Since responsibility for delivering addictions treatment was shifted from the NHS to local government, budgets for addictions treatment have reduced by over 30 percent.

As our population ages, so are the people who use drugs. In fact, it’s the “Trainspotting generation” who are suffering the most from the damaging effects of drugs, particularly opiates such as heroin.

"Intoxication, overdose and withdrawal are all more likely to be fatal in older people who have some degree of heart disease and increased brain sensitivity to drugs."

It is then not surprising that a new report has found this growing group of older and middle aged people, who have survived long term heavy drug use, to now form a larger proportion of those in specialist community drug treatment in the UK. Over half of those in treatment for drug use are over 40 – this number has almost tripled over the past 10 years from around 26,000 to around 75,000.

Nor is it surprising, sadly that it is has been found that the specialist support needed for this group is often not available or up to scratch.

A wake up call came when dramatic rises in drug related deaths in older people were uncovered by the Royal College of Psychiatrists’ report Our Invisible Addicts. In England and Wales, the number of deaths related to poisoning from opiates over the previous 10 years almost doubled in people in their fifties.

Why has this happened? And why hasn’t action been taken to address this situation?

One in five older people have five or more long term conditions such as high blood pressure, diabetes, painful joint problems, breathing problems and kidney disease.

Combined with the wide-reaching effects of ageing, addiction to drugs such as heroin or morphine can be particularly fatal. Intoxication, overdose and withdrawal are all more likely to be fatal in older people who have some degree of heart disease and increased brain sensitivity to drugs. That’s not forgetting the impact of potential interactions with prescribed medication and other drugs.

While more older and middle-aged people are receiving some treatment for addiction drug treatment services are often poorly equipped to deal with their complex needs.

Society can be blind to the ageism, stigma and negative attitudes among health and social care professional are additional barriers to receiving care. The social consequences of growing older - bereavement, social isolation, loss of independence and the impact on families and carers – are often underplayed.

Since responsibility for delivering addictions treatment was shifted from the NHS to local government, budgets for addictions treatment have reduced by over 30 percent.

Burgeoning responsibility

Assessing and treating people with addictions requires specialist skills, even more so when these are older people. With services being cut and removed from the NHS, the provision of addiction psychiatry services has dwindled apace, and the unique skills they hold to treat the complex physical and mental health issues involved are disappearing, as are opportunities to train others in them.

So what can be done? More and better training is certainly needed for staff in the risks faced by older opiate users in specialist community-based drug treatment, covering the complexity of both mental health and physical problems seen in older people.

But if we really want to provide better treatment for our ageing addicts we need to be able to bring services back together so that we can get over the all too common scenario where we “go here for that and there for this”. A lack of joint commissioning of services by both the NHS and Local Authorities for the specialist treatment of drug users, particularly for those who are older with more complex need, is today’s problem.

The burgeoning responsibility of serving the needs of this growing group of addicts cannot be shirked by government. The drawbridge needs to be wound back down and the importance of providing specialist services to meet complex needs to be recognized, as well as the importance of having sufficient numbers of skilled addictions psychiatrists in the provision of drug treatment services.

If we want people using opiate drugs to be able to choose life, we must make sure this is possible.