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Background: To investigate health personnel’s perceptions and experiences of alcohol and psychotropic drug use among older people (65 years and above) and to what extent this is an issue when services are planned for and implemented. Method: Qualitative interviews with 16 health professionals who work with older patients, 13 registered district nurses, two occupational therapists and one physiotherapist, were performed during 2013. The sample included informants aged 34-62 years from 14 municipalities, four were male. Findings: Two main categories emerged: state of practice and a desire to improve services. The first category details the informants’ perceptions of legitimacy and attention to substance use and misuse among older people in need of healthcare, and their competence and knowledge on the topic. The topic was experienced as demanding to bring up. Health personnel described a lack of attention and competence how to handle use and misuse of alcohol and psychotropic drugs. The category is described in the subcategories legitimacy and attention to substance use and misuse and competence and knowledge in practice. The second category demonstrates the informants’ desire to improve services so it better can contribute to detect misuse among older people and contribute to treatment. The variation is contained in the subcategories improving collaboration and changing routines. Conclusion: Use and misuse of alcohol and psychoactive drugs among older people had little attention when the community health service is planned for and implemented. The participating health professionals had a desire to improve routines and collaboration in the healthcare services, but were also in need of improved competence about use and misuse of alcohol and psychoactive drugs. Published by arrangement with John Wiley & Sons.

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