Medical problems related to recreational drug use at nocturnal dance parties

Abstract

During 'I love techno' (edition 2001), an indoor rave party attended by 37 000 people, data about medical problems (especially drug-related problems) were collected. To place these data in a wider perspective, a similar registration was done during 'De Nacht', a traditional New Year's Eve dance party held at the same location and attended by 12 000 people. Furthermore, a prospective study on the time course of the level of consciousness (Glasgow Coma Score) and blood concentrations of illicit drugs, especially gamma-hydroxybutyrate was set up. The results revealed that during 'I love techno' the incidence of medical problems was high (66.5/10 000 attendees), but not higher than during 'De Nacht' (70.0/10 000 attendees). At 'I love techno', however, mainly illicit drugs were used, more frequently leading to severe drug-related medical problems. The observations in patients with a drug-related medical problem who had taken gamma-hydroxybutyrate showed that for a given level of consciousness the gamma-hydroxybutyrate concentrations may show important differences, that the transition from coma (Glasgow Coma Score < or =7) to full recovery (Glasgow Coma Score 15) takes only 30-60 min (and only a small decrease in gamma-hydroxybutyrate concentrations), and that the time it takes before a comatose patient reaches the above-mentioned 'transition area' may be a few hours.

Abrupt awakening phenomenon associated with gamma-hydroxybutyrate use: A case series

“…Another method is to analyze the contents of amnesty bins to gain information on the current drug consumption (27). Our approach was to measure the concentration of several illicit drugs in the blood of patients presenting with serious medical problems to the medical station at large rave parties in Belgium (10). It should be kept in mind that this method of drug detection by quantification in the blood of patients induces a selection bias as blood was only sampled from critically ill patients who needed an intravenous catheter as a part of the medical treatment.…”

“…Nowadays, it is only sporadically used in anesthesia (3), as a sedative in studies with intensive care patients (4,5), and in the treatment of ethanol dependence (6) and narcolepsy (7). In the last decade, however, GHB has been increasingly misused as a recreational drug with high doses leading to deep coma and even death (8)(9)(10). Many case reports and reviews mention a remarkably fast recovery from GHB-induced coma with patients awakening from total unresponsiveness within a few minutes (8,(11)(12)(13)(14)(15).…”

“…installed and staffed with emergency physicians, emergency nurses, and Red Cross personnel as has been described previously (10). When GHB ingestion was suspected either by history or by clinical presentation in a patient with a GCS ≤8, blood sampling and neurological testing (by means of the 3 to 15 point GCS (16)) was performed simultaneously every 10 to 30 minutes until full neurological recovery.…”

The first reported UK fatality related to gamma-butyrolactone (GBL) ingestion

“…In one series of 49 GHB-related deaths, the mean femoral blood GHB concentration was 292 mg/L and in a series of 18 GHB intoxications in which toxicological screening was undertaken, all three patients with a GHB concentration of greater than 220 mg/L had a GCS of 3/15. 11,12 GBL is rapidly metabolized to gammahydroxybutyrate (GHB) in vivo and ingestion of both of these agents, and the other GHB precursor 1,4-BD, cause similar clinical features and complications. 1,2,13 In a recent large UK series (n=158) of acute GHB/GBL toxicity, 47.4% of patients had a GCS % 8/15 on presentation to A&E.…”

Raves y consumo de drogas desde una perspectiva epidemiológica y psicosocial: una revisión bibliográfica sistemática

“…La información aportada por los diferentes estudios muestran que éstos se han centrado en: efectos negativos percibidos de las drogas (Fernández-Calderón et al, 2012;Hunt et al, 2009a;Krul y Girbes, 2011a;Krul et al, 2011b;Riley y Hayward, 2004;Ter Bogt y Engels, 2005;Van Sassenbroeck et al, 2003;Van Wijngaart et al, 1999), los efectos positivos percibidos de las drogas (Hunt et al, 2009a;Fernández-Calderón et al, 2012;Ter Bogt y Engels, 2005), las motivaciones o razones para usar drogas (Engels y Ter Bogt, 2004;Riley y Hayward, 2004, Ter Bogt y Engels, 2005Van Wijngaart et al, 1999).…”