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Baby-boomers’ substance misuse problems ignored for too long

But numbers are rising and clinical services need to adjust their focus, says Royal College of Psychiatrists

Caroline White

Wednesday, 07 March 2018

Despite the growing numbers of baby-boomers seeking help for substance misuse, their needs have largely been ignored by clinical services, concludes a new report from The Royal College of Psychiatrists published today.

Our Invisible Addicts
highlights the burgeoning problem of substance misuse among older people, with the UK now following in the footsteps of other developed countries in having an older population with the highest rises in rates of substance misuse.

Baby-boomers born between 1946–1964 (now aged between 53 and 71 years old) are at the highest risk of substance misuse which is rising within the older population.

But the problem is often hidden from view, says the report. With most problems going undetected, there is a pressing need to improve the diagnosis, treatment, education, training, service development and policy for all older people with substance misuse, it emphasises.

While awareness of alcohol units among older people is improving, there is a general lack of health awareness around lower risk drinking limits among the public.

This also includes practitioners assessing older people with alcohol misuse, says the report, which points out that deaths related to poisoning from substances in older people have more than doubled over the past decade.

Today’s report updates the original 2011 publication, which was an important landmark in recognising the extent of substance-related health problems among older people, says the College.

It makes a series of recommendations, including the need to enhance training at all levels, and training more addictions and old age psychiatrists, to manage the specific needs of older substance misusers.

The report’s foreword points out: “The complex constellation of risks that older people with addictions face and create can result in presentation to a variety of services such as older people’s mental health, addictions, primary care, acute hospital settings, social care, housing, criminal justice and the voluntary sector. In many cases the staff in these settings have little specialist knowledge of how to deal with such complexity.”

Addictions consultant psychiatrist Professor Ilana Crome and old age consultant psychiatrist Dr Tony Rao, who co-chaired the working party that produced the report, said: "In the 21st century, substance misuse is no longer confined to younger people. The public is poorly informed about the relationship between substance misuse and health risks in older people.

“We need a clear and coordinated approach to address a problem that is likely to increase further over coming decades. By improving our approach to substance misuse in older people from detection to continuity of care, we can also improve both quality of life and reduce mortality in a vulnerable group that deserves better.”

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: "GPs are not killjoys but safe drinking limits are set for good reason and we would encourage everyone to try to stick to limiting their intake to a maximum of 14 units a week, with at least two alcohol-free days every week.”

She added: "Substance misuse is a very concerning issue for the whole population – it is not the preserve of young people - and GPs understand that addiction to any substance can have serious, negative consequences on our patients' health and wellbeing.

"It is alarming to see a doubling in deaths related to poisoning from substances in older people and highlights the very real dangers of alcohol and drug misuse.”

She continued: "While alcohol is safe in moderation, it is also important to be aware of your alcohol habits at home, in private - as it can be more difficult to keep track of exactly how many units you're having when they are not being measured out in standard sizes - and if you notice it's becoming a problem, you should be honest with yourself and seek help to limit your alcohol intake."

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