No shirt, no shoes — lots of problems.

To be fair, popular country music artist Kenny Chesney did wear a shirt for his July 2 show — or at least most of a shirt — and we’re pretty sure boots still count as shoes.

Summertime seems to bring out even more wild behavior than is common at other times in the year.

But problems? There were plenty of those.

Maybe it’s just some weird combination of Pittsburgh — which hasn’t had a ton to celebrate lately (other than the Penguins winning the Stanley Cup) — and Chesney, performer of “No Shirt, No Shoes, No Problems.”

At last weekend’s concert, five people were arrested and 57 emergency medical transports were requested. Twenty-five attendees were hospitalized for intoxication and alcohol-related injuries. Local news reported that 48 tons of garbage were left behind by an estimated 15,000 tailgaters.

When Chesney played Pittsburgh in 2013, things didn’t go any better — slightly less trash, slightly more handcuffing. That show resulted in more than 70 arrests, various brawls, and over 30 tons of trash strewn around PNC Park.

But at least no one died at either of Chesney’s Pittsburgh shows. The same can’t be said for Tampa’s Sunset Music Festival in May. Two people, a 21-year-old woman and a 22-year-old man, died of suspected overdoses after attending the electronic dance music (EDM) festival.

And at Bravalla, Sweden’s biggest music festival which took place June 30 through July 2, authorities received five reports of rape and 12 of sexual assault.

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On the face of things, the shows might have little in common, but they are indicators that summertime seems to bring out even more wild behavior than is common at other times in the year. People tend to tailgate more — and longer — when it’s warm and sunny. That corresponds with more drinking and more consumption of illicit substances.

And we’re only about halfway through the season — with big festivals, including Lollapalooza on July 28 in Chicago and Burning Man on August 28 in the Black Rock Desert of Nevada, still to come.

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At the Sunset Musical Festival in May, police made 33 arrests (25 for felony charges), and 57 people were taken to local hospitals. An ER nurse told a reporter she witnessed “back-to-back dehydrated children, all on Molly.” That’s the nickname for a variety of substances related to MDMA, the active ingredient in Ecstasy. MDMA and heat can be an especially dangerous combination.

Related: Sweden’s Migrant Rape Epidemic

Just as concerning is the fact that MDMA and other drugs being shared freely at music festivals — a common occurrence going back to the 1960s — could be filled with all sorts of suspect substances.

But even concertgoers who abstain from illegal drugs can run into trouble at large, crowded shows. It’s fair to say the Chesney fans who partake in mood enhancement are more likely to imbibe in beer and booze than MDMA and its derivatives. Still, the combination of heat, too much alcohol, and a crowded setting has a long history of causing fights, property damage, and other serious problems.

It’s a history that goes well beyond country music and EDM shows.

For all the “peace and harmony” reputation of the 1969 Woodstock festival, two people died there — one of a heroin overdose, another when he was run over by a tractor. The local health department documented more than 5,000 medical cases from the festival, including 797 instances of drug abuse.

Later in 1969, the Altamont Speedway Free Festival — nicknamed “Woodstock West” — was the site of four deaths, including two hit-and-run accidents, one drowning, and the deadly beating and stabbing of a fan by a Hells Angels member providing event security.

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(The fan, who had methamphetamine in his blood, pulled a gun on the biker, who was acquitted of murder charges for reasons of self-defense.)

The more contemporary examples might not be as dramatic, at least in America — nine people were crushed to death at a Pearl Jam performance during a June 2000 festival in Denmark — but they add up.

With that said, the vast majority of people attending summer music festivals and large concerts do just fine. As horrible as it is when anyone dies or is seriously injured at a massive show, there are tens of thousands who come out, have a great time, and leave without incident.

But if there’s one thing to remember, it’s this: Anything that affects your judgment exponentially increases the likelihood of all sorts of problems — so be smart. If you wish to partake, be sensible and responsible.

And if you don’t know where a particular substance originated — beverage or otherwise — you’re always best avoiding it. At any summer show, a little common sense goes a long way.