Why are drug-related deaths among women increasing in Scotland? A mixed-methods analysis of possible explanations

Emily J. Tweed*, Rebekah G. Miller, Joe Schofield, Lee Barnsdale, Catriona Matheson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Drug-related deaths have increased significantly in Scotland in recent years, with a much greater percentage increase in deaths among women than among men. We undertook a mixed-methods project to identify explanations for this trend, comprising three parallel methodological strands: (i) an analysis of available routine data, including drug treatment data, death registrations, and surveys of people using needle exchanges; (ii) thematic analysis of interviews and focus groups with professional stakeholders and (iii) secondary analysis of interviews with women who use drugs. Results indicated that the observed trend is likely to reflect multiple, interacting causes. Potential contributors identified were: ageing; changing patterns of substance use; increasing prevalence of physical and mental health co-morbidities; changing relationships and parenting roles; changes to treatment services and wider health and social care provision; unintended consequences or poor implementation of recovery-oriented practice; and changes in the social security system. Policy responses to rising drug-related death rates require a gender-informed approach, recognising the commonalities and differences between men and women who use drugs; the diversity of experiences within each gender; and the intersections between gender and other forms of inequality, such as poverty.

Original languageEnglish
Pages (from-to)62-75
Number of pages14
JournalDrugs: Education, Prevention and Policy
Issue number1
Early online date11 Dec 2020
Publication statusPublished - 2022

Keywords / Materials (for Non-textual outputs)

  • drug use
  • gender
  • mortality


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