Addiction knows no age

The following article appeared in the Wall Street Journal on May 18, 2011 and speaks to the growing problem of drug and alcohol abuse among our older citizens.

"I retired, I started drinking more," one man said. "I lost my father, my mother, my dog, and it gave me a good excuse," said another.

A remarkable shift in the number of older adults reporting substance abuse problems is making this scene more common. Between 1992 and 2008, treatment admissions for those 50 and older more than doubled in the U.S. That number will continue to grow, experts say, as the massive baby boom generation ages.

"There is a level of societal denial around the issue," said Peter Provet, the head of Odyssey House in New York, another center offering specialized substance abuse treatment programs for seniors. "No one wants to look at their grandparent, no one wants to think about their grandparent or their elderly parent, and see that person as an addict."

All told, 231,200 people aged 50 and over sought treatment for substance abuse in 2008, up from 102,700 in 1992, according to the federal Substance Abuse and Mental Health Services Administration. Older adults accounted for about one of every eight seeking help for substance abuse in 2008, meaning their share of treatment admissions has doubled over the 16-year period as other age groups' proportions shrunk slightly.

The growth outpaces overall population gains among older demographics. Between 2000 and 2008, substance abuse treatment admissions among those 50 and older increased by 70 percent while the overall 50-plus population grew by 21 percent. Experts say that's because boomers have historically high rates of substance abuse, often developed three or four decades ago, that comes to a head later in life.

"The baby boom population has some experience with substance misuse and is more comfortable with these substances," said Dr. Westley Clark, director of SAMHSA's center on substance abuse treatment.

Treatment professionals believe the actual number of older people with substance abuse problems is many times larger than the amount seeking help.

While the number of older people with substance abuse problems is booming, relatively few facilities offer treatment programs specifically for their age group. Most pool people of all ages together; many divide by gender. Those that do offer age-specific programs say it helps participants relate to one another and keeps them focused on themselves, rather than mentoring younger addicts.

Provet said some have questioned whether it's worthwhile to target efforts at seniors, who generally have fewer years left to benefit from treatment than younger people. He dismisses that reasoning, comparing it to arguing that a cancer patient should be turned away from chemotherapy or radiation treatments simply because they're 65.

Besides, older participants at Odyssey House have the highest completion rate — 85 percent during the last fiscal year.

"It's almost as if they say, 'This now is my last shot. Let me see if I can get my life right finally,'" he said.

Among those taking that approach is Henry Dennis, who at 70 has used heroin for the past 50 years. He came to Odyssey before, relapsed and was arrested for drug possession. Dennis says he's seen at least a dozen friends die of drug use, but it wasn't enough to make him stop.

Now in his eighth month of treatment, he says he finally has the resolve to quit.

"I'm going to get it right this time," said Dennis, who has worked a variety of odd jobs. "I don't want to die, not just yet."

Dennis' treatment is paid for by the state of New York. Many pay out of pocket. Medicare offers some coverage for outpatient treatment but generally doesn't cover inpatient programs.

Experts have observed a rise in illicit drug use, while treatment for alcohol has dropped even though it remains the chief addiction among older adults. The 2008 statistics show 59.9 percent of those 50 and older seeking treatment cited alcohol as their primary substance, down from 84.6 percent in 1992. Heroin came in second, accounting for 16 percent of admissions in that age group, more than double its share in the earlier survey. Cocaine was third, at 11.4 percent, more than four times its 1992 rate.

Surveys show the vast majority of older drug addicts and alcoholics reported first using their substance of choice many years earlier, like Dennis. That lifelong use can lead to liver damage, memory loss, hepatitis and a host of other medical issues. A minority of people find comfort in drugs and alcohol far later, fueled by drastic life changes, loneliness or legitimate physical pain.

Don Walsh, a participant at Hanley's support group, falls into the latter category. He is among 19 men and women who gather on this day in the room with pale blue walls and the calming whir of a fish tank. One comes in a wheelchair, another with a walker; one dozes off during the session.

Walsh, a 77-year-old lawyer, says he didn't develop a problem with alcohol until he retired a year ago. His relentless schedule of 12- to 14-hour days disappeared into a series of leisurely lunches and dinners where the wine flowed freely. One day, he blacked out in his garage. Had it happened while he was driving home, he thought, he might have killed himself and others.

After six weeks of treatment, Walsh says he no longer craves alcohol.

"I have a new lease on life," he said.