(News-Press) Moya Chase had been sober for three decades when she prepared to undergo knee replacement surgery — her Valium, vodka, wine and marijuana binges only a distant memory from her 20s and 30s.
But post-operative recovery came with seemingly buckets of prescription pain drugs, particularly those containing highly addictive oxycodone. And Chase, who lives on Marco Island, said she knew should would not be able to resist the urge to abuse again.
"As soon as my husband brought the pills in my room and put them on my nightstand I knew this was party time, and I was going to live in a fog," said Chase, who also resumed drinking. It lasted two about years, she said. "It could have been longer. It's blurry."
Chase made it back to drug treatment in Naples and, having completed it, said she's stronger for the experience. But hers is part of the dramatic rise in substance abuse problems among the nation's older adults in the last two decades.
Though substance abuse usually lessens with age, the number of adults 50 and older needing treatment for drugs and alcohol are expected to double by 2020 to 5.7 million, according to government estimates. Up to 2 million of them will be 65 and older.
Addiction experts say the growing numbers are fueled by the aging Baby Boomergeneration, who used drugs more freely than older generations, and easy access to addictive medications for adults who are prone to more health-related pains and anxiety related to personal loss.
Treatment centers in Lee and Collier counties, home to more than 260,000 residents 65 and older, are starting to take notice.
Hazelden in Naples opened an inpatient and outpatient substance abuse treatment program for older adults in November. The monthlong program costs $20,000. Some private insurance plans will cover much of the cost, but Medicare and Medicaid will not.
The Fort Myers-based SalusCare has started working to find substance abusers among the older patients using Family Health Centers of Southwest Florida, which caters to Medicaid and low-income patients. The program, related to a larger Florida initiative that started nearly a decade ago, refers them to counseling, full-scale treatment or advises them how to reduce their drinking.
"There are a lot other issues that come up for older adults — facing mortality, structuring the day, ending isolation," said Heather Burton, director of clinical services at Hazelden.
Burton used the perspective of an older adult who has never had a drug problem but gets addicted to prescribed painkillers: "I'm going to do what the doctor has ordered. And, if one is good, maybe two is better," she said. "And so all of the sudden I'm physically wired for addiction, I'm physically there. But I'm not my idea of a drug addict at all. An addict is someone in a raincoat in the park with some tinfoil on his head."
Combine all of that with the laid-back, Happy Hour lifestyles of many Southwest Florida seniors.
"I think that it is overlooked," said Chase, a retiree who recently went through the Hazelden program. "If you look at all the country clubs, night after night, they're starting at five and hobbling home after nine."
A recent USA TODAY investigation found that prescriptions of opiate and opiate-mimicking painkillers to adults 65 and older increased 20 percent in the last five years, to 55 million prescriptions. The number of prescriptions of anti-anxiety medication, such as Xanax and Valium, increased 12 percent to that group over the same period, to 28.4 million prescriptions, USA TODAY found.
The combination of these two kinds of drugs can be lethal, particularly if they are mixed with alcohol.
While seniors are not the largest age group needing substance abuse treatment, a recent government report found that the rate of illicit drug use in older adults more than doubled between 2002 and 2012 — from 3.4 percent to 7.2 percent. The 55-59 group jumped from 1.9 percent to 6.6 percent, and the 60-to-64 group went from 1.1 percent to 3.6 percent.
The United Health Foundation, a division of the insurer UnitedHealthcare, recently found that 5 percent of Florida seniors are "chronic" drinkers, meaning they consume up to 60 alcoholic beverages per month. That figure was among the highest in the nation.
About 35 percent of all Hazelden admissions in Naples are people who are at least 50, said Brenda Iliff, Hazelden's executive director. Of those, 93 percent had problems with alcohol, 13 percent were addicted to opiates or opiate-mimicking drugs, and 19 percent had problems with sedatives.
"Yes it's growing. As boomers retire and that senior pop bubbles and balloons — and we're starting to look at it. It is a significant portion of the population," said Stacey Cook-Hawk, assistance vice president for outpatient service at SalusCare in Fort Myers.
The nature of addiction is not necessarily different for older adults. But their reasons for abusing may be very different than those of younger patients. And some research suggests that older users are easier to treat away from those younger patients, whom they may try to "mentor" in lieu of dealing with their own issues.
Older patients tend to have problems with alcohol and prescription drugs, while younger patients abuse a broader array of illicit drugs, including cocaine and heroin.
Problems may also be harder to spot in seniors, experts say. Often they are retired, so substance abuse is not noticed by co-workers or bosses. Many also live alone and are socially isolated, meaning no one will know if they are abusing at home alone.
Doctors also may be more willing to prescribe pain medication to seniors for their many aches and pains.
The U.S. Substance Abuse and Mental Health Services Administration recommends that treatment for older adults be non-confrontational and focus on issues of loneliness, grief, increasing social interaction and making sure they have proper medical care.
Consider just the issue of terminology, said Carol Colleran Petersen, 77, who helped design the Hazelden program and is a national expert on the subject.
"Today's older adults were brought up never thinking about alcoholism as a 'disease' — it was a moral failing, the man living under the bridge," said Petersen, director of public policy and national affairs at the Hanley Center at St. Mary's in West Palm Beach. "The Boomer understands it as a disease."