Abstract

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.

摘要

近年来，苏格兰与毒品有关的死亡人数显着增加，女性死亡人数的增幅远高于男性。我们开展了一个混合方法项目来确定对这一趋势的解释，包括三个平行的方法学分支：（i）对可用常规数据的分析，包括药物治疗数据、死亡登记和使用针头交换的人的调查；(ii) 与专业利益相关者的访谈和焦点小组的专题分析，以及 (iii) 对吸毒妇女访谈的二次分析。结果表明，观察到的趋势可能反映了多种相互作用的原因。确定的潜在因素包括：老龄化；改变物质使用模式；身体和心理健康合并症的患病率增加；改变关系和育儿角色；改变治疗服务和更广泛的健康和社会护理提供；意料之外的后果或以恢复为导向的实践执行不力；以及社会保障制度的变化。应对与毒品有关的死亡率上升的政策需要以性别为依据的方法，承认吸毒男性和女性之间的共性和差异；每个性别的经历的多样性；以及性别与其他形式的不平等（如贫困）之间的交叉点。认识到吸毒男女之间的共性和差异；每个性别的经历的多样性；以及性别与其他形式的不平等（如贫困）之间的交叉点。认识到吸毒男女之间的共性和差异；每个性别的经历的多样性；以及性别与其他形式的不平等（例如贫困）之间的交叉点。