The Health Department of New York City is cooperating with nightclubs in Brooklyn to provide on-site opioid overdose antidotes and overdose prevention information to clubgoers. These new initiatives specifically address the problem of fentanyl-laced cocaine, which is a common nightlife drug compound that often has lethal effects. The use of this drug may be unintentional, as users do not know the cocaine is laced with the opioid fentanyl. The use of this drug may cause cardiac arrest, and it is illegal to obtain and consume.
Nightlife in urban areas has always been an environment for increased substance abuse. People who attend clubs and bars may not be habitual drug users, but use drugs in those isolated contexts. From social smoking and drinking to social drug use, there may be a darker side to this experience.
Illegally manufactured drugs are not regulated, which means that they can contain additional, harmful substances. Drugs that are distributed in a club are often done so in a casual way and without any review by consumers or knowledge of the drug’s chemical components.
Fentanyl-laced cocaine is an increasing problem, according to research published by the National Institutes of Health. Between 2015 and 2016, a substantial increase in cocaine deaths was a direct result of the addition of opioids, most commonly fentanyl.
Adding fentanyl to cocaine is done intentionally to create a rush or stimulation called speedballing. Fentanyl and cocaine have opposite effects on the body. Fentanyl represses or dulls stimulation, while cocaine increases or heightens stimulation. As overdose statistics show, this can be a lethal combination.
Campaign to Bring Awareness to Drug Use in Nightclubs
A campaign launched in New York City is an effort to bring awareness to the dangers of mixing drugs. The outreach campaign, sponsored by the health department, has multiple initiatives, including:
- Passing out literature printed on posters and coasters
- Providing naloxone and medical kits to bars and clubs
- Providing opioid overdose training for staff who volunteer
The multipronged initiatives present information that warns clubgoers and cocaine users that fentanyl may be present in the drugs they are using. Additionally, the outreach program works to increase access to opioid overdose drugs like naloxone.
This approach represents a landmark shift in paradigm, from prosecution to prevention. The city recognizes the complexity of addiction and the reality of drug use. In light of that, it is providing meaningful information and guidance in the midst of drug use. This approach has worked in multiple other cities and outlets.
In 2017, the National Collegiate Athletic Association (NCAA) responded to increased drug activity among student athletes by providing substance abuse prevention toolkits. Research published by the Department of Health and Human Services found that providing on-site prevention services reduces the harm incurred by individuals who are under the influence of drugs.
On-Site Overdose Treatment in Clubs
New York City’s approach has extended beyond prevention as it introduces naloxone and medical kits for staff to use in the event of an on-site opioid overdose emergency. The tools for treating an opioid overdose may be simple and can be administered by trained staff members. In New York’s initiative, staff members in clubs may volunteer to receive this training.
Similarly to New York City, Seattle clubs received naloxone nasal spray doses as part of a pilot project to provide opioid overdose treatment to their clients earlier in 2019. The King County Health Department and a local chain of pharmacies are sponsoring this initiative with training and supplies. It remains to be seen how effective these tactics will be in a crisis, but they are representative of the larger cultural trend of approaching drug use with prevention, treatment and care.
Miller, Brenda A, et al. “Environmental Strategies for Prevention of Drug Use and Risks in Clubs.” 2009. Accessed July 21, 2019. Nolan, ML, et al. “Increased Presence of Fentanyl in Cocaine-Involved Fatal Overdoses: Implications for Prevention.” U.S. National Library of Medicine National Institutes of Health, February 2019. Accessed July 21, 2019.
Miller, Brenda A, et al. “Environmental Strategies for Prevention of Drug Use and Risks in Clubs.” 2009. Accessed July 21, 2019.
Nolan, ML, et al. “Increased Presence of Fentanyl in Cocaine-Involved Fatal Overdoses: Implications for Prevention.” U.S. National Library of Medicine National Institutes of Health, February 2019. Accessed July 21, 2019.