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The Changing Face of Older-Adult Addiction

April 1, 2008
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Baby Boomers are bringing multiple challenges to the treatment milieu

Every hour, thousands of leading-edge Baby Boomers turn 61. By 2030, 33.5% of the U.S. population will be 55 and older. The “Youth Generation,” those born between 1946 and 1964, is aging, and with this age wave comes a surge in older-adult addiction.

At Hanley Center, we already are seeing a new pattern in age 50-plus or “young older adult” addiction that differs from what we see in individuals ages 65 and older. Traditional older adults tend to suffer from alcoholism or prescription medication addiction. What we are finding with older Baby Boomers reflects national statistics. According to a Substance Abuse and Mental Health Services Administration (SAMHSA) study conducted between 2003 and 2005, illicit drug use by people in their 50s increased by more than 60%. But we are also seeing patients in their mid-60s with heroin or cocaine addictions.

Recently, a 66-year-old CEO was admitted to a local trauma center emergency room for severe symptoms of abdominal pain, vomiting, nausea, and diaphoresis (excessive sweating). When his medical work-up showed only slight dehydration, he received a diagnosis of viral syndrome. His next visit was to the Hanley Center admissions department. He was admitted with a diagnosis of heroin dependency, intranasal route. The hospital ER did not test him for this, because staff couldn't conceive of a 66-year-old executive doing illicit drugs.

This man's story isn't unique. As Baby Boomers age, we'll see more of them turning to illicit drugs, just as they did in their 20s. We are diagnosing more comorbidities such as hepatitis C in this group, as symptoms surface after decades of dormancy.

In pursuit of health, youth, and happiness over a lifetime, Baby Boomers also have been widely dubbed the “Me Generation.” They embrace a complex set of values, including a great belief in the quick fix for anything from rocky marriages (the divorce rate is three times higher for Baby Boomers than for their parents) to physical discomfort. “Living Well Through Better Chemistry” sounds like a jest but it became a reality for many who grew up in the ‘60s and ‘70s. Many were introduced to the psychedelic age by ‘60s LSD guru Timothy Leary, who entreated his followers to “turn on, tune in, drop out.”

Young people at the time also were influenced by rebellion against their parents' generational values, as well as the war in Vietnam and the nation's civil rights crisis. Their idealism and energy were rewarded in social change and the creation of the country's wealthiest generation.

The poly-pharmaceutical profile

Baby Boomers demand services of all kinds and, with this, choice and answers for their questions and problems. They can be “health nuts” who link eating organic foods and running 10 miles a day to optimum health, but at the same time millions in this age group are poly-med users. The pharmaceutical industry reinforces this group's very low tolerance for discomfort with consumer advertising for pills that promise to solve everything.

These patients are coming to Hanley Center with an average of 4.5 prescription drugs and 3.5 over-the-counter medications being taken concurrently. When Baby Boomers visit their physicians, 60% leave the office with a prescription. The most commonly prescribed class of drugs is the benzodiazepines. We don't see the patient present to treatment with just one medication, however. Virtually every “young older adult” is admitted to Hanley with a poly-pharmacy issue.

The addiction profile for Baby Boomers is usually complex, with dependency on both alcohol and prescription pain medications, and prescription meds with illicit drugs. Increasingly, a significant number of Baby Boomers are revisiting their old habits of illicit drug use. This is no doubt linked to a number of factors, including more available leisure time. They may find themselves face to face with issues such as loss of youth. This can be staggering for both sexes, as it encompasses losing a sense of purpose, feeling unattractive, facing end of career, and coping with diminished physical abilities and stamina. Increasingly, health becomes an issue. Many have suffered the loss of a spouse or family member, or are caring for an older relative.

The effects of addiction

There are jarring juxtapositions in Baby Boomer attitudes: health, vitality, and self-help versus demand for service and instant relief. We need to remember that in aging, there is angst associated with losing control, a sense of purpose, and power. Baby Boomers have been confident that they would be “younger” at advancing age and would live longer than their parents, and now they are experiencing in growing numbers tangible arthralgia (joint pain), diabetes mellitus Type II, and other chronic conditions. These young older adults profoundly feel the impact of social, physical, and mental changes in their lives.

The significant increase we have found in dual diagnoses among those from age 50 to 65 includes a prevalence of anxiety, depression, and bipolar conditions. Are bipolar disorders on the rise in this age group as a result of better diagnosis or because of poly-drug and illicit drug use? We can't be sure, but with better diagnosis we can more effectively treat the individual holistically.

Physical changes occur in the aging process, and they are exacerbated significantly with addiction. Other conditions that are not generally associated with addiction are also related to alcohol and drug abuse. At Hanley Center, Axis 3 diagnoses are seen repeatedly, including hypertension, diabetes, cardiac disease, cancer, lung disease, chronic pain, and liver disease.

The physiological changes experienced with aging by adults who do not suffer from addictions include:

  • Changes in gastrointestinal tract function;

  • Total body water percentage for men declines from 60% to 54%;