Beyond medication: Life situation of older patients in opioid maintenance treatment

Background: The opioid maintenance population is rising and aging. Although this creates new challenges for society, little is known about the social issues older patients in this treatment face. The Ministry of Health and Care Services in Norway was revising the National Action Plan for Drug Treatment and Rehabilitation in 2015. In this context, the Ministry requested a report on health and social issues and possible challenges for the health care services. Aims of this article are to provide an understanding of the complex social issues associated with older patients in opioid maintenance treatment, and give implications for future work. a Method: Statistical data from national, regional and local reports, plans and projects were collected. A literature search was conducted and qualitative data from focus groups were included. A methodological triangulation was used in the analysis. Results: Patients experienced several social issues, especially: stigmatization, isolation and financial difficulties. Patients were stigmatized from society in general, but also from the social and mental health services. They had difficulties socializing and lacked the skills needed for doing so. Even though the majority of patients received benefit payments, self-reported poverty was emphasized. Conclusions: Raised awareness of issues faced by older patients in opioid maintenance treatment is needed. An improved collaboration between the municipality, specialist health care services, the local community, and voluntary organizations should be used to a greater extent. The patients have to be a part of this collaboration. Organizational challenges need to be approached and professional competence enhanced.