Watch Out for Heat Stroke

Over 100 people have died after taking ecstasy at rave parties. Why?

When you take ecstasy (or any stimulant drug) your body temperature rises. When you take ecstasy in a hot place (like a rave) your body temperature rises even more. When you take ecstasy in a hot place and start dancing energetically, your temperature rises even more again. With body temperatures raised to these very high levels there is a risk of developing heat stroke.

When your body overheats you lose fluid. Some ravers lose pints and pints of fluid when dancing on E in hot places. At a crowded indoor rave you could lose up to 6 pints in 6 hours. These fluids must be replaced.

These cases are not ecstasy overdoses. Heatstroke can happen even if you have only taken one tablet.

What can you do to prevent heatstroke?

1. As a rough guide, you should be looking to drink about a pint of water every hour (2-4 cups). Sip water slowly rather than drinking a lot all at once, as this can be dangerous.
2. Try and eat something salty or drink juice or isotonic sports drinks like Gatorade. This will replenish your body's electrolytes and prevent hyponaetremia (water toxicity).
3. Take breaks from dancing and allow your body to cool down. Chill out areas are perfect for this.
4. Wear loose-fitting clothes and don't wear a hat. Wearing a hat keeps the heat in.
5. Encourage your local promoters to adopt our Safe Settings guidelines.

Warning signs of dehydration and possible heatstroke

1. Failure to sweat.
2. Cramps in the legs, arms and back.
3. Giddiness, dizziness, headache, fatigue.
4. Vomiting.
5. Fainting or loss of consciousness.
6. Suddenly feeling really tired, irritable and confused.

If any of these things happen, stop dancing, drink some water and chill out immediately.

There have been a few deaths reported from people drinking too much water while at a rave. This is extremely rare. However, drinking 2-4 cups an hour when dancing is about the right amount. You should also try and eat something salty (not always easy if you've taken a stimulant drug) or drink fruit juice or a sports drink like Gatorade. Remember, water is an antidote to dehydration, not ecstasy.

What if someone collapses while dancing?

1. Call an ambulance.
2. Get the person to as cool a place as possible. This might mean taking them outside.
3. Drench them with water (as cold as possible) using any means you can. Increase the cooling down process by fanning them with anything that's handy. You are looking to get the body temperature down to 102F (38.9C). Once the temperature is down to this level the person should be wrapped in a dry blanket or given some dry clothes to wear. The temperature shouldn't be allowed to fall much below 102F or other serious consequences might develop.
4. When the ambulance comes tell them what the person has taken (if you know) and that you think it is heatstroke.
5. If the person regains consciousness make them drink water with some salt in it. Gatorade or other sports drinks are ideal. At this point the person might start sweating again. This is a good sign.
6. The person should be taken to the hospital for observation and proper treatment.

Watch Out for DXM!

Sometimes "ecstasy" tablets do not contain real ecstasy. DXM, a cough suppressant that dries out the lungs, is often found in fake ecstasy tablets. In high doses DXM not only raises your body temperature but also dries out your skin and prevents you from sweating. Since sweating is the main way your body cools itself down, DXM is even more likely to cause heatstroke.

If you take a pill and start to lose motor control, hallucinate, feel very "out of your body," or if your skin itches, you may have taken DXM instead of ecstasy. If this happens, it's a good idea to chill out for the night. On DXM you probably won't feel like dancing anyway. DanceSafe offers an E testing kit which can reveal DXM-laced tablets.

Tips for Promoters and Club Owners

Heat Stroke can happen even to people who haven't taken any drugs.

Here are some simple suggestions to prevent heat stroke emergencies from happening at your events. We also encourage you to adopt our full set of Safe Settings guidelines.

1. Provide some form of easy access to cool drinking water. This can be as simple as making sure there is cool, running water in the bathrooms (shutting off access to cool water in the bathrooms is illegal and extremely dangerous). Providing free water is even better.
2. Don't overcrowd your venues. Too many people dancing energetically in an enclosed area can raise the ambient temperature above 100 degrees! Limit your ticket sales based on the "heat capacity" of the venue.
3. Provide a chill out room. Couches, bean bag chairs and ambient music make a comfortable environment for people to relax and cool down after dancing energetically.
4. Establish proper ventilation and temperature control measures. Air conditioning may not be available, but large fans, open windows and doors can often do the job. Fans blowing hot air from the inside out through an open window are better than from the outside in. Also remember that hot air rises. The heat on the dance floor wants to go up. Ceiling vents with exhaust fans provide the best ventilation.
5. Provide safety and harm reduction information to your patrons. DanceSafe offers pamphlets (like this one) and attractive posters (ideal for bathrooms and chill out rooms) with health and safety tips for avoiding heatstroke and other risks of raving.
6. Be prepared. Have your security trained in basic first aid, and hire onsite EMTs for events with more than 500 people attending. Always call an ambulance if somebody falls unconscious or starts having a seizure.

The above recommendations are part of a general set of guidelines for safe dance environments. Visit our Safe Settings page for more information.

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