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Drug Use a Hidden Problem Among Older Americans

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Waismann Method Facilities - rapid detox treatment

The five men seated around a basement table, trading talk about grandchildren and doctors’ bills, could be mistaken for ordinary retirees. But then they tell their stories:
“I started taking crack when I was 56.”
“I had my first sniff of heroin in 1968 — my last one was in November.”
“I came into drugs when I was 48 years old. Little did I know I was going to get hooked on heroin.”
All are in Odyssey House, a private nonprofit rehabilitation center in New York City, to deal with what experts on aging and substance abuse describe as an overlooked and growing problem — addiction to illegal drugs among older Americans.
With rehabilitation efforts generally aimed at younger addicts, experts say most older users of cocaine, heroin, marijuana and other narcotics do not get the help they need, even though their health is more frail.
Instead, they say, treatment services dismiss older addicts as beyond hope and unworthy of care. At the same time, family and friends frequently are in denial about their usage, regarding it as dementia, depression or simply a slip-up.
“This is a terrifically hidden problem,” said John Benshoff, a drug rehabilitation counselor and researcher at Southern Illinois University. “People don’t want to believe Grandma is smoking crack cocaine.”

While the majority of older substance abusers are alcoholics, there is evidence of growing numbers of illegal drug users.

The federal government’s national drug abuse survey for 2003 estimated that 634,000 people 55 and older used illegal drugs in the past month — a 12 percent increase over the 2000 number. The survey also estimated that 1.25 million people 55 and older had used illegal drugs at some point during 2003, and the number is expected to mushroom with the aging of baby boomers.
Experts say most older addicts have used drugs for decades, though some turn to drugs late in life to ward off the boredom of retirement or cope with the deaths of spouses, friends and relatives.
Dave Sykes, 63, of Queens, N.Y., said he abused marijuana, Quaaludes and other drugs from age 20. He spent time in jail at Riker’s Island before entering treatment last year at Odyssey House.
“Growing old is a problem,” Sykes said. “Just the social adjustment of your family not being around as much, and you have friends dying. If you focus on them, it makes you sad.”

Experts say older addicts are everywhere.

Johnny Scales, 61, of Des Moines, Iowa, said he started selling and using heroin and cocaine in his mid-30s. A former professional boxer and building insulation company owner, he remained a “functional addict” for decades despite developing diabetes and other health problems.
“For a long time I never realized I was an addict until it got out of control,” said Scales, who is in a treatment program. “Then I would notice, `Hey, it’s been 36 hours and I’m still sitting here.”‘
By 2020, 4.4 million older adults are expected to need treatment for some variety of substance abuse, according to a recent estimate by the federal Substance Abuse and Mental Health Services Administration and North Carolina’s Research Triangle Institute.
“We are on the crest of a wave coming up,” said Stephan Arndt, a University of Iowa psychiatry professor. “You’ve got two factors: the overall population is getting older, and then you’ve got all the baby boomers.”
Arndt, in a 2003 study, concluded that fewer than one in five U.S. substance abuse programs geared services to older adults in 2001, the most recent year for which figures were available. He found that many elderly either do not receive necessary care or get improper care from programs that pay little attention to their health needs.
Several addiction counselors and substance abuse experts around the country said they already are seeing increased hard drug use among older men and women. They said heroin, in particular, has become more popular because users can achieve a powerful high by snorting it, making it attractive to those reluctant to inject a vein.
“There is a rise in not only younger but older people using it,” said Dr. Clifford Bernstein, medical director of a treatment program in Beverly Hills, Calif. “Sometimes they will get hooked on OxyContin and turn to heroin because it’s cheaper.”
Tyrone Thompson, 56, of Brooklyn, N.Y., began snorting heroin in 1968 and continued using it, along with crack, through three decades and several jail terms. He once kicked drugs for five years, and after a relapse is at Odyssey House.
“The most important thing for us to understand is, we ain’t got long,” Thompson said, gesturing to the older addicts. “My No. 1 fear is that I do not want to die addicted. I want to go in the ground drug-free. If they say nothing else about me, they should say, `He was clean.”‘
Odyssey House operates what experts describe as the only live-in rehabilitation center in the country exclusively for older adults. Demand for the one-year program is so great that it recently opened a separate outpatient clinic for older addicts needing a longer transition back to normal life.
Of the 60 people in the one-year program, 50 are men. Half sought treatment for alcohol, half for hard drugs. Most are black or Hispanic, though experts said for-profit treatment programs tend to be more diverse.
Nationally, the study by Iowa’s Arndt found 64 percent of older users seeking treatment were white, while 23 percent were black. By comparison, younger whites made up 58 percent and younger blacks 29 percent of those in treatment.
Dr. Peter Provet, Odyssey House’s president, said around 60 percent of older addicts stay the full year, double the completion rate of adolescents. He said more programs need to separate older and younger users.
“You take a 65-year-old with a cocaine addiction who’s tired and has a range of medical illnesses and put them in with 20-year-old crack addicts — how does this community function?” Provet asked. “But you put (older users) together and they start confronting each other, knowing what the same issues are.”
Charlie Turane, 73, of Queens, N.Y., said he’s benefited from being around users his age. Seventeen years ago, a friend introduced him to crack, and soon he stopped paying his bills and eventually lost his gardening business.
“Crack actually talks to me,” Turane said sadly. “I was a fool to listen to it.”
Across the table, Jose Cintron, 60, nodded knowingly. He said he began using heroin at 48 to deal with the loss of a relative “and before I knew it, it was 10 years.”
Cintron said he’s responded positively to treatment and has begun seeking work as a custodian and building maintenance worker, but that he has difficulty when asked about his past.
“I’ve been to interviews and all I get is no,” he said. “That’s what I’m facing now. That’s the reality.”
Other older addicts said they try to impart warnings to the younger people in Odyssey House’s other treatment programs, even as they help one another recover.
Sykes said he has been working with four youths in their 20s, something that has helped him focus on his own addictions.
“A lot of these 21- to 30-year-olds won’t accept that this man who’s 60 years old sitting next to them has a drug problem,” Sykes said. “But I’ve been down that road. I know what’s out there.”
 

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