Festival Harm Reduction for People Who Are Not Using: The Bystander Playbook
A checklist-and-scenario guide for sober attendees, designated drivers, and festival medical volunteers who need to recognise drug-related emergencies in strangers and act correctly before professional help arrives, without a clinical background.
Someone in the crowd near you doesn't look right. Maybe they're swaying, gripping a fence, skin flushed and soaked through. Maybe a friend is tugging your sleeve because their mate "took something" and won't stop shaking. You haven't used anything, you don't know these people, and you have no medical training. You are still the person who is there. This is what to do with that.
Read the person in front of you
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Most people on MDMA who are struggling are overheated, dehydrated, overstimulated, or some combination. A smaller number are in a genuine emergency. Your job is to tell those apart and to buy time.
Signs someone needs attention but is probably not in immediate danger:
- Very talkative, jaw clenching, wide pupils, sweating
- Anxious, overwhelmed, wants to get out of the crowd
- Mildly unsteady but responsive and making sense
Signs this is an emergency and you need medical help now:
- Very hot skin with little or no sweat, confusion, or saying strange things
- Seizure, twitching, or rigid muscles
- Chest pain, a racing heart that won't settle, or trouble breathing
- Vomiting repeatedly, or a severe pounding headache with confusion
- Not responding to their name, can't be roused, or has passed out
🚨 In a crisis
if someone is unconscious, having a seizure, struggling to breathe, or burning hot and confused, get professional help immediately. Find the nearest medical tent or send someone to flag a steward or welfare team. Do not wait to see if it passes. Overheating in particular can escalate fast.
Get help without losing the person
At a festival, medical help is usually closer than an ambulance. Learn where the medical tent and welfare points are when you arrive, so you are not searching during an emergency.
- Send a specific person to get help. "You, in the red shirt, go to the medical tent and bring someone." A vague "someone call for help" often means nobody does.
- Give whoever goes a clear location. Stage name, nearest bar, a tall landmark.
- Stay with the person yourself. Do not leave them alone, and do not let them wander off into the crowd.
If you genuinely cannot reach festival medics and the person is in the emergency category above, call your country's emergency number. Tell them what you can see, not what you assume was taken.
Say what you see.
You are not expected to diagnose. Describe the facts: "conscious but confused," "very hot, not sweating," "had a seizure." Medics can work with observations. They cannot work with a guess.
While you wait: cool, calm, protect
For someone overheated and agitated, the two things that matter most before professionals arrive are lowering their temperature and keeping them calm.
Cooling:
- Move them out of the sun and away from the densest part of the crowd.
- Loosen or remove extra layers. Get them somewhere with moving air.
- Wet their skin with water and fan them. Cool water on the neck, armpits, and groin helps most.
Hydration, carefully:
- If they are fully alert and able to hold a cup, small sips of water or an electrolyte drink are fine.
- Do not pour large amounts of plain water into someone over a short time. Drinking too much too fast is its own danger with MDMA. Small and steady.
- Never give fluids to someone who is drowsy, confused, or not fully responsive. They can choke.
Calming:
- Lower your own voice. Tell them who you are and that you are staying with them.
- Give them space and fewer people crowding in. One or two helpers, not ten.
- If they are panicking, slow, steady breathing alongside them can help more than reassurance alone.
If they lose consciousness or vomit
An unresponsive person who is still breathing should be placed in the recovery position: rolled onto their side, top leg bent for stability, head tilted slightly back so the airway stays open and vomit can drain out rather than be inhaled.
- Check they are breathing. Watch the chest, listen, feel for breath.
- Stay with them and keep checking until help arrives.
- If they stop breathing and you know CPR, start it. If you don't, the emergency operator can talk you through it.
🚨 Recovery position first.
For anyone who has passed out but is breathing, on their side is the single most important thing you can do while you wait. It keeps them from choking if they vomit.
What you are not responsible for
You are not there to get anyone in trouble, and reassuring them of that often gets you better information. Most festival medical and welfare teams operate on a harm-reduction basis and are not there to involve security over what someone took.
You are also not responsible for a perfect outcome. You cannot know everything, and you are not a clinician. Recognising that something is wrong, getting the right help, and keeping someone cool and breathing until it arrives is the whole job. That is enough.
The lowest-risk option at any festival is always not to use at all. But the person in front of you has already made their choice, and your clear head is the most useful thing in the crowd right now.
Sources
- https://dancesafe.org
- https://wearetheloop.org
Sources
- https://dancesafe.org
- https://wearetheloop.org