My brother William struggled with drugs and alcohol addiction much of his life. So, I was shocked but not surprised when he was found dead in his apartment, just a few months before he was about to turn 70. The only boy among six sisters, William died alone in a hoard of wadded up papers, tons of cigarette butts, and calcified Thanksgiving turkey sitting atop his rusted and mildewed stove. Pieces of his beloved computer equipment were scattered among traces of crystal meth and marijuana.
A divorced U.S. Navy Vietnam vet and retired Teamster, William was part of the 17 percent of men and women over age 60 with substance abuse issues to alcohol, illegal drugs and prescription drugs, according to the National Institute on Alcohol Abuse and Alcoholism. William had survived a stroke, partial paralysis and an apartment fire. The battle with his drugs of choice — alcohol and opioids — left him powerless, and his family in confusion and denial.
According to the Kaiser Family Foundation’s 2017 article, “Opioid Overdose Deaths by Age Group,” reported overdose deaths for people 55 and older was just 518 in 1999. In 2017, however, that number had soared to 8,877 and continues to rise.
At a time when the average senior could be retired and dealing with the usual illnesses associated with age — cardiovascular disease, cancer, hypertension, osteoarthritis, diabetes, dementia, Alzheimer’s disease — the quiet scourge of addiction and sudden deaths is flying under the radar. For baby boomers, drug misuse can be related to other health issues, in addition to being a problem in and of itself.
Some seniors who overdose are like my brother, dying after a lifetime of abusing drugs. Others acquire their addiction later in life. In fact, according to the World Health Organization’s recent analysis, among people 65 and up, the condition is often underestimated and under-diagnosed, which can prevent seniors from getting the help they need to treat addiction. Elders may feel shame and embarrassment because they are unable to control their drinking and drug use. For some, their college days of using alcohol and drugs recreationally has given way to full-on dependence.
The elderly can become addicted in later life for many reasons. According to Addiction Center, some triggers are retirement, death of a loved one, loss of income or financial burdens, forced placement in a nursing home, insomnia, family conflicts and declining mental health, memory loss and major surgeries. Others turn to drugs and alcohol after what they perceive as a failed life, having unrealized expectations and the feeling of invisibility in a world full of youth and vigor. The most commonly used substances among seniors are alcohol, opioids, prescription drugs, marijuana and cocaine.
Many recovery professionals believe drug abuse and alcoholism is genetic, a family disease. My brother was an alcoholic with addiction issues, even though there was never any alcohol or illicit drugs in our childhood. I believe William became addicted during his time in the Navy. He described how he spent endless days and nights on the ship during the Vietnam War.
When my mother died in 2017, at age 90, my brother fell into a deep depression and self-imposed isolation. His neighbors described him as being “nice, sometimes grouchy” with “strange people” who would come to visit him. I went through his cellphone to see if there was anyone we could tell about his death. What I found were a number of text messages that talked about “buying narcos” from people whose numbers had since been disconnected.
It is estimated that 10,000 baby boomers retire daily. If the current trend continues, substance abuse deaths could quadruple. More research and studies are needed to find strategies and treatments to help senior citizens struggling with alcohol and drugs.
Moreover, it’s my belief that public policy should play a more progressive role in the treatment of addiction.
Criminalizing a behavioral disease only creates more people with addiction and more prisoners. Despite the fact that 33 states have decriminalized marijuana, penalties for use and possession of opioids and other narcotics are reflective of the longstanding criminal legal practice of locking up chronic drug abusers.
According to a 2016 U.S. Department of Justice report, 1,288,466 people were serving sentences in state prisons, of whom 190,100 (14.75 percent of the total) had as their most serious offence a drug charge and a total of 45,300 were jailed for drug possession alone. In comparison, there are just over 13,500 substance abuse rehab facilities in the entire United States.
A nonjudgmental, compassionate approach to mental health and addiction treatment would go a long way to address substance abuse among the elderly. In addition, the availability of age-specific 12-step programs like Alcoholics Anonymous, Narcotics Anonymous and other group therapies can be especially helpful for older adults, although these programs are certainly not for everyone.
Original Medicare, the government-sponsored health insurance for adults 65 and over, offers coverage for in-patient drug rehabilitation, as does the Affordable Care Act. Medication-assisted treatment (MAT) is effective in treating opioid addiction, and while MAT is more available today than it was a decade ago, barriers to access remain. Medications to treat alcohol and opioid addiction need to be more accessible and affordable.
Currently, the cost of Food and Drug Administration-approved drug treatment prescriptions are covered at least partially by some insurance companies. For example, Antabuse — a drug which creates a negative reaction to alcohol — can run around $80 for a 30-day supply. Also relatively inexpensive are Naltrexone, a so-called “opiate antagonist” that blocks opioid receptors, and Campral, which can reduce symptoms of long-lasting withdrawal and could be more effective in patients with severe addiction.
Every year, hundreds of thousands of families lose brothers and sisters, mothers and fathers, loved ones like William, to substance abuse and addiction. A societal commitment to improving treatment and prevention of drug dependence for those who have reached old age will remove the stigma of addiction and encourage those who struggle to seek help.
The Substance Abuse and Mental Health Services Administration, a branch of the U.S. Department of Health and Human Services, offers free and confidential treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders. Call 1-800-662-HELP (4357) for more information.