LC–MS/MS Hair Analysis Reveals Hidden Drug Use at Music Festivals

A study conducted at an international music festival in Portugal aimed to characterize substance use by integrating objective toxicological findings with self-reported information. Hair samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to detect psychoactive substances and metabolites. A paper based on this research was published in Drug Testing & Analysis.¹

Why Are Music Festivals Important Settings for Studying Substance Use Patterns and Behaviors?

Substance use—both legal and illegal—continues to be a major public health issue worldwide. Music festivals are unique environments where people may be more likely to use drugs due to the atmosphere, music, and a sense that the risks are lower. Research shows that drug use is more common among festivalgoers than in the general population, making these events important for studying how people use substances, including combining multiple drugs.^2-10

What Did the Study Reveal About Substance Use when Comparing Self-Reports with Hair Analysis?

Quantitative hair analysis was combined with survey data from 249 participants recruited in 2022 and 2023. Self-reported use was assessed across multiple timeframes, from same-day consumption to use within the previous year. Alcohol (96%) and cannabinoids (90%) were the most frequently self-reported substances overall, based on lifetime self-reported use. Overall, 50% of participants tested positive for at least one compound in the analyzed hair samples, with cocaine, 3,4-methylenedioxymethamphetamine (MDMA), and ketamine being most detected (24.5%, 24.1% and 22.9%, respectively). Some participants who denied consumption tested positive, particularly for MDMA and ketamine. Self-reported non-use was inversely associated with hair positivity for MDMA (OR = 0.25, 95% CI: 0.09-0.65) and ketamine (OR = 0.19, 95% CI: 0.09-0.40), compared with self-reported users. Discrepancies were also observed for cannabinoids, highlighting limitations of self-reported data. Strong correlations were identified between cocaine and benzoylecgonine, and between cannabis-related analytes (cannabidiol and THC), supporting the consistency of the toxicological results.¹

“This study,” write the authors of the paper,¹ “underscores the value of integrating self-reported data with quantitative hair analysis to obtain a comprehensive understanding of substance use behaviors in music festival settings.”

“Overall,” the authors continue,¹ “this research provides robust evidence that combining questionnaire-based self-reported data with quantitative hair toxicological analysis offers a more comprehensive and reliable assessment of substance use behaviors in music festival settings. While questionnaires allow the capture of contextual information, consumption patterns and perceived behaviors, hair analysis contributes as an objective measure of cumulative exposure over extended timeframes. The integration of these complementary approaches enables the identification of discrepancies, improves the interpretation of self-reported data and facilitates the detection of concealed or unintentional drug use. Collectively, this combined methodology enhances the understanding of polydrug use dynamics and supports the development of more effective public health surveillance, harm reduction strategies and targeted interventions in high-risk environments.”

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References

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