People over the age of 40 make up an increasing share of those with an opioid problem in Europe. This is reflected in the increasing age of those in drug treatment and those dying of opioid overdoses.

In this group of older opioid users, the physical ageing process may be accelerated by the cumulative effects of polydrug use, overdose and infections over many years. Older people with opioid problems have higher rates of degenerative disorders, circulatory and respiratory problems, pneumonia, breathlessness, diabetes, hepatitis and liver cirrhosis than their peers and younger people who use drugs. They may also be more susceptible to infection, overdose and suicide.

In addition, their social networks may be reduced because of premature death and stigma, which can further increase social exclusion and isolation from families. The stigma and shame of still using drugs may also act as a barrier to help-seeking.