Gambling With Your Health

Last Editorial Review: 1/30/2005

Greater access to gambling can increase addiction.

WebMD Feature

For Patty, frequenting the slot machines at the Indian casino near her home in Southern California was initially an escape from day-to-day worries. It wasn't until she experienced a substantial win that her gambling spun out of control.

"I could pay off all my bills -- it was great!" she recalls. "Then I couldn't stop. Three and a half years later, my husband gave me one last chance before he kicked me out of the house. I blew it." She lost $100 earmarked for groceries, then tried unsuccessfully to step into oncoming traffic and kill herself.

Patty, who credits Gamblers Anonymous with saving her life, is just one recovering gambling addict in the U.S., where ordinary people are increasingly tempted to indulge in multiple forms of betting. Between 1974 and 1996 the percentage of pathological gamblers in the U.S. doubled; an estimated 1.4% of the population now meets the criteria for pathological gambling, according to the 1999 National Gambling Impact Study Commission Report.

Of course, high-stakes risk taking and an enterprising spirit have always been part of the national psychology. Even the Puritans advocated lotteries to finance public work projects in colonial-era America. But gambling images, once exotic, have now flooded mainstream America, from ubiquitous casino ads in Western states to round-the-clock gambling channels on cable TV. And now it?s easier than ever for adults to place bets. Simply log on to the Internet or use the electronic gambling devices in local fast-food and convenience stores.

There are disturbing signs that young people, too, are being targeted. Industry regulators and critics are concerned about new trends in slot-machine design, specifically the use of popular animated characters, including Betty Boop, the Addams Family, and the Pink Panther. For children six and over, Toys R Us even advertises a mini-slot machine on its web site.

When Gambling Spins Out of Control

What differentiates an occasional gambler from a problem gambler? Any significant increase in gambling or a preoccupation with gambling that takes time away from work and family life may indicate a serious problem. Gamblers Anonymous uses a series of 20 questions (see their web site link below) to help gamblers and their family members determine whether an individual's gambling activity has reached a point that clinicians would call pathological.

Eric Geffner, PhD, a certified California gambling counselor in Los Angeles, emphasizes that compulsive gambling is a medical disorder; the brains of pathological gamblers actually look different under a microscope than those of nongamblers. But unlike other addictions such as alcoholism, an addiction to gambling can be difficult to spot. "We call it a hidden disease," says Geffner. "Gamblers often do very well at work, until their financial setbacks start taking a toll on them and their families."

Gary Lange, PhD, of Palm Springs, Calif, a psychologist and state-certified gambling counselor, speculates that a combination of genetic predisposition, personality type, and environment create the blueprint for the addicted gambler. Also, living within 50 miles of a casino doubles the likelihood that an individual will develop a gambling disorder, he says. "In Palm Springs, there's an exploding problem among retirees who have not one, but five casinos within a 50-mile radius. Add loneliness, boredom, or chronic pain to the mix, and you have an explosion."

The Road to Recovery

Ten years ago, when Bruce R., a 57-year-old insurance broker from Southern California, was on the verge of suicide after having gambled away the trust of his family and three business partners, little help was available. He was advised by two doctors that he just needed to get his gambling "under control" -- which is like telling an alcoholic to drink more moderately. "One doctor even asked me for advice on his own betting scheme," Bruce recalls.

Now, Gamblers Anonymous organizations have sprung up nationwide as well as internationally, and counselors who specialize in treating gambling disorders are available in many states.

Larry Atwood, executive director of the South Dakota Council on Problem Gambling, feels that greater public awareness of the personal toll of pathological gambling will encourage more people to seek help before they reach rock bottom. "Once they come in or call, we advocate intense family involvement because of the disastrous financial implications. Credit counseling is a must, so they can avoid bankruptcy at all costs. This is directly related to the two things that pathological gamblers have to get over to start feeling better: guilt and shame."

But Tom Tucker, director of the California Council on Problem Gambling, stresses that there's a long road ahead. Far more gamblers might be identified, he says, if physicians administered a simple two-page gambling screening questionnaire to patients complaining of diffuse problems related to stress and anxiety. (The questionnaire can be ordered by calling the help line 1-800-GAMBLER.)

The good news, according to Geffner, is that once a pathological gambling disorder has been identified, it is highly treatable. The most successful treatment program is one that combines cognitive and behavioral modification therapy with a 12-step support group such as Gamblers Anonymous and some form of money management. "The goal is to get the patient back into family life, back into working out in the gym, developing alternative habits, and away from the activities that trigger the pathology," Geffner says. "As with any addiction, you have to take things one day at a time."

Indeed, with help from Gamblers Anonymous, Bruce R. was able to get back on his feet again. Due to his gambling debts, however, at age 57 he has no money saved for retirement. "All those years I wasted saying to myself, 'Once I know why I gamble, I'll stop.' It never happened," he says. But the GA support group helped him come to terms with his addiction. "You go to meetings and say, 'I need help,' then someone else says something that might apply. You realize you're not alone. Sometimes that's all it takes to start the process to recovery."

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