Differences in overdose rates by gender at supervised consumption services: an explanatory sequential mixed methods study

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Background Gender differences have been reported regarding patterns of drug use associated with opioid use disorder. In this study, we aimed to identify if gender trends exist in local supervised consumption sites (SCS) overdose data and to understand reasons for gender differences in overdoses from the perceptions of SCS healthcare professionals. Methods A mixed-methods study was conducted at a single SCS. We analyzed 35,777 total visits by SCS clients and interviewed five SCS staff. We assessed overdose rates and naloxone administration, oxygen administration, and emergency medical services (EMS) called. We used Braun and Clark’s reflexive thematic analysis for interview data. Results Among the clinic visits, the frequency of overdoses across the total number of SCS visits was 662, with similar frequency for males and females. When comparing rates of oxygen administration, naloxone administration, and calling EMS, the frequency of all three interventions was higher for males compared to females. Participants attributed these discrepancies to physiological differences between genders and different gender norms that influenced behavior in the SCS. Conclusion Gendered differences impact how men and women utilize and receive SCS care. Staff can be aware of these trends when supporting clients in SCS. No clinical trial registration