Severe Medical Outcomes from "Mega-Raves" (Electronic Music Festivals) in Los Angeles County: A Call for Integration of Emergency and Public Health Services?

OBJECTIVES: To determine common drug exposures and reasons for emergency department (ED) presentation from mega-raves, and challenges for substance abuse prevention. BACKGROUND: Rapidly growing culture and popularity of mega-raves and electronic music festivals elevates public health concern about abuse of ecstasy and other drugs, including alcohol. Young adults are poorly educated about harmful effects of easily accessible drugs at raves. Coordination between law enforcement, emergency medical services (EMS), and Public Health can reduce morbidity and mortality from mega-raves METHODS: One-year retrospective case series of four mega-raves in LA County (LAC). LAC Department of Public Health obtained medical records of patients presenting to ED, via self-transport and EMS. Chief complaints, diagnostics, and treatments were extracted and analyzed to determine the primary reasons for ED presentation. RESULTS: Reasons for hospitalization included drug intoxication, ALOC, trauma, seizure, syncope, SOB, and chest pain. Most common drug exposures (lab report or self report) included ecstasy/amphetamine, ethanol, THC, LSD, and cocaine. CONCLUSION: Toxic effects of multiple drugs and ethanol are common among young adults at mega-raves, and are the primary reasons for ED presentation. Inherent challenges in response to mega-raves include: public jurisdiction policies for mega-raves; EMS and ED practices for patient diagnostics, treatment, and surveillance; and Public Health advocacy and interventions regarding substance abuse and prevention for these planned major events, in which drug use and severe medical outcomes are expected. Multidisciplinary task force and integration of regional Public Health services with EMS and law enforcement may reduce serious outcomes from mega-raves.