{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:46:59Z","timestamp":1777938419090,"version":"3.51.4"},"reference-count":59,"publisher":"SAGE Publications","issue":"5-6","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Corra Foundation"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Nordic Studies on Alcohol and Drugs"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Social, structural and systemic factors are critical to understanding drug-related deaths among adults. The relevance of these factors to young people is not known. This study explores the life experience, drug using histories and the interactions of a group of young people with agencies and services prior to their death. Our approach seeks to look beyond the immediate cause of death and identify broader contextual factors that may have contributed to a death through a \u201cwhole-life view\u201d.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study developed a socio-ecological autopsy approach informed by social autopsy methods and social ecology and risk environment frameworks. Health, social work, police and post-mortem records of the young people were collated and analysed. Summary narratives, chronologies and descriptive statistics were produced using Excel and NVivo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Twenty-one deaths were identified; almost all were due to multi-drug toxicity, mainly heroin mixed with other substances. Almost all the young people had reported mental health issues such as anxiety, depression and self-harm, and had experinced at least one recorded overdose before they died. Most grew up in precarity and poverty in deprived areas. In their short lives, most of this cohort of young people experienced multiple adversities in childhood and as young adults, particularly in the year preceding their death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Complex and fragmented services struggled to respond holistically to early signs of difficulties and to the young people's cumulative experience of trauma and adversity, mental ill-health and drug-related harms in the context of prohibition. There is a need for a radical rethink of systems to enable integrated youth-centred approaches that meet the needs of those at risk of drug-related deaths and to address the broader social and structural contexts of drug deaths.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14550725251370436","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T16:36:36Z","timestamp":1757435796000},"page":"499-513","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Drug-Related Deaths Among Young People in a Scottish Region: A Socio-Ecological Autopsy Approach to Understanding the Context of Drug Deaths"],"prefix":"10.1177","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5961-1090","authenticated-orcid":false,"given":"Aileen","family":"O\u2019Gorman","sequence":"first","affiliation":[{"name":"University of the West of Scotland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Govenden","sequence":"additional","affiliation":[{"name":"NHS Highland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frances","family":"Matthewson","sequence":"additional","affiliation":[{"name":"Highland Alcohol and Drugs Partnership, Inverness, Scotland, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"e_1_3_4_2_1","volume-title":"Drug Misuse and the Environment","author":"ACMD (Advisory Council on the Misuse of Drugs)","year":"1998","unstructured":"ACMD (Advisory Council on the Misuse of Drugs). (1998). Drug Misuse and the Environment. The Stationery Office."},{"key":"e_1_3_4_3_1","unstructured":"ACMD (Advisory Council on the Misuse of Drugs). (2016). Reducing opioid-related deaths in the UK. https:\/\/assets.publishing.service.gov.uk\/media\/5a801ba3ed915d74e33f87d4\/ACMD-Drug-Related-Deaths-Report-161212.pdf"},{"key":"e_1_3_4_4_1","unstructured":"ACMD (Advisory Council on the Misuse of Drugs). (2017). Commissioning impact on drug treatment. https:\/\/www.gov.uk\/government\/publications\/commissioning-impact-on-drug-"},{"issue":"215","key":"e_1_3_4_5_1","article-title":"Deaths of despair: Cause-specific mortality and socioeconomic inequalities in cause-specific mortality among young men in Scotland","volume":"19","author":"Allik M.","year":"2020","unstructured":"Allik M., Brown D., , Dundas R., et al. (2020). Deaths of despair: Cause-specific mortality and socioeconomic inequalities in cause-specific mortality among young men in Scotland. International Journal for Equity in Health, 19(215), https:\/\/doi.org\/10.1186\/s12939-020-01329-7","journal-title":"International Journal for Equity in Health"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227966"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13256"},{"key":"e_1_3_4_8_1","volume-title":"Thematic Analysis: A Practical Guide","author":"Braun V.","year":"2021","unstructured":"Braun V., Clarke V. (2021). Thematic Analysis: A Practical Guide. Sage."},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.32.7.513"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1518393112"},{"key":"e_1_3_4_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2005.01.006"},{"key":"e_1_3_4_12_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2017.304187"},{"key":"e_1_3_4_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)32229-9"},{"key":"e_1_3_4_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.13278"},{"key":"e_1_3_4_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcop.22989"},{"key":"e_1_3_4_16_1","unstructured":"EMCDDA (European Centre for drugs and Drugs Addiction). (2021). European Drug Report 2021: Trends and Developments. https:\/\/www.euda.europa.eu\/publications\/edr\/trends-developments\/2021_en [accessed July 2024]"},{"key":"e_1_3_4_17_1","unstructured":"EUDA (European Union Drugs Agency). (2024) European Drug Report 2024: Trends and Developments. https:\/\/www.euda.europa.eu\/publications\/european-drug-report\/2024_en [accessed July 2024]"},{"key":"e_1_3_4_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(98)00017-8"},{"key":"e_1_3_4_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0740-5472(03)00125-9"},{"key":"e_1_3_4_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/16066359.2018.1544624"},{"key":"e_1_3_4_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(02)00342-3"},{"key":"e_1_3_4_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022343390027003005"},{"key":"e_1_3_4_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/002204268501500406"},{"key":"e_1_3_4_24_1","unstructured":"Graham C. (2020). The role of despair in the opioid crisis: Lessons from the science of well-being. Brookings Institution series on The Opioid Crisis in America (Foreign Policy and Global Economy & Development programs at Brookings) June. https:\/\/www.brookings.edu\/wp-content\/uploads\/2020\/06\/2_Graham_final.pdf"},{"key":"e_1_3_4_25_1","doi-asserted-by":"publisher","DOI":"10.2147\/SAR.S341818"},{"key":"e_1_3_4_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0033354918803938"},{"key":"e_1_3_4_27_1","article-title":"Drug deaths increase as fewer people access treatment","author":"Hamilton I.","year":"2018","unstructured":"Hamilton I., Stevens A. (2018). Drug deaths increase as fewer people access treatment. The Conversation. https:\/\/theconversation.com\/record-level-of-drug-deaths-in-england-and-wales-latest-official-figures-99710. Accessed 1 Feb 2018.","journal-title":"The Conversation"},{"key":"e_1_3_4_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2012.10.003"},{"key":"e_1_3_4_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2019.07.026"},{"key":"e_1_3_4_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000052"},{"issue":"45","key":"e_1_3_4_31_1","first-page":"1","article-title":"Social autopsy for maternal and child deaths: a comprehensive literature review to examine the concept and the development of the method.","volume":"9","author":"Kalter H. D.","year":"2011","unstructured":"Kalter H. D., Salgado R., Babille M., Koffi A. K., Black R. E. (2011). Social autopsy for maternal and child deaths: a comprehensive literature review to examine the concept and the development of the method. Popul Health Metrics, 9(45), 1\u201313.https:\/\/doi.org\/10.1186\/1478-7954-9-45","journal-title":"Popul Health Metrics"},{"key":"e_1_3_4_32_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1006995507723"},{"key":"e_1_3_4_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-021-01226-7"},{"key":"e_1_3_4_34_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2019.0013"},{"key":"e_1_3_4_35_1","doi-asserted-by":"publisher","DOI":"10.1057\/978-1-137-49682-9"},{"key":"e_1_3_4_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11469-024-01257-5"},{"key":"e_1_3_4_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)71146-6"},{"key":"e_1_3_4_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32848-9"},{"key":"e_1_3_4_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(23)00082-8"},{"key":"e_1_3_4_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2016.01.009"},{"key":"e_1_3_4_41_1","doi-asserted-by":"crossref","unstructured":"Miall N. Fergie G. Pearce A. (2022) Health Inequalities in Scotland: Trends in deaths health and wellbeing health behaviours and health services since 2000. Project Report. University of Glasgow. https:\/\/doi.org\/10.36399\/gla.pubs.282637","DOI":"10.36399\/gla.pubs.282637"},{"key":"e_1_3_4_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(19)30104-5"},{"key":"e_1_3_4_43_1","unstructured":"NRS (National Records of Scotland). (2024). Drug Related Deaths in Scotland 2023. https:\/\/www.nrscotland.gov.uk\/statistics-and-data\/statistics\/statistics-by-theme\/vital-events\/deaths\/drug-related-deaths-in-scotland"},{"key":"e_1_3_4_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12470"},{"issue":"357","key":"e_1_3_4_45_1","article-title":"Drug-related deaths in Scotland 1979\u20132013: Evidence of a vulnerable cohort of young men living in deprived areas","volume":"18","author":"Parkinson J.","year":"2018","unstructured":"Parkinson J., Minton J., Lewsey J., Bouttell J., McCartney G. (2018). Drug-related deaths in Scotland 1979\u20132013: Evidence of a vulnerable cohort of young men living in deprived areas. BMC Public Health, 18(357).https:\/\/doi.org\/10.1186\/s12889-018-5267-2","journal-title":"BMC Public Health"},{"key":"e_1_3_4_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/ruso.12307"},{"key":"e_1_3_4_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0955-3959(02)00007-5"},{"key":"e_1_3_4_48_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordhb\/9780199914050.013.4"},{"key":"e_1_3_4_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2010.01.054"},{"key":"e_1_3_4_50_1","unstructured":"SIMD (Scottish Index of Multiple Deprivation). (2021). https:\/\/www.gov.scot\/collections\/scottish-index-of-multiple-deprivation-2020 [accessed May 2021]"},{"key":"e_1_3_4_51_1","article-title":"Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies","volume":"357","author":"Sordo L.","year":"2017","unstructured":"Sordo L., Barrio G., Bravo M.J., Indave B.I., Degenhardt L., Wiessing L., Ferri M., Pastor-Barriuso R., (2017). Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. BMJ. 357, j1550. https:\/\/doi.org\/10.1136\/bmj.j1550","journal-title":"BMJ"},{"key":"e_1_3_4_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.08.036"},{"issue":"3","key":"e_1_3_4_53_1","article-title":"Opioid use disorder.","volume":"6","author":"Strang J.","year":"2020","unstructured":"Strang J., Volkow N. D., Degenhardt L., et al. (2020). Opioid use disorder. Nature Reviews Disease Primers, 6(3).https:\/\/doi.org\/10.1038\/s41572-019-0137-5","journal-title":"Nature Reviews Disease Primers"},{"key":"e_1_3_4_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.13747"},{"key":"e_1_3_4_55_1","doi-asserted-by":"publisher","DOI":"10.1159\/000516165"},{"key":"e_1_3_4_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13260"},{"key":"e_1_3_4_57_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2019-212738"},{"key":"e_1_3_4_58_1","unstructured":"Whittaker A . et al. (2023). Family Stories: Lessons for Practice. Preliminary findings from Governing parental opioid use: a relational ethnography. https:\/\/relations.stir.ac.uk\/"},{"key":"e_1_3_4_59_1","doi-asserted-by":"publisher","DOI":"10.3310\/YOWK7214"},{"key":"e_1_3_4_60_1","doi-asserted-by":"publisher","DOI":"10.1177\/1473225420902840"}],"container-title":["Nordic Studies on Alcohol and Drugs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14550725251370436","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14550725251370436","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14550725251370436","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:38:18Z","timestamp":1777696698000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14550725251370436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,9]]},"references-count":59,"journal-issue":{"issue":"5-6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/14550725251370436"],"URL":"https:\/\/doi.org\/10.1177\/14550725251370436","relation":{},"ISSN":["1455-0725","1458-6126"],"issn-type":[{"value":"1455-0725","type":"print"},{"value":"1458-6126","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,9]]}}}