OLD HABITS

After decades of drug addiction, Adriane Allen believes she has
finally grown too old to smoke crack. At 57, she has chest pains, has
lost most of her teeth and has trouble moving her arms. Lately, she
worries about how her grandchildren will remember her when she is gone.

"I definitely do not want them mourning me as an addict, that I died
as an addict," said Ms. Allen, shaking her head, covered with gray
hair and fidgeting uncontrollably during an interview at a New York
City needle-exchange center.

"You get tired of being tired," she continued. "They say that is a
drug addict's saying, but it is true, you do get tired of being tired.
I am tired of walking around in a daze. I am tired of walking around
with sunglasses on. Blocking out real life. I am ready to face my
demons and just say I don't want it anymore."

As the first of the baby boomers approach 60, addiction treatment
centers are bracing for a growing population of older drug addicts.
Many aging users, veterans of the counterculture 60's, started using
drugs as teenagers and have progressed to harder substances and
addiction, while others turned to illicit drugs, abuse of prescription
medications or increased alcohol intake later in life, with the loss
of jobs or spouses.

Since, traditionally, substance-abuse-treatment programs and research
have focused on teenagers and young adults, doctors, social workers,
therapists and researchers say that new approaches need to be
developed for the ballooning number of boomer addicts.

"In treatment of people 55 and older, we are starting to see much more
cocaine addiction, which we never saw before," said Frederic C. Blow,
an associate professor in the University of Michigan's psychiatry
department, who has developed policy recommendations for the federal
Substance Abuse and Mental Health Services Administration. "In fact,
in some treatment programs, we are starting to see more problems
related to stimulant abuse: cocaine, crack and marijuana use."

The federal government's 2004 survey of substance abuse, released in
September, estimated that more than three million adults 50 and older
had used marijuana, hashish, cocaine or crack, heroin, hallucinogens
or inhalants or had misused prescription drugs during the previous
year. That number could more than double by 2020, said Joseph C.
Gfroerer, director of the substance abuse agency's population surveys.

Willard L. Mays, a delegate to the White House Conference on Aging and
a member of the executive committee of the National Coalition on
Mental Health and Aging, said, "There are not enough geriatric
specialists to handle this increased number of people who need services."

Their medical problems can be overwhelming. Long-term heroin use can
hasten the decline in immunity that comes with age. Prolonged cocaine
use can lead to erosion of the nasal passages, arrhythmia and other
cardiovascular problems. The slower metabolism, lower body mass and
decrease in an enzyme called alcohol dehydrogenase that accompany
aging drive down the alcohol tolerance of older adults, contributing
to liver disease and making them susceptible to falls. Older patients
may already have diabetes, arthritis or hypertension, meaning that
they need to be stabilized before they can start treatment for their
addiction.

At the methadone maintenance treatment program at Beth Israel Medical
Center, doses sometimes need to be adjusted for older patients who are
more likely to be on several prescription drugs, said the medical
director, Dr. Randy Seewald.

Older patients can also present practical treatment problems. Those
with mobility problems might have trouble getting to treatment
centers. They often need treatment literature printed in large type,
or help in unscrewing the caps of methadone bottles, because of
arthritis. Therapy must be tailored to address regret over wasted
youth and lost spouses.

Substance abuse also often goes undetected - and therefore untreated -
for long periods in older adults who are isolated. "When people are
retired and do not have professional obligations and the children have
left home, then our red flags are not raised quite as effectively,"
said Petros Levounis, director of the Addiction Institute of New York.

Even when an older person's drug or drinking problem is noticed,
people are sometimes loath to interfere and deprive parents or other
loved ones of a remaining pleasure, said Julie E. Jensen, a researcher
with the Washington Institute, an academic institution that advises
the public health system in Tacoma.

Some who had been casual drug users in their youth returned to the
substances later in life because of loneliness, the death of a spouse
or a loss of purpose after retirement. "They will go back to what
satisfied them years ago," said Carolyn M. Drennan, director of
nursing at the Beth Israel methadone program.

Moses Henderson, 57, said he started sniffing heroin to cope with
depression after his wife died in 2001. He has hypertension, a bad
heart and diabetes, but is now in treatment. "I don't think my wife
would want me dead," he said, adding that if he uses drugs again, "I
will not make it."

Unlike Mr. Henderson, who is in a residential program, Margaret
Baldwin, 65, lives in a homeless shelter. Two years ago, she fell down
the stairs while drunk and broke her hip. That was the last straw,
after 23 years of alcohol abuse and drinking a pint of gin every day.
"I had no company," she said. "The only thing that entertained me was
the bottle."

Then there are longtime addicts like Ms. Allen. She said she went from
a puff of marijuana at a party in the 60's to "skin-popping" heroin
and smoking crack over the years.

Sometimes, "I found myself asleep on the train," she said, "because I
would be so high."

"I would like, nod out," she said, at the Lower East Side Harm
Reduction Center. "When I wake up, I am like in the Bronx or Coney
Island. Now that I am older I won't do that when I get high. I make
sure I get to a friend's house."

Ms. Allen said she had used cocaine five days a week. She agreed to be
interviewed because she thought her story would help younger addicts
quit.

While some addicts, like Ms. Allen, are unemployed and homeless,
others hold down jobs and lead middle class lives. Take Gwendolyn
Jennings-Hill, a 55-year-old grandmother who says she was a functional
addict. She used to cook up marble-size pellets of cocaine at home in
Hampton, Va., then smoke it quickly, so her daughter would not catch
her.

"I fell in love with crack," said Ms. Jennings-Hill, who is in Odyssey
House's ElderCare program in Harlem. "I used marijuana and then I
progressed to drinking, then sniffing cocaine and freebasing. The 60's
was a time when people started coming out of Vietnam. There was the
hippie generation. I was connected to that age and that era."

This year, encouraged by her family, Ms. Jennings-Hill sought to end
what she called the thrill and insanity of addiction. "I did not go to
crack houses," she said. "I was one of the, I guess, fortunate addicts
that had a house, had food, had money."

Ms. Jennings-Hill's teacher's salary was enough to support a habit
that cost about $3,000 a month. Others use Social Security payments or
rent space in their apartments as crack houses.

In contrast to younger addicts, older substance abusers thrive on
treatment that features personal accounts, counselors say. They dress
up for group sessions, and hesitate to speak openly in mixed-age groups.

At Odyssey House, a dozen residents aged 54 to 75 sat in a circle
recently and told stories of broken marriages and estranged children.
Some were trying to overcome heroin and crack habits while dealing
with hypertension, diabetes, cardiac problems and sleep apnea.

"I been drugging for the past 55 years," Pedro Rosa, 66, said
reflectively, looking at the floor and leaning on his cane, his
tattooed arms protruding from his shirtsleeves.

Several in the group let out murmurs of agreement, like the sounds
listeners make when they not only know the story but have also lived
it.

"I was a very angry man when I was in the street," Mr. Rosa said. "But
now I am too old to continue the life I was living."