Music festivals have become more open to harm reduction initiatives

NEW YORK — The sounds of muffled percussion and audience cheers reverberate throughout the grounds. Brand activations, makeshift bars and restaurant pop-ups control traffic as a sea of bodies move from set to set. Sandwiched between is a row of nonprofits across familiar causes: hunger, housing and voter registration. It's a common music festival scene, until closer inspection. There is a new table, This Must Be the Place. The Ohio-based nonprofit offers attendees free opioid overdose reversal treatment and training on how to use it, an education acquired in under two minutes. Just a few years ago, their inclusion might've been unthinkable amid murky regulations and a lack of public awareness surrounding harm reduction. Advocates say drugs are commonly consumed at music festivals, making them ideal locations for harm reduction activities. While more music festivals are allowing such activities, activists are pushing for expanded efforts as some festivals remain cautious. Harm reduction varies at festivals across the country Founded by William Perry and Ingela Travers-Hayward in 2022, This Must Be The Place has since given away an estimated $4.5 million in naloxone, the opioid overdose reversal medication, at festivals and smaller community events. In the very beginning, without a "proof of concept," as Perry describes it, they had trouble partnering with festivals. Eventually, a few festivals in the Midwest agreed to let them table, which "got us in the door with Bonnaroo in 2022," says Perry, referring to the major U.S. festival operated by C3 Presents, one of the largest concert promoters on the planet. Now they have a presence at 35 major U.S. festivals — including Lollapalooza, Governors Ball and Besame Mucho — where they collaborate directly with C3 and their security personnel. The organization's growth overlaps with advancing federal regulations. According to Daliah Heller, vice president of overdose prevention initiatives at the global public health nonprofit Vital Strategies, naloxone distribution used to be determined by state regulations until 2023, when the Food and Drug Administration approved the first over-the-counter nasal spray. "We no longer need the prescription laws to be amended to allow for the distribution of naloxone," she says. "Now it's like buying aspirin — it's over the counter." Last year, This Must Be the Place gave away 46,146 units of Narcan — a brand name for naloxone — through their national festival outreach. Emmett Beliveau, chief operating officer of C3 Presents, says working with This Must Be the Place was C3's first time implementing public-facing harm reduction strategies, in addition to the promoter's existing medical programs. Bringing the organization into C3's festivals was "not in response to anything that has happened at one of our festivals," he says, but rather because of the "number of fatalities happening in our communities." Some attendees have taken matters into their own hands Some activists believe attendees are most responsive to receiving harm reduction education from peers instead of authority figures. And so, for the last three years, a nonprofit dedicated to combating accidental drug overdoses among young adults, Team Awareness Combating Overdose, has distributed fentanyl test strips and Narcan at the Coachella Valley Music and Arts Festival. Former TACO CEO Kameran Mody says that music festivals are ideal locations for distribution and education because "music and the use of drugs are synonymous with each other." TACO distributes through what Mody describes as "guerrilla-style marketing." They enlist volunteers, train them on how to use naloxone, and ship Narcan and test strips to them to bring into the festival. They do not involve the festival organizers. Representatives for Coachella did not respond to The Associated Press' requests for comment. In 2023, a TACO volunteer administered Narcan to an unresponsive Coachella attendee exhibiting signs of an overdose. The organization says the attendee regained consciousness. "That was one of our biggest successes," Mody says. Local laws and the risk of criminalization hinder initiatives In 2019, at Bonnaroo, a 27-year-old man was found dead at his campsite — right after harm reduction activists had picketed the Tennessee festival because it didn't allow drug testing. The toxicology report found ecstasy and fentanyl in his system. At the time, under state law, test strips were criminalized and classified as drug paraphernalia. That's changed: In 2022, Tennessee decriminalized fentanyl test strips. By the end of 2023, 44 other states and D.C. had done the same. But in some states, drug paraphernalia laws are written in a way that isn't completely transparent — there are test strips that are not fentanyl-specific, Heller points out — and criminalization and social stigmas endure. Some have found workarounds. "Even in the states where the legalities were a bit unclear, instead of just coming in and hoping things worked out, we would reach out to the health department, and say 'We run this project, how do feel about it?'" says Perry. "We would end up with letters from the highest-ranking health official, either in the county or in the state, saying 'We approve of this.' That circumvented any roadblocks." Some festivals, though, might be hesitant to use test strips because "it's tough for them to admit that drugs are being used," Mody says. Some festivals have even banned naloxone. While This Must Be The Place distributes fentanyl test strips at some Ohio events, C3 doesn't distribute test strips at its events and does not plan to. Beliveau doesn't believe fentanyl test strips are effective and expressed concern they could encourage drug use. Test strips, which can detect fentanyl in pills, powders or injectables, are recommended by the Centers for Disease Control and Prevention as a low-cost means of helping prevent drug overdoses. Harm reduction shows promise outside the US At a three-day electronic music festival in Mexico City earlier this year, a booth provided free, anonymous drug testing. The initiative, known as "Checa tu Sustancia" (Check Your Substance), was spearheaded by the Instituto RIA, a Mexico-based drug policy research and advocacy organization. When unexpected substances are detected, users received detailed information on what they are, their risks, potential interactions with other substances and dosage adjustments, empowering them to make informed choices. Perry says they are aware of smaller festivals in the United States conducting drug checking, but "they do it in a very underground and whisper network way" to avoid criminalization. What Perry says his organization would like to see at music festivals in the future would be harm reduction areas — sections where attendees who have taken drugs can be monitored, not to "get them into trouble" but to ensure safety. Heller says there are a number of groups working to destigmatize drugs, promote decriminalization, and promote drug checking. "We already have drug checking happening in cities," she says. "It makes perfect sense to expand the settings where you would offer that to include music festivals. It's the same rationale. ... The issue is this idea of liability. You'd have to create a law, essentially, that would protect the festival from liability."