Older people are using substances at a high rate, yet stigma and ageism often prevent them from obtaining appropriate and compassionate care. Dr Sarah Fraser chats with Dr Lara Nixon and Dr Cathy Scrimshaw about what physicians and the system at large can do to enhance access to services, reduce harm, and treat patients with dignity. Dr Nixon is an FP in Calgary and Dr Scrimshaw is Medical Director of the Collaborative Mentorship Network for Chronic Pain and Addiction with the Alberta College of Family Physicians.