High numbers of people in their 40s are being admitted to hospital for alcohol and drug abuse, while binge drinking is declining, a report has said.
Analysis by data firm Dr Foster shows drug and alcohol dependence accounts for 19% of emergency admissions among those aged 40 to 44 - the highest proportion of any age group.
Among those aged 45 to 49, 18% of emergency admissions are for drink and drugs.
Meanwhile, the impact of binge drinking on hospitals is declining, but the profile of binge drinkers is older than it was a decade ago.
In 2002/3, the typical age for an admission to hospital due to binge drinking was 16, rising to 19 in 2004/5 and 32 in 2012/13.
Nevertheless, teenagers and people in their 20s are still more likely to be admitted to hospital more often for binge drinking than older people.
The report found that more than 500,000 people have been hospitalised for drug and alcohol abuse at least once in the past three years, with 120,000 of those admissions for people in their 40s.
That is about twice the number of people in their 20s or 60s. The typical age for those admitted was 43 in 2012/13, up from 41 in 2002/3.
Of all the drug and alcohol patients admitted in 2012/13, 36% had been admitted more than once previously while 5% had five or more admissions.
Problems arising from drugs and alcohol also affect more people in poorer groups - 36% of patients were from the most deprived areas of the country compared with 9% from the wealthiest fifth of the population.
Dr Foster's director of research, Roger Taylor, said: "The findings show that attitudes and behaviour among the young with regard to drugs and alcohol are improving but the same cannot be said about their parents.
"However, and worryingly, we expect the figures we have shown here to underestimate slightly the actual amount of patients admitted to hospitals with such problems.
"This is because we only looked at cases in this instance of where drugs or alcohol can be 100% attributable to a hospital admission - though we know many admissions are for instances where alcohol is a strong causal factor."
Lord Victor Adebowale, chief executive of the Turning Point charity, said: "The fact that no GP was recorded for 22% of all emergency drug and alcohol admissions highlights the need for primary care to improve the way it supports people with complex needs.
"Some of those issues are hidden and will require a change in the way doctors do things, especially around stigma and embarrassment from patients approaching their GP."
A Department of Health spokeswoman said: "These figures highlight the very real harms that alcohol and illicit drugs can have on users of all ages, and the need for action not just to raise awareness and prevent substance abuse, but also to ensure that the right services are accessed by the people that need them.
"We are helping the NHS target harmful drinkers with measures such as increasing the use of interventions by health professionals, and introducing alcohol liaison nurses in A&E.
"However there must also be more focus on prevention, not just treatment for those with existing problems. That is why alcohol is addressed by GPs are part of the NHS Healthcheck.
"We are also working to both reduce harmful drug and alcohol use and to increase the numbers recovering from their dependence. Our focus is on combining health and social policies to help people affected access services, rebuild their lives and play a full part in society."