Steve Bartels, M.D., director of the Dartmouth Centers for Health and Aging in Lebanon, New Hampshire, warns his patients about the body's declining ability to metabolize drugs as they age. "Older adults who may be abusing marijuana, cocaine, or other drugs are sensitive to smaller amounts than when they were younger," he says. "The problem is, they don't know that. So they get into trouble — motor vehicle accidents, domestic incidents — at much lower levels of use."
Substance abuse in an older adult mimics many of the signs of aging: It causes memory loss, cognitive problems, tremors, and falls. The upshot is that even family members may not be able to recognize that a loved one is an addict. Late-stage abuse — especially in women only 55 or 60 years old — induces weight loss, muscle wasting, and, among alcoholics, elevated rates of breast cancer. "Addiction will move you into 'old old' very quickly," says interventionist Debra Jay, coauthor of Aging and Addiction. "You may be healthy, a runner, a vegan — but if you're doing cocaine or any other drug or alcohol, your body will break down much faster at 55 than it will at 35."The rise in boomer drug use is perhaps unsurprising. This is the generation, after all, that made drug experimentation mainstream, so today's 55-year-old addict is often yesterday's high school stoner. At least two-thirds of boomers who wind up in treatment have been drinking, taking drugs, or doing both for the bulk of their adult lives — and during some of their teen years, as well. "The earlier your onset, the worse your problem," says John Dyben, the Hanley Center's clinical director.
Ron Dash first smoked pot at 13 and "loved it from the start," he says. "I grew up reading about Allen Ginsberg and Timothy Leary. For a kid like me, who wanted to be different, to get attention, pot was cool." And for him it led to hash, cocaine, mushrooms, and LSD, often amplified by alcohol.
Dyben also points to the boomer proclivity to medicate both physical and emotional pain. "So here I am as a baby boomer, hitting 50," Dyben says, role-playing the midlife everyman. "My knees hurt a little more when I play tennis, and from the culture I grew up in I have the mind-set that says, 'If I'm hurting, something's wrong. And if something's wrong, a pill will fix it.' But the idea of ' better living through chemistry' — that you can feel better by taking a pill, or by smoking or drinking something — that mind-set is killing boomers."
Many doctors unwittingly collude with addicts to keep them armed with pills. Russ C., a 61-year-old retired tree-worker supervisor and a grandfather, began taking narcotic pain relievers after a work-related neck injury at 37. Over the years he took more and more narcotics and tranquilizers to tamp down the pain. By 2003 he was in such agony he had to leave his job. He went on disability and experienced a severe depression — a not-uncommon consequence of job loss or retirement. "All I had to do was sit around and take pills," he says. By 2005 "it got to where my wife was afraid to come home from work. Would she find me dead on the floor?"
At age 56, desperate to kick his habit, Russ turned to a psychiatrist — who gave him a bit of misguided advice that outrages him to this day. "You're much too old, and you've been on pain meds far too long, to detox," the doctor told him. Instead he prescribed methadone, piling it atop the other medications he knew Russ was taking. "He told me to make myself as comfortable as possible for however long my life would be," says Russ.