Illicit drug use grows among the elderly

Susie Richardson is not your average recovering addict.

She was 50 years old when curiosity got the better of her and she tried crack cocaine. The result was a "devastating" addiction that for 10 years robbed her of her family's trust and her own dignity. "I had no control over myself," she says quietly. "My husband and kids, they would give me money for bills and instead I spent it on drugs."

Today, after 27 months in a rehabilitation community, Ms. Richardson is clean, sober, and a role model for the more than 50 senior citizens that are battling illicit drug and alcohol addictions at the ElderCare Program at Odyssey House in Manhattan.

Surprising? That's because they're part of what health officials call an "invisible epidemic" of substance abuse that affects an estimated 17 percent of America's senior citizens. The vast majority abuse alcohol and prescription medication. But an increasing number are battling cocaine, heroin, and marijuana addictions as well.

The federal government's National Household Survey on Drug Abuse estimates that 568,000 people aged 55 or older used illegal drugs in the past month. During the next decade, as the baby boomers age, that number is expected to increase significantly. The reason is that the boomer generation used more illicit drugs and alcohol than their parents, and many are bringing those habits with them into their later years.

"The baby-boomer generation will be eligible for Social Security in just six years, and we expect there will be a lot more problems emerging in the not-too-distant future," says Frederic Blow, an expert on drug abuse by the elderly at the University of Michigan.

That will present a significant challenge to the public-health system, already struggling with the unique obstacles that older people like Ms. Richardson present. The first is that older addicts are far more difficult to identify than younger substance abusers. Their problems often become evident at work, or in run-ins with the criminal-justice system. Older people tend to be retired and aren't as likely to rob the corner store as their younger cohorts.

Then there's the stigma. Alcohol and drug abuse are far more likely to be perceived as moral failings in older adults.

"They are more likely to hide their substance abuse and less likely to seek professional help," says Westley Clark, director of the Center for Substance Abuse and Treatment in Washington. "And relatives of elders with substance-abuse problems are often not willing to confront them."

Once they are identified, there's the problem of finding appropriate treatment. It's estimated that only 1 in 10 addicts who need treatment get it in America today. There are even fewer services designed for older adults, who are often coping with other problems at the end of their lives.

Odyssey House has the only long-term therapeutic community in the country designed specifically for seniors battling illicit drugs as well as alcohol abuse.

Alcohol is the primary problem for most older substance abusers, like 71-year-old Julius Small, who had his first drink when he was 16. He struggled with hard liquor most of his life and was even dry for nine years. But a few years ago, his teeth started giving him trouble. "Some fellas said a drink would knock it away, so I started again."

Mr. Small ended up homeless before he was finally referred to Odyssey House, where he's been for 19 months.

Experts say serious problems start later in life for about one-third of elderly substance abusers. Many people like Richardson drank or used marijuana socially for years with no problem.

"Older people have to deal with tremendous issues of loss, from retirement to the death of a spouse. So they begin to rely on the alcohol and other things," says Cynthia Morley, an older-adult-treatment specialist at Crouse Chemical Dependency Services in Syracuse, N.Y. "About two-thirds are the more chronic users."

Sixty-year-old Richard Thompson fits that category. He was 12 when he first started smoking marijuana. The older he got, the more sophisticated the drugs he used, from cocaine to heroin. He became a wily survivor on the streets of Harlem.

"To survive the drug world, you have to learn to adapt to almost any situation. You got to be smart. It's hard work," he says. "But there's no place in the drug world for an older person."

A study done by the federal government's Drug and Alcohol Services Information System indicates that the number of people like Mr. Thompson entering their senior years is already increasing. Between 1995 and 1999, alcohol was the primary problem for the vast majority of the more than 50,000 people over the age of 55 who entered publicly funded drug-treatment facilities. But during that four-year period, alcohol admissions declined by 9 percent while admissions for illicit drugs increased by 25 percent for men and 43 percent for women.

"These individuals have struggled through life, brought families up, paid taxes, and they've somehow never been able to quit this thing," says Peter Provet, the president of Odyssey House. "What we try to do is give people an opportunity to move toward life closure and find inner peace with themselves and hence with their families."

Indeed, Susie Richardson considers that one of her greatest gifts. She now works as a cook at Odyssey House and is able once again to be a fully present mother and grandmother. "I have 18 grandkids, and I always tell them, 'You don't want to go through what your grandmother went through,' " she says, shaking her head. "No way."