Maria Carvalho and Helena Valente - Kosmicare, Boom and Psychedelic Emergency Services

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Today in the show, Joe talks to Maria Carvalho and Helena Valente, founding members of Kosmicare, a drug testing, and harm reduction service at the Portugal Festival, Boom. Joe talks to Maria and Helena on their personal backgrounds, how they got into Boom, research on recreational use, what harm reduction looks like, and what populations are underserved. Drug use is decriminalized in Portugal, and the focus of risk minimization has been useful in getting the population served versus putting people in prison.

3 Key Points:

1. Kosmicare is a harm reduction and psychedelic emergency service starting at Boom music festival in Portugal. Working to support other events in Europe.
2. Boom is in Portugal, where drugs are decriminalized and drug testing is legal. Drug policy has directly affected the number of emergencies that Boom has had.
3. The Portuguese drug policy has resulted in fewer overdoses, drug-related deaths, and HIV infection. Other countries like the US should consider a drug reform with the current opioid crisis.

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Navigating Psychedelics

Show Notes About Kosmicare

• Kosmicare is a non-profit organization that looks to transform nightlife culture through humanistic, comprehensive and evidence-based policies and interventions
• They work toward a world where drugs can be used with liberty and wisdom
• Making festivals safe in Europe

About Maria

• Psychologist, graduated in 1999 at University of Porto
• She started working in the field of problematic drug use
  • Growing up in a difficult neighborhood was her purpose for getting into studying psychology and drug use
  • She began focusing on recreational use
  • Her younger brother was into the Electronic Dance scene and positioning himself with using substances
  • She was interested in studying other motivations to use drugs than just using drugs to feed a problem
• She heard an announcement by MAPS in 2008 recruiting volunteers to do work in psychedelic emergency at Boom
  • It was the perfect match considering her interest in psychology and drug use in recreational environments

About Helena

• Helena is a Psychologist who was interested in drug use
• She wanted to have field experience, and she volunteered in a needle exchange program
  • She began working for a harm reduction project to work in recreational settings that needed volunteers
  • She became interested in the potential that drug checking has in the harm reduction strategy
• They are working toward a 'drop-in' where people can show up to a permanent space for drug checking and harm reduction

The Numbers

• Over 20,000 people showed up to Kosmicare's information session
• This year for the first time, Kosmicare had an HPLC (High Performance Liquid Chromatography) to identify LSD and pills
  • They tested over 700 drug samples in 6 days
• Maria says half of the Boom population gets in contact with Kosmicare
  • They serve 1% of the Boom population for psychedelic emergency (about 350 cases out of 35,000 attendees)
  • The episodes usually have to do with psycho-spiritual situations versus just an emergency about the drug taken

Psychedelic Emergencies

• Boom is a transformational festival that hosts attendees from over 50 countries
• Boom is different from Burning Man in that Boom is in Portugal which has a much more legal framework which helps with the services that can be offered
  • Drug policy has directly affected the number of emergencies that Boom has
  • Joe states that there are numbers of regulatory police at Burning Man
  • Kosmicare is included in the entire setup of Boom, which helps reduce the number of scenarios that would cause an emergency at the festival, such as providing shaded areas all over
  • It gets up to 43 degrees Celcius (108 Fahrenheit)
  • But there is a water element so people can refresh themselves
• In the largest dance areas at the festival, they included medical emergency Teepees so attendees could be helped as quickly as possible

Recreational Drug Use

• They did a survey on recreational drug use and most of the respondents said they use drugs in a beneficial way that doesn't interrupt their lives in a bad way
  • Similarly with Boom attendees, most of them want to use harm reduction techniques so they have positive experiences and don't develop problems with their drug use
  • Mat Southwell "drug users are calculated risk takers"
  • "The legal framework has a terrible influence on people's relationship with drugs" - Helena

Lessons Learned

• Maria says they have had many groundbreaking challenges
• In 2016 they had someone die on them while having a psychedelic emergency
  • It made her really question why she was doing this
  • Her first impression was that she was doing this work to save the inexperienced user
  • She was caught off guard by the person who died because they were an experienced user and didn't taking unadulterated substances
  • "People may go over the top for a wide variety of reasons, it was the biggest lesson I learned working for the Psychedelic Emergency services" - Maria
  • It's hard to determine people's ability to calculate risks
  • If the person had collapsed in front of an urban hospital in the city, the Hospital couldn't have done anything more than what they did at Kosmicare

Collaborations

• Kosmicare has a collaborative relationship with Zendo
• MAPS was hired by Boom to direct the harm reduction services
• They use a lot of Stan Grof techniques for transpersonal psychology
• They are partnered with many other organizations in Europe that are trying to deliver the same type of psychedelic emergency and harm reduction services

The Risks of Drug Policy

• Joe points out that there are so many festivals happening without these services
  • The Rave Act prevents companies from attending festivals because it "harbors" drug use
• In Portugal, the fact that drug use is decriminalized, it opened up a legal framework around harm reduction
  • Portugal is one of the few countries where drug checking is allowed by law
  • The Portuguese drug policy has resulted in fewer overdoses, drug-related deaths, HIV infection, tuberculosis and other things
• Helena says that the US should rethink their drug policy considering the opioid epidemic
  • In Portugal, there were only 12 overdose cases with heroin and opioids

Portugal before the Drug Policy

• In the 80's, there was a heroin epidemic, which had an epidemic of high infection rates and HIV. This motivated the policy change
  • It was evident that prohibition was not working
• Usually when it affects only poor people, no one cares, but the fentanyl crisis is affecting all sorts of populations

Links

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About Maria

Maria Carmo Carvalho, Kosmicare Manager, Boom Festival, Portugal, is a Lecturer at the Faculty of Education and Psychology at the Catholic University of Portugal. She researches if the field of psychoactive substance use and has completed a MSc and a PhD at the University of Porto on the field of psychoactive substance use, youth and recreational environments. She is Vice-President of ICEERS and Kosmicare Boom Festival manager since 2012.

About Helena

Helena Valente began working with people that use drugs in 2004, focusing in nightlife settings. Helena has a vast experience in coordinating national and European projects in the drug field. At the moment she is a researcher and PhD. Candidate at the Faculty of Psychology and Educational Sciences of the Porto University and founding member of Kosmicare Association.