This study's goals included identifying emerging novel psychoactive substances (NPS), ascertaining their overall prevalence, and determining patterns of use and trends within a cohort of electronic dance music festival attendees.
Background research indicates that NPS, often characterized as unregulated psychoactive compounds designed to circumvent existing legislation, have become mainstream on the illicit drug market. Because of their physical and mind-altering properties, NPS may be deliberately or inadvertently ingested at electronic dance music (EDM) festivals to enhance the attendees' appreciation of the music and overall experience. Their widespread use at EDM festivals have been well documented and several adverse events and fatalities associated with NPS ingestion have been reported in the United States. The diversity and rapid turnover in the prevalence of any particular NPS at any given point of time has created several challenges for public health officials, law enforcement, and forensic science communities. Epidemiological studies are often published long after drugs have cycled through the peak of their popularity with users and the scope of testing frequently failing to detect, identify, or report the most recently available drugs. Over the course of 2 years, the current study collected biological samples from 396 EDM festival attendees (126 blood samples, 227 urine samples, and 384 oral fluid samples). Survey data on prescription and recreational drug use within the last week were collected, with follow-up questions on what substance(s) the person had ingested, amount taken, when the substance was last taken, and perceived effects. All biological samples were screened and subsequently confirmed and/or quantified, when appropriate. In response to survey questions, 72 percent of the participants reported using a recreational drug or medicinal substance within the last week. Users most commonly reported using marijuana and alcohol, followed by "Molly" and cocaine. Of the 396 individuals tested, approximately 75 percent tested positive for positive in at least one biological specimen for drugs and/or alcohol. Of those positive samples, 36 percent were confirmed to contain one or more NPS and/or 3,4-methylenedioxy-methamphetamine (MDMA). High rates of turnover and spikes in popularity related to NPS are supported by samples confirming positive for alpha-PVP in 2014; however, one year later not a single case was positive for alpha-PVP, but increasing numbers of subjects were positive for ethylone. (Publisher abstract modified)