Narcan at music festivals? The life-saving drug naloxone is coming to a concert near you

It's festival season, meaning fabulous flower crowns, loud live music and Narcan.

Yes, the overdose-reversing drug Narcan (naloxone) will be available at music festivals near you this year – and with good reason, experts say.

Drugs and alcohol are staple at music festivals and many often overdo it. Combine that with the overwhelming presence of fentanyl in the drug supply in recent years and the risk has become deadly.

"It's just that now, rather than kind of overdoing it, you just die," says Dr. David Deyhimy of MYMATCLINIC. "And that's why we need to have this medication."

What is naloxone?

You've probably heard of the drug naloxone, and may refer to it by its most common brand name Narcan (another brand name is Kloxxado). It's a nasal spray that can reverse the effects of an opioid overdose.

"It's really unbelievable," says Susan G. Sherman, a professor of American Health in the Johns Hopkins Bloomberg School of Public Health’s Department of Health, Behavior and Society. "It blocks the effects of opioids in your brain." 

The FDA approved Narcan for over-the-counter use late last month – a welcome move, particularly when the drug market is full of fentanyl, a synthetic and powerful opioid.

U.S. drug overdose deaths rose 30% between 2019 and 2020, then 15% in 2021. That same year, more than 100,000 people died. The rate of synthetic opioid overdose deaths rose 22%.

Many famous musicians have died of overdoses, but "we frequently don't really feel all the people who are fans of that music that we've also lost," says Nikki Jean, director of social responsibility at independent hip-hop label Rhymesayers.

Visual explainer:How to use Narcan to treat a fentanyl overdose

How naloxone is being used at music festivals

Many groups work in harm reduction, including DanceSafe, Beats Overdose and This Must Be the Place. This Must Be the Place has distributed 14,178 naloxone kits since March of last year; it's done so at big festivals like Bonnaroo and Burning Man.

William Perry, co-founder of This Must Be The Place, is also a certified chemical dependency counselor. The idea for the nonprofit came about during the pandemic amid concerns about the growing fentanyl crisis and people making up for lost time partying post-quarantine.

"It seems like a no-brainer to me," says Robin A. Pollini, associate professor in the Department of Behavioral Medicine and Psychiatry at West Virginia University.

Deyhimy adds that generally, "At the very least, people are drinking or smoking something (at music festivals), and from there it can easily turn into more experimentation or more desire to get high or feel altered."

Many people who use substances at music festivals aren't accustomed to drug use. "They're going to be taking what they would assume in earlier times were safe, recreational substances and these aren't your everyday users," Perry says. "These are your special-occasion users."

Perry quickly realized how in-demand the services of This Must Be The Place were: "People needed this stuff, it was on their list of things to get" – they just didn't know where to get it. Hikma Pharmaceuticals, makers of Kloxxado, donated 10,000 doses of naloxone last year to help. This year, it's 24,000; This Must Be the Place will be at 25 major festivals this year.

How naloxone at festivals should work 

Like a fire extinguisher or AED, naloxone could be and is often readily available to save lives. A death from fentanyl can happen within minutes, whereas heroin usually evolves over hours.

That's why its presence at festivals is crucial.

Experts say those who want to step in to help at a music festival should pay attention to what else is going on to relay that information to professionals.

"If you convey what you have seen and what you have done, especially and including the timelines of what you witness in another person's experience, it helps people who have more information and more qualification, draw additional conclusions," says Rachel Clark, education manage at DanceSafe. 

Signs of overdose, according to the Centers for Disease Control and Prevention include:

• Small, constricted "pinpoint pupils."
• Falling asleep or losing consciousness.
• Slow, weak or no breathing.
• Choking or gurgling sounds.
• Limp body.
• Cold and/or clammy skin.
• Discolored skin (especially in lips and nails).

And if you think you're witnessing an overdose: 

• Call 911 immediately.
• Administer naloxone, if available.
• Try to keep the person awake and breathing.
• Lay the person on their side to prevent choking.
• Stay with the person until emergency assistance arrives.

What about fentanyl testing strips?

Naloxone is a great tool, but experts rally behind one with more legal complexities: fentanyl test strips.

Fentanyl test strips are small strips of paper that check for fentanyl in drugs; the Centers for Disease Control and Prevention provides information on how to use fentanyl test strips.

Advocates argue there is a need for more mainstream acceptance. Robert Valuck, a professor at the University of Colorado Anschutz Medical Campus, says: "People typically say a dead addict cannot recover, has no chance of recovery. So we're trying to keep people alive and fentanyl test strips will tell you if something's there."

These strips are not legal everywhere, and festivals in particular are concerned about liability. Nonprofits like DanceSafe test people's drugs at festivals and offer nonjudgmental drug information; it also sells strips on their website.

This Must Be the Place educates festival goers about harm reduction services and how to help someone. Its naloxone distribution pays off, as overdose reversals have happened both on festival grounds and the day after a festival.

"You wake up, you cry a little bit, because you know, that every bit of it was worth it," Perry says. "And then you're motivated to go to the next one."

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