Adolescents, drugs and dancing

Even though data from national samples suggests drug use among adolescents in the general US population has been declining, targeted samples have shown nightclub attendees tend to report high rates of drug use, above that of the general population. In spite of increasing deaths among dance festival attendees in recent years, no nationally representative studies have examined potential associations between nightlife attendance and drug use.

In order to inform prevention and harm reduction (for those who reject abstinence), data has been needed from nationally representative samples to determine the extent to which nightlife (or "rave") attendees may in fact more likely to use various drugs.

A new study, published in Drug and Alcohol Dependence by researchers affiliated with New York University's Center for Drug Use and HIV Research (CDUHR), is the first to examine the sociodemographic correlates of rave attendance and relationships between rave attendance and recent (12-month) use of various drugs in a representative US sample of high school seniors.

The study, "Illicit Drug Use among Rave Attendees in a Nationally Representative Sample of US High School Seniors," used data from Monitoring the Future (MTF), a nationwide ongoing annual study of the behaviors, attitudes, and values of American secondary school students. The MTF survey is administered in approximately 130 public and private schools throughout 48 states in the US. Roughly 15,000 high school seniors are assessed annually. This study utilized MTF responses from 2011 to 2013, examining data from a total of 7,373 students who, in addition to reporting their sociodemographic data, alcohol and drug use, were asked how often they attended "raves."

Researchers compared rates of recent use of various drugs according to whether or not any rave attendance was reported. They also examined differences by more frequent use (defined as use six or more times a year), and they also examined differences in use by level of rave attendance.

"One out of five students reported ever attending a rave, and 7.7% reported attending at least monthly," said Joseph J. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC). "Females and highly religious students were less likely to attend raves, while students residing in cities, students with higher income and those who go out for fun multiple times per week were more likely to attend."

Most notably, the study found that use of illicit drugs other than marijuana was about 20% higher among rave attendees compared to non-attendees. Moreover, rave attendees were more likely to report more frequent use for each of the 18 drugs assessed.

"Use of each illicit drug other than marijuana was at least twice as prevalent among rave attendees, and the common "club drugs" ketamine and GHB were both almost six-times more prevalent among attendees," said Palamar. "Higher frequency of rave attendance was consistently associated with higher odds for reporting recent use of each of the drugs assessed, especially use of the party drugs LSD, ketamine, GHB and methamphetamine."

A major limitation of this national data Palamar and his team analyzed was that the students who were asked about rave attendance were not asked about use of ecstasy (MDMA, commonly referred to as "Molly"). In addition, he cautioned that the survey questions they examined did not define "rave" for the students so it is unknown whether all respondents considered dance festivals or nightclub parties "raves."

"Our research findings shouldn't be used to label or stigmatize the latest generation of nightlife and festival attendees. While rates of use are in fact higher in this population we need to keep in mind that two-thirds of rave attendees reported that they did not use drugs other than marijuana," notes Palamar.

Accordingly, the study's findings should inform prevention and much needed harm reduction efforts around rave attendees.

"The summer festival season is about to begin," said Palamar. "I commend the recent efforts of festival promoters to ensure safety of attendees--for example, serving free water and having medical staff present to help patrons in need. However, I do worry that increased presence of law enforcement may lead to riskier drug taking practices among those who reject abstinence. We urge patrons to look out for one another to ensure everyone's safety."

Palamar and the other authors of this study advocate for the availability of drug testing services at or outside of raves and realistic education initiatives, such as social media campaigns, to prevent use and adverse outcomes, which would likely reduce poisonings in the new cohort of partiers.