1st Edition

Substance Use, End-of-Life Care and Multiple Deprivation Practice and Research

    222 Pages 8 B/W Illustrations
    by Routledge

    222 Pages 8 B/W Illustrations
    by Routledge

    Focussing on end-of-life care for people who use, or have used, substances, this book explores their social and health care needs and the multiple disadvantages they have often experienced, discussing the complexities around access to care that result.

    Presenting models of good practice, case studies and empirically based evidence, Substance Use, End-of-Life Care is informative, rigorous and useful for policy and practice development. The first section foregrounds the personal experiences of people living with substance use, their families and friends, and the health and social care professionals who work with them. The second section looks at how health inequalities can impact people in need of palliative care, including chapters on health literacy, mental health and learning disabilities. The final section explores social challenges that may be experienced, including homelessness, sex work, racism and incarceration.

    This interdisciplinary volume is essential for researchers, practitioners, students and educators working around substance use, mental health and palliative and end-of-life care, who are looking for guidance and a reference for their work in supporting people at the end of their lives who have multiple and often complex needs.

    Chapter 1- Introduction

    Gary Witham, Sam Wright, Sarah Galvani

    Part I: Different voices (Introduction by Gary Witham)

    Chapter 2 – Death is not an abstract now: approaching end of life as someone using substances

    Sam Wright, Amanda Clayson and Jo Ashby

    Chapter 3 – Views from the coalface: social and health care professionals working with people using substances at, or near, the end of their lives

    Sarah Galvani, Cherilyn Dance and Sam Wright

    Chapter 4 - Seeing the common ground: family and practitioner caregivers’ perspectives of palliative care for people using substances

    Sam Wright, Sarah Galvani and Gemma Yarwood

    Part II: Health inequalities (Introduction by Sam Wright)

    Chapter 5 - Health literacy and substance use within palliative and end-of-life care

    Gary Witham

    Chapter 6 - Learning disabilities and substance use at the end of life: listening to the unheard

    Gary Witham and Sarah Galvani

    Chapter 7 - Improving end-of-life care for people with co-existing mental health and substance use

    Lucy Webb

    Chapter 8 – Ageing (dis)gracefully: People who inject drugs living with hepatitis C and the provision of end-of-life care

    Peter Higgs

    Part III: Social inequalities (Introduction by Sarah Galvani)

    Chapter 9 – Homelessness and substance use within palliative and end-of-life care

    Niamh Brophy and Alison Colclough

    Chapter 10 – Jane’s journey: substance use, palliative care and sex work

    Adele Brien

    Chapter 11 – Reflecting on the challenges and inequalities facing Black and minoritized communities in accessing substance use services, palliative and end-of-life care

    Anya Ahmed and Lorna Chesterton

    Chapter 12 - Unequal in life and death: substance use, disadvantage and end-of-life care in prison

    Marian Peacock and Mary Turner

    Chapter 13 – Reflections and recommendations: multiple disadvantage, substance use and end-of-life care

    Sarah Galvani, Sam Wright and Gary Witham


    Gary Witham is a Senior Lecturer in Nursing at Manchester Metropolitan University, UK. His research interests are exploring marginalised populations' experiences and access to palliative and end-of-life care services. Specifically, he has co-investigated the experiences of people using substances at the end of life, their carers and family as well as health and social care professionals. He has also worked on projects exploring the implementation of good practice models of care related to support people using substances at the end of life.

    Sarah Galvani is Professor of Substance Use and Social Research at Manchester Metropolitan University, UK. Sarah is a social worker by profession, having started out working as a volunteer in the UK and USA with homeless people with mental ill health and/or people who use alcohol or other drugs. As an academic, she currently leads work on end-of-life and palliative care for people using substances and focusses on substance-related research among marginalised populations.

    Sam Wright joined Professor Sarah Galvani and a multi-disciplinary team at Manchester Metropolitan University in 2016 to work on a large exploratory study focussing on end-of-life care for people with alcohol and other drug problems. Her main focus has been interviewing people approaching the end of life, their family caregivers and the health practitioners working with them. More recently she has been helping to develop a new model of end-of-life care for people using substances in Liverpool and Sefton (UK) and also evaluating effective ways of supporting people who are street homeless.

    Gemma A. Yarwood is a Senior Lecturer in Criminology and Sociology, Manchester Metropolitan University, UK. A key focus of Gemma’s research is end-of-life care and substance use. Her research informs the core curriculum of the top 10 rated MA/MSc/BA/BSc Criminology and Sociology degrees which she delivers at Manchester Metropolitan University.  She has written for many publications, including journal articles, website content, book chapters, reports for various organisations and national charities.