Brett Jonathan, Siefried Krista J, Healey Amy, Harrod Mary Ellen, Franklin Erica, Barratt Monica J, Masters Jem, Nguyen Lynn, Adiraju Santosh, Gerber Cobus
Clinical Pharmacology and Toxicology Department, St Vincent's Hospital, Sydney, Australia.
Alcohol and Drug Service, St Vincent's Hospital, Sydney, Australia.
Clin Toxicol (Phila). 2022 Apr;60(4):440-445. doi: 10.1080/15563650.2021.1979233. Epub 2021 Sep 20.
Implementation of wastewater surveillance at music festivals has been limited to date. We aimed to use wastewater analysis and a self-report survey to determine the range of psychoactive substances being used during a music festival season in New South Wales, Australia.
We sampled six single-day music festivals requiring a music festival license in New South Wales from March 2019 to March 2020; between 15% and 100% of portaloos (temporary, un-fixed toilet facilities) were sampled at each festival. Samples were screened for 98 psychoactive substances and/or their metabolites with results qualitatively expressed as detection frequencies for each substance at each festival and across all festivals. We compared these data with the results of surveys of self-reported drug use at four of the six festivals.
Festival attendance ranged from 6200 to 14,975 people. Amphetamine, cocaine, ketamine, methylone, MDMA, MDA, alprazolam, diazepam, etizolam, oxazepam and temazepam were found in almost all samples from all festivals. Ethylone, mephedrone and methcathinone were also found in over 50% of festivals. A norfentanyl (a fentanyl metabolite) and n-ethylpentylone were found at 2/6 and 1/6 festivals. No festival survey participant reported intentionally taking cathinones.
The detection frequency for cathinones was higher than expected relative to recent other data sources and this may represent adulteration or substitution. Similarly, the appearance of etizolam may be related to the use of counterfeit alprazolam. The detection of highly toxic substances such as N-ethylpentylone and norfentanyl may warrant public health alerts.
If provided close to real time, wastewater analysis at festivals could be complemented with information sources such as drug checking, on-site surveys, medical presentations and intelligence from peer networks to feed into early warning systems, public health alerts and peer-based harm reduction education during the festival season.
迄今为止，音乐节废水监测的实施情况有限。我们旨在通过废水分析和自我报告调查，确定澳大利亚新南威尔士州音乐节期间使用的精神活性物质范围。
我们在2019年3月至2020年3月期间对新南威尔士州六个需要音乐节许可证的单日音乐节进行了采样；每个音乐节对15%至100%的移动厕所（临时、非固定厕所设施）进行了采样。对样本进行了98种精神活性物质及其代谢物的筛查，结果以每种物质在每个音乐节以及所有音乐节中的检测频率进行定性表示。我们将这些数据与六个音乐节中四个音乐节的自我报告药物使用调查结果进行了比较。
音乐节的出席人数从6200人到14975人不等。在所有音乐节的几乎所有样本中都发现了苯丙胺、可卡因、氯胺酮、甲酮、摇头丸、MDA、阿普唑仑、地西泮、艾司唑仑、奥沙西泮和替马西泮。在超过50%的音乐节中还发现了乙酮、甲氧麻黄酮和甲基卡西酮。在2/6的音乐节中发现了去甲芬太尼（一种芬太尼代谢物），在1/6的音乐节中发现了N-乙基戊酮。没有音乐节调查参与者报告故意服用卡西酮类物质。
相对于最近的其他数据来源，卡西酮类物质的检测频率高于预期，这可能代表掺假或替代。同样，艾司唑仑的出现可能与假冒阿普唑仑的使用有关。检测到N-乙基戊酮和去甲芬太尼等高毒性物质可能需要发布公共卫生警报。
如果能接近实时提供，音乐节期间的废水分析可以与药物检测、现场调查、医疗报告和同行网络情报等信息来源相结合，为音乐节期间的预警系统、公共卫生警报和基于同行的减少伤害教育提供信息。
