Drug fatalities and treatment fatalism: Complicating the ageing cohort theory

Abstract

Deaths related to drug ‘misuse’ remain at an all‐time high in the United Kingdom (UK). Older heroin consumers are particularly at risk, with the highest rates of deaths among people aged 40–49 and the steepest rises in the over‐fifty age bracket. Accordingly, a popular theory for the UK’s increase in drug‐related deaths, made by the government, and propelled in the media, is that there is an ageing cohort of heroin users with age‐related health complications predisposing them to an overdose. However, drawing on in‐depth interviews with those people deemed to be most at risk, this article works to complicate this theory, with participants citing a shift in (a) experience and responsibility, (b) route of administration, (c) desired effects, (d) acceptance of their drug use and ‘user’ status and (e) valuing health. Disrupting age as a given risk factor, this article turns attention away from the individual and these ‘natural’ processes to what participants describe as a singular, punitive, and inflexible treatment system and its intersecting structures. Approaching life and death as a matter of sociomaterial ‘mattering’, this article rethinks a reductionist, causal link between age and drug‐related death with a treatment despondency and fatalism that could prove fatal.

“I don’t go to funerals anymore”: how people who use opioids grieve drug-related death in the US overdose epidemic

“…In response, study participants altered their drug use in the wake of a drug overdose death in their social network, with most toggling between periods of intensified drug use to numb the pain of their grief to abstinence or safer drug use practices to protect themselves from death. Our findings echo research showing that PWUO often develop a sense that overdose death is an inevitable result of opioid use, leading to fatalism and ambivalence to overdose that may diminish their willingness to engage with harm reduction services and practices, especially among those who are structurally vulnerable [35,[44][45][46]. Complex grief in DRD bereavement may be a factor in these more general findings about fatalism and ambivalence to overdose among PWUO, although it is not often discussed in the literature.…”

The risk matrix: Drug‐related deaths in prisons in England and Wales, 2015–2020

“…This echoes the findings of Dennis (2021) who has argued that drug-related deaths in the community to be set within the wider context of risk related to cuts to treatment, rigidity of treatment regimes and shift towards abstinence-oriented approaches, as well as increasing health and social inequalities. She identifies the 'problem of treatment response-ability, where our often inflexible and limited treatment options are failing to respond to older people who have used drugs for a long time' (Dennis, 2021(Dennis, , p. 1181.…”

“…The debate around drug-related deaths both in the wider community and within prisons has become unhelpfully polarised: it should not be a matter of blaming either individual or environment but of understanding the way in which multiple risks collide and interconnect to produce harm. As Dennis (2021) argues in relation to drug-related deaths in the community, the danger with solely focussing on substances, individuals and risk behaviours is that these deaths become seen as inevitable and it is assumed that little can be done to prevent them. Although the…”

Mortalidad entre los pacientes adictos a opiáceos al cabo de 30 años de seguimiento

“…Analizado en conjunto, hay que concluir que es difícil conocer los datos exactos de mortalidad de estos pacientes, ya que las distintas formas de recoger las causas de muerte en los distintos países y estudios, unido a los distintos diseños utilizados en los estudios son factores de confusión difícilmente superable si no se homogeniza la investigación y recogida de los datos (Bahji, Cheng, Gray y Stuart, 2019;Bahji et al, 2020;Cruts et al, 2008;Degenhardt et al, 2011;Degenhardt, Hall y Warner-Smith, 2006;Dennis, 2021;Giraudon et al, 2012;Horon, Singal, Fowler y Sha-rfstein, 2018;Larney et al, 2020;Mathers y Degenhardt, 2014;Mathers et al, 2013;Molist et al, 2018;Onyeka et al, 2014;Onyeka et al, 2015;Slavova et al, 2019).…”