ArticleThe International journal on drug policy2021
Overdose among mothers: The association between child removal and unintentional drug overdose in a longitudinal cohort of marginalised women in Canada.
Article in The International journal on drug policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 93 citations in OpenAlex.
- Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis.Harm reduction journal · 2024Pooled it
- Reproductive health considerations for HIV prevention integrated care models for women who inject drugs: Qualitative perspective of participants and providers in HIV Prevention Trials Network 094.Drug and alcohol dependence · 2026Article
- "I Know So Many Women That Have the Same Story as Mine": Exploring How the Increase of Benzodiazepines in the Unregulated Drug Supply Shapes Experiences of Gender-Based Violence Among Women and Gender Minorities in Vancouver, BC.Contemporary drug problems · 2026Article
- Article
- Cohort profile: Mothers who use substances and their children in British Columbia, Canada.PloS one · 2026Article
- Tailored strategies to reduce opioid overdose deaths for pregnant and postpartum women: Examples and lessons learned from the HEALing Communities Study.Journal of substance use and addiction treatment · 2025Article
- Parenting through the eyes of mothers with substance use disorder: Implications for treatment and related services.Drug and alcohol dependence · 2025Article
- Health Promotion and Support Grounded in Interconnected Influences on Alcohol Use in Pregnancy.International journal of environmental research and public health · 2025Review
- Spatial epidemiology of nonfatal overdose in a community-based cohort of marginalized women in Vancouver, British Columbia (2014-2022).Drug and alcohol dependence · 2025Article
- State Policy Variation in Implementation of Federal Drug and Child Abuse Laws and Stigmatization of Pregnant and Postpartum Individuals with Opioid Use Disorder.Journal of women's health (2002) · 2025Article
- Substance use and use disorders during pregnancy and the postpartum period.American journal of obstetrics and gynecology · 2025Review
- Just an unfair score: Perceptions of gender inequity in the treatment of substance use disorders among women involved in the criminal legal system.Journal of substance use and addiction treatment · 2025Article
- Understanding the needs of postpartum emerging adults with substance use disorders to improve recovery supports.Frontiers in public health · 2025Article
- Opioid toxicity deaths in Indigenous people who experienced incarceration in Ontario, Canada 2015-2020: a whole population retrospective cohort study.Lancet regional health. Americas · 2025Article
- Development of a Clinical Decision-Making Framework to Address Parental Substance Use and Child Safety.Parenting, science and practice · 2024Article
- "They Give you a bus Ticket and They Kick you Loose": A Qualitative Analysis of Post-Release Experiences among Recently Incarcerated Women Living with HIV in Metro Vancouver, Canada.Violence against women · 2024Article
- "Instead of just taking my baby, they could've actually given me a chance": Experiences with plans of safe care among birth parents impacted by perinatal substance use.Child abuse & neglect · 2024Article
- Lessons Learned from Implementation of a Post-opioid Overdose Outreach Program in a Rural Massachusetts Community.Community mental health journal · 2024Article
- Adolescent child custody loss and substance use treatment as predictors of young adult substance use trajectories among females with foster care and juvenile justice involvement.Children and youth services review · 2024Article
- Staying Together No Matter What: Becoming Young Parents on the Streets of Vancouver.Culture, medicine and psychiatry · 2023Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundAccidental overdose is a major public health concern in North America with research primarily focused on cisgender men. Little is known about the burden of overdose among marginalised women, particularly in the context of child custody loss. This study aims to examine the prevalence of overdose and the association with child removal in a cohort of marginalised women.
methodsThis study draws on a merged dataset (2010-2018) of two community-based longitudinal cohorts of over 1000 marginalised women in Canada recruited using time-location sampling. After restricting to women who had ever had a live birth, bivariate and multivariable logistic regression using generalised estimating equations (GEE) were used to examine the association between child removal and overdose. Joint effects of child removal and Indigeneity were also investigated.
resultsOf the 696 women who reported ever having a live birth, 39.7% (n = 276) reported child removal at baseline. Unintended, non-fatal overdose rates were high, with 35.1% (n = 244) of women reporting ever having an overdose. Using bivariate GEE analyses, having a child apprehended and being Indigenous were positively correlated with overdose. Using multivariable GEE, child removal increased the odds of overdose by 55% (AOR: 1.55; 95% CI 1.01-2.39) after adjusting for education and Indigenous ancestry. Using multivariable joint-effects analysis, Indigenous women who had experienced child removal had over twice the odds of an unintended overdose than non-Indigenous women who had not lost custody after adjusting for education, food insecurity, and sex work (AOR: 2.09; 95% CI 1.15-3.79).
conclusionThis analysis suggests that, after controlling for known confounders, women who have a child removed experience higher odds of overdose, and these odds are highest among Indigenous women. The high prevalence of overdose in this cohort suggests the need for further strategies to prevent overdose among pregnant and parenting women.
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Registered trials
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