Specific Populations

Chapter 3.1

All services and elements of the care system should consider their accessibility and adaptability to meeting the needs of population groups who may face additional barriers. This includes people from black, Asian and minority ethnic communities, those who identify as LGBTQI+ and disabled people.

We have identified that women and young people, groups with an increased percentage of drug-related deaths, may need specific interventions.


While men are more likely to die from drugs than women, the gap has decreased over the last two decades.

Women, especially mothers, are likely to experience barriers to accessing care, including stigma. Mothers may be particularly reluctant to seek support due to concerns about having their children removed from their care.

The deaths of a large proportion of women with substance use problems that occur in the perinatal period are closely associated with child protection proceedings or having their child taken into care (23).

What needs to change

Services must recognise the specific needs of, and additional barriers faced by, women accessing treatment. They can effectively support women by considering issues such as appointment location and timings, methadone collection options, safety, choice in the gender of worker and options for home visits. Women-specific services, spaces and/or groups may also be appropriate.

Workforces need to be trained in respecting women’s rights, recognising power imbalances and domestic abuse, and breaking down barriers to engagement and sexual and reproductive health services.

We published the report Women and Drug-related Deaths (16) in December 2021. It presents recommendations in four key areas: developing services, collaboration, information services and workforce training. We welcome the Scottish Government’s commitment to publish an action plan to take forward the recommendations. More than six months on, however, this has not yet been published.

Action 29. Local services must consider their provision and pathways through an equalities lens, ensuring that women can access the support they need when they need it.

Young people

Drug-related deaths among young people (under 25 years) have risen sharply in recent years.

The deaths recorded in 2020 – 78 – was more than double the number in 2017. Hospital stays are also increasing. Patterns of drug use among young people seem to be changing, with increased use of cocaine and sedatives/hypnotics.

What needs to change

Early identification and intervention to support young people before drug use becomes problematic is crucial. The Scottish Government’s working group on care and standards for early intervention treatment is a positive development in this regard.

Young people with care experience can be particularly at risk. Work in this area needs to join up with the Keeping the Promise implementation plan (24).

Services often do not have specific pathways in place for young people who may not seek treatment or support through traditional services. Local areas need to ensure young people can access pathways into treatment and support no matter where they live.

Action 30. ADPs and services must ensure specific pathways are developed to ensure young people can access the support they need when they need it.