Still Here, Still Becoming

Recovery is possible. Recovery is possible.

Recovery is possible.

Recovery is possible.

Recovery is possible.

Recovery Dialogues and Sober Stories.

16 years old for his first sniff of cocaine. 19, and he's already working the number hole for Bumpy Johnson. Already got his own apartment. Already agreed to let bundles of heroin sit in that apartment for a few hundred dollars a week. Russell has a name for that whole stretch of his life. A velvet trap. 30 years later, he's out of it. This is what comes after. Welcome back to Recovery Dialogues and Sober Stories. I'm Antonio Matta, trauma-informed peer support counselor, and this is the show where lived experience and clinical insight sit down together instead of talking past each other. This country marks addiction and overdose the way it marks almost everything else: for a day, or if we're generous, a month. August 31st was International Overdose Awareness Day, 25 years old this year, with a theme that says the quiet part out loud: 25 years on, still no cure. Now we're into September, National Recovery Month, running since 1989, built this year around the idea that recovery is real and restores every part of a life, not just the part that stopped using. A day. A month. Both real. Both necessary. Both gone before most people notice they happened. Then there's the thing they're both pointing at, and it doesn't fit inside either one. 30 years. That's how long the man you're about to meet has been in recovery. Not a day, not a month. 3 full decades. Most of them lived before this country had a single day set aside to talk about any of it. His name is Russell. He's 80 years old. He grew up deep in Harlem street life, running cons, hustling, using cocaine. What actually shifted, and how, is something I'm going to let him tell you himself in just a minute. If you're counting days right now, 30 of them Or 300. I want you to hear that number, 30 years, as proof the door stays open a lot longer than anybody tells you. And if you are a family member or a clinician listening for someone else, older, further along, maybe already written off as too set in their ways to change, Stay close. Addiction and mental health recovery in older adults reaches beyond substances too. It reaches into gambling and other behavioral patterns that tend to surface hardest around retirement, when structure and purpose disappear all at once. It reaches into dual diagnosis, where substance use and depression, anxiety, or grief travel together far more often Then they get treated together. Between 7 and 38% of older adults with a psychiatric illness are also managing a substance use disorder. That's not a small population at the margins. That's a population the healthcare system still isn't built to see. According to CDC data, overdose deaths among adults 65 and older have quadrupled over the past 2 decades. And opioid overdose deaths in adults 55 and older rose by more than 1,800% between 1999 and 2019. A day and a month of attention against numbers that have been climbing for 20 years. That math doesn't add up, and it's worth sitting with why. So we brought in a clinical voice too, someone who works specifically where aging, substance use, and mental health meet. Their job today is to help make sense of what the research says and what treatment can look like when it's built for a person who's 70 or 80. Not the 25-year-old the system was originally designed around. Let's start with Russell. Our lived experience expert today is Russell. He's 80 years old, on an ever-evolving ascent upward as a hermeticist, and He's the oldest guest this show has ever had on. He grew up deep in Harlem street life, and for the last 30 years, he's been living something entirely different. Here's Russell. Nobody else can tell this part of the story the way you can. In your own words, what actually happened between the years you spent deep in cocaine and hustling on the streets of Harlem and the 30 years of recovery you're living now. Start wherever the story starts for you.

It started for me very young. I couldn't have been no more than 16 years old when I first had my first sniff. It didn't take off until I was approximately 19 years old. That's when I really started sniffing. The allure of the streets, The alpha males had such a presence. The lifestyle was so attractive. Big cars and fly clothes, and sniffing cocaine was a part of that, but there was no stigma attached to it then. It was a social drug. In fact, only the big-timers sniffed cocaine. So I'm saying that to say it was— I had the experience of working in the number hole for Bumpy Johnson, and I had my first apartment. When I was 19 years old, another hustler older than me came to me with a proposition and explained to me how there was a drug seller who needed a stash house, and he would pay the rent and give me a couple hundred dollars extra every week to keep his drugs in my apartment. So this is when my sniffing really started taking off. When I started sniffing heroin, I started taking a bag 'Cause it was 25 bags in a bundle back then. It was so many bundles that he wasn't gonna miss it. I would take a bag out of a bundle and I'd start sniffing. I was doing this for long enough to get a habit, but still, I was making money, so it didn't look like I was an addict. That term wasn't even used back then. It was called junkies, and I didn't even look like a junkie 'cause I was young, so it hadn't beat me up yet. So I continued on until I eventually started selling drugs myself. So I had hooked up with some people downtown and it was quarters scrambled. So I was raised in a neighborhood where some guys was from a junior high school on Pleasant Avenue. Pleasant Avenue was where the white boys, where the Italians went to school with Black guys. So they were a big connection. So my neighborhood had access to these guys. And so I became a fairly big connect myself because of this close proximity. My using now was matter-of-fact. I was driving pretty cars and dressing nicely and having lots of money. All the people around me was the same way. There was no stigma attached to using then, even though I was sniffing heroin and cocaine. I was respected in the community, a situation that wasn't conducive to stopping. Why would I stop? I'm getting high all the time. I look good. I'm respected. So this went on for years till some stuff started happening in the crowd I was in. People was getting killed all around me. There was an attempt to kidnap me. So I really was over my head. In this lifestyle, because I wasn't what we call a hard boy. I was a nerd, good hustling nerd born in Harlem. We have a saying, it's not what you know, it's who you know. So I knew everybody, but I wasn't all that gangster. So I got out of the dope game and got into the paper game with my best friend. And paper game was wonderful. Paper game is checks and credit cards. So we came up with a hustle that was brand new. It was so new that first time I got busted, the prosecutor couldn't even explain to the judge what I was accused of. And the judge got disgusted and told me to get out of his courtroom because he didn't have time for all this. I had a suit and tie on and I got a credit card. So I paid a $50 fine and left. I went right back into another bank. It was like a hustler's dream because you get everything with it. You get cash out of the bank, you could buy clothes, everything you think of, anything you can think of what you can do with money, you could do with a credit card. And this was early with credit cards, so they didn't have no safe Safeguards. And New York was the best place in the world for nonviolent crime because everybody in New York is a crook. The police is a crook. There's people in the stores is crooks. So I had people in stores I would go to and the security guard would stop me and say, yo, Russell, man, I want to talk. I said, yeah, well, what's happening? He said, man, my daughter getting married. I need to get something for her, for a wedding. But I'm sure this is security in the store now knowing I'm a crook. But this is New York City because there's no violence. So if you're not violent in New York City, you're welcome. So this went on for 6 years before it became a federal crime. I've been busted several times. The state was so easy to get around. We devised ways to do that. I had 5 or 6 warrants, but I never did no time until the feds got in. The feds got into it, and that's when the Secret Service busted me. I was like What the— the Secret Service? Don't y'all guard the president? They said, no, no. They said they found out there was some Black guys in Harlem. At first they thought it was small potatoes, but y'all was making a lot of money disrupting the economy, so it is a federal crime now. I was in the bullpen with John Gotti, and I'll never forget what John Gotti asked me, what am I in there for? I said, credit card fraud. He said to me, oh man, you all right. You ain't— they ain't gonna hurt you. He said, I'm facing life. That was his first case. He beat that. I got 4 months for that charge, and I was asked by my lawyer, did I want to go out on appeal bail? I said, yeah, I want to go out on appeal bail. Right. I can go out now? He said, yeah, I can appeal this. So I appealed a 4-month sentence. Then I got busted in another bank while I was out on appeal bond. Now, it's federal law, if you get busted out on appeal bond, You get no less than 2 and no more than 20 just for being busted on appeal bond. The new charge, I got a year. The old charge was 4 months. And being busted out on appeal bond was 2 years, but they forgot all that. I did 1 year in a co-ed penitentiary. So conducive to continue using. There's no reason to stop using. I went to a co-ed penitentiary because I was a level 1 prisoner, nonviolent. There was females in this It was a federal lockup. Got out of there, same— soon as I got out, the very day I got out, I'm in another bank. This went on for some years. I'm gonna leave this story right there because it starts to become like I'm glamorizing it. I'm not glamorizing it. I'm just trying to speak about it the way it happened.

You'll be the oldest guest this show has ever had on. What does it mean to you to be the one carrying that number into the room?

What does it mean being the oldest? Well, no way for me to compare. Just being as old as I am, period. I am so grateful, our Lord, that I got to be as old as I am. I'm 80 years old and I've been clean for 30 years. I started getting clean at around 50, at 50, and I'm so grateful. Something that I wanted all my life, and that's just to be responsible. Be a man. That's when I was a kid and looking at the guys that were respected in the neighborhood, the boys that wore sharp clothes, drove cars, they were men. The lifestyle they was in, they was a man. That's what I always wanted to be, just a man. I have been given a chance to grow up because you remember I started using at 19. I've heard it said more than once that the age that youth Emotionally, that's how old you are from that age. So if I stop using at 50 and I'm 80 now, so I'm 30 years old emotionally. That makes all the sense in the world to me now because I'm doing some other stuff where I have learned that our emotions is life lessons. And using means that I didn't want to feel because anytime you use, that's what you're doing. You don't want to feel. You want to change how you feel. I was not taking the lesson that life was giving. To be this old and to be healthy and have some clarity, some doors has been opened up because of the fact that I haven't used in 30 years. I got a job driving the school bus in Hamlet. I had 2 jobs, the first real jobs I ever had in my life at 50. I'm trying to answer your question the best way I can, and it is, how do I feel? I feel great. I'm learning from the system I study of Hermetic philosophy. I was given a new lease on life. It wasn't so much that I was given it, I took it myself. Because I often hear people say, oh, God's grace, God's grace. I said, no, no, no, I've learned. I just started availing myself of God's grace. That's the difference. There is the chance of getting more touch with what is in life, opposed to what I think it is or what I feel like it is. Not using. That's how they used to put it years ago when I was a kid. They said, you know that boy using? Everything was under the desk to the older people. Wonderful people with such dignity and wisdom who, at my stage in life when I started using when I was young, I didn't see their dignity. I'm trying to answer your question. I am so grateful. I'm grateful for NA, AA, all the 12-step programs. I'll get to that later on. I'm sure one of the questions will have referred to how I actually got clean. So I don't want to put it all into the question I'm being asked now. If you don't ask me, then I will tell you.

30 years is longer than many of our listeners have been alive. What does staying sober feel like now compared to year one?

First thing that comes They asked you a question, what it feels like now opposed to year 1. I'm no longer afraid. Fear is not what's motivating me to stay clean now. The first year I was terrified. I would have dreams of using and be really scared that I had started using again. That first year I had those dreams and I would be, I did it again. Then I would wake up and be so relieved. Fear is a great motivator in the beginning, but not now. You know, all I got is right now. It's always hard for me to— like, the way the question is asked, because where I'm at, it's not about then, it's about now. El Hall is about now. Anybody listening, it's about now. I love the fact that that's how life unfolds, in the now. You know, what happened 30 years ago, it happened 30 years ago, but now.

You ran cons. You learned to read people out of necessity. Is there anything from those years, a skill, an instinct, that you still use, just pointed somewhere else now?

The skills that I developed, do I use any of them skills now? Of course. Whatever preceded this moment, whatever the experiences that you have, reflects on how you live your life now. That question is Answer it by saying yes. And what are those skills? It's knowing that you're accountable for the choices you make. I'm trying to accept that there's consequences to the choices I make. Always consequences. There's a poem that I love by— it says, the moving finger, having wrote, moves on, and no mild apology or crying will change it. It means that what's happened already happened. So make good choices in the moment because you're going to have to account for them. It doesn't matter, man. The universe don't care. Okay, you grow up with a father and all that. Okay, all that may be true. You still got to account for your choices, man. So it's hard for me to answer some questions in a way that I deem would normally be answered because I'm coming from a different perspective. I'm coming from a man that, yes, there's some skills in hustling, skills working on the school bus, skills driving, and all those skills is used in the moment if a person is taking the lessons. Because when you're using, you're not taking your lessons. I wanted to share with young people, instant gratification, stay away from instant gratification. Discipline in life. who you hang out with. Say, if you tell me who you hang around, and I'll tell you who you are. So be mindful who you hang around. Choices you make at any time in life is always a consequence. It's called cause and effect. It's a universal law.

You've described a spiritual path running through all of this. Without naming names or organizations, What does spiritual growth look like on an ordinary Tuesday at 8?

What does spiritual growth look like to me at 8? Just being able to know what I want, what Russell wants, not what the environment dictated what I want, because that's mostly what's going on in Russell's life, what was instilled in him as the Toddler, grade school environment, the street environment, TV, movies, all telling Russell what to want. And so Russell had no clue what he actually wanted. He wasn't in touch with himself. So what the difference now is that I could sit down and honestly ask Russell, what do you really, really want? And it takes some sitting still. To get the answer, because thoughts just come, any number of thoughts. And to wait and feel, this is joy. It's a quiet joy. And not have to run after every thought that comes in Russell's head, which is not even his own thinking, but just thoughts coming to him. Just knowing that I don't have to look for peace and satisfaction and happiness Outside of myself, which is never going to happen anyway. I found everything I ever wanted is right inside Russell. That's the difference now. And it takes, takes more than just this happening. Like one day I became aware of this. No, not at all. It was being pointed in the right direction. I mentioned in the second question that was asked of me, I spoke of how I go to a school that has the— you're really looking at yourself, especially after using all them years. You have no clue of self. The spiritual difference now, I have no compunction about caring for other people. I would be not telling the truth that I don't care about what people think because I do, but I'm careful. to be mindful of is, well, not let what people think determine what I do. Because surely I care. I got family, daughters, grandchildren. I'm a great-grandfather. I got nephews, a big sister. Of course I care about what they think. I don't even know who's listening to this, but I care about what the people listening to this think. But the key is not to care about people thinking, which would have me do something, because what people think is none of my business anyway. So that's the answer to your question.

Does the fear of relapse ever fully leave, or does it just change size? What does it look like for you now, this far out?

I ain't even thinking about that. That guy, that you, he's gone. I look back now, me and some of my friends, there's some old cats too, We look back on ourselves then and that lifestyle then, it's like a whole different person. It's like, we really did that?

Yeah.

So am I afraid of using? No. What I'm afraid of is being afraid. That is what I'm coming to grips with. Because to live life afraid, I don't want to live life afraid. Fear is when it's not necessary, okay, sure. If there's some danger, but when there's no danger and I can feel fear, and I do, that's what concerns me. Not the actual using itself. That's easy. If you don't pick it up, you can't get out. That's so true. And I'm not about, well, how am I going to get out? I'm going to go out in the street and look for some drugs and buy some drugs. I'm going to get on the train and go down and get it. I ain't even thinking about nothing like that. So to answer that question, No, I ain't afraid. I ain't afraid of that.

Someone hears 30 years and thinks their own 30 days doesn't measure up. What would you say to them?

All that person with 30 days has, all I have with 30 years, is right now. That's the beauty of this life and the gift of the present. That's why it's called a present, because it's a present. You can't deal with the past because it don't exist. You can't deal with the future because it hasn't came. But what you can deal with is right now. That's the present. That's the gift. So that's what I would tell a person with 30 days. Just deal with right now. That's how I got 30 years clean. When I first was getting clean, I was trying to wiggle out of staying clean. I was with this 40-year-old friend of mine who was taking me to meetings, and I was still withdrawing because I'd been sniffing pure heroin for years. This is the first time I ever was detoxing from it, unless I was in jail, but not in the street. He was taking me to another meeting, and I said to him, man, I can't do this from now on, man. He paused, and there was a pause. Nice little interval of silence before he said, well, if you can't do it from now on, how about just for the day? And that rocked me. That rocked me. Stopped in my tracks because that made so much sense. Just do it for the day. Actually being clean for a year or more, when I started reading and studying, I realized life don't even unfold a day at a time, at a moment at a time. So I ain't got to stay clean for even a day. All I got to do is stay clean for right now. That's what I would tell the guy with 30 days. Be concerned with right now. Don't worry about all this that is not in your purview, your control, your future, because it don't exist. Just right now. And that Right now, understanding made this 30 years clean a walk in the park. That's how sweet it was. Me and my friends, we laugh about it now, man. That shit was a walk in the park, man. 30 years. I've never relapsed in the 30 years. How one of my best friends put it, a walk in the park, when I realized all I have to do is stay clean one time, just now.

One more thing before this next question. What Russell says here touches on something researchers have documented for years too. How seriously this country has taken a drug crisis has often tracked who it seemed to be hurting most. Here's Russell. International Overdose Awareness Day fell on August 31st this year, its 25th anniversary. Now we're in National Recovery Month. You were alive and using long before either of those existed. What do you make of a country finally setting aside time to talk about what you've been quietly living for 30 years?

Accepting of reality that there is an addiction, substance addiction problem in this country, in this world. The difference now is that White folks is being affected by it, or it has became a given that it ain't just people of color. In fact, there's more addiction in other cultures, other ethnic groups, white in particular, even though that's a false construct, the word white. But anyway, I'm going to use it here. They serious about it. They getting very serious about it. That's a good thing. That's how I see it. It's a good thing. Yeah, it's a good thing.

If someone found one line you'd written 50 years from now, what would you want it to say?

And this is not original, not by any means, but it would be, know thyself.

What Russell just described didn't happen in a day, and it isn't finishing on any calendar schedule either. It's still happening, 30 years in, which is exactly the timeline our research almost never studies. Close to 2% of Medicare enrollees over 65 meet the diagnostic criteria for a substance use disorder, and about half of that same group takes 4 or more prescription medications every day. Real medical need and real risk sitting on top of each other. For years, most studies never follow anyone long enough to see. This is where a clinical perspective matters. What does current research actually say about a brain's ability to keep healing 30 years into recovery? Not just the first year. Why does dual diagnosis in older adults go undiagnosed so often? And what does treatment look like when it's built around a person managing arthritis and grief and a medication list, not just a substance? Our clinical expert today is Dr. Sylvie Stacey, an addiction medicine physician who spent more than a decade treating patients across nearly every setting recovery happens in, from residential programs to correctional facilities. She's dually board certified in addiction medicine and preventive medicine, and she currently serves as medical officer for rehab.com. Her focus reaches past alcohol and opioids into cannabis dependence and behavioral addictions too, which matters for exactly the conversation ahead. She spent her career watching what honest, tailored treatment can actually do for someone. Ahem, here's Dr. Stacey. Picture the patient nobody screens for. Walk me through why substance use disorder in older adults gets missed by families, by primary care, even by behavioral health systems built for younger patients.

Doctors, family members, caregivers, we all have blind spots. Family members can sometimes overlook the signs of a substance use disorder because older adults often don't have the typical social or occupational indicators of an addiction that are generally associated with younger people. They're often retired, they drive less, many are living alone. So interpersonal or legal consequences aren't as common or as obvious in them. Families and even clinicians also sometimes write off warning signs like cognitive issues or falls or sleep disturbances, they write them off as natural consequences of aging. In some situations, family members actually kind of enable a substance use by viewing alcohol or drugs as their loved ones' like one last pleasure in life. And because older adults tend to have more medical issues that need to be treated, doctors might not screen for substance use disorders. because they simply don't feel like they have the time during a clinic visit, or they're subconsciously fearful that a positive screen will result in yet another problem that needs to be evaluated and managed in that patient.

Overdose deaths in adults 65 and older have quadrupled over the past 2 decades, and opioid overdose deaths in adults 55 and older rose by more than 1,800% between 1999 and 2019. Why do you think public attention still points almost entirely at younger people?

Addictions where they're most prominent, and that has historically been among younger people. Because younger people have traditionally shown higher rates of illicit drug use, there's this sense that substance abuse somehow has an age limit. But there's also ageism at play. We're often quick to dismiss an older adult's mental or physical issues as they're getting old as just features of old age. We don't always investigate them to the extent that they'd be investigated in younger people, or sometimes they don't get investigated at all. Plus, older adults more often misuse legal prescribed medications. Like pain relievers and anxiety pills rather than solely illegal drugs like cocaine or fentanyl. And they will often use drugs or abuse prescriptions by themselves at home rather than at parties or in the office or with a group of friends. Also, in medicine, our diagnostic frameworks and the clinical tools that we use were mostly validated entirely on younger cohorts of people. So the criteria and assessment tools that we're used to using might miss signs and symptoms that are more likely to appear in older people, and they might overemphasize the presentations of younger people who have substance use disorders.

Depression and alcohol use show up together in older adults more than almost any other pairing. What does integrated treatment for that combination actually look like? Versus treating one and hoping the other follows.

When we treat depression and alcohol misuse as separate problems, like sending a patient to a therapist for their mood and then to a rehab program for their drinking, we're basically asking that patient to navigate 2 pretty complex health systems. And that takes a lot of time, a lot of energy, and a lot of money. It's more doctors and clinicians that they need to talk to and more opinions about how they should be treated. It's a lot and it can be frustrating for them. True integrated treatment does basically the opposite of that. It treats both conditions at the exact same time by the same clinical team in a single setting. So it might mean offering treatment for an addiction in a regular primary care office or ensuring that an addiction treatment program or a specialty practice is also treating co-occurring mental health conditions rather than just referring patients to a psychiatrist or telling them to go see their primary care for depression or other issues.

Gambling and other behavioral addictions tend to spike around retirement. How does an intake process catch that when almost nobody walks in saying, I think I have a gambling problem?

Since people don't usually come into a doctor's office specifically to talk about a gambling problem, an effective intake has to look past that label of addiction and focus more on lifestyle shifts of retirement and/or older age for these older adult patients. We need to ask questions and hopefully in a way that's more conversational than confrontational, Ask questions about how they're filling their time in retirement or whether they're lonely, et cetera. Easy, quick screening questionnaires can be really helpful too. We just don't want them to be long and cumbersome, which can seem intrusive and off-putting to the patient. housing instability in an older patient who was previously quite stable. That kind of thing can quickly devastate a retiree who's living on a fixed income.

What does current research actually say about the brain's ability to keep healing 30 years into recovery? Not just the first year, the 30th.

So, this is That's a really tough for me to answer because the clinical literature operates on a much shorter timeline. Most studies have very short follow-up periods compared to 30 years. Oftentimes we're looking at weeks or months for follow-up periods in clinical studies, not even years. What the research does tell us is that central nervous system adaptations like restoring neurotransmitter function, restoring normal sleep patterns, and changes to brain mass, they typically take months of abstinence from a substance. When it comes to more severe deficits, the research shows that alcohol-induced dementia, for example, can resolve over months of sobriety with documented cognitive improvements continuing to take place for a few years after cessation. So does the brain keep healing in year number 30? I'm going to say probably not, or it very minimally, but that's not because the brain has given up or doesn't have the ability to heal anymore. It's more likely that just all of the healing of, of damage specifically due to a prior addiction has already taken place. Certainly, we can continue to grow as humans 30 years later. We can learn from past experiences. We can gain coping skills for issues related to our past traumas. But as time goes on, those things become more and more separated from the addiction itself.

Older adults are often managing 4 or more prescriptions a day for entirely legitimate reasons. Where's the line between necessary medication and a new risk for misuse or accidental overdose?

So the line is thin in general and even thinner for older patients. But in older adults, they're very rarely looking to get high off of a substance. They're more likely trying to get through the night or manage their pain or deal with grief or pass the time. So in that sense, there's less risk of misuse than in some cohorts of younger patients. But we do need to be concerned about the body's physiologic changes as it ages. We lose muscle, gain fat, our kidney and liver function might slow down. We've had more time to potentially accumulate various chronic diseases that take a toll, like COPD, or diabetes. So a dose of a sedating medication like a benzodiazepine or an opioid that might have been safe in a person 10 or 20 years ago could potentially have significant side effects or even toxic effects in older age. And as an added layer, those toxic effects might not even manifest as the classic signs of intoxication that we're used to seeing in younger patients. It might be more subtle, like more frequent falls or a subtle slowing of the cognition.

Does long-term recovery mean something clinically different at year 30 than it does at year 3? Or is the work the same, just quieter?

We know addiction is a chronic, progressive, and often relapsing disorder. Many people relapse. And they do so on various timelines. Having a permanent remission requires ongoing vigilance and really actively maintaining that abstinence. There's no simple cure for any addiction that ensures you'll never have any cravings or urges or triggers down the road. At year 3, I'm often still managing patients with medication and encouraging them to keep attending therapy. and stay active in support groups. At year 30, though, I'm more likely to focus more heavily on making sure that they have a good support network and making sure they sustain those coping skills that they've already learned and practiced for years.

Widowhood, retirement, friends passing— loss stacks up differently for older adults. How much of late-life relapse risk is really grief that never got a name.

I'd say grief is an important piece, but it's really just one thing that kind of shifts or intensifies as people age. Older people are often dealing with grief, but they're also likely to be dealing with a loss of their daily routine when they retire, perhaps a loss of professional identity. They're dealing with a change in their social network. They might have a partial loss of independence. They might have a newfound boredom or be experiencing social isolation or just struggling to find a new purpose in life. And at the same time, their physical health is declining, which might be accompanied by chronic pain, which can lead to self-medicating with alcohol or to abusing prescription medications. So relapse risk later in life is intensified by all sorts of risk factors kind of coming together at a similar point in time.

When you hear about a guest like the one on this episode, 80 years old, sober exactly 30 years, what does that tell you clinically that the research alone can't?

One thing that sticks out to me is the recovery identity, if you will, that many people in recovery have. Outside of my work, when I tell people that I'm an addiction medicine specialist, it's pretty common for them to briefly mention that they or a loved one or a friend is in long-term recovery from an addiction. So they'll say like, oh, I've been in recovery for 20 years, or my dad is 37 years sober this year. And they're excited to tell me that when they learn that I work in the field of addiction medicine. And even though the actual problematic substance use that they're telling me about was years and years ago, and the tangible problems that it caused, like relationship issues or job loss or financial struggle, that was also years and years ago. But being in recovery is still a very important part of their identity. And I think this demonstrates that the skills people learn related to coping and resilience, those aren't temporary skills. They become deeply ingrained and they help us adapt moving forward and they help us survive the future challenges that life throws at us.

Thank you, Russell, for your story and being here, and Dr. Stacey, for your time and insight. Today's conversation asks something specific of you. Whether you're 4 days sober, 4 years sober, or watching someone you love struggle at 70. If there's an older adult in your life you've quietly worried about, a parent, a grandparent, a neighbor, don't assume the moment has passed. Don't assume they're too far gone or too set in their ways to change. Say something. One honest conversation without judgment attached to it opens doors that lectures never do. And if you're the one who just heard a list of symptoms and recognized yourself in it, at any age, The SAMHSA National Helpline is free, confidential, and answers every day of the year at 1-800-662-4357. You don't need a plan before you call. You need one true sentence said out loud. Let's bring this back before we close. Today we covered 3 things. First, that overdose and substance use disorder in older adults are rising faster than almost anyone realizes, and the reason is visibility, not vulnerability. Second, that recovery, whether from a substance or behavior like gambling, does not come with an age cutoff, and dual diagnosis is common, treatable, and too often missed. Third, that the specific healing tied to an addiction has its own timeline. Most of it finished years before year 30, but the growth that comes after, the coping, the identity, The life actually built, that part never stops. A day of awareness and a month of observance are how this country remembers to look. 30 years is how somebody actually lives it. If today gave you a word, a number, or a moment of recognition, the most generous thing you can do costs nothing. Share this episode. Follow the show. Leave a rating wherever you're listening. For an independent show like this one, that single action does more than most people realize. Recovery Dialogues and Sober Stories run. Runs almost entirely on people like you. If you're able to give, you'll find the show's GoFundMe at gofundme.com/recoverydialogues, and every dollar goes back into keeping these conversations honest, accessible, and free. If you're part of an organization, a treatment center, or practice whose mission. feels aligned with this one, reach out. I'd welcome the conversation about sponsoring an episode or a season. If you're a clinician or a leader inside a treatment organization and something in this conversation is making you think about how your own team talks about what you do, that's also work I do outside this mic, helping behavioral health organizations put their clinical voice into words people actually understand. You can also support the show through merch with meaning at recoverydialogues.com. Hoodies, tees, joggers, mugs, even plush companions, each one carrying an original design built around the show's recovery mantra. Every piece is a small, wearable reminder that somebody, somewhere, made it through. Wherever you are tonight, whatever number you're counting, a day comes once a year, and a month comes once a year, but you get another one of these tonight. Another day to add to whatever number you're building. That's the whole point of 30 years. It's just today, repeated, longer than anyone thought you would. I'm Antonio Matta. Recovery is possible. Let's prove it, one story at a time.

Recovery is possible.

Recovery is possible.

Recovery is possible.

Recovery is possible. Recovery is possible.

Recovery Dialogues and Sober Stories.