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      Recreational Drug Use During the Amsterdam Dance Event: Impact on Emergency Services

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          Abstract

          Background:

          Recreational drug use is common at large-scale dance events such as the Amsterdam Dance Event (ADE) and severe drug-related complications and deaths occur. Increasing concentrations of cocaine, amphetamine and MDMA have been observed in samples from dance events. Therefore, large dance events are expected to cause an increasing amount of recreational drug related complaints (RDRC) and an increased demand on emergency medical services.

          Aim:

          To evaluate the impact of recreational drug related complaints (RDRC) during ADE 2016, compared to regular weeks, and to evaluate the requirement for additional medical personnel.

          Methods:

          For this prospective, observational cohort study, patients >12 years old presenting with RDRC at first aid stations (FAS), ambulance service (AA) and ED during ADE, between October 19th and October 24th 2016 were included. From 2 EDs and AA, the RDRC 2 weeks before and after ADE were also collected.

          Results:

          An estimated 375.000 people attended ADE. The number of patients with RDRC was 459 at the FAS, 113 at AA and 81 at the ED, and increased significantly during ADE with 225% at AA and with 236% at OLVG ED. Eight patients were admitted. A higher percentage of poly-drug use among ED patients (58%) was found, compared to FAS patients (25%). Also, the proportion of tourists in ED’s (51%) was higher compared to FAS (30%).

          Conclusions:

          During ADE 2016, the number of intoxicated patients increased significantly. Eight patients were admitted to the hospital, without any deaths. The absolute number of patients stayed within normal range of emergency medical services capacity.

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          Most cited references20

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          Adverse drug-related effects among electronic dance music party attendees

          Drug use is prevalent among electronic dance music (EDM) party attendees, but research is needed to determine the extent of adverse drug-related outcomes in this population in order to better inform prevention and harm reduction efforts. 1,029 adults were surveyed entering EDM parties in New York City in 2018. Those reporting past-year use of a drug were asked if they experienced a harmful or very unpleasant effect after use in which they were concerned about their immediate safety. They were also asked about co-use of other drugs and whether they sought help. We estimate that a third (33.5%) of EDM attendees has experienced a drug-related adverse effect in the past year. Two-thirds (67.8%) of adverse effects involved use of alcohol. Relative to use, adverse effects most commonly resulted from use of opioids (e.g., prescription opioid misuse, 41.1%) or alcohol (33.9%). Concomitant use of other drugs was common, particularly among users of cocaine (55.7%), LSD (55.7%), ketamine (56.5%), LSD (41.2%), and ecstasy/MDMA/Molly (47.7%). Adverse effects resulting from synthetic cathinone (“bath salt”) use were most likely to result in a hospital visit (57.1%), followed by opioids (e.g., prescription opioids: 14.3%). Adverse effects from drug use are common among those in the EDM scene and polydrug use appears to be a common risk factor. More research is needed, however, to determine the extent of event-specific adverse outcomes. Results can inform prevention and harm reduction efforts in this population.
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            Emergency department crowding in The Netherlands: managers’ experiences

            Background In The Netherlands, the state of emergency department (ED) crowding is unknown. Anecdotal evidence suggests that current ED patients experience a longer length of stay (LOS) compared to some years ago, which is indicative of ED crowding. However, no multicenter studies have been performed to quantify LOS and assess crowding at Dutch EDs. We performed this study to describe the current state of emergency departments in The Netherlands regarding patients’ length of stay and ED nurse managers’ experiences of crowding. Methods A survey was sent to all 94 ED nurse managers in The Netherlands with questions regarding the type of facility, annual ED census, and patients’ LOS. Additional questions included whether crowding was ever a problem at the particular ED, how often it occurred, which time periods had the worst episodes of crowding, and what measures the particular ED had undertaken to improve patient flow. Results Surveys were collected from 63 EDs (67%). Mean annual ED visits were 24,936 (SD ± 9,840); mean LOS for discharged patients was 119 (SD ± 40) min and mean LOS for admitted patients 146 (SD ± 49) min. Consultation delays, laboratory and radiology delays, and hospital bed shortages for patients needing admission were the most cited reasons for crowding. Admitted patients had a longer LOS because of delays in obtaining inpatient beds. Thirty-nine of 57 respondents (68%) reported that crowding occurred several times a week or even daily, mostly between 12:00 and 20:00. Measures taken by hospitals to manage crowding included placing patients in hallways and using fasttrack with treatment of patients by trained nurse practitioners. Conclusions Despite a relatively short LOS, frequent crowding appears to be a nationwide problem according to Dutch ED nurse managers, with 68% of them reporting that crowding occurred several times a week or even daily. Consultations delays, laboratory and radiology delays, and hospital bed shortage for patients needing admission were believed to be the most important factors contributing to ED crowding.
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              Acute health problems due to recreational drug use in patients presenting to an urban emergency department in Switzerland.

              To describe acute toxicity of recreational drugs including novel psychoactive substances.
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                Author and article information

                Journal
                Subst Abuse
                Subst Abuse
                SAT
                spsat
                Substance Abuse: Research and Treatment
                SAGE Publications (Sage UK: London, England )
                1178-2218
                19 October 2022
                2022
                : 16
                : 11782218221114965
                Affiliations
                [1 ]Emergency Department, OLVG Amsterdam, Amsterdam, The Netherlands
                [2 ]Section General and Acute Internal Medicine, Department of Internal Medicine, VU University Medical Center, Amsterdam, and The Institute for Cardiovascular Research (ICAR-VU), Vrije Universiteit, Amsterdam, The Netherlands
                [3 ]Ambulance Service Amsterdam, Amsterdam, The Netherlands
                [4 ]Emergency Department, VU University Medical Center, Amsterdam, The Netherlands
                [5 ]Department of Epidemiology & Health Promotion, Public Health Service Amsterdam, Amsterdam, The Netherlands
                [6 ]Event Medical Service, Uden, The Netherlands
                [7 ]Section Acute Medicine, Department of Internal Medicine, Academic Medical Center, Amsterdam, The Netherlands
                Author notes
                [*]Femke MJ Gresnigt, Emergency physician, Emergency department OLVG hospital, Oosterpark 9, Amsterdam 1091AC, The Netherlands. Email: f.m.j.gresnigt@ 123456olvg.nl
                [*]

                Both authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0002-6428-8600
                Article
                10.1177_11782218221114965
                10.1177/11782218221114965
                9597048
                36312590
                11737030-c4c2-4d0c-8671-b37de499f32d
                © The Author(s) 2022

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 9 February 2022
                : 4 July 2022
                Categories
                Original Research
                Custom metadata
                January-December 2022
                ts1

                Health & Social care
                emergency medicine,prehospital emergency medicine,recreational drugs,dance event

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