Intentions, actions and outcomes: A follow up survey on harm reduction practices after using an English festival drug checking service.

The unprecedented rise in synthetic drugs, many containing unknown toxic agents, has made timely analytical diagnosis more difficult, and has reduced the confidence of clinicians providing ED management to this population of patients. This has also impacted the quality of evidence informing harm reduction responses. The Emerging Drugs Network of Australia (EDNA) brings together emergency physicians, toxicologists and forensic laboratories to establish a standardised ED toxicosurveillance system in Australia. Blood analysis of intoxicated patients will be conducted by forensic laboratories to enable precise identification of the substances causing acute toxicity. This will be linked with clinical data collected at the time of ED presentation to enable analysis of the clinical effects and outcomes associated with different illicit and emerging drugs. Toxicological and clinical data collected across sentinel sites will align with a nationally endorsed minimum dataset. EDNA's collaborative network will establish a national system of surveillance and reporting of illicit and emerging drugs causing acute toxicity. Standardisation of data collection recorded in a national clinical registry will provide more robust data on epidemiology and associated harms. This will facilitate the translation of clinical and toxicological evidence into timely, appropriate harm reduction and policy. Our work represents a collaborative response to calls for more sophisticated data on emerging drug trends in Australia. EDNA will improve coordination between clinicians and analytical services by way of its standardised approach to surveillance and reporting.

The Emerging Drugs Network of Australia: A toxicosurveillance system of illicit and emerging drugs in the emergency department.

Implementation of wastewater surveillance at music festivals has been limited to date. We aimed to use wastewater analysis and a self-report survey to determine the range of psychoactive substances...

Wastewater analysis for psychoactive substances at music festivals across New South Wales, Australia in 2019-2020.

Adulteration, substitution or contamination of illicit substances can have clinically significant implications when other illicit substances are included. Such circumstances can present as clusters...

A cluster of lysergic acid diethylamide (LSD) poisonings following insufflation of a white powder sold as cocaine.

Introduction There are few contemporary data on illicit drug use at music festivals. We describe drug use patterns and prevalence of specific higher-risk drug-related behaviours, and their associations with festivalgoer characteristics. Methods We approached attendees at six major music festivals in New South Wales, Australia, from November 2019 to March 2020. Participants self-completed an anonymous survey on prior and intended drug use and associated higher-risk behaviours; double dropping; higher-volume ethanol alongside drug use; higher quantity 3,4-methylenedioxymethamphetamine (MDMA); mixing stimulants; and preloading. Logistic regression and UpSet analyses were performed to identify festivalgoer characteristics and the intersection of high-risk behaviours, respectively. Results Of 1229 participants, 372 (30.3%) used or planned to use drugs at the festival. In multivariable analyses, men and those purchasing drugs both inside and outside the venue had greater odds of engaging in higher-risk behaviours. Of those using MDMA, 47.9% reported double dropping. People using drugs for the first time had 3.3 (95% confidence interval 1.2-8.7) greater odds of higher-volume ethanol alongside drug use. People reporting that police/police dog presence influenced their decision to take drugs had 2.2 (95% confidence interval 1.4-3.6) greater odds of preloading. In UpSet analysis, preloading was the most common intersection (17% of those using drugs). Discussions and conclusions Engagement in the five higher-risk drug behaviours was common, particularly amongst males and those using drugs for the first time, while police/police dog presence appeared to influence higher-risk behaviours amongst festival attendees. This information can be used to inform harm reduction advice, public health and law enforcement strategies.

Correlates of higher-risk drug-related behaviours at music festivals in New South Wales, Australia.

Toxicological analysis of serious drug-related harm among electronic dance music festival attendees in New South Wales, Australia: a consecutive case series

Buprenorphine is effective at reducing relapse to opioid misuse, morbidity and mortality in opioid‐dependent patients. Urine drug screening (UDS) to assess adherence is used routinely in opioid agonist treatment (OAT). The primary aim of this study was to determine factors which may be associated with a negative qualitative urine drug screen for buprenorphine in OAT patients.

Catherine McDonald

Papers

Toxicological analysis of serious drug-related harm among electronic dance music festival attendees in New South Wales, Australia: a consecutive case series

A cluster of lysergic acid diethylamide (LSD) poisonings following insufflation of a white powder sold as cocaine.

Evaluation of adherence monitoring in buprenorphine treatment: A pilot study using timed drug assays to determine accuracy of testing

Survival after pentobarbitone overdose confirmed through Prescription, Recreational and Illicit Substance Evaluation (PRISE) programme in Australia

Changing radiotherapy practice for early glottic cancer: Is it a good idea?