Illicit drug-related harm during the Sydney 2000 Olympic Games : implications for public health surveillance and action

Aims: To describe presentations to emergency departments during the Sydney 2000 Olympic Games for conditions related to the use of illicit drugs; to discuss the implications of such presentations for surveillance and public health action at similar events in the future. Design: Identification of target presentations in sentinel emergency departments: entry of data into a purpose-built database; and daily electronic transfer of data for central collation and analysis, Setting: Fifteen sentinel emergency departments in the greater Sydney metropolitan area for a 38-day period spanning the Sydney 2000 Olympic Games. Participants: Four hundred and twenty-four presentations to sentinel emergency departments with conditions related to illicit drug use. Measurements: Patient's age, sex, country and region of residence, location of emergency department, types of illicit drugs involved and departure status. Findings: The mean daily number of presentations for adverse events due to illicit drug use was significantly higher (13.3 versus 8.8 presentations, t = 2.2. P=0.04) in the 2-week Olympic Games period than in the lead-up to the Games, culminating in a large peak following the closing ceremony. There was also a significant increase (5.1 versus 1.7 presentations, t = 2.8, P= 0.007) in the mean daily number of presentations related to use of ecstasy or amphetamines, whereas no change was noted in presentations related to heroin use. Over half (52%) of presentations occurred at two emergency departments in areas known as being 'hot-spots' for illicit drug use. Conclusions: Enhanced surveillance of adverse events following illicit drug use, possibly targeting known 'hot-spots', should be considered for future mass events. Advance preparation of preventive strategies, such as 'party-safe' messages, will enable rapid response to unusual patterns of illicit drug-related harm during future mass events.