Drug-induced deaths among women: a scoping review

Background: At least one in four drug-induced deaths are women, and these deaths are increasing, however very little research has focused specifically on women in this area.

Objective: To undertake a scoping review to find out what is known in the literature about drug-induced deaths among women and identify potential knowledge gaps in this area.

Method: Tailored search strings were developed to search Pubmed, EMBASE and Web of Science in for articles published in English within that last twenty years. This search was supplemented with grey literature, library references and online searches. Appropriate references cited in selected articles were also considered for inclusion. Experts in the area of drug-related deaths were also consulted. Findings from the final selection, which contained specific detailed information on drug-induced deaths among women, are outlined below.

Results: In the initial review the majority of literature on drug-induced death had limited gender specific data. Existing research on drug-induced deaths among women shows that;

• opioid substitution treatment reduces the risk of mortality however, women face many potential barriers in accessing treatment and have different treatment needs
• women have been highlighted in ‘at risk groups’, such as older women who use prescription drugs
• higher rates of mental health issues are found among women
• there are more females among drug-induced suicide victims
• psychotropic drugs, especially antidepressants, are detected to a higher degree in women
• prescribed opioids are more prominent among women
• women who died of drug-induced deaths were more likely to have experienced violence and alcohol dependency
• the impact of polydrug use as a risk factor for drug-induced death seems to be more substantial in women.

The literature recommends further research in the areas of;

• older women and misuse of prescription drugs
• the impact payment of benefits may have on drug-induced deaths among women
• sex work
• imprisonment risk factors
• drug-induced suicides
• overall more detailed gender specific research in the area of drug-induced deaths.

Conclusions: This review found that the majority of the published research is not gender specific. Research evidence highlights the upward trend in drug-induced deaths among women, much higher than among men. However, it is well recognised that mortality data is dominated by males and therefore the absence of gender specific research on mortality may mask identifying potential risk factors specific to women.