Music Festival Embraces Overdose Reversal Drug, But Fentanyl Testing Kits

A 26-year-old man was found dead in his campsite during the Bonneroo Music and Arts Festival in 2019. Toxicology reports linked her death to a grisly trend that has since worsened. He had both ecstasy and fentanyl in his system—a dangerous combination, especially if people don’t know that the party drug contains extremely powerful synthetic opioids.

Attendees at multi-day concert festivals like Bonnaroo, held on an isolated farm in Coffee County, Tennessee, don’t seem to have much trouble sneaking pills and powder past security. And those drugs can be laced with fentanyl, which is why medics who work these events carry the overdose reversal drug naloxone these days. But first responders can’t be everywhere, and fast-acting drugs need to be administered quickly.

“We’re showing up a lot with it,” said Angela Travers-Hayward, whose Ohio-based nonprofit This Must Be The Place is flooding the festival with Cloxado, a nasal spray version of the life-saving drug. “We want to go around the campground and actively hand it out.”

Travers-Hayward and her husband, William Perry, who became a rehabilitation counselor after addiction sent him to prison for a decade, are distributing Cloxado doses across the country this summer that have been donated by the manufacturer, Hikma Pharmaceuticals. Their summer tour ends at Burning Man in Nevada’s Black Rock Desert over Labor Day weekend.

Music festivals once frowned upon naloxone and some banned it. But even though what’s known as harm reduction — the idea of ​​reducing the negative effects of illicit drug use without trying to stop it entirely — has gained acceptance, adoption is far from over. Among the promoters of the concert is helping people get their medication tested for fentanyl, less accepted than naloxone. Companies don’t want to be seen as rejecting drug use. They are navigating a legal gray area and battling public perception.

Harm reduction advocates picketed outside Bonneroo in 2019 because the festival did not allow recreational drug testing for fentanyl. Live Nation, which is the majority owner of Bonnaroo and among the world’s largest concert promoters, did not directly respond to questions about whether it now allows fentanyl testing, saying in an email that Bonnaroo is always “looking for ways to care” and educate our patrons.”

US drug deaths to top 100,000 nationwide in 2021, with two-thirds caused by synthetic opioids. That has prompted federal and state governments to try to think of new ways to deal with the crisis, with the Biden administration giving $30 million to support programs often run in the shadows. In the past few years, the Substance Abuse and Mental Health Services Administration has also fully adopted fentanyl test kits.

Still, many communities outside of music festival grounds are resistant to harm-reduction strategies, particularly fentanyl-testing tools. Dr. Ingvild Olsen, director of SAMHSA’s Center for Substance Abuse Treatment, says harm reduction requires an evolution in thinking, and he encourages organizations to consider harm reduction a life-saving tool — especially when massive overdoses are possible.

“The lethality of fentanyl has changed the game so much, because it takes a while for someone to stop breathing,” Olsen said. “If we have these very effective tools that we know can save lives, I think that’s what we can rally around.”

Attendees of the Bonnaroo Music and Arts Festival in Manchester, Tennessee, pick up naloxone nasal spray from a booth set up by This Must Be The Place, a nonprofit organization that distributes the overdose reversal drug at music festivals across the country. (William Perry)

Public health agencies increasingly recommend that even those who do not use the drug carry naloxone, which can be obtained with a prescription or over the counter, although laws vary from state to state. But often governments take a back seat to harm-reduction efforts, relying instead on nonprofits and volunteers.

“It’s a fine line to walk, and health departments try to stay within the boundaries of the law and proactively communicate as well as get good public health education out there,” said Laurie Tremmel Freeman, CEO of the National Association of County and City Health Officials.

But few people bring antidote with them to concert venues, Perry said, and free doses can be difficult to track down. “It’s not something anyone puts on their to-do list.”

For those willing to buy it, even generic forms can be expensive. And name-brand reversal kits cost more than $100 each without insurance.

“What we’re learning is that all of these people know what naloxone is — they also know people who have had their lives back because of naloxone,” Travers-Hayward said. “But we’re able to be the people who give them the original first kit.”

He and a team of volunteers handed out 2,500 doses at this year’s Bonneroo. One person died during the four-day event in June, although toxicology reports that would indicate whether an overdose was to blame have not been released.

Laws and policies regarding handing out such drug-safety equipment vary by state. Naloxone, for example, technically remains a prescription drug, so handing it over means relying on Good Samaritan laws that protect organizations and people from legal liability.

Although more states, including Tennessee, are criminalizing fentanyl test strips, some states still classify them as illegal drug paraphernalia. Even in states where test strips are legal, big-time festivals still don’t welcome them publicly due to concerns about liability or image.

“They’ve given us a long list of insurance requirements in the past,” says the founder of Bank Police, a company that secretly sells test kits at festivals. “We rocked the planet, I kid you not, for underwriters who would insure us in this situation.”

The founder, who goes by Adam Ochter, doesn’t share his real name — he fears for his safety as he tracks drugs down to certain dealers and tries to persuade them to destroy their supplies. He has testimonial videos showing dealers crying after realizing their drugs could kill someone. But others aren’t so grateful, he said.

Auctor says he’s been kicked out of Bonnaroo twice and doesn’t go anymore. But he sneaks into various other festivals days before, parking his truck — filled with thousands of test kits — to avoid security in the woods until he blends into the crowd. “We’re barely even asking permission to come anymore,” he said. “We know they will say ‘no’ to us.”

But the need is great, he said.

“Drug checking is no longer an option,” said Mitchell Gomez, executive director of DanceSafe, a nonprofit that provides drug checking and other public health education at nightclubs and party venues. “It’s something that anyone who uses substances has to do.”

People line up at the Bonnaroo Music and Arts Festival to receive free naloxone from This Must Be The Place, a harm reduction nonprofit run by William Perry and Angela Travers-Hayward. (William Perry)

DanceSafe follows rules set by promoters, though Gomez won’t reveal which festivals are cooperative. Where permitted, the nonprofit sets up a tent with a tabletop machine that screens drugs for fentanyl.

Overdose — often from substances containing fentanyl — is now the leading cause of death for Americans ages 18 to 45. The dire trend line has softened some promoters, Gomez said, but not all of them.

While corporate legal teams remain idle, Gomez said, he sees potential liability working both ways. “If someone dies at your event from something that DanceSafe could have prevented and we reach out to you about being on site and you turn us down, I actually think that probably creates some liability as well,” he said.

Sometimes he is welcome at festivals but drug testing is prohibited. So Gomez put out information about the dangers of fentanyl and handed out earplugs — a less controversial way to help people stay safe at the festival.

This article is from a partnership that includes Nashville Public Radio and KHN.

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