‘We’re making harm reduction cool’: overdose reversal Narcan becomes a rave essential

It’s Saturday night in Los Angeles, and Marie is heading to a rave downtown. She arrives before the doors open, creating a chillout zone by fluffing out a rug and pillows. Then, she lays a hundred little green packets on a table, and waits for strangers to approach.

Around midnight, an agitated man walks over and pulls a bag of white powder from his pocket. “Can you help me test this?” he pleads. “I don’t want to die.”

Marie rips open one of the green packets. Inside: testing strips that can detect whether substances like cocaine and ketamine contain fentanyl, a deadly opioid that’s increasingly infiltrating the street drug supply. Scooping out some powder from the bag, she dilutes the sample in water, and dips a test strip inside. One line: positive. The man runs back into the party and confronts his drug dealer. But the dealer denies it’s her batch. “I tested my drugs at home,” she says, “and it was negative on every supply”.

So Marie tests the drug dealer’s drugs too. Two lines: negative. Now everyone’s confused. In the end, the man throws his bag into the trash: better safe than dead.

Marie is one of the many harm reduction workers helping distribute testing strips in leisure spaces. Fentanyl testing strips as well as the opioid-reversal drug naloxone (commonly known as Narcan) are becoming the sine qua non of the party scene, distributed everywhere cultural denizens hang out: nightclubs, art galleries, downtown streetwear stores, even housewarming parties in Brooklyn.

Fentanyl, a prescription pain medication developed for cancer patients, has turned into an indiscriminate spectre in the club scene. The deadly synthetic opioid has been flooding the street market as dealers bulk out recreational drugs like cocaine and heroin with fentanyl. No one can say exactly why it has become so common, but a variety of factors, including pandemic supply chain shortages, accidental cross-contamination, and increasing potency have been suggested. The drug is now the number one cause of death among adults aged 18-45 according to CDC data analyzed by Families Against Fentanyl, and was involved in 60% of the 100,000 overdoses that occurred in the past year, a record high that eclipses gun fatalities and car crashes combined. Dr. Robert Anderson, the chief of mortality statistics at the CDC’s National Center for Health Statistics, estimates that more than half of those overdose cases involve fentanyl mixed with another drug.

Many clubbers now see recreational drug use akin to a game of Russian roulette, and as nightclubs reopened this year, warnings spread through social media about bad batches causing accidental overdoses in these communities.

The harm reduction movement’s growing downtown presence is perhaps best exemplified by Dirty, a print magazine recalling the grittier days of New York street culture. The magazine kicked off its third issue launch party this month with a conversation on the overdose crisis hosted by novelist Nico Walker. Fentanyl test strips and Narcan training were provided by Asap Foundation (a harm reduction organization named after A$AP Yams, the founder of the rap collective A$AP Mob who died of a drug overdose aged 26) that distributes these supplies to many stores around the city. To raise funds, the magazine teamed up with the artist Sucklord to sell pop art figurines inspired by Narcan nasal sprays.

Editor-in-chief Ripley Solano explains that needle exchanges and other harm reduction programs are vital, but that it is equally important to introduce these ideas on a cultural level. “I think there is a lot left out of traditional organizing,” Ripley says. “What me and my friends can contribute is to make harm reduction cool.”

As a set of policies, harm reduction aims to mitigate the risks of drug use through resources and education, offering an alternative to decades of prohibition and punishment. The movement first gained popularity in the US during the 80s Aids crisis, as programs distributing clean needles among intravenous drug users successfully reduced the spread of HIV. New York City activists scored a major victory in November with the opening of the nation’s first two supervised drug-injection sites, and similar campaigns are under way in cities like Denver, San Francisco and Seattle.

But in some states, fentanyl test strips are considered drug paraphernalia, possession is punishable as a misdemeanor. A federal “crack house” statute also makes it a felony for any space to knowingly facilitate drug use. As it stands, most music festivals and venues in the US do not allow drug-checking services out of fear of attracting law enforcement.

The current spike in fentanyl fatalities may be tipping the risk calculus: for venues, an overdose could be more likely than a police raid. In a sign of shifting political winds, the New York City mayor’s nightlife office launched a “Narcan Behind Every Bar” campaign this month to encourage nightlife venues to obtain free supplies of Narcan from the health department, and train staff on how to use it. “Much like CPR kits behind every bar, we think it would be important, but not mandated, for venues to be aware that this is necessary,” says the nightlife mayor, Ariel Palitz.

Palitz says that the campaign aims to assuage “fears and misconceptions” among venue operators and law enforcement around harm reduction. “I do believe the police are understanding that this is a life-saving measure, not necessarily a condoning of drugs, or an attempt at finding a loophole to decriminalize drugs.”

But many non-governmental harm reduction practitioners do celebrate drug use. “There has been a shift in harm reduction in general to be less about risk, and more about enjoyment and having fun,” agreed Al Ostapeck, harm reduction assistant manager at the Lower East Side Harm Reduction Center. “It’s a party, here’s how to do it safer.”

Established in 1992, the center recently revamped their Instagram, posting nightlife-inspired graphics with safety information about ketamine and poppers (an inhalant popular on the party scene), as well as promoting their “safer sniffing” kits of candy-colored straws.

“We had a lot of conversations about utilizing this medium to connect with people who think harm reduction is only for intravenous drug users,” says Sophia Reinicke, a harm reduction assistant manager who manages the center’s social media. The strategy worked: many young people coming to the center now cite Instagram as their driver.

Popular demand for harm reduction in the nightlife community is also driven by the focus on mutual aid and mental health during the pandemic. “I was begging people to come to my events a year ago, but now everyone is promoting harm reduction at their parties,” says Salman Jaberi, founder of Rave Scout Cookies, a nightlife platform that publishes eye-catching drug education booklets inspired by 90s rave flyers, along with DJ mixes and interviews. “Everyone is thinking about self-care hygiene when it comes to nightlife,” Jaberi continued. “Harm reduction is about protecting each other and oneself, and that’s why it has become such a thing.”

“We need to normalize naloxone so your friend doesn’t drop dead in front of you,” says the New York DJ Lauren Flax. In 2019, Flax founded a platform called Last Night a Deejay Saved My Life to supply her DJ friends with free Narcan, so they could travel and tour with it. The program has since expanded into hosting Narcan training sessions for ravers at popular clubs like Nowadays in Brooklyn. Flax says fentanyl has left no corner of the club world untouched, everyone knows someone who has overdosed she says.

However providing testing strips alone is not enough. The strips can often give false positives or negatives, especially when used in dimly-lit and rowdy nightclubs. Most strips were produced by a medical supply company BTNX for urine drug tests, and their use to detect the drug in substances like MDMA is entirely off-label. “Because fentanyl is active at such small amounts, these tests are extremely sensitive as they’re made for forensics purposes,” says Mohawk Greene, the technical program manager of Next Distro and former president of New York DanceSafe.

According to Greene, improper dilution can produce false positives, while testing only a sample of a batch instead of the whole supply can result in false negatives. Ravers can also risk legal trouble for pulling out their baggies in venues with zero-tolerance drug policies. “You can’t just throw test strips in the bathroom and think that’s going to enable people to make more informed choices,” Greene says. “Because there’s a severe lack of understanding in how this stuff works, it’s not very useful.”

Underfunding also remains a chronic issue for grassroots harm reduction programs. “We catch flak because we’re not an anti-drug organization, so it’s hard for us to get grants,” says Theo Kryzwicki, an LA City firefighter who founded End Overdose, an organization that distributes free Narcan and fentanyl test strips to underground raves. Instead, End Overdose relies on the music community’s support via microdonations on their website and social media. “These young kids in their 20s in Simi Valley lost their friend” Kryzwicki recounted. “They sold T-shirts and stickers, and donated money to us.”

Until drugs are fully decriminalized, life-saving measures will often operate in a legal grey zone, with grassroots organisations taking on legal and financial risk to provide this kind of healthcare. Yet, as fentanyl expands its devastating sweep across America, so will public demand for mutual aid and safer drug use.

At the recent Surround music festival in Los Angeles’s Grand Park, Marie once again set up her harm reduction booth next to a row of food trucks and vintage pop-up shops, handing out sleek black kits of Narcan and fentanyl test strips provided by End Overdose and the Los Angeles LGBT Center. “If harm reduction was a known thing four years ago, my friends would still be here.”

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