Harm-reduction measures, including pill testing, should play a vital role in educating music festival attendees about the dangers of drug use, especially in hot conditions.

“MDMA (or ecstasy) triggers the release of substances that interfere with our temperature regulation, leading the body to generate more heat than usual,” Milad Haghani and Pegah Varamini wrote in The Conversation. “This elevation in body temperature happens even if the person using drugs is not exerting themselves and not in a hot environment. In this context, the effect can still cause dehydration. However, the effects may be greater if a person is exerting themselves in hot, crowded settings.”

In extreme cases, a sharp increase in body temperature can lead to organ failure and even death, they say.

A study in rats showed a moderate dose of MDMA that is typically non-fatal in cool, quiet environments can be fatal in rats exposed to conditions that mimic the hot, crowded settings where people often use the drug. The researchers say harm-reduction measures, including pill testing, should play a vital role in educating music festival attendees about the dangers of drug use, especially in hot conditions.