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Opiates and the Elderly

      When I think of an addict, I see a skeleton-thin man or woman with abscesses up and down their arms, trembling and feverish, looking for that next fix.  I don't for a second picture a retired elderly couple with two Subaru hatchbacks parked in the driveway of their quaint cottage in the mountain community of Lake Arrowhead, California.  But that's the case with my next door neighbors, though instead of street drugs, it was all about prescription medications.

     I don't know exactly when their addictions took hold, but their seemingly good lives went downhill fast after they each suffered a fall one cold winter.  Freddie slipped on their icy driveway and had to have a hip replacement.  About a month later her husband, Neddy, wrenched his back dragging their garbage cans down to the street for the trash collectors to pick up.  His was a watch-and-wait situation, but he told me that if he bent over a particular way, or turned a particular way, that it sent a paralyzing jolt of pain from his spine down through one leg.  In both cases, I later learned, doctors prescribed them a number of medications, from opiate pain killers to sleep aids and anxiety


     I like to remember them before their accidents.

     I like to remember Freddie tending to her rose bushes and tomato plants in the summer, dressed in bright yellow culottes and a matching yellow sleeveless blouse.  I like to remember Neddy working alongside her.  They seemed happy.  They seemed healthy and strong.  Often, on those warm summer evenings, they liked to relax on their deck on lounge chairs and watch the sun set behind the mountains in the distance.  If I had to guess, I'd put them in their late seventies.

What I would prefer not to remember is how radically their lives soon changed.  They became reclusive.  I rarely saw them outside, and when I did, no matter the time of day, Neddy was usually in his bathrobe and pajamas.  And Freddie, when I sometimes spotted her on their deck, never seemed to change out of her white, flowing nightgown.  Where before my wife and I never heard a peep out of them, now they frequently had loud bitter arguments, mostly about money.  The friends who used to visit them, and they were few, stopped coming around all together.  Then one day I noticed that their Subarus normally parked in the driveway were no longer there.  I assumed they had to sell them.  Or, worse, that they were repossessed.  In either case, this is when they started calling Paula and me, asking if we'd be kind enough to drive them to the grocery store or one of their many doctor's appointments.  We helped them out whenever we could, which was often, but we felt that we had to stop when Freddie said she needed a ride and it turned into an all day affair, taking her to two doctors, one on the mountain, the other in San Bernardino, and then to two separate pharmacies to have her prescriptions filled.  Outside the first pharmacy, before we even got back to the car, she opened one of the bottles, shook several pills into her hand and swallowed them dry.  Helping your elderly neighbors is one thing.  Enabling them in their addiction is another, and as a recovering alcoholic-addict myself, now with twelve years of continuous sobriety under my belt, I'd seen this sort of behavior many times before.  And it sickened me. 

     After that episode we quit answering the phone when their last name appeared on the little screen.  Freddie started leaving angry messages, saying she saw our cars in the driveway, she knew we were home, and ordering us to pick up.  And if they weren't angry calls, they were desperate, pleading ones, begging us to help. It got ugly.

     They began calling 911.  I'm guessing the paramedics came to their home more than the two times I observed and carted one or the other off to the hospital, and I'm guessing, too, that in calling 911 so often they placed themselves squarely into the cross-hairs of the County of San Bernardino.  Then, on Christmas day, Paula and I put together a nice turkey dinner for them, and when I went to deliver it I found a bright orange eviction notice stapled to their front door.  Though it was dated several days earlier, apparently Neddy hadn't seen it yet, because when he answered the door, he tore it off and grumbled.

      "Bastards," he said.  "Miss one goddamn payment and this, this."

       I wanted to say "Merry Christmas," but given the circumstances it didn't seem appropriate.

Clearly, if they had reserves, they'd exhausted them.  Even  with Medicare you have deductibles, and along with the regular bills we all have to pay, it can be hard if not impossible to make ends meet when you're on a fixed income.  Add multiple doctors and prescriptions to the list and maybe that, mixed with poor judgement clouded by drugs, pushed them over the brink.  I can't say for sure, but I've known others who hit on hard times and lost their homes.  Never though, until Freddie and Neddy, have I witnessed the former owners actually whisked away.  But that's what happened.  Two paramedics, two deputies, and a woman in a pants suit who was probably a social worker came and took them.  Neddy must've known they were coming, because he was dressed in slacks and a short-sleeved shirt.  Freddie, however, was still in her nightgown and

slippers with Neddie's bathrobe draped over her shoulders.

      The house remained vacant for close to a year, and in that  time, when it seemed clear that they weren't coming back, I thought about the lounge chairs on their deck.  It would be nice to have them, so Paula and I could sit out on our deck and watch the sun set over the mountains in the distance.  Any day, I figured, the house and everything in it would go up for auction, so I rationalized that it wouldn't exactly be stealing if I grabbed them. 

     I last recalled seeing the chairs on the west side of the deck overlooking the mountains, and when I didn't find them there I thought that maybe thieves had beat me to it.  But when I walked around to where the deck was hidden by the forest, I spotted them, barely, peeking out from underneath bags and bags of garbage that Neddy had been unable to drag to the curb for the trash collectors.  The coyotes and raccoons had torn into them, scattering coffee grounds all over, plastic milk jugs and crumpled paper towels, old corn husks and shriveled up banana peels, the rib cage of a rotten chicken carcass, and some empty prescription bottles.  I picked up one and read the label. 

Vicodin.  Use as needed. 

     I picked up another and another.  Valium.  Use as needed.  Oxycodone.  Use as needed.  Halcion.  Use as needed.  Xanax.  Use as needed.  Several were prescribed by the same doctor, others by different ones.  I even found an empty for Fentanyl.  This one  is so powerful that it's often given to the terminally ill in their

last days.  I'm sure there were more little bottles in that garbage

but I didn't keep looking.

     What, I thought, does use as needed mean?

     Combined, or used separately in large doses, these drugs are potentially lethal, particularly for the elderly whose systems can't process them as well as a younger person.  What really gets me, though, is why so many doctors prescribe so many tranquilizers and pain killers when they know they're addicting.  Is it because the patient is always complaining of this or that and becomes a nuisance and it's easier to just give them what they want than correct the source of their pain or condition?  Or is there no fixing what ails them?  Do the doctors figure, well, they're old anyway, they'll die soon enough, what does it matter if they become addicts?   It's a small but important step that new laws have since gone into effect that keep an eye on doctors too quick to prescribe addictive medications.   

       Of course all the laws in the world aren't enough to solve  the opiate crisis in America, but one thing is for certain.  The problem is real and it's growing and it infects us all, from the homeless to the wealthy, every race and gender, and, very possibly, your sweet, elderly next door neighbors.

      So what happened to Freddie and Neddy? 

     I got a call about a year after they were evicted.  Their last name appeared on the tiny screen on the phone and I picked it





     "It's me.  Freddie."

     "How you doing?"

     "We're doing good," she said.  "I had to go the hospital for a while but I'm okay now.  We both are.  No more, well, you know.  Anyway, Neddy and I are living in a seniors apartment in Palm Springs and we wanted to give you our number.  Got a pen?"

     "Sure," I said.  "Shoot."

      But I didn't have a pen.  I knew I'd never call them, but I'm glad she called me.  I had worried about them, and I was heartened, as I am heartened now in writing this, from one recovering addict to another, that she and Neddy had reclaimed their precious last years together. 


(Note: This is a condensed version of "The Good Neighbors" from the memoir, Apology to the Young Addict.)





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