Designer drugs, which contain a variety of unconstrained psychoactive elements, have emerged as typical on the illicit drug market. These compounds, collectively known as novel psychoactive substances (NPS), generally are used for their stimulatory and euphoric effects. Because of their physical and mind-altering properties, NPS commonly appear at electronic dance music (EDM) festivals. Widespread use at these events has been well-documented. Adverse effects and fatalities associated with the ingestion of these drugs have been reported in the United States. Public health officials, law enforcement, and forensic science communities face numerous challenges due to the diversity and rapid turnover of any particular NPS at any given time.

Over a 2-year period, blood, urine and oral fluid samples were collected from EDM festival attendees, in addition to survey data regarding prescription and recreational drug use. The intent was to examine emerging NPS, establish their overall prevalence, evaluate oral fluid compared with blood as an alternative for drug detection, and determine patterns of use and trends within this population.

Rapid changes in the synthetic drug market cause studies to be published long after drugs have cycled through the peak of their popularity with users. Testing often fails to detect, identify, or report the most recently available drugs. Incomplete literature exists regarding metabolites of many NPS, making laboratories’ ability to maintain a current scope both difficult and incomplete.

Throughout 2014 and 2015 samples were collected from 396 individuals (126 blood, 227 urine, and 406 oral fluid). Additionally, surveys were administered to the same persons. In response to survey questions, 72 percent of participants reported using a recreational drug or medicinal substance within the previous week. Partakers most commonly reported using marijuana and alcohol, followed by “Molly” and cocaine. Approximately 75 percent of the individuals tested positive for drugs in at least one biological specimen.

In 2014 several samples confirmed use of alpha-PVP (n=17); however, in 2015 none of the samples tested positive for the same drug. Instead, increasing numbers of subjects showed positive results for ethylone, which demonstrates the high rate of NPS turnover.

In comparing the three matrices, the specimens agreed with respect to reporting positive results. The study confirmed the value of using oral fluid as a specimen for drug detection compared with blood.

For additional information this study, Identification and Prevalence Determination of Novel Recreational Drugs and Discovery of Their Metabolites in Blood, Urine, and Oral Fluid, can be located at www.ncjrs.gov, NCJ 250338.