Opioid use prevalent among electronic dance music partygoers

The study, published in the journal Drug and Alcohol Dependence, suggests that prevention and harm reduction efforts need to target this increasingly popular scene as efforts continue toward reducing the opioid crisis.

Opioid use has grown to epidemic proportions in the United States and has been a main contributor to a resurgence of heroin use, as well as the spread of HIV and Hepatitis C. In 2016, approximately 11.5 million Americans had misused prescription opioids, with 1.8 million meeting criteria for dependence or abuse.

"We've always known that electronic dance music party attendees are at high risk for use of club drugs such as ecstasy or Molly, but we wanted to know the extent of opioid use in this population," said CDUHR researcher Joseph Palamar, PhD, MPH, the study's lead author and an associate professor of population health at NYU School of Medicine.

Since the study was conducted specifically on EDM partygoers, the researchers note that the results may not apply to the general population, but, rather, highlight the need for prevention efforts in this high-risk group.

"This population of experienced drug users needs to be reached to prevent initiation and continued use, which can lead to riskier and more frequent use, dependence, and deleterious outcomes such as overdose -- particularly if opioids are combined with other drugs," Palamar said.

Throughout the summer of 2017, the researchers surveyed 954 individuals (ages 18 to 40) about to enter EDM parties at nightclubs and dance festivals in New York City. Attendees were asked about nonmedical use -- defined as using in a manner which is not prescribed (such as to get high) -- of 18 different opioids -- including OxyContin, Percocet, Vicodin, codeine, fentanyl, and heroin.

The researchers found that almost a quarter (23.9 percent) of EDM party attendees have used opioids nonmedically in their lifetime and one out of 10 (9.8 percent) did so in the past year, which is higher than the national prevalence of past-year use of approximately 4 percent of adults 18 and older. Five percent of respondents reported misusing opioids in the past month.

OxyContin was the most highly reported opioid used in this scene, followed by Vicodin, Percocet, codeine, and Purple Drank, also known as Sizzurp or Lean (which typically contains codeine syrup). A smaller portion of users also snorted (15 percent) or injected opioids (11 percent) in the past year, which increases risk for overdose and dependence.

People who smoke cigarettes or use other drugs (including amphetamine, methamphetamine, and cocaine) were more likely to report misusing opioids in the past month. In particular, nonmedical users of benzodiazepines such as Xanax were at high odds for also using opioids, and, on average, reported using more different opioid drugs in the past year than those who did not use opioids. While the study did not measure whether multiple drugs were used simultaneously, research has shown that users of benzodiazepines and prescription opioids commonly combine the drugs to enhance or come down from the effects of other drugs.

Previous opioid use predicted the likelihood of someone reporting willingness to use if offered in the future. Among non-users, 5.7 percent reported that they would take opioids if offered by a friend in the next month. However, among those who had taken opioids in the past year, almost three out of four (73.6 percent) reported they would be willing to use again.

Notably, almost nine out of 10 past-year users of Purple Drank indicated that they would use again if offered by a friend, although these findings on this cocktail may be limited. "While real Sizzurp, Lean, or Purple Drank contains codeine syrup, it is likely that many people consumed concoctions without codeine," Palamar cautioned. However, the authors note that prevalence of opioid misuse did not change when removing this concoction from the list of opioids examined.