BOOMERS' OVERDOSE DEATHS UP MARKEDLY

Californians age 40 and older are dying of drug overdoses at double
the rate recorded in 1990, a little-noticed trend that upends the
notion of hard-core drug use as primarily a young person's peril.

Indeed, overdoses among baby boomers are driving an overall increase
in drug deaths so dramatic that soon they may surpass automobile
accidents as the state's leading cause of nonnatural deaths.

In 2003, the latest year for which the state has figures, a record
3,691 drug users died, up 73% since 1990. The total surpassed deaths
from firearms, homicides and AIDS.

Remarkably, the rate of deadly overdoses among younger users over
that period has slightly declined, while the rate among those 40 and
older has jumped from 8.6 to 17.3 per hundred thousand people.

The change has caught many prevention programs, which tend to be
geared toward young people, off guard. Several drug abuse prevention
officials and other experts said there was virtually no strategy in
place to address the risk of overdose among older users.

"We have seen a massive, long-term trend toward more middle-age drug
abuse that is leading to an unprecedented number of deaths," said
Michael Males, a sociology researcher at UC Santa Cruz. But "no one
is doing anything about it. It has gotten almost no attention at the
state, federal or local level."

Because the problem has been recognized only recently, it is
difficult to say what is behind the generational split.

Some experts suggest, however, that California is merely reflecting a
national trend in which Americans increasingly are using illicit
drugs long past the days of youthful resilience. According to the
U.S. Substance and Mental Health Services Administration, more than a
third of drug users today are older than 35, compared with 12% in 1979.

"Baby boomers are the first generation that is facing a drug and
overdose epidemic in their middle age," said John Newmeyer,
epidemiologist and drug researcher at the Haight-Ashbury Free Clinics
in San Francisco. "They started using drugs recreationally or
regularly over 20 years ago, and they aren't really slowing down."

To a degree, it seems overdoses are following the same generation
through time. In California, the age at which someone was most likely
to die from a drug overdose in 1970 was 22; by 1985, it was 32; and
today it is 43, according to calculations by Males, based on state health data.

Many of those who die are hard-core drug users who never quit, even
when they reached middle age.

As such, they are likely to be in poor health, enhancing their overdose risk.

"Using year after year can have a clear and deleterious physical
effect. [Drugs] take a toll as people continue to use," said Dr. Karl
Sporer, a San Francisco emergency room physician and drug treatment expert.

With age, even occasional users grow more susceptible to medical
complications such as strokes, heart attacks and respiratory distress.

By far the greatest number of overdose deaths is among users of
opiates, such as heroin, which in excessive doses can shut down the
lungs. Doctors say that because older users tend to have slower
metabolisms, the opiates may remain in their systems longer,
increasing the risk of cumulative overdose.

Cocaine is the next most lethal drug. It can lead to heart attacks,
especially among long-term users, whose habits can cause their hearts
to become weakened or enlarged.

Drugs such as methamphetamine and barbiturates account for a smaller
number of overdose deaths.

Treatment experts said people most at risk are older users who try to
stop, then return to using drugs at their previous dosages. The drugs
may kill them because the users have lost tolerance or the drugs are
more potent. Many street drugs have gotten purer in recent years,
experts said, which adds to their potential lethality.

It is unclear from the data available what role prescription drugs
play. The state's drug overdose data do not include a small number of
cases in which medications led to an overdose even though they were
taken as directed.

Some researchers believe that rising incarceration rates around the
state could be leading to more overdoses, because many released
prisoners return to drugs after long periods of abstinence.