‘Drug problems have no age limits,’ says the EU drugs agency (EMCDDA). In a special review published today alongside its 2010 Annual report, the agency reveals why drug use is no longer simply a ‘youth phenomenon’ (1).
Europe is experiencing a pronounced ageing of its population, around a quarter of which will be aged 65 or over by 2050. Statistics published today show that Europe’s drug-using population is also ageing and that meeting the needs of older drug users is a growing issue for treatment services. This is particularly the case in western countries which saw the EU’s first heroin epidemics in the 1980s and 1990s.
Focusing on dependent drug users aged 40 or over, the review highlights the ‘severity’ of their needs and ‘poor quality of life’. But it warns that ‘specialised treatment and care programmes for older drug users are rare in Europe’.
Data from specialised drug treatment centres and opioid substitution treatment providers show that older drug users now make up a substantial proportion of their clients and, in many countries, this share is growing. On average, around one in five (19 %) of all those entering treatment in Europe are aged 40 or over, while in some countries the figure is close to 30 % (Figure 3). This represents a major increase compared to a decade ago when, in most Member States, the proportion of older clients did not exceed 10 %. Portugal reports the highest share (28 %) of older drug users entering treatment, while Spain reports the highest increase: 15 percentage points since 2000 (Figure 4). Data specifically on substitution treatment show that, in some countries, over half of the clients are over 40.
While the largest shares of older problem drug users in treatment are found in western EU countries, in most central and eastern European countries, the over-40s make up a small percentage of problem drug users in treatment. ‘As drug epidemics there began later [late 1990s, 2000s]… these regions can expect, over the next decades, to see increasing numbers of older problem drug users’, states the report.
Older drug users in treatment report high levels of unemployment and social isolation and present the chronic physical and psychosocial consequences of long-term drug use (e.g. liver disease, overdose-related damage, depression). Alcohol and tobacco-related problems are also common. With the ageing process in older drug users accelerated, by the age of 40 a dependent user may need a level of care more typically associated with a person 20 years their senior. Current treatment services are usually tailored to younger drug users and staff may be unfamiliar with late-life drug problems or dealing with health and social changes naturally occurring with age (e.g. reduced mobility, cardiovascular disease, death of relatives).
‘It is commonly assumed that people in their mid-30s grow out of drug use’, says EMCDDA Director Wolfgang Götz, ‘but data from drug treatment centres in Europe show that this is not always the case. Increasingly services are called on to meet the needs of ageing clients who bear the health effects of long-term drug use combined with those of getting older. So far we have been slow to grasp the implications of this change, but it clearly presents a growing issue for both specialised drug treatment services and mainstream health and social care providers alike’.