Patterns of recreational substance use, help seeking and harm reduction among UK music festival attendees

Background Substance use at UK music festivals presents a significant public health challenge, with evolving patterns of drug use, associated risk behaviours, and harm reduction practices among attendees. Methods A sample of UK festival attendees ( N = 773) completed a lengthy online survey detailing their typical substance use practices and related behaviours within music festival contexts. Results This study reports patterns in substance preferences and polysubstance use combinations, where younger individuals report the use of novel substances, while older attendees to use more historically popular drugs. Users of ketamine ( z = −10.58, P < .001), or novel psychoactive substances ( z = −4.23, P < .001) were significantly younger than non-users. The findings highlight the prevalence of alcohol use (92.8%, N = 718), and polysubstance use (60.7%, N = 476). Alcohol was particularly prevalent within the context of polysubstance use (71.6%, N = 341). Notably, polysubstance use involving the combined use of five substances (alcohol, cocaine, cannabis, ketamine, and MDMA) during the same period was concerningly common among those engaging in polysubstance use (25%, N = 119). The study identified a lack of engagement with critical harm reduction practices and provisions, such as accessing drug checking services ( N = 53, 6.7%) or onsite welfare provisions ( N = 82, 10.6%). Conclusions The low reports of accessing formal onsite services suggests the need for improved educational outreach and the potential to enhance engagement through informal online platforms. This study highlights the importance of context-specific drug use patterns and targeted interventions, aiming to facilitate more effective public health responses. These findings indicate the necessity for adaptive and targeted interventions, particularly those addressing alcohol consumption, polysubstance use, and the promotion of early help-seeking.