Older drug users’ everyday lives and struggles

Due to the success of harm reduction programs and services, marginalized drug users in Denmark and the rest of Europe live longer, and there is an increase in the number of long-term drug users who experience physical and mental age-related difficulties (Bjerge et al. 2024, Fahnøe and Kronbæk 2024). The age-related difficulties make it challenging and risky for older drug users to participate in social life in drug use environments where social order is shaped by a hierarchy based on physical strength and willingness to use violence (Andersson 2000). And as a consequence, older drug users retreat from these environments even though they continue to use drugs. Effectively, the retreat from drug use environments is also a retreat from social life, as the older drug users rarely have social relationships outside these environments.

The older drug users struggle with multiple problems, where social problems and substance use interact with physical, mental, and cognitive impairments that are the result of aging and a life with substance use. Besides causing experiences of suffering, these intertwined problems make it difficult for older drug users to access welfare services. On the one hand, they do not fit in with services for the elderly, and on the other hand, they have difficulties profiting from services for drug users, which usually target younger people. The older drug users who have had to retreat from social life in drug use environments thus face a double socio-spatial exclusion: they are de facto excluded from social life and from welfare services.

In this presentation, we show how aging and the related double socio-spatial exclusion are tied to the experiences of social suffering (Frost and Hoggett 2008) in everyday life for this group of older drug users; moreover, we discuss how social work can alleviate their suffering.

The presentation reports on findings from two separate research projects on the everyday lives of drug users and their experiences with welfare services and professionals (Houborg et al. 2022; Fahnøe and Kronbæk 2024). Based on qualitative interviews with 33 older drug users, we show that the age-related difficulties that influence older drug users’ everyday lives include: 1) physical impairment and pain resulting from a lifelong of drug use, violence, accidents, lack of health care, and malnutrition 2) psychological trauma from being victims of violence and sexual assaults, as well as their own actions 3) Impaired cognition and memory due head traumas, infections and substance use 4) Loneliness related to death among peers, broken social relationships and lack of mobility and opportunities for engaging in social activities.

Informed by these findings, we discuss the needs of the new group of “survivors” and how social work practices and what kind of services are needed to make it possible for them to have a meaningful and satisfying life, and ensure that harm reduction will benefit this group of older drug users.