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U.S. face of drug abuse grows older

A government survey estimates that the number of adults aged 50 or older with substance abuse problems will double to 5 million in 2020 from 2.5 million in 1999, in large part due to their comfort with prescription drugs.
/ Source: Reuters

When Patrick Gallagher first began nodding off at dinner, his family thought it was a symptom of old age. Their fears grew as it worsened.

Withdrawing from the world at age 64, Gallagher was addicted to a cocktail of alcohol and prescription painkillers.

“My whole life was centered around making sure I had an adequate supply of drugs and alcohol,” said the former instructor at the University of Miami.

Gallagher, of Jensen Beach, Fla., is an elderly substance abuser, a fast-growing group in the United States as baby boomers age.

A government survey estimates that the number of adults aged 50 or older with substance abuse problems will double to 5 million in 2020 from 2.5 million in 1999, in large part due to their comfort with prescription drugs.

“There is a huge concern that what we’re going to be seeing is a tidal wave of seriously affected substance abusers in later life,” said Frederic Blow, an associate professor at the University of Michigan Medical School who specializes in geriatric substance abuse.

Unlike their predecessors, the Woodstock generation is comfortable taking medications for a wide range of problems, including pain, insomnia, depression and anxiety. As a result, they are more vulnerable to substance abuse in later life, experts say.

Rush Limbaugh, the politically conservative, 55-year-old talk show host, who was charged last month with prescription drug fraud in connection with his addiction to painkillers, is representative of the new kind of patient showing up in treatment centers and emergency rooms, experts say.

'Late-onset' substance abuse
So-called “late onset” substance abuse is often linked to medical problems and the emotional traumas that can accompany old age, from isolation to the death of friends and family.

Alcohol remains the most commonly abused substance in the elderly, followed by prescription painkillers such as OxyContin, made by Purdue Pharama, and Vicodin, by Abbott Laboratories Inc , and anti-anxiety pills such as Valium, by Roche, and Xanax, by Pfizer .

Of 495,859 emergency-room hospital visits in the United States in 2004 for the non-medical use of pharmaceuticals, 32,556 were by people aged 55 to 64 years old and 31,203 were by people older than 65, according to the first national government survey of its kind.

Gallagher’s problems began when he began taking OxyContin and oxycodone to treat serious back pain.

OxyContin is a sustained-release version of oxycodone, whose brand names include Percocet and Percodan, both made by Endo Pharmaceuticals and whose abuse potential is similar to that of morphine.

“I felt tremendous,” he said. “I thought I’d died and gone to heaven because I was pain-free.”

Gradually, however, those positive feelings gave way to lethargy and crippling depression. He needed more and more pills to gain the same effect and he increased his alcohol intake dramatically to help.

“My life became unmanageable,” said Gallagher, who entered treatment about a year ago after his family intervened to help him. Now aged 65, he manages his pain through alternative, holistic methods such as acquatherapy and massage.

Illicit drugs, too
It’s not just prescription drug abuse that is on the rise. Illicit drug use is also increasing, though the absolute numbers are still relatively small.

Of 383,350 emergency admissions nationwide for cocaine abuse in 2004, 10,790 were patients between the ages of 55 and 64, while 1,503 were aged 65 and older.

“We are beginning to see an increase in heroin and cocaine addiction at the front-end of the baby boom wave,” said Carol Colleran, executive vice president of public policy and national affairs at Hanley Center, a treatment program in West Palm Beach and the author of “Aging and Addiction.”

“The increase is slight yet, but it begs the question as to whether that figure is going to increase dramatically if the baby boomers revert back in retirement to the drugs they tended to use in their college years.”

While pharmaceutical companies are introducing new medications to combat pain, anxiety and sleeplessness, supposedly without the potential for abuse, those drugs can carry their own problems.

Ambien, the insomnia drug made by Sanofi-Aventis cited by U.S. Rep. Patrick Kennedy as the cause of his recent car crash near the U.S. capitol, has been blamed recently for causing blackouts in patients that have led to car crashes, sleepwalking and binge eating.

“The drug companies want you to believe their drugs are safe,” said Blow, “but I think I think we are just going to see new problems in the future.”