Why are so many over-50s dying from cocaine poisoning? The Office for National Statistics revealed that older people continue to register the highest rates of drug misuse mortality. The Telegraph explores drug harms for the middle-aged.
The Telegraph writes on:
‘Like putting a supercharger onto a Ford Anglia’: What drugs do to your body in middle-age
As reports show highest rates of deaths after drug misuse among older people, experts take a look at the health risks
There were 1,118 deaths involving cocaine registered in 2023, according to the Office of National Statistics.
Its recent report revealed that older people continue to register the highest rates of drug misuse mortality. According to the ONS, there were 1,118 deaths involving cocaine registered in 2023, which was 30.5% higher than the previous year and nearly 10 times higher than in 2011.
“I actually think those figures are an underestimate,” says Dr Niall Campbell, a Priory consultant psychiatrist specialising in addictions. “When people die from drug-related causes, it’s often not recorded.”
Campbell is quick to point out that far from being the preserve of urban professionals, this phenomenon occurs throughout the UK.
The dangers of common drugs
- Cocaine is by far the most serious source of concern when it comes to accidental death, but the other drugs that are commonly misused in the UK (according to the most recent ONS statistics) can also damage your health.
- Used chronically, ecstasy (MDMA) depletes your serotonin levels, which can lead to depression, anxiety and lethargy.
- Despite the growing numbers of people microdosing psilocybin as a treatment for depression, so-called “magic” mushrooms have been known to bring on panic attacks and can also exacerbate existing mental health problems.
- Regular use of cannabis, especially when smoked together with tobacco, has been linked to chronic respiratory conditions, depression, impaired memory, motor skills and cardiovascular function – and its negative effects increase as the user gets older.
- The dangers of excessive ketamine use, meanwhile, are well-documented, with chronic users risking bladder damage, cognitive impairment and personality change. But the over-50s have not embraced it as a drug of choice.
Aside from its toxicity, there are two other factors that make cocaine more of an immediate cause for concern than any of these drugs. Firstly, accessibility: it is the second-most used drug in the UK after cannabis; it’s easily available, and its relative cost has gone down over the past decade.
Secondly, cocaine is frequently – and incorrectly – perceived to be less harmful than it is.
Why are so many over-50s dying from cocaine poisoning?
The ONS reported in 2019 that the reason Generation X cohort are dying in greater numbers by suicide or drug poisoning is partly because “during the 1980s and ’90s more people started using hard drugs habitually”.
“These people still feel young at heart,” says Campbell. “They think they can still do what they used to do in the old days. Unfortunately, they can’t. Even if they’re aware of the health risk – say for example another person in their group has previously had an episode – they choose to ignore it.”
In essence, a certain group, now in their fifties, have either continued to take drugs since their twenties or now occasionally dabble “for old time’s sake”.
But the body of a 55-year-old is very different to that of a 25-year-old. The stakes become much higher because of the increased vulnerability of ageing bodies to the physiological and cognitive effects of cocaine.
“The typical scenario is a group of men in their fifties who say, ‘Come on, lads, let’s go to Ibiza and party like we did in 1999,’” says Campbell. “The trouble is, their bodies can’t take it, and they end up facing severe cardiac problems, or even death. As you get older, every time you take cocaine you’re playing Russian Roulette.”
The critical factor, he adds, is the cardiac toxicity of cocaine: “Cocaine gives you a massive release of dopamine from your limbic system into your brain, and it also speeds up your heart rate. That may be survivable if you’re 20 or 30, but as you get older, your heart isn’t as robust as it was. For them, doing a line of cocaine is like putting a supercharger onto a Ford Anglia.”
How does taking cocaine affect your brain and body – and how does this change as you get older?
Older adults are more susceptible to the effects of drugs and alcohol, because as the body ages, it cannot metabolise these substances as easily as it once did.
The short-term physical effects of using cocaine include constricted blood vessels, increased heart rate and high blood pressure. These factors can dramatically increase the risk of having a heart attack.
“What we commonly see when we’re called to A&E is arrhythmias, which are irregularities of heart rhythm,” says Dr Farhan Shahid, a consultant interventional cardiologist at The Harborne Hospital, part of HCA Healthcare UK.
“What happens when you take cocaine is that you’re stimulating the body’s flight and fight response, and the heart responds appropriately by speeding up. In the older population you’re often dealing with a patient who has other underlying medical problems – which makes treating them a lot less straightforward. They may be on blood pressure tablets, for example, or they might have had a stroke in the past.”
Long-term cocaine use brings with it a whole suite of potential health problems. It can increase an individual’s chances of suffering an aneurysm, because constricting the blood vessels over a long period may reduce the amount of oxygen the brain receives. It can raise the risk of strokes and lead to impaired cognitive function. And it can also cause damage to kidneys and liver, especially when used – as it almost invariably is – in tandem with excessive amounts of alcohol.
Shahid confirms that he frequently treats patients who display the chronic effects of taking cocaine: “It might, for example, be a 56-year-old who has high blood pressure as a background, regardless of the misuse. Taking cocaine on top of that will send their blood pressure off the chart, so to speak.
Over time, they become resistant to medication, and they may require admission into hospital and intravenous medication to bring their blood pressure down.
Cocaine causes a compromise in the demand and supply of the heart muscle: it causes a constriction of the arteries and a state where the blood is thicker and has a greater predisposition to clot.
It’s also worth noting that chronic cocaine use is linked with mental health issues like anxiety, panic attacks and psychosis. Even a one-off line at a party can cause an individual to behave erratically and recklessly, leading to accident and injury.
“Cocaine-induced paranoid states get worse as you get older,” says Campbell. “I had a patient who got together with friends to relive old times. They went away for the weekend, took cocaine, and as a result, he had a huge depressive crisis. He went back to the hotel and attempted suicide. Fortunately, he didn’t succeed.”
How to counteract the damage of cocaine
“The simple answer is – stop,” says Campbell. “If you’ve taken cocaine and you’ve experienced palpitations, for example, that’s a serious red flag. A user needs to get themselves checked out. If you’re worried, talk to your doctor and be honest about it. Your GP can perform an ECG and arrange a full cardio workup.”
Anyone concerned should also take encouragement from the fact that it’s never too late to take a positive step. “With the right treatment and the cessation of the misuse, you can reverse the effects of cocaine misuse,” says Shahid. “Cocaine drives up blood pressure, so if you stop the cocaine use, you can reduce that blood pressure change, and – with the correct medications in the background – bring it down to safe levels.”
Of course, not everyone can afford to seek treatment at Priory, but as a first port of call, Campbell advises contacting Cocaine Anonymous, which he says is “free and widespread, and staffed by people who really know what they’re talking about”.
“This phenomenon is certainly a matter for concern,” he says on a final note, “and it’s on the increase, as the generation comes through that were partying in 1999. Could it get worse? I think it will, because people are reluctant to seek help. Unfortunately, they have no idea how much of a risk they’re taking.”
Help is available if you are worried about alcohol or drug use. It it’s time to talk visit talktofrank.com/help
Treatment services available include Alcoholics Anonymous, Cocaine Anonymous, Narcotics Anonymous and SMART Recovery UK.
For families and friends Al Anon and Families Anonymous can offer extra support.
