Rave gone wrong: MDMA- induced medical emergency at electrical daisy carnival. A case report

3, 4-methylenedioxyamphetamine (MDMA) has gained significance over the years, especially at rave festivals, as a recreational drug for its noted effects in mood enhancement and autonomic stimulation. While these effects have been noted, severe adverse outcomes, and even death, following the ingestion of MDMA have been recorded. We present a 35-year-old male who ingested the drug at the Electric Daisy Carnival (EDC), the largest electronic dance music festival in North America as of 2024 [1]. Every year, many young adults are brought to local hospitals from the festival for drug overdoses, hyperthermia, and dehydration. At the festival, the patient was witnessed to have a seizure, presented with altered mental status and deemed hyperthermic at 109 degrees Fahrenheit. For these reasons, he was rapidly intubated and submerged in an ice bath at the festival's medical tent. At the county hospital, the patient was diagnosed with multiorgan failure, cerebrovascular ischemia, and coagulopathy. He received life-saving treatment such as continuous renal replacement therapy as well as intubation for acute hypoxemic respiratory failure. MRI of the brain showed central- embolic infarcts and the patient was closely monitored in the intensive care unit (ICU) for eight days. After twenty days of inpatient treatment, the patient was discharged. He was discharged with his mental status at baseline and without gross neurologic deficits. A permacath was placed for hemodialysis to be continued outpatient. This case report highlights the importance of prompt medical management which can be crucial for patient survival following a life-threatening overdose with MDMA. It also exemplifies the need for increasing social awareness regarding the severe and detrimental outcomes an MDMA overdose can cause as this drug continues to be widely used in the setting of rave and music festivals.