Older Adults and Illegal Drugs

Katherine R. Schlaerth, MD


Geriatrics and Aging. 2007;10(6):361-364. 

In This Article

Abstract and Introduction

Most practitioners assume that the use of illegal or "street" drugs is confined to the young. However, a recent phenomenon has been the use of such drugs by individuals above the age of 50. Social trends play a part: many older addicts began using in the 1960s. Others share the use of illegal drugs with other family members as a mode of family recreation. The latter trend is probably more common in inner cities where drugs are more easily obtained. Older men are twice as likely to use illegal drugs as are older women, though the latter outnumber the former demographically. Many illegal drugs, especially cocaine, methamphetamines, and even marijuana have cardiovascular effects that are especially dangerous when they occur in older individuals who may already have underlying cardiovascular disease. Practitioners must be vigilant about querying patients about their use of illegal drugs, no matter what their age, and especially if cardiovascular illness is involved.

Use of illegal drugs has long been assumed to be a problem seen only in the young. Those of us treating adolescents and pre-adolescents are urged to inquire about street drug use whenever we treat youngsters ranging in age from the preteens to early adulthood. Yet illegal drug use is happening right under our noses among older adults, and the consequences of snorting cocaine or taking amphetamines may be much more severe in those older individuals who already may have serious, albeit unrecognized, cardiovascular disease ( Table 1 ).

Very few studies have tackled the problem of identifying users of illegal drugs who are over 50 years of age. Many clinicians feel that questioning a mature individual about illegal drug usage demeans that individual and makes the questioning professional appear somewhat eccentric. Yet the persons who used illegal drugs in the 1960s are now approaching retirement, and while most have matured and now recognize the risks associated with such usage, a significant number of former "flower children"[2,3] have continued to indulge in illegal drug use well into their 50s, 60s, and beyond. The problem will undoubtedly become more evident as this cohort of individuals ages further (see Table 2 and Table 3 ).

An interesting study looking at U.S. birth cohorts from 1919-1929 through 1970-1975 showed that whereas only 1 in 50 teenagers born before World War II had ever tried marijuana, fully half the teenagers born in the 1950s and early 1960s had done so.[4]

Although alcohol and prescription drug abuse has been fairly well documented in older adults, illegal drug usage has not. Yet most physicians whose practices contain mature patients can recall one or perhaps two patients whose illegal drug usage has surprised them. The choice of illegal drugs may be somewhat regional, and may parallel the drugs being used by younger members of society.[5] Therefore, it behooves practitioners to know what illegal substances are most easily accessible where they practice.


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