Aim
The problems of older substance misusers do not just relate to prescribed drugs and alcohol , but increasingly to illicit drugs. The management of these individuals is often complicated by social , psychological , and physical health problems. The UK does not have designated services for their treatment. Current policies prioritise younger people and research in this area often excludes older substance misusers, or does not analyse them separately. The modern style of treatment provision may not meet their needs. We wondered if this was the case in our own service.
Method
We analysed the clinical notes of individuals in our service aged 50 and above who misused substances other than alcohol.
Results
40 patients were identified aged 50 to 68. Of these 31 were long term misusers whose drug use began in early life .5 misused only prescription drugs while 35 misused illicit drugs.30 misused more than one substance.37 were on the opioid maintenance programmes.34 had significant physical illnesses, and 10 had impaired mobility impacting on appointment attendance. 30 had psychiatric diagnoses. 2 patients died during the period of our analysis with factors such as polydrug misuse, physical illness and self harm. contributing to their deaths.
Conclusion
The particular needs of older individuals in substance misuse services are beginning to be recognized. There are implications for treatment provision, notably allowing more time for direct care and liaison with other services where this is indicated. The issue of which services will manage the increasing number of older substance misusers will also need to be addressed.
Relevant papers
Crome,I.,Bloor,R.(2005) Older substance misusers still deserve better services-an update. Part 1 &2. Reviews in Clinical Gerontology. 15;125-133,255-262
Crome,I.,Bloor,R.(2006) Older substance misusers still deserve better services-an update. Part 3. Reviews in Clinical Gerontology. 16;45-57
Gossop,M.,Moos,R. (2008) Substance misuse among older adults: a neglected but treatable problem . Addiction. 103;347-348
Verity, R. (2004). Substitution therapy service provision into older age. Addiction.99; 649
Department of Health.(2007) Drug misuse and dependemce. UK guidelines on clinical management
