Roberts Emmert, Parmanand Sharmila, Copeland Caroline
National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
South London and the Maudsley NHS Foundation Trust, London, UK.
Drug Alcohol Rev. 2025 Sep;44(6):1805-1810. doi: 10.1111/dar.70008. Epub 2025 Jul 15.
Individuals engaged in sex work are an understudied population recognised to be at differential risk of experiencing drug-related harms. We aimed to determine the case characteristics, circumstances of death and type of implicated drugs among sex workers dying due to drug-related causes.
Retrospective cohort study in the United Kingdom using coronial records from the National Programme on Substance Use Mortality, 1997-2023. Information was available on decedent sociodemographics, characteristics of death and implicated drugs.
Nineteen decedents were reported to be sex workers at the time of their death. Overall, decedents were predominantly female (n = 17, 90%) with a mean age of 36.4 years (SD 8.0; range 26-58). Poisoning was the only disease or condition that was certified as a direct, antecedent or contributory cause of death. The mean number of drugs detected at post-mortem was 5.4 (SD 2.5; range 1-10) with multiple drug toxicity implicated in the majority of cases (n = 18, 95%). The most commonly implicated drug groups were opioids (n = 17, 90%) and benzodiazepines (n = 9, 47%). All decedents had a history of substance dependence (n = 19, 100%), with almost a third injecting (n = 6, 32%).
There have been low but consistent numbers of drug-related deaths each year where individuals were reported to be sex workers, results likely representing significantly conservative estimates. Polysubstance, opioid and benzodiazepine use are overrepresented within a largely female population with a significant burden of substance dependence. Non-judgmental facilitation of access to evidence-based addiction treatment, in particular for opioid use disorder, should be a priority.
从事性工作的人群是一个研究不足的群体，被认为面临与毒品相关伤害的风险存在差异。我们旨在确定因毒品相关原因死亡的性工作者的病例特征、死亡情况及涉事毒品类型。
在英国进行回顾性队列研究，使用1997 - 2023年国家药物使用死亡率计划中的死因记录。可获取死者的社会人口统计学信息、死亡特征及涉事毒品信息。
有19名死者在死亡时被报告为性工作者。总体而言，死者以女性为主（n = 17，90%），平均年龄为36.4岁（标准差8.0；范围26 - 58岁）。中毒是唯一被确认为直接、先前或促成死亡原因的疾病或状况。尸检时检测到的毒品平均数量为5.4种（标准差2.5；范围1 - 10种），大多数病例（n = 18，95%）涉及多种药物中毒。最常涉及的毒品类别是阿片类药物（n = 17，90%）和苯二氮䓬类药物（n = 9，47%）。所有死者都有药物依赖史（n = 19，100%），近三分之一有注射吸毒史（n = 6，32%）。
每年报告为性工作者的与毒品相关的死亡人数虽少但较为稳定，结果可能是明显保守的估计。在一个主要为女性且药物依赖负担较重的人群中，多药使用、阿片类药物和苯二氮䓬类药物的使用比例过高。应优先以非评判性方式促进获得基于证据的成瘾治疗，尤其是针对阿片类药物使用障碍的治疗。
