There’s a ‘hidden epidemic’ of older drug addicts. The good news is they’re kicking the habit and giving back

By Reed Karaim
Published in AARP Bulletin, March 2005

Jon Roberts has lived what appeared on the surface to be a fairly ordinary life. He worked as a waiter and then in the construction trades in Boston and New York. He married, became a father, and later a grandfather and a widower. At 50, he took a job as a building manager, a position of responsibility and trust.

But Roberts was also a heroin addict. He struggled with his addiction for nearly three decades until in his 50s things took a turn for the worse, and he began stealing from apartments in his building and other places, even selling drugs, to pay for his habit.

"People don’t think of drug addicts being my age," says Roberts, now 59. "I was what you’d call a ‘functioning’ addict. But after a while, I had to do everything I could to support my habit, and it finally got me in trouble with the law."

Busted for stealing jewelry, Roberts was given a choice—jail or treatment at Odyssey House, a residential center in New York that has a program for addicts age 55 and older. Four years later, he is clean and works as a counselor at the center, helping others his age beat their addictions.

Roberts’ case and those of the people he now counsels are part of what one federal agency report called a "hidden epidemic." Substance abuse among older Americans is a problem that challenges our assumptions while also offering a surprising testament to the human capacity for change.

No one worries about grandpas on drugs. With the exception of alcoholism, drug addiction is widely viewed as a problem of the young. Prevention efforts are overwhelmingly aimed at people in their teens and 20s, and most treatment is geared toward people under 50. And yet many people in treatment, it turns out, are over 50.

"We’re at the leading edge of a wave," says Stephan Arndt, a University of Iowa psychiatry professor and a prominent researcher of the growing problem. About 1.25 million people age 55 and older used illegal drugs sometime during 2003, estimates the federal government’s latest drug use survey, and the number who used drugs in the same month in 2002 and 2003 rose 12 percent.

The ranks will swell as baby boomers age. "First, there’s just the sheer numbers of that generation," Arndt says. "And then, with the boomers, the incidence of use is higher, which is going to magnify the whole thing."

By 2020, 4.4 million Americans age 50 and older will have drug and alcohol problems, estimates the U.S. Substance Abuse and Mental Health Services Administration.

The most commonly abused drug among Americans remains alcohol. But there has been tremendous growth in both the prescribed and unprescribed use of painkillers and other medications that can be addictive.

Hospital records indicate increasing numbers of patients are admitted for misusing medication, but experts believe cases of addiction are still underdiagnosed. "With older people," says John Benshoff, a professor of rehabilitation at Southern Illinois University in Carbondale, "the tendency is to say, ‘He’s such a nice old man, he couldn’t be an alcoholic or a drug addict.’ "

Drug abuse among older people cuts across social and economic lines. There are, of course, hard-core addicts who have survived on the street. But the residents in Odyssey House also include David Sykes, 63, who ran several successful businesses before beginning to use drugs while helping dealers manage their finances. And Gloria Staley, 57, who worked for years with the mentally handicapped, raised a son and on weekends used crack cocaine.

Not all substance abusers started young. Marvin Seppala, M.D., chief medical officer of the Hazelden Foundation, an alcohol and drug rehabilitation center in Center City, Minn., remembers a patient who became addicted to cocaine at age 75. Another former Hazelden patient, "Thomas," who asked that his real name not be used, started to abuse alcohol around age 40. After a career as a successful editor with a New York publishing house, he struck out on his own as a freelance editor and writer and found himself drinking to fill up the solitary hours. Eventually, his addiction stole much more than time.

"I went from being co-writer on a series of lectures at Harvard to working at Walgreens as a cashier," Thomas says. Today he’s sober and working to rebuild his freelance career.

Late onset of substance abuse often differs from more typical cases by being "very specifically related to a traumatic event, death of a spouse, retirement, some big life change," says Benshoff. "So working on this issue can have very good results."

In fact, older addicts as a group do very well in treatment. At Odyssey House they complete the program, one of the prime indicators of long-term success, at more than twice the rate of the national average for people of all ages in residential treatment programs. Older addicts are, many experts say, often more ready for the reflection and reappraisal that is critical to coming to terms with substance abuse.

"They’re really enjoyable to work with," says Seppala, "because when they get well, they often get remarkably well. You see families get back together, people really working out their problems."

Many treatment professionals have found that substance abusers age 50 and over do better in programs tailored to their needs. But just one in five existing programs offers services specifically designed for them, according to Arndt at the University of Iowa. Odyssey House runs one of a handful of long-term residential programs for people 55 and over.

The Hazelden clinics have found the pace of some programs too fast for older clients. "They often need more time to examine their lives," Seppala says. Many of those who arrive at Odyssey House have failed treatment elsewhere. Such patients do best in group sessions that are less confrontational than those for younger addicts, says Peter Provet, Odyssey House’s president, and they also have "a very specific need of giving back, of making meaning out of their lives."

At Odyssey House, which operates programs for many different ages, some older residents work with children or help counsel younger residents. The relationships benefit both sides. While dealing with his addiction, David Sykes has been mentoring some younger residents. "It’s allowed me to turn around and look at how I got where I am," he says. At the same time, he adds, "I’ll be in the smoking area, and I’ll hear one of them say, ‘Go talk to that old-timer over there. He knows the story.’ "

Most important to Odyssey House’s success rate with older residents may be the simple fact that they were ready to make a change. "I was addicted to crack cocaine for over 30 years," Staley says. "At that time, in the ’60s, a lot of us just fell into it." Last year she reached some sort of threshold. "The decision was just me," she says. "I was tired. I called my son and told him, ‘You’ve got to get me into a program.’ He found Odyssey House."

Not all stories end well, of course. No age group is invulnerable to failure, and drug and alcohol addictions are powerful urges to overcome. The point, say those who work with older addicts, is that with the proper help a surprising number can succeed.

Roberts, who once stole to support his heroin habit, is now working hard at Odyssey House to support his three youngest children, who are still at home—a 12-year-old boy and twin girls age 11. It’s not an easy life, but he considers it a chance "to try to make amends." His children, he says, are proud of him now.

At Odyssey House, he has seized the chance to make further amends as a counselor. "It’s one of the most rewarding things in the world," he says, "helping someone else do what I’ve done."

Reed Karaim is a freelance writer in Tucson, Ariz.

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