Aging drug users are increasing and facing chronic physical and mental health problems

Health and social services are facing a new challenge, as many illicit drug users get older and face chronic health problems and a reduced quality of life. That is one of the key findings of research published in the September issue of the Journal of Advanced Nursing.

UK researchers interviewed eleven people aged 49 to 61 in contact with voluntary sector drug treatment services.

"This exploratory study, together with our wider research, suggest that older people who continue to use problematic or illegal drugs are emerging as an important, but relatively under-researched, international population" says lead author Brenda Roe, Professor of Health Research at Edge Hill University, UK.

"They are a vulnerable group, as their continued drug use, addiction and life experiences result in impaired health, chronic conditions, particular health needs and poorer quality of life. Despite this, services for older drug addicts are not widely available or accessed in the UK."

Figures from the USA suggest that the number of people over 50 seeking help for drug or alcohol problems will have risen from 1.7 million in 2000 to 4.4 million by 2020. And the European Monitoring Centre for Drugs and Drug Addiction estimates that the number of people aged 65 and over requiring treatment in Europe will double over the same period.

The nine men and two women who took part in the study had an average age of 57. All were currently single and their homes ranged from a caravan, hostel or care home to social housing.

Key findings from the study - by the Evidence-based Practice Research Centre at Edge Hill University and the Centre for Public Health at Liverpool John Moores University - included:

• Most started taking drugs as adolescents or young adults, often citing recreational use, experimenting or being part of the hippy era. Child abuse and the death of a parent were also mentioned.
  
• Some started taking drugs late in life due to stressful life events like divorce or death. Meeting a drug using partner was another trigger. One man started taking drugs later in life to shock his drug taking partner into stopping and ended up developing a drug habit himself.
  
• First drug use varied from magic mushrooms, LSD, amphetamines and cannabis to heroin and methadone. Alcohol and smoking often featured alongside drug use.
  
• Some increased their drug use over time, while others had periods when they tried to reduce or even abstain from drugs. All but two of the participants were taking methadone, either as maintenance or as part of a reduction strategy in order to give up drugs.
  
• A number of the participants said they were trying to use drugs responsibly and it was felt that their age and the influence of drug treatment services were factors in this. They also appeared more aware of the need to maintain their personal safety, based on previous experiences.
  
• Most recognised that their drug use was having detrimental and cumulative effects on their health, as they had developed a range of chronic and life-threatening conditions that required hospitalisation and ongoing treatment.
  
• Physical health conditions included: circulatory problems such as deep vein thrombosis, injection site ulcers, stroke, respiratory problems, pneumonia, diabetes, hepatitis and liver cirrhosis. Malnutrition, weight loss and obesity also featured, as did accidental injuries due to falls and drug overdoses.
  
• Common mental health problems included memory loss, paranoia and changed mood states, with anxiety or anger also featuring.
  
• All wished they hadn't started taking drugs and would advise young people not to. A few were keen to give up, but others felt it was too hard. One man described his drug use as "disgusting and squalid" while another said that the older he got the worse his drug use got and that it was a "crazy" situation.
  
• All were single or divorced and drug use was a common factor in relationship breakdowns. Most lived alone, with three relying on carers who were also drug users. Pets were often important for some, providing companionship as well as a sense of responsibility and structure to their day.
  
• Drug use was often associated with chaotic lifestyles and relationships and some reported periods of imprisonment.
  
• Participants were positive about the support they received from voluntary drug services, but had mixed experiences of primary and hospital care. Some felt stigmatised by healthcare professionals, while others received compassion and acknowledgement of their drug use.

"It is clear that further research is needed to enable health and social care professionals to develop appropriate services for this increasingly vulnerable group. We also feel that older drug users could play a key role in educating younger people about the dangers of drug use."