In the last 20 years, the number of people over 50 receiving drug treatment has increased seven-fold and the number receiving alcohol treatment has increased four-fold.  In 2024, nearly 90,000 over 50’s received drug or alcohol treatment, with over a quarter aged over 60. 

Many people who are dependent on drugs or alcohol eventually require long-term or permanent care in a care home, often at a relatively young age as a result of heavy drug and alcohol use. Others will require a shorter stay in a home following detox or illness in hospital.  1,756 care homes for older people reported caring for at least one person with substance dependence during 2022/23 in England alone. 

The project will be led by Dr Sarah Wadd, Director of the Substance Misuse and Ageing Research Team (SMART) at the University of Bedfordshire, and is funded by the National Institute for Health and Care Research Programme for Social Care, a major funder of global health research and training.

Speaking about this research, Dr Wadd said: “Caring for people with drug and alcohol dependence in care homes can present complex practical, ethical and legal issues, particularly if the person is unable or unwilling to stop drinking or using drugs. For example, should care staff acknowledge that some people will inject drugs in their rooms and provide them with a safe storage box for their drugs and sharps bins to reduce risk to others?  Should care staff help residents space out alcoholic drinks to avoid potentially life-threatening withdrawal symptoms? Is there a need for more care homes for people with substance dependence who are not ready to stop drinking alcohol or using drugs? 

“We are delighted to be awarded funding for this research which aims to improve how care homes look after people with drug and alcohol dependence.  The research will help the care home sector to support the rapidly growing population of older people with substance dependence.  Working with the Care Quality Commission, we will carry out research interviews and focus groups with people living in care homes, family members, care home inspectors, care home staff and other professionals and prepare case studies of homes providing good or innovative care.  When we have this evidence, we will bring together a group of experts, including people with lived experience, to agree the recommendations.” 

Chris is a member of the research team. He is alcohol dependent and was discharged from hospital to a care home. Chris is managing his alcohol dependence well with help from care home staff but says: "I know that not everyone is as lucky as me. I’m aware that there are huge disparities in the care and treatment of people with alcohol dependence across the country. This study could help ensure consistent and improved care and treatment across all services and providers”.

Amy Hopwood, a Care Quality Commission Policy Manager and member of the research team, said added: “The Care Quality Commission is pleased to be part of this important research which will help care homes balance the complex issues of person-centred care, health needs and legal responsibilities in caring for people with substance dependence.”

This new research is one of 14 newly-funded projects by the NIHR Research Programme for Social Care, designed to produce research that will improve the lives of people who draw on social care support and their carers.