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Older Addicts Face Uncertain Twilight

Drug-Dependent Seniors a Growing Concern, Experts Say

By Michelle Boorstein

Washington Post Staff Writer
Tuesday, January 18, 2005; Page A01

James Gulick looks around at the recovering drug adAddiction cost Butler four marriages and estranged him from his family. (Michael Williamson -- The Washington Post) dicts in the room and thinks: Yeah, I fit in here. He has the whole sad list of credentials: the estranged family, the drained bank account, the regrets.

But he doesn't look the part. The 62-year-old crack cocaine addict stands out among the dozens of people in his Fredericksburg treatment group, with his full head of white hair and bifocals in a sea young men with goatees and young women in tight jeans.

Unlike many of them, Gulick, a retired food distributor, isn't here to rebuild a career or a marriage or save his house; those things went up in the smoke of a crack pipe long ago. All he wants now is a peaceful place to watch stock car racing on television and to reconcile with his son.

So Gulick is trying to get used to baring his soul in group therapy and undergoing regular drug screening. And the counselors are trying to adjust to him.

As unusual as Gulick seems -- the others have nicknamed him "Gramps" -- experts say he represents a larger, unseen wave of addicts who came of age before it was common to admit addiction and seek treatment. They say the numbers, growing for a decade, will swell as baby boomers -- the first generation in which recreational drug use was widespread -- reach old age. With age, they say, can come more isolation, more free time and changing body chemistry, all of which can help turn a weekend habit into a daily compulsion.

Although there are few geriatric addiction specialists, the subject is starting to appear on conference agendas. The National Institute of Drug Addiction held its first forum on the issue in September, and the Department of Health and Human Services recently released a study predicting that the number of seniors with substance abuse problems will rise 150 percent by 2020.

Addicts of all ages have traits in common, but seniors have some distinguishing ones. Their systems may be less tolerant of drugs than those of younger people. They have more free time, and no small children or bosses to be accountable to. And they have lost more in their lives, according to Margaret Anne Lane, a counselor at Sentara Williamsburg Community Hospital, who recently began a substance abuse counseling program for people older than 60.

But when they are ready to quit, they often have more success, according to David Oslin, a psychiatrist at the University of Pennsylvania's medical school. Although they may regard therapy with suspicion, having grown up before it was common, they are highly motivated and keep appointments. Their age often means that sessions must be tailored for them, Lane said.

"There's a greater need for respect and privacy, good manners, and logistically, things like having sessions during the day since they don't like to drive at night, shorter sessions, good lighting, people speaking louder," she said.

Generally, people older than 60 make up less than 3 percent of the millions who seek treatment each year, though the number of senior addicts is estimated to be higher. Few older addicts seek treatment, but when they do decide to quit, they are generally more successful than younger ones are, Oslin said.

"They are trying to maintain their independence and their health," he said. "They realize, 'If I want to be around for my grandkid to graduate from high school, I need to get my act together.' "

In 1992, 77 percent of people older than 50 being treated for substance abuse were alcoholics; the rest had a drug problem or an alcohol and drug problem, according to Health and Human Services. By 2002, half of people older than 50 being treated had a drug problem.

But only 2 percent of people older than 50 are considered addicts, compared with 4 percent to 5 percent of the general population, so little is known about addiction among the elderly -- including whether they are more or less likely to relapse after treatment.

Gulick's counselors at the Rappahannock Area Community Services Board say they do not see enough people his age to draw conclusions about them. One case manager says some older addicts serve as mentors to the younger ones in drug courts, where 1 percent of participants nationwide are older than 60. Gulick, reluctant to preach, isn't one of them.

But he couldn't contain himself during a recent session when the counselor threw out this question: Is it worth your time to warn young people to stay off drugs?

"Maybe some of these young people should learn the hard way!" Gulick said, folding his arms across his chest and smiling a surprised smile -- as though he couldn't believe he had ventured an opinion.

Gulick's voyage into treatment began the way it began for the other members of the group -- in the back of a police cruiser.

After being arrested one December night two years ago as he bought cocaine at a Spotsylvania hotel, he was given a choice by prosecutors: spend six months in jail or make a commitment to drug court, a treatment program for addicts. Treatment would require him to learn things about himself that he wasn't eager to know.

"I can't think about why I've done drugs; there's no answer," Gulick said in the low drawl of his native southeastern Virginia, nervously wiping imaginary crumbs off the Denny's restaurant table for the fourth time in a half-hour.

"I just know the life I had before drugs, I know the life I had on drugs, and I know the life I have now. It was time to come off it."

Eighteen months after starting drug court, he hasn't delved very deeply into the whys. He took the first pipe from a friend when he was in his forties and, during a decade, lost his marriage, his home and contact with his son and brother. When he retired from a sales management job in 2000 with $238,000 in savings and a pension, he began pouring money into crack, spending $1,000 a day by the end, he says. He dropped 30 pounds.

He spent the first several months of treatment in denial. At weekly check-in sessions with Fredericksburg Circuit Court Judge John W. Scott Jr. -- who chats briefly with each participant and often jails those who have failed surprise drug tests -- Gulick would lean back in his pew and let an easy smile rest on his weathered face. He looked like the rebellious student who laughs when he is sent to the principal's office.

But in recent months, Gulick and his counselors agree, his outlook began to change. Broke and required by drug court to work or volunteer, Gulick went nearly a year ago to the local day-labor office and struggled through construction work. After a few months, a friend gave him a job at a publishing house, where he packs boxes. On weekends, he tries to stay busy, barbecuing or fishing.

Settling into a new life at his age hasn't been easy. He moved from Caroline County to Fredericksburg to be closer to drug court, and it took three months to find a roommate who wanted to live with an older man with special requirements.

"I'd say, 'Look, I don't drink, I don't do drugs.' They'd say, 'I'll call you back and let you know if you got the apartment,' and then you never hear from them," he said. "That's how you know."

If Gulick is all laid-back pragmatism, Richard Butler is the opposite, bouncing off walls one minute with tear-choked regret and the next with elation over the life he has reclaimed in his seventh decade. The burly carpenter embraces the self-examination that came with drug court, carrying self-help books and churning with analysis.

"No, no, no!" he responds to Gulick's suggestion. "If only someone would have told me that freedom comes from living life today as honestly as possible!"

With his tousle of sandy brown hair and puppylike grin, Butler, 62, looks as if he should be organizing a family touch football game, not smoking crack alone in the Fredericksburg motel where he was living when he was busted in 2003.

"It was the right time," Butler said one morning, a book about "the pursuit of happiness" on the restaurant table next to his Marlboros. "I needed to travel all those little side roads and ravines. I just wish the right time would have happened earlier."

His decades of addictions -- of crack, scratch lottery cards, bowling, women -- cost him four marriages and estranged him from his three children and 11 siblings.

Butler grew up in a large family in which there was a lot of drinking, violence and transience. "We'd stay somewhere as long as people could tolerate us," he said.

He joined the Navy, where he became a health worker, giving sailors information about alcohol and drugs. He smoked pot for the first time at 32 at a port in Africa, after a sailor challenged his lectures by noting that Butler had never tried drugs. "I wasn't going to accept that," he said, shaking his head at what identifies now as deep insecurity and anger.

After the Navy, Butler drifted through Ohio and Texas before winding up in the Fredericksburg area, where he was offered crack in 1991 by a man who was always accompanied by attractive women. In the three years before his arrest, he said, he smoked crack every day.

Next month, Butler and Gulick are set to leave drug court for an uncertain future. Both are optimistic.

Before a recent session, Gulick was elated over what he said was a recent milestone; he had called his son for the first time in years, he said, and planned to see him over the holidays. But David Gulick, 32, of King George, Va., said he hadn't received any message from his dad. "But I'd be more than happy to talk to him," he said. "Everyone makes mistakes."

Butler was excited about plans to expand his carpentry business. Despite two heart attacks, he works seven days a week. His goal, he said, "is to get clean to the point that I can live without fear of falling back in."

With the zeal of a convert, he tells his younger peers: "Look at me, I've missed 62 years."

A 19-year-old group member said his sermons are "annoying" -- but she's listening.

"That's not going to be me," said the woman, who spoke on condition of anonymity. "I wouldn't be alive if I'm still using at that age."