FOR OLDER ADDICTS, A NEW APPROACH

Treatment Centers Use Age-Specific Units to Address a Growing Trend

In his sixties, Ramon Loper spent the last few years of his musical
career desperately feeding a heroin addiction. He rushed from gig to
gig, getting cash and getting high.

"And then," he said, "I broke my hip. Thank God!"

The members of his group session erupted with laughter. A chorus of
"Thank God!" rang out.

Loper is a client in the ElderCare program at Odyssey House, one of few
residential drug treatment programs in the country specifically designed
to treat the growing population of older substance abusers. Everyone
here understands how a broken hip can be a blessing, how it can help end
the cycle of drug abuse.

From a well-kept brick building in East Harlem, the 50-bed Odyssey House
treats recovering addicts of all ages. But the building's fourth floor
is reserved for ElderCare, which accepts only people ages 55 and older
- -- clients who tend to feel uncomfortable being candid about their
problems in other treatment programs, where participants are usually
between the ages of 18 and 44, sometimes younger.

Odyssey staff say the close peer relationships allow older people --
many of whom have had addictions for decades -- to finally recover.
Residents typically stay in the program for 12 months or more, living in
same-sex suites with several other clients.

"You put peers together and you allow them to live together, to support
one another, to grow together, to share their stories, their pain, their
hopes," said Peter Provet, the president of Odyssey House.

The publicly funded Odyssey House, founded in 1967, is widely known for
a program that allows recovering mothers to live with their children
while in treatment. The ElderCare program was founded in 1997, when
staffers began to see a small but increasing number of older adults
seeking treatment.

Manuela Bookman, 58, is recovering from a 35-year cocaine addiction. The
courts referred her to ElderCare after she was arrested on a
drug-dealing charge.

"When I was first offered the program, the first thing that came to my
mind was, 'I can't deal with all these young kids. They're
disrespectful,' " Bookman said. "They told me, 'No, you're only going to
be with people your age, people who can identify with you.' It sounded
okay to me."

Provet said the program started with a few beds grouped together on the
fourth floor. Now, there are always several people on a waiting list to
get in.

The number of older adults being treated for substance abuse in the
country is relatively small -- 1.6 percent of the more than 1 million
substance abuse clients in the nation -- but has grown steadily over the
last decade, according to Leah Young, a spokeswoman for the Center for
Substance Abuse Treatment, a federal agency.

The center reports that in 1991, 8,206 clients over the age of 65 were
in substance abuse treatment in the United States. By 1998, the number
had more than doubled, to 16,247. Young said older adults are more
likely to abuse alcohol or prescription drugs, but a persistent number
of them are addicted to such "hard" drugs as cocaine or heroin.

"The abuse of illicit drugs in the country has been growing, and you
would assume that most of these people will stop before they get to that
point," says Herbert Kleber, director of Columbia University's Center on
Addiction and Substance Abuse. "But as you increase the total number,
some will end up staying on [drugs] into their older years."

Take Bertie Alston, for instance.

"Aren't drugs a young person's game?" an Odyssey House counselor asked
her.

"Yes, but I started as a young person," replied Alston, 58, who has
spent 36 years addicted to heroin.

Although the federal government doesn't track exactly how many treatment
centers nationwide are geared specifically for older adults, Young said
there are very few. One, the Hanley-Hazelden Center in West Palm Beach,
Fla., offers a 14-bed Center for Recovery for Older Adults, whose
clients are mostly alcohol and prescription drug abusers.

Carol Colleran, director of older adult services at Hanley-Hazelden,
said thousands have gone through its 28-day program, but addiction in
older adults remains a largely undiscussed problem.

"People shy away from talking about it," Colleran said. "It's really
difficult to put a nice little gray-haired grandma in the same sentence
that you're talking about alcoholism or drug abuse."

Colleran said treatment for older adults is less confrontational than
therapy for younger people, and that older people -- who did not grow up
in what she calls the "self-help" era -- have more trouble talking about
their feelings.

Provet said treatment in the Odyssey House program addresses such
life-stage questions as "What have I done in my life?" and "What
mistakes have I made, and how can I correct those mistakes?" The program
succeeds, he says, because residents are able to share their life
experiences and empathize with one another.

In a recent treatment session, Julius Small, a recovering alcoholic,
told the group he had recently celebrated his 70th birthday.

The room erupted with applause. It is this kind of support that allows
older people to recover, Provet said.

More than 100 people have completed the ElderCare program at Odyssey
House since 1997. Before a resident leaves, he or she creates an
"after-care plan" that includes plans for housing, identifies a support
network and works toward independence and financial stability.

When he leaves, Loper said, he would like to counsel other former
addicts. Bookman said she will help take care of her grandchildren so
her daughter can complete a college degree.

"I finally am able to look at myself in the mirror and see a human
being," Bookman said, "instead of what I was looking at before."