Organizing a music festival means knowing how to throw a party. It also means knowing how to save a life.

“When it comes to bad drug interactions and overconsumption, we’re talking about some of the biggest risk factors at the core of many live music experiences.”

Thrival Crowd Shot
Adam Piscitelli / Courtesy of Thrival

Twenty-five suspected GHB overdoses in Australia. Twenty-four suspected THC overdoses in Ohio. Thirty suspected Fentanyl overdoses in Toronto. Dozens of molly overdoses in Florida. A fatal LSD overdose in California, and 90 people hospitalized for overconsumption in Connecticut.

It’s unclear whether the year’s worth of concert-related headlines reveals growing rates of concert drug use, the side effects of a growing festival movement, the changing and often unpredictable nature of drugs — or all three.

Earlier this month in Burgettstown at Farm Aid, an event less closely associated with hard drug use than the Electric Daisy Carnival or Burning Man, for example, police arrested revelers for everything from cocaine to methadone, methamphetamine to LSD and marijuana to suspected heroin.

For all these reasons, Dan Law, director of Thrival Music Festival, said questions of substance abuse and related questions of public safety remain inescapable for concert promoters and organizers like himself.

Thrival Innovation + Music Festival kicked off Wednesday, with two days of innovation talks and sessions, followed by a music festival today and Saturday, headlined by Wiz Khalifa.

“When it comes to bad drug interactions and overconsumption, we’re talking about some of the biggest risk factors at the core of many live music experiences,” Law told The Incline.

“Whether you agree with the behavior or not, this stuff is a part of festival culture, regardless of an organizer’s or promoter’s ability to curb its prevalence.”

Not that they won’t try.

Law described an extensive planning process at Thrival aimed at keeping drugs out and those who may use them safe. (More on that later.) He also stressed the role of individuals in that equation, adding, “It is the festival goers’ responsibility to behave with care, but there are always the exceptions to the rule.”

Perhaps this is the fundamental dilemma of the music festival era we’re living in, one involving the need to balance personal freedoms with personal safety, to imbue a sense of freedom alongside a sense of self-restraint. Law knows this juxtaposition well.

“For Thrival, we’ve taken a number of steps to help mitigate these issues, with the understanding that no precautionary steps can 100 percent guarantee bad things from happening.”

When they do, medical professionals are waiting, he added. Often, that’s when the real challenges begin.

Dr. Thomas Campbell remembers the Kenny Chesney concert in particular.

“That’s always the one that sort of jumps to mind,” the Allegheny Health Network chair of emergency medicine said.

There’s good reason for that.

The July 2016 show at Pittsburgh’s Heinz Field made national headlines for both the tons of trash it left behind and the number of attendees requiring medical attention — some 136 in total, almost all of them alcohol-related cases. Of those, more than 30 were taken for treatment to local hospitals like Campbell’s, where they accumulated like the walking wounded in a triage system.

“We certainly had a larger volume of patients than normal, almost all of them related to alcohol drinking — whether it was simple falls and hurt legs and ankles to really being intoxicated, so much so that they couldn’t walk and had to have some support,” Campbell recalled. He added, “Almost everybody was able to be taken care of easily and just required some IV fluids and observations. Very few people were of a critical nature.”

Beyond the immediate aftermath, the Chesney show became emblematic of the larger obstacles facing emergency personnel and officials in similar situations.

For first responders, those challenges can be particularly acute — often involving the navigation of crowded and dark venues in search of patients and more often attempting to determine what substances those patients may have taken.

“That’s probably the No. 1 challenge for paramedics,” Campbell said of locating patients in a crowd. “It’s also a challenge trying to figure out what the drug is, but on the pre-hospital side, there’s a need to really get a patient out of the venue and en route to the hospital.”

Thrival Music Back Crowd Shot
Adam Piscitelli

Once they’ve arrived, Dr. Michael Lynch, an assistant professor of emergency medicine at the University of Pittsburgh, said assessments are made and symptoms can begin to be treated.

“With concert crowds, more often it’s hallucinogens and stimulants which carry a different set of risk factors. ‘X’ or ‘molly’ can mean a lot of different things, many with amphetamine compounds. Those can cause seizures, hyper-excitation, delirium, excessive sweating, fast heart rate, heart rhythm abnormalities and low sodium or electrolyte abnormalities.”

On the other hand, Lynch said sedatives like GHB, Benzodiazepines like Xanax and dissociative agents like Ketamine can cause excess sleepiness and trouble breathing.

“When an agency is called, they don’t know which of these things they’ll be dealing with,” Lynch explained.

“And the agents being used are always changing and evolving, and so we’re always responding to what’s new.”

He continued: “I will say that there is a broader variety [of drugs now], and some are much more potent than what people may want or realize.”

But as with the Chesney show, alcohol remains a far more common culprit in these kinds of emergency calls and disruptions, Campbell and Lynch added. Drug and alcohol cases accounted for 13 percent of the deaths seen at music festivals worldwide between 1999 and 2014, Vice reported.

Pittsburgh’s Department of Public Safety, the Swissvale Police Department (which will oversee Thrival) and the Department of Public Safety in Washington County — home to this year’s Farm Aid — did not respond to inquiries.

Meanwhile, Law said Thrival is taking no chances, especially on the heels of drug deaths and overdoses at festivals across the U.S. and even here in Pennsylvania. This year, the precautions at Thrival include heightened security and a more “manageable bag policy” to keep illegal substances out.

“We’re attempting to eliminate any confusion. No large frame back packs. Only book bags and smaller. For CamelBak-type bags, they just have to be empty of liquid,” Law said.

Re-entry into Thrival has also been discontinued so that, as Law puts it, “festival goers are disincentivized from leaving the concert site to engage in otherwise illegal activity.”

First aid and ambulatory services will also be available, along with free water stations, to ensure festival goers remain “hydrated and cool” at its outdoor venue, Carrie Furnaces. This as heat stress and dehydration remain frequent factors with medical emergencies involving drugs or alcohol at shows, experts say.

Elsewhere, festival attendees have been allowed to bring overdose antidotes with them to concerts, just in case, while some festivals have taken to offering on-site drug testing that tells patrons which substances they actually have and how to use them safely.

“It’s a very important conversation to have that demands attention,” Law said of drugs on the festival circuit.

“For any festival to be truly successful, the safety and security of guests and attendees must always be the foundation of any plans.”

Editor’s note: Thrival Innovation + Music Festival was a sponsor of The Incline’s Who’s Next bash.