Trainspotting Generation: Heroin Woes of the Over 40s

Trainspotting Generation: Heroin Woes of the Over 40s

During the 1980s and 1990s cheap heroin arrived on our shores here in the United Kingdom from places as far afield as Pakistan and Afghanistan. The influx of this deadly drug was accompanied by harsh recessions and general industry decline in a Thatcher era Britain. The once great mining and docking cities of the North were all but obliterated.

This sorry state of affairs was immortalised in Irvine Welshes’ 1993 book ‘Trainspotting’ and subsequent film of the same title. And believe it or not, many of the same heroin addicts are still on the street scoring crack and/or heroin to this very day, despite the rise of many heroin treatment programmes and an array of ‘tools’ such as Methadone and buprenorphine.

Although the number of heroin addicts has, according to the National Treatment Agency (NTA), fallen below 300,000 for the first time since 1997, a massive third of their numbers consists of over 35 year olds.

Many of these addicts are homeless and suffer from a variety of mental illnesses.

This group has rather unfortunately been coined the ‘Trainspotting Generation’ amongst popular press outlets in the UK.

Here at Help4Addiction we thought the ‘Trainspotting Generation’ idea would be an interesting topic to cover, not least because many of the current articles on the subject around the internet are now over five years old.

It makes sense to look at some of the more recent statistics published since.

England and Wales drug related deaths

The stats in England and Wales for both men and women do indeed show that the ‘Transporting Generation’ trend is probably set to continue.

Below, Office of National Statistics data shows a rise in drug related deaths for over 40 year old males whilst a decline for other age groups over the same period.

 

ONS-males-drug-deaths-england

 

And this sorry state of affairs equally exists for women addicts over the age of 40.

Below the Office of National Statistics data illustrates a rise in drug related deaths for those over 40 years old amongst females in England between 1993 and 2013 whilst a showing a decline for other age groups over the same period.

 

ONS-females-drug-deaths-england

 

The below statistics, sourced from Public Health England, shows trends in age group and drug group among the entire treatment population from 2006 to 2013 in England.

The number of patients aged 40 or over has increased from 32,406 to 65,339. This means that in 2012-13 10% of the adult treatment population were aged 18-24 and 34% were aged 40 or over, compared to 19% aged 18-24 and 18% aged 40 or over in 2005-06.

 

England-drugs-council-2006-2013-in-treatment-figures

 Scotland drug related deaths

If you pop over the border, the situation is equally bleak for those over 40 years old in Scotland.

Below, National Records of Scotland, shows a rise in drug related deaths for those over 40 years old in Scotland between 1996 and 2013, whilst showing a decline for other age groups over the same period.

Scotland-drug-related-deaths-1996-2013-men-women

 

So the statistics show in England, Scotland and Wales that the this trend is set to continue in the absence of some change in policy at the heart of society.

Is this label ‘Trainspotting Generation’ helpful?

Tennessee based Bill Dinker, Director of Admissions at Discovery Place, a residential drug and alcohol treatment centre, said

“I don’t buy into pigeon-holing a particular substance abuse demographic with a catchy phrase like trainspotting generation.”

“To me, it depreciates the inherent value present in each human being who needs help. And it makes the individual easier to ‘write off,’ so to speak.”

“I can see people saying, ‘Well here’s another lost soul from the trainspotting generation. Poor guy/girl, he/she used to be somebody.’ Viewed from the lens of victims of chronic relapse, these people stand a better chance of receiving the heartfelt compassion necessary to begin recovery.”

“The term itself conjures images of a young, rough-and-tumble generation of hard-core substance abusers. The over 40 and addicted crowd doesn’t really fit that mould, so I think the label is intrinsically confusing” concluded Dinker.

A ‘chicken or the egg’ scenario?

Robert Weiss, Clinical Director at Long Beach, California’s Elements Behavioral Health Systems, feels the ‘Trainspotting Generation’ is merely due to the fact that a stubborn element simply refuse to ‘give up’; something that gets stronger as an addict ages in their ‘ways’.

“Addiction is an equal opportunity affliction. It does not discriminate based on age, race, gender, religion, financial status, social status, or anything else”.

“Sadly, most addicts wait far too long to seek treatment — if they ever seek it. This “Trainspotting Generation” you’re asking about may be just another example of that,” said Weiss.

Bill Dinker of Discovery Place feels that placing ‘blame’ for this situation is complicated, and woes of the ‘Trainspotting Generations’ should be viewed in context of the advantage younger groups have when it comes to kicking their habits, advantages which are often not available to their aging counterparts.

“I think failure is a two-sided coin. It’s easy to place blame here or there, but more difficult to recognize shortcomings across the spectrum. Lack of funding is a major issue” Dinker said.

“And Youth tend to have the advantage of financial support from parents. But the over 40 crowd often lacks this asset”.

“Without adequate funding, quality care is difficult (if not impossible) to provide. The problem is compounded by the fact that the longer addiction persists, the more difficult it is to treat.”

“So we’re left with the worst-case scenario: cases of chronic substance abuse with inadequate resources for care” concluded Dinker.

Los Angeles based Anna David, Founder of AfterPartyChat, feels the trend is due to the unique psychology of this demographic.

“The older people get, the less likely they are to be willing to change their ways. There are exceptions—we’ve done stories on seniors who actually get sober—but the more heavily committed people are to their lifestyles, the harder it becomes to change it” she said.

Policy changes

It’s likely a long term solution to this ‘scourge’ may be need at the law making level. Some have looked to the model in Portugal, where the number of opiate related drug deaths has fallen consistently since the drug was de-criminalised in 2001.

 

portugese-figures-drug-deaths-2000-2006

 Getting help

If you’re over 40 and suffering from an addiction to heroin, contact the Help4Addiction admissions team today. You can reach us on 0330 088 9518.

If you enjoyed the above blog article, make sure to leave a comment below and press the social share buttons on the left.

Sources:

Deaths related to drug poisoning, 2012 Office of National Statistics

http://www.ons.gov.uk/ons/taxonomy/index.html?nscl=Drug-related+Deaths#tab-data-tables

National Records of Scotland – Drug Related Deaths in Scotland in 2013
http://www.gro-scotland.gov.uk/files2/stats/drug-related-deaths/2013/drugs-related-deaths-2013.pdf

Drug Statistics from the National Drug Treatment Monitoring System (NDTMS), Public Health England, 2013

http://www.population-health.manchester.ac.uk/epidemiology/NDEC/factsandfigures/statisticsfromndtms201213.pdf

Instituto da Droga e da Toxicodependência de Portugal (Institute on Drugs and Drug Addiction of Portugal), “The National Situation Relating to Drugs and Dependency,” 2006 Annual Report (2007), p. 31.

http://www.unodc.org/documents/ungass2016//Contributions/Civil/Transform-Drug-Policy-Foundation/Drug-decriminalisation-in-Portugal.pdf

Garry Davis / 13th March 2018/ Posted in: Drugs, Heroin

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Detoxification (detox) is the medical intervention required for someone who is physically dependent to drugs or alcohol. If required, medical detoxification would be the first step taken in residential rehab. Detox is used to prevent uncomfortable and dangerous (even fatal) withdrawals symptoms resulting in suddenly becoming abstinent from alcohol/certain drugs.

The goal of a medical detox is to aid in the physical healing required following long term addiction and rid the body of all together of substance whilst providing a cushion for unpleasant symptoms of withdrawals. Detox is not considered the whole treatment for drug/alcohol addiction and it is always recommended that a comprehensive rehabilitation program is used along side to help maintain long term abstinence.

Medication is often required for alcohol detox. If you are dependent on alcohol and experiencing withdrawal symptoms it is vitally important to seek medical advice prior to stopping. There is a long list of medications used when treating alcohol addiction and the exact medication given to an individual will depend on their needs/medical history. Some of these include;

  • Chlordiazepoxide (Librium)
  • Lorazepam (Ativan)
  • Diazapam (vailium)


Librium and Valium are the most commonly used detox medication in the UK. All medication used to help with alcohol detox have been proven to help reduce the effects of withdrawal symptoms.

There are also a number of drugs recombined by the NHS to help treat alcohol misuse. Some of these include:

  • Naltrexone
  • Disulfiram (Antabuse)
  • Nalmefene
  • Acamprosate (campral)

Medication is always required for heroin detox. For someone suffering from heroin addiction, the thought of detoxification (detox) can be exceptionally daunting. Withdrawal symptoms from opiates, such as heroin, can be severe and include pain, vomiting, nausea and shaking.

There are different ways that heroin detox can be carried out, most usually either ‘maintenance therapy’ or ‘full medical detox’.

Attempting to switch from heroin to a heroin substitute, usually on a controlled prescription, is known as Maintenance therapy. Subsites used are most often methadone or buprenorphine.

A full medical detox from heroin will always be carried out in a residential rehab setting and will allow the individual to switch form heroin to a substitute and slowly withdraw completing treatment free of all substances. Someone using a heroin substitute can choose to have a full medical detox at any time, however detoxing substances such a methadone can often add to the length of detox required. Drugs most commonly used to fully detox from heroin are, Subutex, Suboxone and Methadone. Much like alcohol, the exact drugs used will be dependent on the individuals needs/medical history.

Once detoxed from heroin the risk of overdose is much higher following relapse due to tolerance following withdrawal.

The length of treatment in a residential rehab depends on a number of elements. Some substances require longer periods of detox than others.

Private paying patients will also often choose a length of stay that suites their therapeutic and financial needs. As a rule, a full treatment program in a rehab is considered to be 28 days (often referred to as a month), however, treatment is offered in several different ways and lengths starting at 7 days.

Treating alcohol addiction will always require a minimum of 7-10 days, this would be considered the detoxification (detox) faze. The length required for treating drug addiction can vary drastically depending on the substance being used. Detox for Heroin addiction is generally around 14 days minimum, with more time required if substances such a methadone are being used. Treating prescription drug addiction can often take the longest. The time required for treating gambling addiction, eating disorders and sex addiction will be based on the individuals needs.

Rehab programs can be as long as an individual requires but primary treatment is normally caped at 12 weeks, with the offering for further secondary and tertiary treatment thereafter.

*based on average rehab stays, everyone will vary dependant on needs and medical requirement/history.

There is no need for your employer to know that you are seeking help for trauma and addiction unless you choose to involve them with the process. All employers should have a policy that explains what you do if you cannot come to work due to illness – illness to include treating alcohol addiction/treating drug addiction.

If your work absence extends over 7 days your employer is likely to require an official statement of fitness to work which would be obtained from your GP. This would need to supply evidence of your illness as well as any adjustments required for returning to work, fazed return or reduced hours, but does not need to specify in detail the reason why you have been absent.

If you are absent from work for 7 days of less, for example entering rehab for a detoxification (detox) on a Saturday for 7-10 days taking a full week away from work, you can self-certify your illness by letting your employer work you will not be attending work for that period of time. Exactly how an individual would do this would be dependent on a specific companies’ policies on taking sick leave.

Any time longer than 7 days it is likely an employer will require a note from the individuals GP certifying their sickness and a fit note on return. Most companies have a clearly outlined policy on sickness and receiving sick pay so the exact requirement can vary. A rehab will always be willing to advise on time off work.

How much does rehab cost is a very frequently asked question. The cost of treatment can range from £1,000 per week upwards depending on the place, with luxury rehab being the most expensive.

There are free options available on the NHS but the waitlist of those looking for free treatment is longer than that for privately paying patients. Some private health insurance policies will cover treatment in some rehabs around the country.

Choosing the right rehab centre will often be based on priced but it is important to follow guidance on the most suitable treatment centre for an individual’s needs which our expert team of advisers are on hand to offer.

There are certainly pro’s for both treatment near by and traveling for treatment with one of the most asked question being should I get rehab near me? There are rehabs all over the UK and around the world that all offer expert programs, let’s look at how to choose a rehab.

Local treatment

Being close to home gives certainly has benefits. Visitors are normally permitted in rehab following the first 7 days stay, therefore if an individual is in treatment for a length of time longer than that being local will make it easier for loved ones to visit.

Most rehab centres will also provide a full aftercare plan for someone following treatment, this will include ongoing aftercare in the specific treatment centre. Living close by can make it easy to take full advantage of ongoing aftercare. There can also often be the option for ongoing care with an individual therapist, again being close by will allow that treatment to be carried out face to face.

Some individuals wish to be local but are willing to look broader, for instance the greater city of residence (London, Manchester, Liverpool, etc)

Treatment Away

Getting treatment away from home can be very appealing to some. Being out of the local area makes it a lot harder to just walk out of treatment as resources locally are unknown. Some also take comfort in knowing that they are not near home and focus more on treatment.

As the price for treatment can vary so much from one residential treatment centre to another, private paying patients often would rather travel to keep the cost down. Those using private health insurance may also have to travel to find a treatment centre covered in their policy.

When opting for treatment away from home this can be anywhere in the UK and also abroad. Aftercare can still be carried out and very successful using tools such as The Online Rehab.

There is no right or wrong when choosing where to go to residential rehab, but our expert advisors are always on hand to help provide information on all possible options.

Whilst millions of people in the UK have taken recreational drugs (amphetamine, cannabis, cocaine, crack, crystal meth, GHB, heron, ketamine, methadone, and prescription drugs) and drank alcohol not all become ‘addicted’. Most recent reports show that 279,793 individuals were in contact with drug and alcohol misuse services in the last year with over half of that being from opiate addiction and a quarter for alcohol.

There are several risk factors invoiced in addiction and those using drugs and alcohol socially, simply take the risk. These risks are as follows;

Tolerance – basically, if a substance is used repeatedly an individual’s tolerance to it will build. This will result in more of the same substance being required to get the same effect. In the long run this can easily lead to addiction and physical dependencies.

Environmental risks – these can include influences such a peer pressure and stress as well as physical or mental abuse of an individual (particularly as a child). Overall, those who live with frequent pressures and stress are more likely to reach for a substance to cope and are therefore at higher risk of becoming addicted.

Drug type – it is very well known that certain drugs are simply more addictive than others. Using substances such as heroin increases the risk of becoming addicted for need to ‘chase’ a high as well as physical dependency.

Drug administration – how a drug is administered can affect its addictive qualities. A drug injected rather than smoked or snorted will release a quicker and more intense high thus making it psychologically (and in many cases physically) more addictive.

Biological factors – it is now widely reported that being an addict is not only psychological but also biological. This includes your genetic makeup, mental health, sex and age. It is also reported to be 8 times more likely for the child of an addict to become an addict themselves.

Its believed that addiction is approximately half genetics and therefore some are 50% more likely to become addicted than others.

How do you help a loved one trapped in addiction?

The first step is to help and encourage the individual to become willing to accept help. They do not need to be shouting this off the rooftops, but they do need to be willing to go into treatment. There are ways to help someone become willing to get treatment for alcohol or treatment for drugs.

Set boundaries – set boundaries and stick to them. Once you have laid them out follow through with whatever consequences you have set however hard it is.

Stop finances – if you are financially supporting someone stopping these finances can be the quickest way for the addict needing to ask for help. With no money to acquire a substance an addict’s options become very limited.

Intervention – getting together with other family members/friends/colleagues and staging an intervention is often very successful in the fist stage of acceptance and gaining an admission to residential rehab.

You can’t make them quit, this can lead to dangerous withdrawal. Boundaries are very important in helping someone become willing to get help. Unfortunately you cannot do someone’s recovery for them and without self-motivation it is very hard to make it work.

The next step is to call our highly trained advisers 0330 088 9518.

There is a huge range of rehab options available and where to start can be completely over whelming so let us help.