Deaths related to drug ‘misuse’ remain at an all-time high in the United Kingdom (UK). Older heroin consumers are particularly at risk, with the highest rates of deaths among people aged 40–49 and the steepest rises in the over-fifty age bracket. Accordingly, a popular theory for the UK’s increase in drug-related deaths, made by the government, and propelled in the media, is that there is an ageing cohort of heroin users with age-related health complications predisposing them to an overdose. However, drawing on in-depth interviews with those people deemed to be most at risk, this article works to complicate this theory, with participants citing a shift in (a) experience and responsibility, (b) route of administration, (c) desired effects, (d) acceptance of their drug use and ‘user’ status and (e) valuing health. Disrupting age as a given risk factor, this article turns attention away from the individual and these ‘natural’ processes to what participants describe as a singular, punitive, and inflexible treatment system and its intersecting structures. Approaching life and death as a matter of sociomaterial ‘mattering’, this article rethinks a reductionist, causal link between age and drug-related death with a treatment despondency and fatalism that could prove fatal.

中文翻译：

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药物死亡和治疗宿命论：使老龄化队列理论复杂化

在英国（UK），与药物“滥用”相关的死亡人数仍处于历史最高水平。年龄较大的海洛因消费者面临的风险尤其大，40-49 岁人群的死亡率最高，50 岁以上人群的死亡率上升幅度最大。因此，由政府提出并在媒体上推动的英国与毒品有关的死亡人数增加的流行理论是，有一个老龄化的海洛因使用者群体，患有与年龄相关的健康并发症，使他们容易吸毒过量。然而，通过对被认为风险最大的人进行深入访谈，本文使这一理论复杂化，参与者引用了（a）经验和责任，（b）管理途径，（c）期望的转变效果，(d) 接受他们的药物使用和“使用者”状态，以及 (e) 重视健康。本文将年龄作为一个给定的风险因素，将注意力从个体和这些“自然”过程转移到参与者所描述的单一、惩罚性和僵化的治疗系统及其交叉结构上。将生与死视为社会物质“重要”的问题，本文重新思考了年龄与药物相关死亡之间的简化论、因果关系，以及可能证明是致命的治疗沮丧和宿命论。