DRUG users over the age of 35 face some of the “most extreme health inequalities seen in Scottish society today” according to a new report.

The Scottish Drugs Forum (SDF) Expert Working Group on Older People with a Drug Problem has spent the last two years talking to users and service providers in a bid to have the country prepared for the challenges of ageing addicts.

“Those aged over 35 will become the main client group in specialist services for the foreseeable future,” the report warns.

The NHS and front-line services will need to adapt to “better meet the needs of this population”.

The group is at high risk of fatal overdose or dying of other causes.

Scotland’s drugs death figures are already incredibly high. The most recent statistics 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.

There are 133 drug deaths per million people in Scotland. In Portugal, where drugs were decriminalised in 2001, the figure is just three deaths per million.

Often labelled as the “Train- spotting” generation of drug users, the report said these Older People with a Drug Problem (OPDP) find themselves isolated with very little social interaction, and deteriorating physical and mental health, often suffering depression, and anxiety.

The report suggests long-term drug users often present with medical problems more likely to be found in someone 15 years older.

But there is often an unwillingness to engage with services until it is too late.

According to the group, the cost to the NHS of OPDP in 2012/13 was an estimated £50.8 million.

The report says many of the users 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.

“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, Although the majority of users had accessed drug treatment services, they often dropped out, feeling that there was a lack of support for someone of their age.

One 39-year-old male user quoted in the report said: “I don’t know, I think they [service providers] should just try and chill out a bit … when you get to 40 years old and you’ve been taking heroin for 20 years, as I say, it’s pretty obvious that, if you’ve no’ been able to conquer it up to now then, you’re obviously struggling.

“Rather than just kicking people out o’ the service because, fae their point of view they’re no trying hard enough, they should have a certain part o’ the service that just allows for people to still get the help, the support the substitute medication, but allowing for the fact that they’re still gonna take illicit drugs because they cannae help it.”

The report said there were also clear gender specific issues for OPDP, including support around abuse, responsibilities of childcare and the trauma of having children removed.

One solution suggested by the group is a form of sheltered housing, on a “core and cluster” model, with homes offered next to dedicated services.

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.”

There are an estimated 37,500 older drug users in Scotland, and that could exceed 40,000 by 2023.