The psychosocial characteristics of older heroin-dependent patients (defined as 45 years and over) attending a specialist addiction clinic in Stoke on Trent, UK were studied using retrospective record analysis of the case notes of the 20 oldest heroin-dependent patients. This study draws attention to the multiple psychosocial problems facing ageing heroin addicts. On average, patients were 48 years old, had first been exposed to heroin at age 29, 85% were injectors and the majority were polydrug users. In 20% a major life event had preceded first use of heroin. Nineteen were male, 17 were single, only 10% were employed, while just 10% did not have a criminal history. Depression, self-harm and memory disturbance were frequently reported. Retention in treatment was a feature, with consequent improvements including reduction in criminality and injecting behaviour. However, there is little specific guidance on treatment, training or policy for this group in the UK.
