Treatment experience and needs of older drug users in Bristol, UK

Abstract

Recent publications raise concerns about meeting the treatment needs of an ageing drug-using population. At Bristol Drugs Project (BDP) we noted the absence of older users attending services beyond health centre-based opiate substitution therapy (OST). Twenty drug-users aged 55 or over were interviewed about their experience of treatment, barriers to further treatment, and what might encourage participation in our community drugs project. Thematic analysis revealed barriers as reluctance to be associated with younger drug users and a sense of shame at ‘still using at this age’. Assumptions that health professionals would interpret asking for medical help with other age-related symptoms as ‘merely seeking more medication’ prevented some from getting adequate pain relief and there was a tension between fear of detox and fear of drug dependency in old age. Most reported positive relationships with general practitioners (GPs) and BDP Shared Care workers in respect of their drug use, but others had felt stigmatized and inadequately treated within Tier 4 (mainly hospital) services which they attributed to their drug-user status. A focus group developed ideas for an age-specific support group to be piloted. Advocacy work and training for health professionals should be ongoing to improve treatment for older drug users.

• Older drug users
• treatment
• qualitative interviews

Acknowledgements

The authors wish to thank St Monica Trust (a major care provider for older people) for funding this work, members of the Bristol Drugs Project Peer Support Group for helping with the interviews and Jenny Scott and Caryl Beynon for commenting on the manuscript.