AGEING heroin addicts should be housed together in specialist units to stem the rising tide of drug deaths, a new report has claimed, as it emerged the number of users in Scotland could soar to 40,000 by 2023.

An expert working group set up by the Scottish Drugs Forum (SDF) warns of a coming crisis due to rising numbers of older people with drug problems (OPDP).

The group’s report classes anyone over 35 in this category, as experts warn many long-term users have the physical and health problems of someone 15 years older.

The report says many are not offered appropriate treatment for health conditions – because they are wrongly attributed to drug use, or because some services such as mental health will not offer treatment until addiction issues have been addressed. SDF is calling for the Scottish Government to challenge sub-standard NHS care and improve the ability of services to treat underlying health conditions.

“Given the wealth of evidence over the shocking health outcomes for this group of citizens, it is clear that they face some of the most extreme health inequalities seen in Scottish society today,” it says, calling for services to work better with patients who frequently have chronic conditions associated with the elderly, such as dementia, respiratory disease and chronic pain, as well as mental health problems compounded by isolation and stigma.

This group are almost entirely responsible for Scotland’s rising rate of drug-related deaths. The most recent figures show 706 people died as a result of drug abuse in 2015, a 15 per cent increase on the previous year and part of a steady trend since 1995.

In order to improve access to services , the report proposes a form of sheltered housing, on a “core and cluster” model, with homes offered next to dedicated services, without setting conditions about a person’s substance use. This would have an additional benefit in addressing the isolation and loneliness experienced by many drug users, the report says.

David Liddell, director of SDF, said: “Services cannot continue to see this as a fringe group, the over 35s will be the mainstream in the future. We need to get better at keeping people in treatment so we can deal with their other problems.

“The cluster and core model would help do that. If you insist people are drug free before you give them housing, then it is a catch 22.”

The gradual ageing of people who acquired an addiction in the eighties and nineties mean the number of older drug users in Scotland has risen sharply since 2009 to an estimated 37,500 today. If relapse rates increase that could reach exceed 40,000 by 2023, the report warns.

John Budd, a GP with the Edinburgh Access Project, and chair of the working group, said it was in everyone’s interest to improve the health of long-term drug users. “Some people would view this as a lifestyle choice, but the vast majority of people who have a drug problem are self-medicating, dealing with underlying trauma or untreated mental health issues,” he said.

“Aside from the human cost, there is a societal benefit in reducing the cost of avoidable hospital visits and treatment.”

One drug user, Gary, said it was common for older drug users to be dismissed by health services with efforts focused on younger users. “Down the line they tell you to go away, you’ve had your chance,” he said.