Policy and practice briefingsNightlife, festivals and other recreational settings

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Issues

Drug and alcohol use in nightlife settings, such as bars, nightclubs and other recreational venues, is linked to health and social problems, including acute health harms, aggressive behaviour and violence, and driving under the influence of alcohol and drugs. There are also longer-term health effects and addiction. Adverse social consequences may include drug dealing and public nuisance. Because many of these harms are associated with excessive use on a particular occasion, many responses aim to reduce the amounts of alcohol and drugs that are used.

Response options

  • Most of the evidence on responses in recreational settings relates to alcohol. Few interventions targeting drug use in recreational settings have been robustly evaluated.
  • Prevention or harm reduction information material can be provided to young people in recreational settings. Peer educators disseminating this type of information may be seen as more credible. These activities can be supported by websites and apps providing more detailed information on drugs, alcohol and related harms, and tips on avoiding them. However, the evidence for behavioural change effects from these interventions is scarce.
  • Environmental strategies have a better evidence base. This approach includes measures that target factors that promote excessive consumption (e.g. discounted drinks, loud music and poor serving practices) or that create safer spaces and venues (e.g. by reducing crowding, providing chill-out rooms and free water, serving food, enforcing rules on behaviour and access).
  • Drug-checking services (sometimes called pill testing) enable individual drug users to have their synthetic drugs chemically analysed, providing information on the content of the samples as well as advice, and, in some cases, counselling or brief interventions. The effectiveness of this approach in changing behaviour is not clear, but it may provide a valuable opportunity for engaging drug users and for drug monitoring purposes.

European picture

Various environmental and regulatory approaches are used across Europe to address substance-related problems in nightlife and other recreational settings. These include zero tolerance rules, regulatory measures against venues that have visible problems, the training of door and security staff, health and safety measures, and training in recognising and responding to drug- and alcohol-related emergencies. Structured evidence-based environmental prevention approaches are now being used in more countries, as are local regulatory coalitions between the police, the nightlife industry and services (prevention and harm reduction). Two European projects, the Nightlife empowerment and well-being implementation project (NEWIP) and the Club Health Project, are developing good practice standards for people working in this area.

The number of drug-checking services available across Europe is growing. These use a variety of different models, including off-site testing centres and on-site testing at festivals and in nightclubs. The impacts of different models of drug checking need to be investigated.

Summary of the available evidence

Good practice in responding to drug problems in nightlife settings

The available research evidence and expert opinion suggest that a balanced approach is needed to tackle the drug- and alcohol-related health and social problems associated with recreational nightlife. There is less consensus on individual measures, although all of the following items merit consideration as part of a comprehensive response in this area:

  • co-ordinated multicomponent interventions involving community stakeholders, generic health and emergency services, regulatory bodies, and policing and law enforcement;
  • environmental strategies, such as providing chill-out rooms or free drinking water;
  • training staff in these venues;
  • rapid emergency response measures;
  • early warning systems and monitoring of substances being consumed, including drug-checking services;
  • provision of prevention and harm reduction materials — although on their own they are unlikely to be effective.

Overall, the evidence for the effectiveness of interventions to reduce alcohol-related harm is stronger than that for drug-related harm.

Implications for policy and practice

Basics

  • Provision of environmental prevention and harm reduction interventions, supported by the guidelines and standards drawn up in the NEWIP and Club Health projects, should be implemented as appropriate.
  • There should be provision of emergency health care to deal with adverse events in recreational settings and linked to emergency departments. The European guidelines may be useful here and need to be built on.
  • Community-based initiatives that deliver a range of co-ordinated interventions through a multi-agency partnership are more effective than single interventions. They often combine community mobilisation, staff training and enforcement and appear to be effective in reducing violence, problem drinking and street accidents.

Opportunities

  • Increase the sharing of good practice and guidelines for prevention and harm reduction interventions in these settings and promote evaluation of their effectiveness.
  • Drug-checking services have the potential to be useful both for reducing harmful use of drugs and for monitoring what drugs are on the market. However, research is needed into the effectiveness of different models of provision and their appropriateness in different scenarios.

Gaps

  • The evidence on the effects of information provision for clubbers/peer education (often harm reduction) is limited. It has the potential to be counterproductive so more research is needed on the most effective ways to present information on risks, safe dosing etc.

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