Rising incidence of ageing opioid users within the EU wide treatment

Background and aim: Literature identifies older people who use opioids as a neglected population. Little is known about temporal changes, or about treatment demand among this population. The aim of this study was to utilise national epidemiological treatment data to describe the changing opioid treatment population over a twenty year period.

Design: Cross-sectional study

Setting: Ireland

Participants: A total of 20,698 new individuals entering treatment for opioid use between 1995 and 2015.

Measurements: Trends in age-adjusted incidence rates were examined using Joinpoint regression analysis. Changes in patient characteristics including age, gender, sociodemographics, drug using career, and injecting risk behaviours were investigated.

Findings: Data from 20,698 individuals entering treatment for the first time showed that while the trend of age-adjusted incidence declined between 1995 and 2015, incidence among older age groups increased, with a rising incidence not previously observed among those aged 50 years and older. Subgroups of early and late treatment entries, and early and late opioid onset were observed. The median age commencing opioid use increased by three years from 17 to 22 years (U=246292.0, p < 0.001). The median age entering treatment increased by 11 years (from age 20 to age 31) (U=89416.5, p < 0.001). The median opioid-using duration prior to treatment increased by 5 years (from 2 to 7 years) (U=60636.0, p < 0.001). Half of the individuals started injecting within one year of first using opioids. The median time between first injecting and commencing treatment increased by 4.5 years for men and 3 years for women.

Conclusions: The study utilises European TDI data and finds that those entering treatment in Ireland is older, are injecting longer and are taking longer to enter treatment. These findings highlight how TDI data can be used to identify hidden groups at risk of chronic harm which may require prioritising in policy and practice. The study findings can assist treatment services to improve responses and prepare for future challenges posed by ageing opioid users.