Editor’s Note: Readers should understand that Insomniac’s study was not reviewed by an Institutional Review Board, has not been reviewed by the FDA, and their localized results should not substitute normal emergency medical procedures.
In the world of Harm Reduction, the first goal is to prevent any harm from happening in the first place. This is the purpose of drug education, pill and powder testing, and chill zones, to name just a few proactive approaches. However, even with an arsenal of information and services at our disposal, some people still do slip through the cracks and get themselves into serious trouble. This is where emergency treatment becomes the final line of defense.
In the music industry nowadays, designer drugs are the popular means of a “good time,” mainly drugs like MDA and MDMA (of course commonly referred to as Molly). Unfortunately, just like all drugs, these can be a unpredictable, often adulterated, and dangerous in the wrong circumstances. The side effects can cause the body to go into what is called drug-induced hyperthermia, the cause of many a festival death in recent years.
For those familiar with the opioid crisis sweeping the continent, Narcan is the last line of defense in preserving life. This drug is administered to a victim of an overdose from opioids like heroin, OxyCotin, fentanyl, and more. It almost immediately reverses the effects of the overdose and allows the patient to walk away (relatively) unharmed.
On the pathway to discovering a “Narcan” of MDMA-induced hyperthermia, we come to Dantrolene. Dantrolene is a drug that has primarily been used in the treatment of malignant hyperthermia caused by general anesthesia. The drug has been around since 1967, but its potential usefulness in harm reduction became apparent only recently. The drug’s main function is as a muscle relaxant. It acts by preventing the release of calcium ions from your muscle cells, which help to cool the body. Or in scientific terms according to Wikipedia…
“Dantrolene sodium is a postsynaptic muscle relaxant that lessens excitation-contraction coupling in muscle cells. It achieves this by inhibiting Ca2+ ions release from sarcoplasmic reticulum stores by antagonizing ryanodine receptors. It is the primary drug used for the treatment and prevention of malignant hyperthermia, a rare, life-threatening disorder triggered by general anesthesia.”
Scientific mumbo-jumbo aside, the bottom line about this drug is that it acts fast. Maren Steiner, Health and Safety Director for Insomniac Events, told us that she was able to take a patient with a temperature of 106 degrees Fahrenheit down to 99 Fahrenheit in less than 3 minutes when combined with an ice bath. Suffice it to say, that’s a pretty damn impressive speed to bring a core body temperature down, taking someone from a life-threatening scenario into potentially stable condition.
The study was conducted strictly as an observational study last year, and not in the traditional Institutional Review Board study. During the observational study, a total of 9 patients were treated with Dantrolene at EDC Las Vegas. Of the 9 patients, all of them experienced a total reversal of hyperthermia, and 8 patients survived their experience.
The process of treating a patient varies per patient. Pete Carlo, PA-C of C&C Medical Events (a partner in Insomniac’s observational study), explained to us that there is currently not a standard for treatment across the board. As medical professionals, it is their “obligation to treat the patient.” What he means by this is that each person metabolizes substances differently. We have also been told by Pete that other studies are being conducted on the Asian population concerning the use of MDMA. Studies out of Canada are finding the Pacific-Asian population have a gene that causes them to metabolize MDMA 100 times slower then other populations, thus causing this demographic to be at a greater risk for drug-induced hyperthermia.
When it comes to the way drugs affect different people, you can have a patient who has a core temp of 104 degrees and can be “talking to you completely coherently,” and have another patient who is crashing at that temperature. What’s important is treating each person on a case-by-case basis, especially since the process for treatment is still in its infancy. From what we have been told by these subject matter experts, right now it involves a rectal thermometer, a horse trough filled with ice water, and a healthy dose of Dantrolene or benzodiazepines.
That being said, if you ever feel like you are in danger (or you think a friend of yours is in danger), please, please. please head to the medical tent. At the harm reduction summit last year in Seattle, Maren Steiner told us about the initial results of her and her partner’s observational study. She told to us about the one person who may have been saved, if only her friends just brought her into the medical tent. “They walked right by the tent as they left,” she said while tears ran down her face. This drives home the importance of being aware of your own and your friends’ health. According to Maren and Pete, Dantrolene will now be available at all Insomniac Events shows.
Edit: The article has been updated to clarify that Dantrolene is not a yet-proven analogue in the fight against MDMA-induced hyperthermia to Narcan/naloxone in the fight against opioid overdose, and to clarify the parameters of the study itself.
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