Kai was already drunk when she picked up her 18-year-old niece at the airport to take her to dinner. By the end of their meal, she was so intoxicated that she slurred her way through conversation, leaving the girl so confused and embarrassed, she couldn’t bring herself to look at her aunt.
Kai had hit bottom.
“I was mortified,” recalls Kai, a 54-year-old accountant from West Palm Beach, Fla., who asked that we withhold her last name. “They say you have to want to get well for yourself, but I didn’t want my family to suffer anymore.”
Kai is among a growing number of middle-aged Americans who have abused alcohol, prescription medication or illicit drugs as a crutch to face a combination of challenges, including empty-nest syndrome, divorce, unemployment, retirement, health setbacks and the death of a parent or spouse.
Illicit drug use among people in their 50s has more than doubled since 2002, according to the National Institute on Drug Abuse. And a recent survey by the Hanley Center, a Florida-based drug and alcohol treatment and recovery facility for boomers owned by Caron Treatment Centers, found that 40 percent of its alumni reported that the onset of their substance abuse occurred after age 48.
Why Boomers Turn to Drugs and Alcohol
These studies, and the experience of adults like Kai, presents a different image of midlife addicts than many expect. When Juan Harris, now clinical director of boomer and older adult treatment at Hanley, started working with middle-aged addicts a decade ago, he says he expected to encounter “aging hippies” who had used illicit drugs steadily since their 20s. Instead, he discovered that many of his patients became dependent in midlife.
“When people begin drinking heavily to deal with life stress, it can lead to addiction where there wasn’t any before," says Dr. Michael Miller, at-large director of the American Board of Addiction Medicine and medical director of the Herrington Recovery Center in Oconomowoc, Wis. He believes a predisposition to addiction is genetic and most likely to manifest when people are in their 20s. “It’s not about drugs and alcohol," he says. "It’s about your brain and how it responds to drugs and alcohol.”
But stress, particularly the kind generated by the nation's recent economic downturn, can prompt people in middle age, especially men, to self-medicate with drugs or alcohol. The pressure of paying for college while losing equity in their homes, or of becoming unemployed or working for less money, are among the major stress factors for men, Harris says. For women, whose identities are often tied to their roles as wives and mothers, substance abuse can be triggered by divorce or empty-nest syndrome. “Her identity has been Mrs. So-and-So,” Harris says, and if her husband leaves or dies, "she’ll drink more and withdraw from events that were for couples.”
A Life Gone Awry
For Kai, a combination of issues — including financial difficulties, marital stress and her father's death — left her feeling unmoored and, eventually, depressed. She's been married and divorced twice, and has no children. “Here I was in my early 50s, and I expected the white picket fence, the two-car garage and three kids.” Kai says. "I had an emptiness inside I couldn’t manage.”
She turned to alcohol as a coping mechanism and drinking soon infiltrated her daily routine. If her family called in the evenings, Kai would either slur her words or not answer the phone at all. Soon, she began drinking in the afternoons, too. On Saturday mornings, she’d treat hangovers with Bloody Marys and then beer, figuring, as she now says, “What the heck? It’s Saturday.”
As her tolerance increased, Kai drank more, sometimes downing eight bottles of beer just to feel calm. Eventually, she started blacking out, waking up in a pool of sweat, terrified and wondering what she’d done the previous night.
Her work suffered as well. As drinking took over more and more of her day, she lost several clients and handed off others to different accountants. Yet she kept on drinking, even after losing a family member to complications of alcohol abuse. She had become convinced that she couldn’t enjoy life without the calming influence of alcohol, she says.
Finally, her mother and sisters intervened and prompted Kai to seek treatment at the Hanley Center. “You don’t have to have DUIs, lose your job or go to jail” to know that an addiction has gotten out of control, Kai says. “It’s becoming more OK to say, ‘I think I’ve got a problem,’ and ask for help."
Twenty-five years ago, Harris says, "the disease of addiction was whispered about. It’s no longer like that.”
In August 2011, Kai entered Hanley’s 30-day residential treatment program specially designed for boomers. (Many patients require a 60- to 90-day stay, Harris says.) Residential therapy can cost several thousand dollars per month. Kai's stay at Hanley, a nonprofit facility, was not covered by insurance; her family helped foot the cost.
Hanley's program is based on the 12 steps of Alcoholics Anonymous, as well as client-centered Rogerian therapy, which promotes self-discovery over therapist interpretation. In therapy, patients share their stories because they know they will not be judged. Late-onset patients like Kai often have the best odds of staying clean after rehab, Harris says, in part because they can clearly remember a time when they were sober.
"Two days in, I was a mess," Kai says. "It was like I’d been sent off to summer camp, my mom came to visit and I said, 'Take me home!'" But she credits her peers in treatment with making her feel less alone. "Being boomers, many of us had grown up in similar settings where our parents didn’t talk about anything but happy times," she says. "We grew up thinking life was going to be grand," and were unprepared for setbacks. She now believes that an unacknowledged lifelong battle with anxiety, as well as genetics, were among the causes of her late-onset alcohol dependency. Her successful residential treatment was a big factor in her recovery, but she knows it's an ongoing process.
The Struggle to Rebuild
After returning home, Kai began attending AA meetings as often as three times a day. She bought new clothes, rearranged her apartment and changed her eating habits to remind herself every day of her new commitment to sobriety. She has built new routines into her day as well, rising at 5:30 or 6 a.m. to stretch, read, drink coffee and write in her journal. “I have a whole new way of life,” she says.
But she has also had to work to keep from transferring her addictive personality to other pursuits, even exercise, and she constantly works to avoid anxiety, often asking herself, "Where are your feet?" to stay, as she says, "aware of being in the now."
A year after her time in rehab, Kai has re-established frayed relationships with family members, including the niece she once embarrassed. She continues to attend rehab alumni meetings to share the coping skills she acquired with other boomer alcoholics, and she escorts patients fresh out of rehab to AA meetings. She's also begun training to enter the addiction recovery field as a professional herself.
Challenges remain, though. People who have not faced alcoholism as she has, both personally and through watching friends die from alcohol-related conditions, have a tough time understanding what it's like to drive along a highway and, as Kai says, "see five billboards about how great cold beer tastes," knowing that, for her, "to pick one up can be death."
Staying grounded, she says, is all she can do to stay healthy. “All we have is now," she says. "Life is a gift, life is the present.”