2025/07/15 by Emmert Roberts, Sharmila Parmanand, Caroline S. Copeland · 1 voice
Social Sciences · Medicine · Pharmacology, Toxicology and Pharmaceutics · #Sex work and related issues #HIV, Drug Use, Sexual Risk #Forensic Toxicology and Drug Analysis
paper · pdf · doi:10.1111/dar.70008
openalex publication_date 2025/07/15 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28
INTRODUCTION: 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. METHODS: 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. RESULTS: 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%). DISCUSSION AND CONCLUSIONS: 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.