An ageing population of opioid users

The number of first-time heroin clients more than halved from a peak of 56 000 in 2007, to 23 000 in 2013 before increasing to 29 000 in 2015. The recent increase can be seen in several countries, but it needs to be interpreted with caution, as changes in national reporting may have had an impact on the EU total.

Treatment entrants with opioids as primary drug: shifts in the age structure over time (left) and mean age by country (right)

Many long-term opioid users in Europe, typically with polydrug use histories, are now aged in their 40s and 50s. Between 2006 and 2015, the mean age of those entering treatment for problems related to opioid use increased by 4 years. During the same period, the average age of drug-induced deaths (which are mainly related to opioids) increased by 5.5 years. A history of injecting drug use and poor health, bad living conditions and tobacco and alcohol use makes these users susceptible to a range of chronic health problems, including cardiovascular and lung problems.

Long-term opioid users also report chronic pain conditions, while chronic infection with the hepatitis C 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 considerable implications for treatment, social support services and prevention of drug-related deaths.

Heroin users entering treatment