Do older people not do drugs? drug use in old age
When we talk about drug use, the image that usually comes to mind is that of a young person. However, recent data are starting to break that stereotype: older people are also part of this silent reality. In Europe, drug use among older people—especially those with a long history of use, meaning they started at a younger age—is on the rise. This trend not only challenges certain stereotypes (even if it’s through such a bad habit), but more importantly, raises significant health and social challenges.
The phenomenon is relevant enough that it is beginning to be studied specifically in European reports, such as Older people and drugs: health and social responses (2023). Regarding younger people, we have the European Drug Report 2024, along with many others. These do not reference older adults, but they served as the starting point for this post because they highlight the increase in drug-related deaths at older ages. To put things in perspective, the report states that between 2012 and 2022, drug-induced deaths among people aged 50 to 64 increased by a staggering 66%! Contrary to the common perception that overdoses mainly affect young people, the data show that many of these deaths occur in men aged 40 and older. It is also noted (and this is important) that the population of opioid users in Europe is aging, which undoubtedly has implications for treatment services and healthcare. More than suggesting an increase in drug use among older people (i.e., that people start using at older ages), what this makes me think is that people with addictions are also living longer—but there are other realities behind this as well.
The analyzed reports refer to the use of illegal drugs (such as heroin, cannabis, cocaine, and new psychoactive substances), but they also include legal substances that are misused and can hide strong addictions (e.g., prescription opioids). In other words, when we talk about drug use, we don’t necessarily have to imagine 85-year-old Mrs. Juana taking a psychotropic at a music festival; it could be that Juana (or Juan) is accessing these substances through the healthcare system but using them in a problematic way. They’re still drugs, and they are still a response to a problem that Juana is experiencing and suffering from (whether it’s anxiety, sadness, or general psychosocial distress). But I’ll talk a bit more about this later.
As mentioned earlier, according to the European Drug Report 2024 by the European Union Drugs Agency (EUDA), one of the most significant changes in recent years is the progressive aging of the population with substance use disorders (to add context: maybe Juana was a user before and still goes to festivals). We’re not talking (at least not in the majority of cases) about people who begin using drugs in old age, but about people with long-term use trajectories who are now aging. This is clearly reflected in treatment and death data: in 2022, 27% of drug-induced deaths were among people aged 50 and older. Between 2012 and 2022, overdose deaths in the 50 to 64 age group increased by 66% (EUDA, 2024).
It’s important here to reflect on the definition of an “older person.” I’ve written in this blog on several occasions about how the threshold of old age, in my view, should be adjusted based on factors that aren’t necessarily subjective. In this case, although we traditionally consider someone 65 or older to be “elderly,” in the context of drug use it may be appropriate to lower that threshold. Reports indicate that people with long-term problematic drug use can experience premature aging, with health issues typically seen in much older individuals. This is another reality to keep in mind.
But who uses more drugs among older people? First, it’s worth noting that the available statistics aren’t “very precise,” but they’re detailed enough to show that intragroup differences exist: the reports show that most are men, with drug use trajectories starting in adolescence or early adulthood, especially with heroin or other opioids. However, there are also women and people with other types of drug use (perhaps more along the lines we mentioned earlier, where medical prescriptions evolve into addiction—like our poor Juana, not the one at the festivals, the other one). These individuals are definitely less visible, but it’s important to highlight that we’re not only talking about aging addicts. We’re also seeing late-onset problematic substance use, often tied to chronic pain, cognitive decline, or social isolation. And this is the part that concerns me most; these are the cases and situations that usually involve the misuse of medications (especially opioids) that may have been prescribed in medical contexts. It’s what happens, for example, with the medicalization of loneliness or the oversimplification of social problems as if they could be treated medically. A “don’t be sad” response in the form of a pill.
That said, one of the major limitations highlighted by the reports is the lack of qualitative studies or surveys specifically targeting older adults who use drugs. For example, the European Web Survey on Drugs doesn’t have representative samples of older people (even if we lower the threshold). This once again reveals a form of ageism that assumes drugs are not an issue for older adults—or at least not one worth analyzing. Why do older people use drugs? I have more doubts than answers, but the few existing studies suggest that loneliness and isolation can be triggers. There are also barriers that make it harder for them to stop using, such as stigma (they’re afraid to admit it) or difficulty accessing services—whether due to physical barriers (accessibility issues apply here too) or simply not knowing the services exist. And there’s also a very harsh reality that applies at all ages: admitting you’re an addict is incredibly hard.
Current models are largely designed for younger people; this isn’t necessarily a problem (they are more frequently affected by this major issue), but this approach—ageist, ultimately—can create significant barriers for older adults who need care and may require different approaches than younger individuals.
To end this short (but I believe necessary, given how overlooked it is) reflection: it would be important to incorporate the aging perspective into harm reduction and treatment services. If we’re really talking about the “challenge of aging” (a phrase I don’t personally agree with, for the record), we must also acknowledge these realities. We need to train addiction professionals—and also primary care providers—to detect and support older adults with problematic drug use. We should also reflect on medical prescriptions: what’s behind that pain? Is it social pain? Are we treating sadness with pills? This is not a critique of medical practice (which is already overwhelmed enough), but rather an invitation to look more deeply at what’s really going on. Because not all pain is physical, and not all of it can be solved with medication.
