Pubdate: Mon, 16 Mar 2015
Source: Wall Street Journal (US)
Copyright: 2015 Dow Jones & Company, Inc.
Author: Zusha Elinson

Aging Baby Boomers Bring Drug Habits Into Middle Age

Older adults are abusing drugs, getting arrested for drug offenses 
and dying from drug overdoses at increasingly higher rates

UPLAND, Calif. - From the time he was a young man coming of age in 
the 1970s, Mike Massey could have served as a poster child for his 
generation, the baby boomers. He grew his hair long to the dismay of 
his father, surfed, played in rock bands and says he regularly got 
high on marijuana and cocaine.

The wild times receded as he grew older. In his 30s, he stopped using 
drugs altogether, rose into executive positions with the plumbers and 
pipe fitters union, bought a house in this Los Angeles suburb and 
started a family. But at age 50, Mr. Massey injured his knee running. 
He took Vicodin for the pain but soon started using pills heavily, 
mixing the opioids with alcohol, he said.

"It reminded me of getting high and getting loaded,"  said Mr. 
Massey, now 58 years old, who went into recovery and stopped using 
drugs and alcohol in 2013. "Your mind never forgets that."

Today, the story of this balding, middle-aged executive continues to 
reflect that of his generation.

Older adults are abusing drugs, getting arrested for drug offenses 
and dying from drug overdoses at increasingly higher rates. These 
surges have come as the 76 million baby boomers, born between 1946 
and 1964, reach late middle age. Facing the pains and losses 
connected to aging, boomers, who as youths used drugs at the highest 
rates of any generation, are once again - or still - turning to drugs.

The trend has U.S. health officials worried. The sharp increase in 
overdose deaths among older adults in particular is "very 
concerning,"  said Wilson Compton, deputy director for the federal 
government's National Institute on Drug Abuse.

The rate of death by accidental drug overdose for people aged 45 
through 64 increased 11-fold between 1990, when no baby boomers were 
in the age group, and 2010, when the age group was filled with baby 
boomers, according to an analysis of Centers for Disease Control and 
Prevention mortality data. That multiple of increase was greater than 
for any other age group in that time span.The surge has pushed the 
accidental overdose rate for these late middle age adults higher than 
that of 25- to 44-year-olds for the first time. More than 12,000 
boomers died of accidental drug overdoses in 2013, the most recent 
data available. That is more than the number that died that year from 
either car accidents or influenza and pneumonia, according to the CDC.

"Generally, we thought of older individuals of not having a risk for 
drug abuse and drug addiction,"  Dr. Compton said. "As the baby 
boomers have aged and brought their habits with them into middle age, 
and now into older adult groups, we are seeing marked increases in 
overdose deaths."

Experts say the drug problem among the elderly has been caused by the 
confluence of two key factors: a generation with a predilection for 
mind-altering substances growing older in an era of widespread opioid 
painkiller abuse. Pain pills follow marijuana as the most popular 
ways for aging boomers to get high, according to the federal 
Substance Abuse and Mental Health Services Administration, which 
conducts an annual national survey on drug use. Opioid painkillers 
also are the drug most often involved in overdoses, followed by 
antianxiety drugs, cocaine and heroin.

Wall Street Journal interviews with dozens of older drug users and 
recovering addicts revealed an array of personal stories behind the 
trend. Some had used drugs their entire lives and never slowed down. 
Others had used drugs when they were younger, then returned to them 
later in life after a divorce, death in the family or job loss.

"If you have a trigger, and your youth is caught up in that Woodstock 
mentality, you're going to revert back,"  said Jamie Huysman, 60, 
clinical adviser to the senior program at Caron Treatment Centers, a 
residential drug treatment organization that plans to break ground 
this summer on a $10 million medical center in Pennsylvania catering 
to older adults. "We were pretty conditioned that we could be 
rebellious, that we could take drugs, and so this is how we respond today."

Drug-rehabilitation programs are grappling with how to handle the 
boom in older patients. More than 5.7 million people over the age of 
50 will need substance-abuse treatment by the year 2020, according to 
estimates from government researchers. Meanwhile, hospitals have seen 
a sharp increase in the number of older adults admitted for 
drug-related health problems, government statistics show."We're still 
in the process of figuring out: How do we ensure we have a strong 
workforce that can address this, and the appropriate settings to 
address this?"  said Peter Delany, director of the Center for 
Behavioral Health Statistics and Quality at the Department of Health 
and Human Services.

Over the past decade, illicit drug use among people over 50 has 
increased at the same time that the rate for teens""the group that 
draws the most public concern when it comes to substance abuse""has 
declined, according to the federal government's annual survey on drug 
use. A similar pattern exists for drug arrests: rates fell in nearly 
every younger age group in the country between 1997 and 2012, but not 
for those between the ages of 45 and 64.

Boomers have always ranked high on the charts that measure drug use. 
In 1979, high school seniors, born in 1961, set the record for 
self-reported illicit drug use in the past year, according to an 
annual national survey called Monitoring the Future. The rate of drug 
use among boomers has fallen significantly as the cohort has aged, 
but it is about triple the percentage of people in the previous 
generation who reported drug use in their older years.

Neil Howe, a historian and author of several books on generational 
trends, said that boomers have always stood out for their willingness 
to break with convention and take risks, which included using drugs.

"They themselves continue to behave in a less inhibited fashion even 
as younger generations turn away from that type of risk taking,"  he said.

(Rates of major sexually transmitted diseases have also increased for 
people over 45 in recent years, according to the CDC.)

Rehab centers that were designed for younger people are adjusting to 
the new clientele. Getting rid of bunk beds, hiring more experienced 
addiction counselors and providing medical care on-site are some 
measures being taken. Amid prescription painkiller abuse, old-age 
aches and pains are treated with acupuncture and nonaddictive 
painkillers. Another change is therapy sessions that are designed for 
older adults.

Caretaker children At the Hanley Center at Origins in West Palm 
Beach, Fla., there is a treatment program just for baby boomers 
separate from both older and younger adults. They live together in 
the same building during their stay and attend group therapy together.

At one session, a woman who said she was an alcoholic told the dozen 
people sitting in a circle that she had received roses from her 
family that day. It made her feel guilty: "I really don't deserve 
anything from them,"  she said, breaking down in tears.

Deborah Christensen, a counselor and boomer herself, then led an 
exercise where other recovering addicts acted out the woman's family 
dynamics. In the scene, her adult daughter was the voice of reason, 
calming the family during frequent fights over substance abuse.

The guilt from having forced adult children into that role struck a 
chord. "I identify,"  another woman chimed in. "My ex-husband was an 
opiate addict, and I saw my oldest as the caretaker."

John Dyben, who heads the boomer and older adult programs at Hanley, 
said that there are different barriers to getting each generation on 
the road to recovery. With the oldest generation, it is shame about 
admitting an addiction; with youth, it is a belief that they are 
indestructible. With boomers, he said, it is an attitude that they 
know all the answers and a belief that drugs aren't necessarily a bad thing.

To that end, counselors at Hanley put less emphasis on the 
traditional stories about how substance abuse ruins people's lives 
when treating boomers because, "for every story you've got, they've 
got 15 others about people who expanded their minds with drugs and 
then became successful CEOs,"  Dr. Dyben said.

Instead, they focus on educating them about the science of addiction. 
They also give them a more active role in planning their own treatment.

Opiates are the drug that is most frequently landing boomers in 
treatment, according to federal data that tracks admissions to 
centers that receive some public funding. In 2012 for those aged 
45-64, 36% of admissions for drugs were for heroin, with an 
additional 12% for opioid painkillers, followed by 22% for crack 
cocaine, and 10% for methamphetamines.

Alcohol and alcohol mixed with a secondary drug made up more than 
half of the overall admissions.

For Clare Mannion, 64, the trigger was looming retirement from a long 
career in real estate. Five years ago, Ms. Mannion said, as she 
settled down in Florida after a lifetime of moving around the 
country, "most people were saying, "'What more do you want? Why 
aren't you ready to - the magic word - 'retire?' "

"What I heard, given my personality was, "'Aren't you ready to retire 
from life?' "  she said. "Internally, I felt pretty hopeless, and 
what was the most easily accessible were prescription drugs and alcohol."

Ms. Mannion said she would mix antianxiety pills known as 
benzodiazepines with alcohol. After two DUI arrests, Ms. Mannion 
landed in treatment in 2013 in a program designed for baby boomers 
and run by the Hazelden Betty Ford Foundation in Florida. She has 
been clean ever since, she said. Today, she said, she feels 
"electrically alive."

For older adults, the side effects of getting high can be much 
harsher than for younger people, experts say. As the body ages, the 
metabolism slows, making it harder to process drugs, said NIDA's Dr. Compton.

The rates of hospital stays and emergency room visits for 
drug-related health problems have skyrocketed for older adults in the 
past two decades. In 2012, people between the ages of 45 and 64 had 
the highest rate of inpatient hospital stays for opioid overuse; two 
decades ago, it was those between 25 and 44, according to the federal 
Agency for Healthcare Research and Quality.

For Mr. Massey, the Southern California executive, a near-overdose 
two years ago was one of the dramatic events that pushed him toward 
getting clean. One night, sitting on his bed after taking a cocktail 
of painkillers, he had a seizure and blacked out. "Next thing I know 
I was waking up and my wife was upset and my kids were crying and 
these paramedics were pumping on my chest,"  he said.

Before getting hooked on pills, Mr. Massey said he thought he had 
left the habits of his younger days behind. Back then, in the 1970s, 
doing a line of cocaine was a pickup move at parties, and pot was 
plentiful. He worked as a welder in San Diego and played lead guitar 
in a rock band called Loose Enz. His idol was Rolling Stones 
guitarist Keith Richards. "I tried to live like I was in the 
Stones,"  he said dryly. "I was on tour every night."

Lucky Dare Fleming, 66, a friend who was a drummer in the band, said 
he didn't realize at the time that drugs would become a serious 
problem for Mr. Massey. "Me, I've just gone along and dabbled 
recreationally,"  said Mr. Fleming. "It was a little more alluring to 
Mike, and he had to get away from it."

Mr. Massey's late father, George, was a World War II vet, a tough 
steward in the plumbers and pipe fitters union, and a heavy drinker, 
said his son, who recalls him carrying his union contract, a 
half-pint of whiskey and a pistol in his lunch pail.

A knee injury, and pills After getting clean, Mr. Massey said he came 
to realize that he had been harboring deep shame about not being 
strong or tough enough his whole life, and that a violent childhood 
had affected him more deeply than he knew. He grew up in hardscrabble 
neighborhoods, carried weapons to school and fought frequently. But 
he doesn't like to cast blame for his drug use, saying, "I never put 
anything in my body against my will."

After he stopped using drugs - which included a stint with meth in 
his late 20s - for the first time, his career took off: At age 35, he 
was promoted to a leadership position at a Los Angeles-based trust 
fund that represents the interests of unions and union contractors in 
the plumbing and piping industry. He met his wife, Dena, bought a 
home in the suburbs and had two children.

Then eight years ago, while exercising to lose weight, he aggravated 
an old knee injury and took a few Vicodin pills from a friend for the 
pain. A day later, he took a handful.

"I thought, no big deal - my knee hurts and they're prescription 
drugs,"  he said. "The fact of the matter was I was abusing them the 
second day I had them."

After surgeries to repair his knee and an arm he also injured, 
prescriptions brought him a steady supply of pain pills. He would 
down about 40 every day while drinking heavily. By that time, he had 
become executive director of the trust fund and several associated 
businesses, an organization known as the PIPE Group, which employs 
more than 200 people across the country. It was a stressful job 
probably better done by two people, saidSid Stolper, Mr. Massey's 
boss for 21 years.

After Mr. Massey got, in his own words, "blasted"  at work on pills 
and alcohol, Mr. Stolper called a meeting and delivered an ultimatum: 
Get clean or you're fired.

"He is a very valued employee and does a lot for the 
organization,"  said Mr. Stolper. "He was worth the effort of saving."

At first, Mr. Massey resisted. But after detoxing for two weeks at 
home, he entered a two-week recovery program in San Diego. The 
center's president, Tom Horvath, is a seminal figure in a 
rehabilitation movement called SMART Recovery, a secular, 
cognitive-behavioral-therapy based alternative to the 12-step 
approach. Mr. Massey now leads an online SMART Recovery group, and he 
is back at his job.

Talking about his generation, Mr. Massey said: "What I suspect is, we 
know how to get high; we know the sensation. In a broad sense, once 
you've been there, it's easier to get back into it."
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MAP posted-by: Jay Bergstrom