European opioid users are ‘ageing cohort’

The average age of opioid users entering treatment in Europe increased by five years between 2006 and 2013, a new report has revealed.

The European Drugs Report 2015 found that a significant number of opioid users in Europe with a history of long-term polydrug use were now in their 40s and 50s and as a result were particularly susceptible to a range of chronic health conditions.

“Clinical guidelines that take account of the demographic shift in Europe’s problem opioid users are needed,” the report published last week stated. These would support effective clinical practice and cover issues such as: drug interactions; take-home dosages of substitution treatment medications (for example methadone or buprenorphine); managing pain; and treating infections.

While few countries reported the availability of targeted programmes for older drug users, the report found that Germany and the Netherlands had set up retirement homes catering for the needs of older drug users.

“In the future, drug treatment and care programmes will have to be modified and developed if this ageing cohort is to receive an appropriate level of care. This is likely to require staff training and changes in care provision.

“As this is a client group with relatively poor engagement with the general health system and poor adherence to treatment for drug-related infections, the importance of a multi-disciplinary approach that continues after drug treatment is clear,” the report stated.

Published by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the report is the 20th annual analysis of the drugs situation in Europe. It found that the number of overdose deaths among younger drug users decreased between 2006 and 2013. However, there was an increasing number of such deaths among older users.

During 2006 to 2014, the average age of drug-induced deaths (which are mainly related to opioids) increased from 33 to 37 years, according to the EMCDDA.

“Long-term heroin users are also reporting chronic pain conditions, while infection with hepatitis virus can place them at increased risk of cirrhosis and other liver problems. The cumulative effects of polydrug use, overdose and infections over many years accelerate physical ageing among these users, with growing implications for treatment and social support services,” the report stated.

Welcoming the report, Aodhán Ó Ríordáin, Minister of State with responsibility for the National Drugs Strategy, said: “Like other European countries, Ireland faces major challenges ahead due to the rapid emergence and spread of new psychoactive substances, the changing nature of the heroin market, the ageing population of heroin users and the increased demand for treatment by those with cannabis-related problems.”

Source: June Shannon, Irish Medical Times, 11/06/15