With all the information we have today we have no excuse not to take initiatives that can help save lives,’ EMCDDA director Alexis Goosdeel told the agency’s Safe festivals and healthy nightlife – sharing experience among practitioners webinar.
Europe was home to a wealth of useful experience and initiatives, he said, although ‘they’re not always well known, and they’re not always well supported and well financed.’ The continent’s ever-changing drug market and ever-growing number of new psychoactive substances meant we ‘cannot afford not to be ready’, he stated. ‘It’s not about promoting specific services, or one specific model. It’s really to integrate and support the development of the harm reduction system, which is a combination of interventions.’
‘Most of our volunteers are party attenders who come together to help each other,’ said Gabriel Borkowski of the DÁT2 Psy Help grassroots organisation in Hungary. ‘We’re not backed by any government organisation or anything like that. In the winter we go to indoor parties and clubs and in the summer we attend outdoor festivals.’ The three pillars of support offered by his organisation were physical wellbeing, mental wellbeing and providing information, he said. ‘We provide water, vitamins and minerals, fruit, snacks, condoms and a safe space for people to rest or get some shade. We also have psychologists to sit with people and help them through difficult experiences.’
CHALLENGING ENVIRONMENTS
Many festivals could be challenging events that could really take their toll, both physically and mentally, said Mar Cunha of Kosmicare, which runs a permanent drug checking facility in Lisbon as well as providing services at festivals throughout Portugal. ‘These are large events, sometimes up to ten days long, and there’s a lot of heat. In Portugal it can be 42 degrees – it’s really, really intense.’
‘The space you’re operating in sets the boundaries,’ said Mikk Oja of the Night Fairies nightlife harm reduction programme in Estonia, which provides support at festivals, clubs and underground events through a network of volunteers. ‘If you’re in a nightclub you don’t have room for a psych care area, for example.’ His organisation operated from tents in festivals but also had outreach teams to go looking for festival-goers who needed help.
When it came to best practice, it was important for any organisation to work on their messaging, he said. ‘We also put a lot of effort into our training programme because we’re volunteer-based’, which included role-playing difficult situations – ‘a much more practical way of understanding problems than the theoretical side’. Night Fairies was now considered a trustworthy partner for other organisations, including law enforcement, he said. ‘We’re trying to build a network – we’re a mediator between underground clubs, law enforcement and governmental institutes.’
POLITICAL PROBLEMS
The political situation in Hungary, however, made for a challenging atmosphere for organisations like DÁT2 Psy Help, said Borkowski, meaning implementing something like drug checking was an impossibility. ‘There’s been no nationwide drug strategy for years. Mostly it’s anti-drug propaganda rather than the “support, don’t punish” approach we’d like to see, and because of that there’s no real funding or support for organisations like ours.’ There was also a real lack of education, he pointed out. ‘Young people going to clubs and parties for the first time don’t have any background – they don’t know what to do, what not to do. They learn on the fly, they learn from their friends, or if they’re lucky enough they meet people like us and we give them information on how to not harm yourself.’
Maintaining a synergy between all the actors involved also presented a challenge, said Elisa Fornero of the Neutravel Project in Italy. ‘Organisers, club owners, DJs are all stakeholders for us, but so are security teams, first aid staff and, in a big festival, the police. You have to consider all of them and that can be difficult, especially in big events.’
Some club owners in Hungary could be an obstacle to effective harm reduction, added Borkowski. ‘Sometimes they’ll prevent people from drinking water from the tap because they want them to buy it in the bar.’ What was encouraging, however, was how some people his organisation had helped through a difficult experience would later sign up with DÁT2 Psy Help to support others, and the organisation was now making a real difference across the country. ‘We come from the psychedelic Goa trance party scene but more and more we’re asked to attend parties from different organisers, like techno or even general music festivals. These are often young organisers – 20, 25-year-olds – so they’re the next generation, and it shows that they all understand the need for harm reduction.’
PEER POWER
Working with peers was essential, stressed Cunha – both for their input and for vital information on what drugs were circulating and how people were taking them. ‘Sometimes it’s hard to keep track of everything’ – this was especially the case now that trends in drug use were constantly shifting.
‘Harm reduction workers are like researchers or anthropologists,’ said Fornero. ‘They’re in the field and they monitor and study the evolution of cultures, because a big part of planning a harm reduction intervention is considering the subculture you’re going to meet. Mixing cocaine and ketamine is very popular in Italy at the moment, for example.’
Portugal, meanwhile, was seeing ‘an increase in the consumption of cathinones, especially since the pandemic’, said Cunha. ‘And in the drug-checking service we’re seeing constant change in which cathinones are circulating. We have a lot of 3-CMC, and more recently 2-MMC. When you have a lot of new substances appearing – some of them very recently synthesised – it brings a lot of challenges, because it’s very hard to know doses and duration of effects to build a harm reduction approach or know what to tell people. You can only get information from people taking it.’
NEW DRUGS, NEW CHALLENGES
This was a growing problem across the continent, said Borkowski. ‘Unlike with established and known-to-science drugs like MDMA or LSD, people are taking substances that no one’s ever heard of that have been synthesised in some shady lab in Asia. So we have no idea why people are feeling bad or tripping for 24 hours or more – it’s really difficult to work in these situations, because we don’t have any data.’
Polydrug use was on the rise in Estonia, said Oja, with increasing rates of drug-related harms. The Baltic states were also seeing a surge in use of nitazenes, he said, as highlighted in the EMCDDA’s latest European drug report (see news, page 4), and with a consequent rise in drug-related deaths. It was a ‘perfect storm’, he warned – at the same time that young people were using more prescription medicines like benzodiazepines recreationally, more and more counterfeit pills were coming onto the market – many containing nitazenes.
UNIQUE OPPORTUNITY
All of this meant that festivals were a unique opportunity for real-time monitoring and understanding of new substances and behaviours, said Goosdeel. ‘They’re unique settings for harm reduction interventions, the problem being that not everyone is convinced by the need for harm reduction.’ In some countries these services were accepted or mainstreamed, while in others this wasn’t the case, and there were inevitably different approaches and policies at national and local levels. ‘There are constraints everywhere, so we just need to respect that and cope with it.’
Even though drug checking still wasn’t mainstream it was important to avoid simply rejecting opportunities, he stressed. One key lesson from harm reduction was that it was self-defeating to not build a partnership because the authorities you were dealing with wouldn’t accept one particular element – such as drug testing – he stated. ‘If every time you only bring the one thing the other party doesn’t want – and won’t listen to – then all you get is that nothing happens.’
At many events it was only possible to check drugs that had been seized, for example, but ‘you still have a lab and the possibility to know if something new and problematic is appearing, so you can disseminate information and tell people to be aware and be careful. There are always intermediary options. It’s about establishing a dialogue with the authorities and law enforcement, so they can see the added value.’
And with growing numbers of new synthetic drugs on the market, it was vital to convey the message that we need to be prepared, he said. ‘Not just for people who use drugs, but for the national authorities as well.’