James Gulick looks around at the recovering drug addicts 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.
Addiction cost Butler four marriages and estranged him from his family.
(Michael Williamson -- The Washington Post)
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.