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When Aging and Addiction Collide

It's not just young folks, the aging are falling victim to America's next wave of addiction. Think Medicare covers drug treatment? Think again.
 
 
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Carol Aronberg’s drunkalogue is common: she grew up outside New York City in a privileged family full of drinkers; both her parents were alcoholics, and her father was a mean drunk whose verbal abuse damaged her self-esteem. Still, she went to college, got married, had kids and started a successful business. And then, eight years ago, her mother died, and Carol’s drinking blossomed, and she expanded her repertoire to include drugs. Finally, after three overdoses on booze and benzodiazepines and a pharmacopeia of other pills (“the 'Cets,” she calls them—Percocet, Fioricet, the combinations of painkiller or sedative with acetaminophen), she checked into rehab. Now she has 18 months clean and sober.

Here's the biggest difference between Aronberg's story and that of most alcoholics: She was 69 years old when she became an addict.

Aronberg is part of what some analysts have described as an approaching tidal wave of addiction in America: older adults and members of the baby-boom generation now in their late 40s to their mid-60s, who develop addiction and get sober late in life.

 

report issued by the Substance Abuse and Mental Health Services Administration (SAMHSA) has warned that the aging of the baby-boom generation is leading to huge increases in levels of addiction among adults over 50—a fact that, SAMHSA says, will require double the availability of treatment services by 2020. And many of these people, having come of age in the drug-friendly culture of the 1960s and 1970s, have little hesitation about popping painkillers and other pills to deal with the physical and emotional stresses of aging.

“I call it ‘Pharmageddon,’” says Barbara Krantz, medical director of the  Hanley Center, a nonprofit addiction treatment facility located in West Palm Beach, Fla. Hanley’s Center for Older Adult Recovery was the first treatment center to pioneer programs specifically designed to help elderly and baby-boom adults recover from addiction. Krantz says Hanley’s older-adult programs are always at full capacity with patients who come from the entire East, because so many older adults need treatment. “If you look at the SAMHSA data,” she says, “the prediction is that five million older adults will need treatment in 2020.” That’s twice the number requiring treatment in 2000. 

Another SAMHSA study found that drug abuse (including prescription drug abuse) among adults 50-59 jumped from 2.7 percent of that population in 2002 to 5.8 in 2010, and that among those 55 to 59, the rate roughly doubled from 1.9 to 4.1 percent.

Aronberg traveled from her New Jersey home to spend 60 days at Hanley. She admits she was fortunate to have the resources to pay for private rehab services (at a cost of nearly $50,000). Not everyone is so lucky. Many older adults who need treatment are unable to get it due to the simple, shocking fact that Medicare does not pay for addiction treatment, says Neil Capretto, medical director of Gateway Rehabilitation in Pittsburgh, Pa. Capretto’s region has the highest concentration of elderly people outside the Florida retirement communities. “I’d take Medicare, but Medicare won’t take us,” Capretto says. “Medicare would recognize us if we were still hospital-based.” But many treatment facilities that offer “medically-monitored” detox are free-standing and independent of hospitals.

When Aronberg completed the 30-day program, she says, “I was no more ready to get out than the man in the moon,” and she re-upped for another month. She had arrived not just with her alcohol addiction but also with 30 bottles of prescription drugs—after her third OD, she says, “When they swept my house, you could have sold them on the street to pay your mortgage off. The doctors never told me to stop taking anything—they kept giving me more. My daughter went to the doctor and said, ‘My mom’s been taking too much,’ and he said, ‘That might be true, but it would be harder to get her off.’”