Having friends who use and reporting intent to use or willingness to use if offered were also associated with use of various NPS classes. Conclusions: This study delineated attitudinal and belief-related correlates of use of various NPS classes. Results can inform prevention effects as NPS continue to emerge.