The specter of a burned-out Baby Boomer using hard drugs way into middle age may conjure images of addiction, destruction and death.
That certainly can be true, but it’s not the complete picture, at least according to a new study from researchers at the University of Alabama at Birmingham, who found that people who occasionally use drugs like cocaine, amphetamines and opiates over the course of their lives are more common than anyone might suspect.
“When you think of a drug user, you often think of someone strung-out, using every day, and in deep trouble, but national data shows that that's not the most common thing you see," says Dr. Stefan Kertesz, an associate professor in the UAB Division of Preventive Medicine. “The most common pattern is illicit drug use at lower levels."
In other words, these sporadic drug users are “dabblers,” says Kertesz, lead author of the study that followed more than 4,300 people from four cities recruited between the ages of 18 to 30 in 1985 and 1986 -- and then tracked them for almost 20 years.
He confirmed what he suspected from his experience in clinical care: that some perfectly functional middle-agers still turn to the drugs of their youth.
"I meet people who use harder drugs on an intermittent basis," says Kertesz, who was trying to find ways doctors can better help patients who use drugs recreationally.
"I wasn't at all surprised that we had a lot of people who use hard drugs at a lower level,” he said. “The question we're trying to answer is: What are the likely health outcomes for those people?"
According to statistics from the most recent National Survey on Drug Use and Health, about 7 percent of Americans ages 35 to 49 and more than 9 percent of those ages 50 to 59 reported use of a drug other than marijuana sometime in the past year.
While many dabblers may think there’s no harm in the occasional habit, Kertesz found those Baby Boomers and Gen Xers who continued to use hard drugs into their 50s were five times more likely to die earlier than those who didn’t.
Those early deaths weren’t necessarily from drug overdoses, but instead from the risky kinds of lives the longtime users lived, Kertesz said.
“I'd say that those who start at higher levels and persistently dabbled seem to be high-risk people,” he says.
While the notion of parents (or even grandparents) using heroin and/or cocaine may seem like a hard pill to swallow, Kertesz isn’t the only one who’s seen it.
Jeff Wolfsberg, a Boston drug education specialist (and recovering addict), says he's heard plenty of stories of Baby Boomers still indulging in hard drugs.
"I can't tell you the number of conversations I've had with students about how they know their parents did coke on their vacation," he says. "There are probably more people using heroin sporadically then there are addicts.”
The difference is that the occasional users often also have good jobs, nice homes, and families, he adds. “If you have a lot going on in your life, you're not going to let yourself fall too deep."
Cindy, a 60-year-old upper-middle-class retiree from Boston, is a prime example of an older user. Though she declines to reveal her last name for obvious reasons, Cindy does say she and her husband use cocaine now and then because they like the "subtle high."
"I don't have this addictive thing where I have to go out and get it," she says. "I do it very sporadically. A gram of coke will last two months."
Cindy says she tried pot in high school, but didn’t like it. Alcohol has never been much of a draw for her, either. She’s never tried heroin or LSD or amphetamines.
"I'm a total scaredy-cat," she says. "I would never do anything else. I guess I don't consider coke a hard drug. I know there are people who do it and can't stop but I believe they have an addictive personality. I don't think I have an addictive personality. Although I do have a little shopping addiction. I love to shop."
While Cindy has discussed her sporadic drug use with her doctor, she says he told her that as long as she wasn't doing it every single weekend, she was fine.
But hard drugs like cocaine can pose a problem, even if you’re not addicted, says Dr. David Sack, an addiction psychiatrist and the chief executive of Promises Treatment Centers in Malibu and Los Angeles, Calif.
"There are people who can drink every weekend for 25 years and not become alcoholics," he says. "It doesn't mean the alcohol isn't doing them harm. And there are people who use cocaine or other drugs the same way. They don't miss work, but there are still complications.”
There’s the risk of stroke or seizure, for instance, or of triggering a blood pressure crisis.
“Much of the risk associated with these drugs occurs whether you're addicted or whether you're using it for a single night,” Sack adds. “The toxicity of these drugs doesn't go away just because you're not addicted."
And there are other things to consider when it comes to using illicit drugs. Jail time, for instance. Why would someone from an upper middle class background take that kind of risk?
"It can be something as simple as they're looking for excitement in their lives," says Wolfsberg.