Exploring the biopsychosocial needs of ageing heroin users in treatment in Malta: implications for service provision

The National Report on the Drug Situation and Responses in Malta (2021) indicates a local aging heroin-using population. While some substance users naturally progress out of addiction, others persist in their addiction careers, often experiencing comorbid disorders and various challenges. The European Monitoring Centre on Drugs and Drug Addiction (EMCDDA) has noted that this client group face a number of challenges. This project seeks to investigate the biopsychosocial needs of aging heroin users in treatment in Malta and their implications for service provision. This research poses several research questions regarding physical and mental health difficulties, social and criminal justice problems, and unique challenges faced by older heroin users. It also engages with implications for drug treatment and wider health, support, and care services.

This research project investigates the specific needs of this aging drug-using population, identifying service provision gaps, and proposing recommendations. It employs a biopsychosocial conceptual framework for addiction. Drug use exacerbates or accelerates conditions associated with aging and causes premature aging among chronic drug users as young as 40. Given the limited data on older addicts in Europe, this study's impact lies in identifying areas for further service development to meet the specific needs of this population, thereby contributing to their health and well-being. It is expected that the study will identify ways to combat social isolation, stigmatization, unemployment, homelessness, and poor health among older heroin users, ultimately improving their quality of life. Additionally, it will contribute to the evidence base on a pressing issue in Europe and align with the United Nations sustainable development goals 1, 3, and 10.

The research adopts a mixed-methods approach, quantitative data is gathered through the use of a questionnaire adapted from a previous study by the Scottish Drugs Forum. Subsequently, in-depth interviews are conducted to explore their lived experiences. Based on National Report Data, our research identifies an estimated overall pool of approximately 350-400 heroin users over the age of 40. To ensure a representative sample, we targeted 10% of this population and recruited individuals in accordance with the specified numbers and male-to-female ratio. This approach will culminate  in a set of recommendations to address the biopsychosocial needs of aging heroin users in treatment in Malta. The study's findings will be widely disseminated among policymakers. Ethical clearance has been granted by the FREC/SWB (SWB-2022-00150).