COVID-19 is an emerging, rapidly evolving situation.

Get the latest information from CDC ( | NIH Resources | NIDA Resources

Drugs & Health Blog

Concerts and Drugs: Is There a Way to Reduce the Dangers?

This blog post is archived and is no longer being updated. For the latest content, please visit the main Drugs & Health Blog page.
The NIDA Blog Team

Summer is back, and outdoor concerts can be an awesome part of it. Concert festivals are all about good music, good friends, and big crowds.  But for some people, these events are also about using drugs. Every year, we hear about drug overdoses and drug-related deaths happening at concert festivals.

These tragedies, as well as the many injuries and arrests, are terrible, life-changing and even life-ending events. There are no words of comfort for the families and friends of those who never come back from their “bad trip.” 

Even concert hosts have to take stock when the drugs used at their events get more news coverage than the bands. It’s against the law to make concerts “drug-friendly,” so many concert organizers have gone with a zero tolerance policy. Others find it easier to turn a blind eye (at least, until they’re shut down).

But some music festivals are trying a different approach to reduce the bad experiences for concert-goers determined to get high on illicit drugs. 

A “harm reduction” approach

“Harm reduction” is an approach that is based on the belief that some people will do risky, dangerous, and sometimes illegal things even if they know that it could hurt them or have an outcome they don’t want. Risky behaviors include things like using drugs, having unprotected sex, and binge drinking. And examples of unwanted outcomes from these behaviors include HIV infection, pregnancy, arrests, and drunk-driving accidents. 

Supporters of harm reduction feel that educating and protecting people about how to reduce unwanted outcomes is more realistic and helpful than educating them on why they shouldn’t do it in the first place. However, others say there should be a “zero tolerance” approach and that by trying reduce harm from using drugs, you are encouraging drug use.

So how does this work at concerts?

Well, in recent years, organizations that promote safe drug use have distributed drug-testing kits at music festivals to help people who buy drugs to be sure that they're really getting what they think they're getting.

For example, much of what is sold at concerts (and on the street) as “Molly” (MDMA powder) is really one of various synthetic cathinones, the extremely dangerous and unpredictable stimulant chemicals in bath salts.  You might have read about this before on this blog. (Drug dealers lie. Who knew?)

The drug test kits are used to check what’s actually in that little baggie and alert buyers when they have been duped. (A recent documentary found that what people bought as Molly was really bath salts 100 percent of the time!) But it turns out that the drug tests being distributed aren’t totally reliable. They may not be accurate, and they might miss the presence of many potentially harmful chemicals. So they could promote a false sense of security.

Lightning in a Bottle

The Lightning in a Bottle Music Festival, held over Memorial Day weekend in California, took extra steps to try and reduce negative outcomes for concertgoers who used drugs by partnering with harm-reduction organizations like DanceSafe. This group offers drug testing and tries to educate people at electronic music festivals and nightlife venues about potential warning signs connected to drug use, like heat stroke and dehydration, since these are the main reasons people die or become seriously ill from MDMA at music festivals. DanceSafe also hands out water.

Lightning in a Bottle also offered help to anyone going through a difficult experience while on psychedelic drugs like acid or mushrooms.

But is harm reduction helpful?

Not everyone thinks harm reduction is a good idea. Some people think trying to make drug use safer is just a way to promote drugs rather than keep people from using them altogether. By making it a little bit safer, they say, you are giving people the green light to go ahead and do something that could harm them.

Few would argue against the idea that knowledge—including a person knowing what’s really in the powder they bought at a concert—is always better than ignorance. But we don’t know how much that information actually influences people to change course when they find out they got swindled. Does finding out they've bought bath salts and not Molly keep them from taking the product they just spent money to get? We also don’t know if these harm-reduction programs have prevented any overdoses or deaths, or if anyone has been more likely to use drugs when they know an aid station is there to help if something goes wrong. In the end, the only way to ensure good health is to stay away from drugs offered at these concerts.

What do you think? Will harm-reduction programs at concerts help people make smarter decisions about their health, or encourage risky behavior?

Comments posted to the Drugs & Health Blog are from the general public and may contain inaccurate information. They do not represent the views of NIDA or any other federal government entity.


If harm reduction encourages drug use than seat-belts encourage speeding and should be banned.
"Hey man! I was not going to do drugs but then I heard they were giving out free water!"
"Hey man! I wasn't going to do drugs but then I heard they were giving out free water!"
so true
I think that what people want to do is their choice. we cant make them stop.
people just dont know how harming it is to there bodies and one day they will find out what it will do to them
Thank you NIDA for publishing this article and for asking the important questions. As the founder of DanceSafe and a harm reduction advocate for over 20 years, I can answer definitively that harm reduction, including drug checking services, have saved countless lives. PMA and PMMA have together killed hundreds of Molly users over the last decade, and remain the most deadly adulterants found on the Molly market. Drug checking kits can, when used properly, weed these pills out, as well as bath salts and other more dangerous substances. The only time the reagent kits cannot identify PMA and PMMA in a tablet is when a psychopathic manufacturer combines them with MDMA in the same tablet. Pills like this have been discovered, which begs the question... why have we put the manufacture of MDMA in the hands of criminals and psychopaths? The deadly, adulterated MDMA market is a direct result of prohibition. Not only has MDMA prohibition created the most highly adulterated drug market in the world, but it also has made MDMA itself, more available to children. Through strict, legal regulation, we could allow adults safe, legal access to MDMA while simultaneously reducing access to minors. Teenagers today can more readily purchase "Molly" (whatever it contains) than alcohol. Criminals don't ask for ID. This is not to say MDMA should be as readily available as alcohol. Proper legal regulation of MDMA should be strict, and should be designed to eliminate the adulterated, illicit market. This can be accomplished in a number of ways. And truth be told, alcohol should be regulated much more strictly than it currently is. Saving lives will require a rational assessment of the benefits and risks or particular drugs, including the effect prohibition has on these risks. With regards to a drug like MDMA, prohibition is the cause of the bulk of the risks and harms, as you so readily point out in the above article. Drug checking services like the kind DanceSafe provides (modeled off the original program started by Dutch government) is not an attempt top reduce the harms of MDMA. It is an attempt to reduce the harms of MDMA prohibition. As to whether harm reduction services lead more teenagers to try drugs, the answer is probably yes, but not that much. However, the alternative of no harm reduction services has been proven conclusively to result in more fatalities. From needle exchanges to drug checking services, harm reduction is evidence based. I am so glad to see NIDA engaging in this important discussion. Finally, there is one glaring oversight in your article. Abstinence is actually a form of harm reduction. It is the best form of harm reduction and the only way to avoid the risks and harms associated with any drug (legal or illegal). Harm reduction organizations like DanceSafe always educate young people on this value of abstinence. The only difference is that harm reduction is not an "abstinence only" model. Abstinence-only educational models have been shown to fail. A study on the DARE program, for example, showed that graduates of the program were actually more likely to use drugs than teens who did not go through the program. Once again, thank you for this article. Let's continue the public discussion around drug policy. We can do better as a country and a society. Thank you, Emanuel Sferios Founder, DanceSafe
Thanks, NIDA, for acknowledging DanceSafe's services. I am the current executive director at DanceSafe. We, too, are interested in behavioral intent around drug checking. We would be happy to improve our drug checking technology and provide data to you if you would please approve our R21 grant request. I'd also like to make mention that we do not educate or argue that drug testing kits detect MDMA purity or potency. We educate on the limitations of this method and always inform young people that no drug use is entirely safe. We provide honest, fact-based information on effects, risks, and protective factors to prevent a false sense of security. Additionally, people who approach DanceSafe in search of testing services already have a substance intended for use. Thus, offering this service does not result in a person seeking out a drug for testing. We understand that despite zero tolerance policies and abstinence-only education that many young people will assume the risks. Thus, providing education and drug checking services are essential tertiary prevention strategies. We aim to fill a gap in education and services to meet young people where they are at because it is medically and morally negligent not to provide people with potentially life-saving information. If we can't keep drugs out of prisons, how can we keep them out of concerts and music festivals? Missi Wooldridge, MPH Executive Director, DanceSafe [contact information removed per commenting guidelines]
It is also conceptually disputable whether low drug use prevalence should be a goal in itself—or is it actually a lower harm-to-prevalence ratio that should be pursued?
I think that this article encourages ignorance rather than addressing the issue at hand. If "bath salts" are "extremely dangerous and unpredictable stimulant chemicals," then people need to know this and have hard research and reinforced data. If they are not, and it is possible to use them safely, then we should avoid scaring people and instead ensure that they have accurate information to avoid misuse and self harm.
In the end, NIDA, the only way to ensure good health is to stop using a zero-tolerance approach when educating adolescents on potentially risky behaviors. Abstinence only education never helped to reduce rates of teen pregnancy or STIs, there is no evidence supporting that it helps teens stay away from drugs or use them safely.
As a Los Angeles Dancesafe Volunteer that does perform onsite testing at various events where the venues permit it, I can safely say that the turnout we have out there increases at every event. Every substance we check, helps give people more insight on what they may, or may not happen to consume. We always leave the decision with the user and offer nothing more than facts and well documented education pulled from peer reviewed medical journals. As far as our testing kits are concerned, we've been using the same kits that major law enforcement agencies across the country have been using for decades. also known as National Institute Of Justice Standard–0604.01, outlines precisely what we use in the field. These exact standards, are currently in use everywhere from Local Law Enforcement, to the DEA, ICE, and every other 3 letter agency that you can imagine. Along with most international agencies as well. We freely admit that our testing is not absolute, it's far from it, and regardless of what result comes up, we tell everyone that no drug is safe, no drug is good, and that the result that appears through chemical reagent testing may indicate one thing, it's still possible that there may be something else inside of it. What we offer, is a tool in which others can use to become more knowledgeable about their use, to learn more about what can happen if they happen to ingest a particular substance. The good, the bad, and the ugly. All from the stance of non-profit organization that holds no opinion on use in and of itself. Just information. In the 2 years I've been with the organization, I've personally seen a tremendous benefit in the events that I frequent.
Hmm is harm reduction helpful? I've talked to people who have told me that harm reduction organizations like DanceSafe have saved their lives by getting them emergency help when necessary, helped prevent them from getting heat stroke by providing them water and helped them make decisions regarding their drug use via testing. I've seen people throw drugs out, having seen the results of their drug checking be different from what they expected them to be. No one that I've ever spoken to has indicated that they intend to do more drugs because harm reduction was there.
"Hey man! I wasn't going to do drugs but then I heard they were giving out free water!"
I have tested pills at many venues and I never witnessed a person take a pill that came back with a "negative" for MDMA result. In fact, I witnessed many people throw suspect pills in the trash. So yes, Harm Reduction does work through education and offering honest choices. When you say that "the only way to ensure good health is to stay away from drugs offered at these concerts," are you referring to alcohol as well? And why just single out concerts? Sporting events, too, permit the sale of alcohol. Well Harm Reduction, in the form of "moderation management," has you covered by talking about consumption and safety. Festivals, clubs, and sports stadiums need to offer sound, truthful information. Then, and only then, can we be sure that we done as much as possible to reduce the risk of injury or death at entertainment venues. But remember, we can never remove entirely the risk of living...that's why it's called Harm Reduction not Harm Elimination.
Hey NIDA... there's this thing called the internet, and another thing called Google. You can use these to look up all sorts of information. Pretending that you don't know how effective harm reduction services. programs and policies are, is either sheer ignorance, or an attempt to mis-educate your audience. Not taking a harm reduction approach ends up with sick and dead people. Please, get real.
The imperative to show evidence of effectiveness is appropriate but it cuts both ways. Drug harms and overdose deaths have increased under prohibition (and drug use has increased too). Why would we continue to endorse that?
My comment meant to read... Hey NIDA...There's this thing called the internet, and another thing called Google. You can use these to look up all sorts of information. Saying that we don't know how effective harm reduction services. programs and policies are, is either sheer ignorance, or an attempt to mis-educate your audience. Not taking a harm reduction approach ends up with sick and dead people. Please, get real.
Saying that we shouldn't give people the information about what their pills are made of is akin to saying we should turn off speedometers in cars when people go over the limit. Who comes up with these kinds of policy ideas?
Harm reduction saves lives!
great to see this coverage. but it seems like you are underplaying the "we don't know"-ness regarding the effectiveness of harm reduction measures. a perusal of the articles in the, for example, will show readers just how much evidence-based support there is for this sensible public health and safety approach.
Harm reduction is essential for those who reject abstinence. The majority of the population has used an illicit drug and the majority of the population uses the most dangerous drug--alcohol. Anyone who uses any drug--whether or not society deems it socially acceptable--needs to know how to prevent or reduce potential harm. There wouldn't be so many adverse effects and deaths if people were properly educated. These adverse outcomes are largely preventable and preaching and enforcing abstinence only is irresponsible as it neglects the majority of the population who decide to engage in drug use. Harm reduction in no way promotes use. It saves lives.
I think its a pretty clear analogy to compare it to sex education. Its all very similar arguements both for and against. The evidence, if this analogy is valid, is in favor of harm reduction. Study after study has demonstrated that places where abstinence-only approaches to sex education have the worst outcomes in teen pregnancy and STDs. Likewise, Portugal, which is a country that decriminalized drugs of abuse, has drastically cut their negative outcomes from drug use, and Holland, which decriminalized marijuana, has lower rates of use than the United States since adopting this policy. In both cases, ending programs that were focused on abstinence from substance abuse and allocating that money to harm reduction efforts such as addiction treatment have led to great many successes in managing the negative outcomes of drug use in those countries.
Ignorance is bliss- just ask any conservative or reckless concert attendee.
As a music festival harm reduction service provider, I can tell that there is abundant practical evidence to support the theory of harm reduction. MDMA and psychedelics are not "escape drugs" - their users have decided to use those substances for fun purposes, to feel good. In a "rave" setting, "bath salt" type synthetic stimulants are rather seen as adulterants with unwanted side effects, inferior to a "real" MDMA experience (of loving, etc.). Drug checking, pill databases, and substance information are helping people (who have already purchased their pills) to make informed decisions about their drug use. If the pill is not MDMA, most of these people would flush down the stuff on the toilet. Therefore, harm reduction measures reduce the probability of drug use from 100% (they would eat the pill, in the lack of further information) to BELOW 100% (they choose not to use the drug, based on further information). In the presence of good quality MDMA, nobody would choose balt salts. In other words, the bath salt market flourishes because of the illegality of MDMA, as bath salts are "last choice" options in the lack of MDMA. Harm reduction is practically the only way to save some of the consumers from carcinogenic aminonaphthyls or nephrotoxic halogenated cathinones on the bath salt market.
This is a bad article, and I would like to welcome its author to engage me in debate in this comment section if they are so willing. "Few would argue against the idea that knowledge—including a person knowing what’s really in the powder they bought at a concert—is always better than ignorance... the end, the only way to ensure good health is to stay away from drugs offered at these concerts." If your original point is that we don't have information on whether or not harm reduction works, why would your conclusion state that we should act as thought it doesn't? You're contradicting yourself. A quick google search shows plenty of available information: is a good start. To the original author - why do you think people do drugs? Do you think, based on your experience, that it's possible to use drugs like MDMA without adverse health affects? To the reply above mine - a better analogy to this article, in my opinion, would be to say that "condoms encourage sex" and "the only safe way to live is to stay abstinent until marriage".
An example of harm reduction ACTUALLY saving lives: --> in one year, 100 people's lives were saved thanks to the administration of the "overdose antidote" naloxone since it became legal to distribute in North Carolina Another example of harm reduction from the same documentary referred to in this article, titled "What's In My Baggie?": for anyone who has actually watched the documentary in its entirety, you will see that after testing their drugs and finding out the drugs were bunk, not one person went on record as saying that they would still use the drug anyway. They were disappointed, but glad to know that they would not be taking bath salts that day.
Portugal has been following a policy of harm reduction for over a decade and the result is conclusive - almost no drug-related deaths, fewer addicts and people turn for help when they begin to have problems - not wait for the problem to become more serious than a drug conviction. Drug use didn't increase radically, in fact it seems to have decreased. But even if it went up, I'd rather have more people enjoying drugs without problems than less use but more death, addictions and other problems
This is a good example of how decriminalization can be mis-promoted to imply that it is acceptable to use drugs, especially by those that stand to benefit from use, such as drug testing companies ...and dealers. Decriminalization DOES NOT mean that its now acceptable to use drugs. Its admitting that imprisonment does very little to reduce use. Look, its cool if youve decided to use alright. That is YOUR choice, YOURS! Why are you people intent on taking the rest of the planet down with you by confusing facts and in the process encouraging impressionable young people to use? Is it because misery loves company? I believe that is indeed the case. Its easier to get every else to sink to your level than it is to have the balls to actually admit that drug use has not helped you in any way and quitting is the better answer. My apologies if youre not an active user. Yes, I just assumed...
" Will harm-reduction programs at concerts help people make smarter decisions about their health, or encourage risky behavior?" Harm reduction is done by educating users on risk reduction. The instruction of and use of practices designed to reduce risks, and thus harm, is the exact opposite of encouraging risky behavior. " By making it a little bit safer, they say, you are giving people the green light to go ahead and do something that could harm them." That is incorrect. Harm reduction consists of educating people on how to drive and how to tell the difference between a green, yellow, and red light. Prohibition consists of driving with your eyes closed or not driving at all. Obviously people are going to drive. Don't we want them to know when it's ok and when they should slow down and when they should stop?
The idea that making things "drug friendly" is problematic is exactly because of the RAVE Act, sponsored by Joe Biden, passed in 2004. If you amend the rave act, harm reduction can be brought in to make parties safer. Not "drug friendly," as that statement is disingenuous & exactly the type of behavior we're trying to fight in the harm reduction movement.
Harm reduction saves lives. Instead of banning drugs like on Holy ship. And any mention of drug use on their Facebook page help reduce the dangers. Even in countries where drugs carry the death penalty people still use it.
As an avid music and arts festival attendee, I believe harm reduction will reduce a greater number of unwanted drug-related consequences than just telling people to abstain. As someone who attended Electric Zoo Music Festival in New York in 2013 when they had to cancel the last day of the festival due to drug-related deaths of the festival attendees, I truly believe having organizations like DanceSafe there would help save lives. People are going to partake in activities whether you tell them to or not, so at the very least we should be able to stop them from unintended risks.
I live in a country that decriminalized drug use 15 years ago and embraced a harm-reduction approach. When I was a kid my country was fighting a huge epidemic of heroin abuse. Every corner had one junkie , every family had someone with a life destroyed, every move on the war on drugs seemed not to work. Then we thought: This is not working, let's try something different: and we moved to a harm-reduction approach, together with a total change in our drug policies. The results: Now we are the country in Europe with less overdoses (check the latest European Monitoring Center for Drugs and Drug Addiction report for some hard facts), when someone needs help, he/she knows he can find it and doesn't have to hide anymore in dark corners, drug use has become a minor social problem in our society even with a lot of budget cuts on the drug policies. And stop saying we are a very different society from the USA, last time I've heard we had all 2 lungs, 1 heart, 1 brain and 99,999% of the same DNA, I'm from Portugal and if that example is not enough, think about sex abstinence: priests and churches have tried to impose it for thousands of years, and it never worked. Do you think it will miraculously work now? Policies should be evidence-based, not acts of blind faith - That's the difference between the middle-ages and modern societies.
There is no question that harm reduction is more effective than the zero tolerance policy. The sooner that people start to realize that the sooner less people will get hurt.
Harm reduction encourages risky behavior as much as the war on drugs curbed drug use, which is to say, not at all.
Harm Reduction Efforts in British Columbia "This is probably the city with the most aggressive harm reduction approach, yet we're seeing declining rates of drug use within this community"
Thank you NIDA for highlighting the importance of harm reduction as a strategy to save lives and promote knowledge over ignorance. Similar to making condoms available on college campuses and at events, harm reduction offers a way to mitigate risks, promote an atmosphere of safety, cooperation, and respect, and most assuredly, save lives. The NIH agrees, saying "There is sufficient evidence to support the wide-spread adoption of harm reduction interventions and to use harm reduction as an overarching policy approach in relation to illicit drugs." ( Thank you for continuing the conversation, and inviting comment.
Harm reduction absolutely saves lives!! I have witnessed friends of mine who took bad pills at "raves" that sent them into seizures, excessive vomiting, and many other health issues. If pill testing and other harm reduction services were available I know they would not have taken said pills. As others have said here what people are meaning to take in these settings is often MDMA, and the alternative of taking a multitude of different adulterants is undesired. Pill testing directly would reduce instances of overdose or death if used more commonly. Another important aspect of what Dance Safe does is opening up a platform for event attendees to talk to approachable, knowledgeable people behind the booth that can give them truthful information to aid in their decisions. Having this peer-based education system allows for a greater understanding for both dance safe and event attendees, and ability to more fully understand these types of things. I truthfully believe that harm reduction does not encourage drug use or other risk behaviors at all and I believe that these efforts would greatly benefit everyone as I have personally seen many times.
I don't know how to reduce these dangers. Concerts were always full of drug dillers. I was always curious why people take drugs while enojying music 'cause the true drug is the music itself for me... Best regards, [link removed per commenting policies]
So real Molly is safer than FAKE Molly??? Have either been tested and approved by anyone???
I would be very interested to know what NIDA thinks.
As the article said, knowledge is better than ignorance, and harm reduction promotes knowledge where zero tolerance promotes ignorance. The information and messages most of us receive about drugs and drug use are very general, harsh, and light on useful content that helps people make decisions. Harm reduction bridges this gap and provides factual information (in the form of literature, reminders about safety, substance screening, etc.) that helps people assess the risks and potential outcomes of drug use themselves. "Don't do it, it might hurt you" is a much less compelling reason to use safely or abstain than a full rundown of the effects, risks, and potential outcomes, and harm reduction uses the latter approach to encourage reasonable decision making paired alongside tools to keep people alive and healthy. In the end the most we can really do for people is give them resources, as we can't control their actions, and harm reduction is critical because it provides these resources. It truly does save lives and encourage healthy lifestyles.
Yesss harm-reduction!!! DanceSafe is advocating for harm-reduction at maaad festivals!
Thank you NIDA for making the concept of harm reduction more visible to the general public. However, this article encourages ignorance and it seems like you're question harm reduction more than you're questioning the status quo.
Science-based drug education and harm reduction are essential tools that should be used when considering drug policy within the US. Drugs are a frequent topic in the news, government, and popular culture. It is undeniable that people will be exposed to the topic through these manners. However, because most current drug education programs are not science-based and harm reduction services are sparse, people who inevitably try drugs will have less knowledge about their potential risks and fewer resources to seek help from. Dr. David Nutt and other scientists have published population data on subject-based drug harms that NIDA and other science institutions continue to ignore. For example:
Harm reduction is only controversial to people who hate drug users and want to see them dead.
As more countries, individual states and various entities begin to refocus their efforts on harm reduction practices it is important to pressure law makers to embrace harm reduction efforts
I’m an addiction psychologist with 40 years of experience, now primarily working with adolescents, young adults and their families. After 35 years of experiencing repeated failure in providiing successful outcomes in treatment for young people, my career took a dramatic turn as more and more of my clients began dying from overdose. I lifted my head out of the sand and became aware of public health policies that criminalize substance use and stigmatize drug users and are directly contributing to my failures as a clinician. These experiences shone a glaring light on how the traditional education, prevention, and treatment models were failing my clients and their families and led me to incorporate harm reduction approaches into my work. As I learned about harm reduction, it quickly became apparent that the tenets of harm reduction parallel those of effective parenting: facilitating self-empowerment by being compassionate, respecting uniqueness, encouraging autonomy, enhancing a dialogue, and establishing trust and safety. Harm reduction offers unbiased information based on established science and research. Our kids aren’t stupid. They want information given with honesty and the faith that they can make their own informed decisions. Talking to kids about drugs in this way is more likely to empower parents AND them. This type of conversation is not sending a messaging that getting high is ok; the message our kids get is letting her know she can talk to you about drugs in a healthy way.
To tell people to stay away from certain substances is naive, wishful thinking. Educating people on these substances, with unbiased information, will help them make better decisions. Harm reduction isn't encouraging people to do drugs, just informing them about what they're choosing to put into their body.