The population of people who use drugs (PWUD) in France has undergone a profound demographic shift, with adults aged 40 and over now representing over one-third of CAARUD users. Yet the structural architecture of French CAARUD services has not adapted accordingly. This narrative review identifies five dimensions of this gerontological blind spot: accelerating epidemiological greying of drug-using populations; age-specific vulnerabilities including polypharmacy, accelerated biological ageing, and cognitive impairment; structural mismatch between CAARUD design and older PWUD needs; international models demonstrating feasibility of gero-sensitive harm reduction; and identifiable policy levers within the French system. Five evidence-informed recommendations are proposed: systematic geriatric screening, interdisciplinary training, cross-sectoral partnerships, adapted physical environments, and legislative reform.
Alexandre DELFORGE (Fri,) studied this question.