Drug Poisoning Deaths Among Women in Ireland

More men than women die of drug poisoning deaths. However, due to biological, social, and psychological differences between men and women it is important for evidence to be stratified by sex so that effective policy and practice responses to drug poisoning deaths can be developed for both men and women. The majority of data on drug poisoning deaths is aggregated data; therefore, as these deaths are dominated by men, specific risk factors relevant to women may be masked. The overarching aim of this research is to explore what is known about poisoning deaths among women, identify gaps in knowledge and contribute to evidence-based practice. Specific objectives include to: (1) investigate the extent of existing knowledge on drug poisoning deaths among women; (2) explore trends in drug poisoning deaths in Ireland stratified by sex; identify specific drugs/drug groups involved and if they differ by sex; (3) explore factors associated with an emerging drug, pregabalin, in drug poisoning deaths in Ireland, by sex and (4) explore factors associated with suicide drug poisoning deaths in Ireland among women relative to men. The scoping review highlights the current dearth of knowledge on factors associated with drug poisoning deaths among women. An overview of trends in drug poisoning deaths over a fourteen-year period, stratifying by sex, found multiple CNS depressant drugs to have a significant role in drug poisoning deaths among women. In a study examining factors associated with pregabalin positive drug poisoning deaths, women who died of a drug poisoning death where pregabalin, a CNS depressant drug, was present on toxicology were 3 times more likely than men to have ≥2 other CNS depressant drugs present. Finally, a study examining characteristics associated with suicide drug poisoning deaths found consistent findings in relation to associated factors, with small variation in magnitude of effects, for both men and women. However,≥2 CNS depressant drugs were found to be associated with decreased odds of the death being a suicide relative to a non-suicide drug poisoning death for men only. In summary, this thesis demonstrates a significant association between multiple CNS depressants and drug poisoning deaths among women. The findings indicate the need for increased education among prescribers and users on differences between sexes in relation to drug metabolism and actions, and practical implications are suggested to facilitate more appropriate and mixed treatment options for people who use drugs.