This qualitative study examines older adults’ alcohol and other drug addiction and service effectiveness from the perspectives of 30 social workers grounded in intersectionality. Findings indicate that while loneliness and social environment contribute to addiction, common outcomes include bio-psycho-social, economic, and familial impacts. Intersectional factors, including gender, class, education, marital status, parenthood, social capital, and criminal involvement, differentiate these experiences. Women experience greater stigma and reduced access to services, while class and education influence substance use patterns and weakening socio-economic capital increases criminal involvement. Marital status, parenthood, and social capital influence service access, while institutional scarcity and stigma hinder engagement.