Nijmegen nursing home allows controlled drug and alcohol use for elderly with addictions
A specialized nursing home in Nijmegen that permits regulated alcohol and drug use is drawing attention to a growing question in Dutch health care: where to place older people with addictions and complex physical and psychiatric needs who do not fit into traditional care systems.
At care organization De Waalboog in Nijmegen, dozens of older residents with substance use disorders receive daily, regulated doses of alcohol, cannabis or substitution medication such as methadone, NOS reports. The specialized residential facility, which opened six months ago, is designed for people who fall between traditional care systems.
“We see that older people with an addiction often fall between the cracks,” Ewoud de Jong, a physician at the residential care home, told NOS. He said they are often not eligible for standard nursing homes, while at the same time they are too physically ill to remain in psychiatric institutions or supported addiction housing.
Residents receive standard elderly care, but substance use is integrated into daily routines under supervision. “In addition to that, some people drink quite a bit of alcohol or smoke a joint, but there are agreements between residents and caregivers about quantities and timing,” De Jong said. “The addictive substances are therefore also a kind of daily necessity for residents, but with regulated use.”
The approach includes residents like a 59-year-old woman identified as Door, who was previously addicted to cocaine and heroin. She now receives methadone twice a day as a substitution medication.
“They come at fixed times, and then you have to take it,” she told the newspaper. Door said such treatment would be unthinkable in other elderly care settings. “I think it is good that they support and help you here.” She added, “I am happy that it is possible here.”
Residents in the Nijmegen facility have substantial freedom of movement. “Their lives vary. Some sit on the balcony all day; others often go into the city center,” De Jong said.
De Waalboog works with outside experts in addiction and psychiatry alongside its own geriatric care specialists. “We have knowledge in the field of specialized elderly care. As for addictions and psychiatry, we have engaged external partners,” the organization stated.
The approach is being watched closely as broader trends emerge in the Netherlands. Research by Ladis, the national Alcohol and Drugs Information System, shows that excessive alcohol and opioid use occurs more frequently among older people than other types of substance use.
De Waalboog stated that residents’ functioning is reviewed weekly, but the core approach focuses on well-being and controlled substance use. “If it turns out that a resident is doing so well that detoxing becomes a viable option, that is a nice bonus, but that is never the goal.”
According to the Salvation Army, excessive alcohol or drug use can contribute to unsafe or misunderstood behavior. National figures published by Statistics Netherlands show that in 2024 police registered more than 60,000 people with unexplained behavior, and more than 18 percent of them were aged 65 or older.
Bianca Buurman, a professor and chair of the professional association for nurses and caregivers, said initiatives like De Waalboog’s are welcomed. “For people with unexplained behavior, there is often a lack of a place where they can live properly,” she told NOS.
She added that nurses frequently struggle with patients who have both addiction and physical health problems. “In nursing homes, knowledge of mental health and psychiatric conditions is not always present, and within mental health care, knowledge of physical complaints is not either,” she said. Bringing that expertise together in nursing homes, she said, could be a major improvement.
However, experts also voiced concerns. Wilco Sliedrecht, chair of the Association for Addiction Medicine, warned against complacency. “Addiction is often a survival strategy for people who do not see meaning in life without the numbing effect of intoxicating substances,” he told NOS. “That is why it is important to offer alternatives, such as meaning and purpose.”
The Dutch Association for Mental Health Care also supports exploring alternatives but says quality of life must come first. “You must also limit health damage,” the organization said, adding that abstinence is not always achievable.
Sliedrecht added that approaches should be evaluated every six months. “It remains important to motivate reduction or recovery,” he said. He added that underlying issues such as depression or trauma often drive addiction and may require targeted treatment.