Ageing in the context of the Opioid Maintenance Treatment in Portugal: Impact of public health policies on ageing users
Abstract
Introduction: The ageing of illicit substance users and the increase in their health care needs has imposed new demands on treatment services. The last few decades of legislative changes in Portugal and the scant knowledge about this ageing population has been raising challenges for the health system. Namely, there is a need to understand the impact of the Opioid Maintenance Treatment-Methadone Programme (OMT Methadone). Objectives: The aim of this study is to improve the understanding of the ageing substance users by converging the sociodemographic and clinical description of this population with an exploration of the perceptions they have about the influence of the OMT-Methadone on their ageing and the clinical and social interactions arising from substance use and treatment. Methodology: The impact of public health policies will be assessed accordingly with the response to the new health needs and the ageing of the population, by using a mixed-methods approach consisting of an ethnographic and descriptive study, with cultural immersion/observation and collection of quantitative and qualitative data from users attending the OMT-Methadone Programme. Outcomes: It is expected that the present study will allow: (1) understanding the different dimensions at the Micro, Meso and Macro levels (individual, health care, political and economical, respectively) that influence the ageing of users in the OMT-Methadone Programme; and (2) obtaining a profile of ageing associated with the use of substances with a focus on syndemics, enabling a perspective on the life course of this ageing population highlighting the pathways throughout life, age-related roles, transitions and trajectories over time. Such will allow us to understand the interaction and inter-influence of changes in the individual, the family and the community, as well as their impact on biological, psychological, cognitive and social development that arise during their lifespan. Discussion/Conclusion: This holistic approach makes it possible to assess how the social context and structures play a shaping role in the individual's life patterns, and additionally contributes to the characterization of consumption trajectories and patterns in a structured way, by identifying and analysing the critical events due to the persistence and repetition of behaviours or due to behaviour changes throughout life.
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