{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T18:55:42Z","timestamp":1780599342059,"version":"3.54.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:00:00Z","timestamp":1650499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>This study aimed to examine drug-related deaths in the UK in which novel psychoactive substances (NPS) are an implicated substance, and to focus on female deaths in comparison with male deaths. While male overdoses dominate epidemiological statistics, there is an increase in female drug-related deaths and a narrowing of the gap between gender mortality rates which is to date unexplained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This study analyzed data from the National Programme for Substance Abuse Deaths (NPSAD) database that records drug-related deaths in the UK from coronial records. A dataset was constructed using parameters to capture all drug-related cases during the period 2007\u20132017 when NPS were legal and highly available in the UK, in order to capture deaths recorded among both regular and occasional drug users, and to include all cases recorded during that period regardless of NPS status in order to make comparisons. The final dataset comprised 10,159 cases, with 456 NPS-related deaths. Data for NPS and non-NPS were compared, and comparisons were made between cohorts by gender. The dataset also includes coronial narrative notes which allowed a qualitative analysis of NPS female deaths to add contextual explanation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The proportion of male NPS deaths is significantly higher than that for female NPS deaths but does not reflect the generalized difference between male and female drug-related mortality of this period studied. Demographic and outcome data by gender difference were significant for all drug-related deaths, but not for NPS-only deaths, indicating a greater homogeneity among NPS deaths by gender. Older women using NPS were more likely to have methadone or diazepam as another drug implicated and have established histories of drug misuse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Where NPS have been used, differences in drug death profiles are less likely to be accounted for by gender than other demographic or behavioral differences more typically found in opiate deaths. The social and health problems of older women may be key characteristics that differentiate female deaths from male deaths. These findings also support evidence of increasing uptake of NPS among older established drug users that adds further risk to polydrug use.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2022.890840","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T06:01:37Z","timestamp":1650520897000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Trends in Mortality From Novel Psychoactive Substances as \u201cLegal Highs\u201d: Gender Differences in Manner of Death and Implications for Risk Differences for Women"],"prefix":"10.3389","volume":"13","author":[{"given":"Lucy","family":"Webb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Goodair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Survjit","family":"Cheeta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,21]]},"reference":[{"key":"B1","unstructured":"World Drug Report 20212021"},{"key":"B2","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.drugalcdep.2019.02.007","article-title":"A systematic review of sex differences in treatment outcomes among people with opioid use disorder receiving buprenorphine maintenance versus other treatment conditions","volume":"197","author":"Ling","year":"2019","journal-title":"Drug Alcohol Depend."},{"key":"B3","volume-title":"Drug-Related Deaths in Scotland, 2020","year":"2021"},{"key":"B4","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1080\/09687637.2020.1856786","article-title":"Why are drug-related deaths among women increasing in Scotland? A mixed methods analysis of possible explanations","volume":"29","author":"Tweed","year":"2022","journal-title":"Drugs: Educ Prevent Pol"},{"key":"B5","volume-title":"ESPAD Report 2015: Results From the European School Survey Project on Alcohol and Other Drugs.","year":"2016"},{"key":"B6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.mm6801a1","article-title":"Drug overdose deaths among women aged 30-64 years \u2013 United States, 1999-2017","volume":"68","author":"vanHouten","year":"2019","journal-title":"CDC Morbid Mortal Wkly Rep."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e29","DOI":"10.2105\/AJPH.2015.302843","article-title":"Worldwide prevalence and trends in unintentional drug overdose: a systematic review of the literature","volume":"105","author":"Martins","year":"2015","journal-title":"Am J Public Health."},{"key":"B8","unstructured":"Psychoactive Substance Act2016"},{"key":"B9","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/S0140-6736(18)31203-0","article-title":"Women and opioids: something different is happening here","volume":"392","author":"Mazure","year":"2018","journal-title":"Lancet."},{"key":"B10","volume-title":"Drug-related deaths in England, Northern Ireland, The Channel Islands and the Isle of Man, January \u2013 December","author":"Claridge","year":"2015"},{"key":"B11","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1021\/acs.estlett.1c00807","article-title":"A taste for new psychoactive substances: wastewater analysis study of 10 countries","volume":"9","author":"Bade","year":"2022","journal-title":"Environ Sci Technol Lett."},{"key":"B12","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1111\/bcp.14168","article-title":"Understanding the uk psychoactive substances act","volume":"86","author":"Hill","year":"2020","journal-title":"Br J Clin Pharmacol"},{"key":"B13","unstructured":"Synthetic Drugs Trends in 20212022"},{"key":"B14","unstructured":"Synthetic Cannabinoids Market Worldwide Major Trend Outlook 2020 to 20302022"},{"key":"B15","volume-title":"Reducing Opioid-Related Deaths in the UK","year":"2016"},{"key":"B16","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1002\/wps.20174","article-title":"Novel psychoactive substances of interest for psychiatry","volume":"14","author":"Schifano","year":"2015","journal-title":"World Psychiatry."},{"key":"B17","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1002\/hup.528","article-title":"Death rates from ecstasy (MDMA, MDA) and polydrug use in England and Wales 1996-2002","volume":"18","author":"Schifano","year":"2003","journal-title":"Human Psychopharmacol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2120","DOI":"10.1007\/s12640-021-00416-z","article-title":"Hard boiled: alcohol use as a risk factor for MDMA-induced hyperthermia: a systematic review","volume":"39","author":"van Amsterdam","year":"2021","journal-title":"Neurotoxicity Res."},{"key":"B19","volume-title":"The Novel Psychoactive Substances in the UK Project: Empirical and Conceptual Review Work to Produce Research Recommendations","author":"Mdege","year":"2017"},{"key":"B20","doi-asserted-by":"publisher","first-page":"6848","DOI":"10.1136\/bmj.i6848","article-title":"Novel psychoactive substances: types, mechanisms of action, and effects","volume":"356","author":"Tracy","year":"2017","journal-title":"BMJ."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/phr07140","article-title":"Evidence for public health on novel psychoactive substance use: a mixed-methods study","volume":"7","author":"Higgins","year":"2019","journal-title":"Public Health Res"},{"key":"B22","doi-asserted-by":"publisher","first-page":"e0232038","DOI":"10.1371\/journal.pone.0232038","article-title":"Drug trends and harm related to new psychoactive substances (NPS) in Sweden from 2010 to 2016: experiences from the STRIDA project","volume":"15","author":"Helander","year":"2020","journal-title":"PLoS ONE."},{"key":"B23","doi-asserted-by":"publisher","first-page":"102691","DOI":"10.1016\/j.drugpo.2020.102691","article-title":"Circumstances of overdose among street-involved, opioid-injecting women: drug, set, and setting","volume":"78","author":"Ataiants","year":"2020","journal-title":"Int J Drug Policy."},{"key":"B24","volume-title":"Ageing Cohort of Drug Users","year":"2019"},{"key":"B25","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1093\/jat\/bks085","article-title":"Fatal mephedrone intoxication\u2014a case report","volume":"37","author":"Adamowicz","year":"2013","journal-title":"J Anal Toxicol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1177\/02698811211026","article-title":"Deaths from novel psychoactive substances in England, Wales and Northern Ireland: Evaluating the impact of the UK psychoactive substances act 2016","volume":"35","author":"Deen","year":"2016","journal-title":"J Psychopharmacol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1186\/s12888-016-0909-3","article-title":"Nonmedical use of prescription drugs in the European Union","volume":"16","author":"Novak","year":"2016","journal-title":"BMC Psychiatry."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.890840\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T06:01:47Z","timestamp":1650520907000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.890840\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,21]]},"references-count":27,"alternative-id":["10.3389\/fpsyt.2022.890840"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2022.890840","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,21]]},"article-number":"890840"}}