Drug overdose victims ‘on fire’, suffer organ damage

A study of overdoses at music festivals, during a “horror” period for drug-related deaths, has found that users can suffer long term organ damage from dangerously high body temperatures.

The Psyfari music festival was cancelled after ten years with organisers blaming the ‘war on festivals’ among other issues for the shutdown. Picture: Facebook

A study of drug overdose cases at music festivals has found that users can suffer long-term organ damage from dangerously high body temperatures, highlighting the need for quality care at events amid a surge in life-threatening toxicity cases.

The research by the Royal Melbourne Hospital and St John Ambulance Victoria compiled 47 cases of life- threatening serotonin toxicity from using ecstasy, and the treatment results in 2017-2019 when a high number of drug-­related festival deaths occurred.

The patients in the study included 13 cases classified as mild, 20 as moderate and 14 as severe, requiring treatment in intensive care with temperatures higher than 40C. Of the total, 19 were taken to hospital.

Of the 14 severe cases, 11 suffered organ damage including to the brain, kidney and heart, and sustained “profound risk of disability” after the drug caused them to burn up and effectively “cook” from the inside.

Physician Lachlan Miles, an author of the research, said it was remarkable no deaths had been included in the study, which had confronted him with the “sickest patients” he had ever treated.

“Drugs that can cause serotonin toxicity do so in one of two ways, by either increasing the ­release of serotonin uncontrollably, or preventing it being ­broken down – MDMA (ecstasy) does the former,” he said.

“This massive release of serotonin overstimulates serotonin receptors throughout the brain and central nervous system.

“Some of this serotonin acts on the serotonin receptors in the parts of the brain responsible for temperature control and control of heart rate and blood pressure, as well as behaviour, manifesting as high temperature, fast heart rate, sweating and agitation.

“Serotonin also acts on other serotonin receptors in the body, like those found on platelets and in muscle, causing clotting problems and muscle contractions and rigidity, which can look like a seizure.

“At the extremes, the muscles of the body begin to break down, causing kidney failure and blood flow to the heart can be disrupted, causing a heart attack.”

St John Ambulance Victoria state medical officer Martin Dutch, who also contributed to the research,

said serotonin toxicity was once “a rare thing many doctors would never have seen” but was becoming increasingly common, highlighting the need for festival venues to have well-equipped, expert medical teams on site when events return after the pandemic.