Our Invisible Addicts (2nd edition, CR211 Mar 2018)

For too long, the topic of substance misuse in older people has been ignored.

A new approach, that is non-discriminatory, comprehensive and needs-led, is now essential.

We recommend that a national strategy outlining cohesive integrated policies devised by stakeholders, with financial support and direction by government, and driven at local, regional and national levels be developed and implemented.


  • The older substance misuser is poorly represented in the range of policy initiatives, though this may be very gradually changing.
  • Greater value needs to be placed on the requirements and wishes of older substance misusers.
  • Diverse approaches are required to minimise the health, social and economic consequences for a population of “baby boomers” who have the fastest increase in rates of substance misuse in the population.
  • Campaigning is needed to reduce the stigma associated with alcohol and substance misuse among the public and professionals.
  • Greater recognition of the scale of the problem should be promoted via wider dissemination of up-to-date research.

Key Recommendations

  • Support the implementation of minimum unit pricing (which has a strong evidence base for reducing alcohol-related harm) across the UKthrough joint working with the Alcohol Health Alliance and the British Medical Association.
  • Develop partnership working between old age and substance misuse services. Develop training supported by Royal Medical Colleges to ensure comprehensive assessment of substance misuse in all older people presenting to older people’s mental health services and of alcohol misuse in memory clinics and dementia services.
  • Share best practice in existing care pathways for substance misuse within mental health services for older people and mental health treatment for older people within substance misuse services across NHS and third sector providers.
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