PowerPoint Additional Information Due to time and space constraints, the following slides were omitted from the webinar PowerPoint and have been included here for your information. DMHAS Problem Gambling Services 2009

Gambling’s Place in History “One of the few social activities that occurs in nearly all cultures and every period of time…” George Caleb Bingham, “Raftsman Playing Cards”, 1847Miners playing poker and shooting craps down by the river bank. Clover Gap Mine, Harlan County, Kentucky, 1946

Socially Acceptable Gambling as Revenue Source A first class lottery ticket for the Jeffersonville Canal Company, an enterprise established by the Indiana legislature in 1818 for the purpose of building a canal at the Falls of the Ohio. (Library of Congress), Shelby College, KY Lottery, 1864, (Duke Digital Scriptorium)

The Role of Money Americans spend more $ on gambling (over $600 billion/yr) than on food ($400 billion/yr). AP, 3/04 27% to 47% of gambling industry revenue comes from problem gamblers. DMHAS PGS 2005

More About Money Average current debt of CT Helpline callers: $34,000 ($63,000 for SE CT callers, 2003 ). CCPG, 2006 CT leads US in embezzlements. CTGS, 6/09

More About Money, con’t State of CT made over $715 million from legalized gambling revenues in DSR, 2008 State $ allocated for prevention, treatment, and research on PG: $0. Budget for treatment/prevention of problem gambling as legislated from CT Lottery funds: $1.7 million DMHAS PGS 2007 State budget to advertise the CT Lottery: $10 million Hartford Courant August 2008

Prevalence of Problem Gambling One out of twenty CT citizens will develop a gambling problem at some point in their lives. Each problem gambler impacts eight other people. Range: Problem to Pathological Adult lifetime rate of problem & pathological gambling combined: 6% DMHAS PGS 2003

Populations at risk for developing a gambling problem include: Youth: underage & college students, college athletes Recent phenom: Scholar-athletes Women Substance abuse & mental health clients Older adults who gamble Internet users Athletes Cultures of luck/numbers People who gamble People who live within 50 miles of a casino (The rate of PG doubles within 50 miles of a casino, NGISC, 1999 )

Top Gambling Activities Causing Problems for PG Helpline Callers Slot Machines: 54% (Males: 31%, Females: 77%) Lottery scratch-off tickets: 34% Blackjack*: 26% (Males: 30%, Females: 21%) Lottery-Lotto: 16% Lottery-Powerball: 16% * At casinoCCPG, 2007

Youth Gambling: Then and Now A group of Newsies playing craps in the jail alley at 10 P.M. Albany, N.Y., (National Archives) A group of boys play a game of poker Sunday, Oct 23, 2005, at Erdmann's home in Fargo, N.D. The high schoolers often play poker with their parents approval. (AP Photo/The Forum, Britta Trygstad)

Youth/Underage Problem Gambling PG rates for youth range from 11% to 13.2%, more than double adult rates. (Study of CT High Schools,1998 & CT Youth Gambling Rpt, 2008) Youth who gamble have higher rates of depression, anxiety, crime and delinquency; are more likely to participate in alcohol and other drug use; have lower self esteem, poorer coping skills. (Shaffer, et al, 1999)

“The earlier people begin gambling, the more likely they are to experience problems from gambling.” National Academy of Sciences, 2001

Gambling and PG among CT High School Students More high school students have gambled for money at some time (87%) than have used alcohol & other drugs (67%). 32% of students under the age of 18 have purchased lottery tickets. 18% of high school problem gamblers report a current or past problem with alcohol (compared to 5.3% of non-problem gamblers). Students who gamble excessively are more likely to abuse substances and vice versa. A history of problem gambling and/or substance abuse among family members is significantly related to problem gambling among students. CCPG, 1998

Gambling & PG among CT H.S. Students, con’t. Key Findings from Youth Gambling in CT, % Gambled in past year. 81% Played cards w/friends for money. 60% Bet w/friends. 42% Received instant lottery tickets as gifts. 66% of all students began gambling between % began gambling at age 11 or younger. 33% of students classified as pp/pg reported starting gambling at age 8 or younger. 11.8% of all students have worry/concern over the gambling of a close family member.

Youth and Online Gambling 87% of youth (12-17) are internet users In US 88% of teens (12-18) play video games Gentile, 2009 In spite of illegal status 300,000 young adults (14-21) gamble on line weekly and 700,000 at least monthly Annenburg, 2008 Pathological video gaming Gentile, 2009 –8% pathological play –Pathological gamers 2X as likely to be diagnosed with attention problems.

Internet/Electronic Gambling More potential for addiction than other types of gambling due to: Easily accessible, 24/7; Speed of play; Images, lights and sound rapidly condition the brain; Using debit or credit cards; Anonymity of play.

Does your school sponsor or support any gambling events throughout the year? 40% “yes” 29% “I don’t know” 31% “no” From Youth Gambling in CT Report 2008

Cerebellum Neurological maturation starts at the back of the brain, and moves to the front Prefrontal Cortex Judgment is last to develop ! Nucleus Accumbens Amygdala Physical Coordination Emotion Motivation Judgment

“The adolescent brain has an accelerator that is more developed than the brakes.” Dr. Ken Winters, National Conference on Law Higher Education, February 2008 “Adolescence is a time-limited disorder.” Howard Shaffer, Harvard Institute of Addictions, 1999

Adolescents may be prone to make decisions that: Are more impulsive; Focus on and overestimate short-term payoffs and underplay longer-term consequences; Fail to consider alternative courses of action; Reflect a high degree of risk; and Are vulnerable to peer pressure.

The Pruning Process: “Use it or loose it” “If a teen is doing music, or sports, or academics, those are the cells and connections that will be hardwired. If they are lying on the couch, or playing video games, or watching MTV, those are the cells and connections that are going to survive.” Dr. Jay Giedd, NIMH, 2000

Family History Plays a Role Problem gamblers report growing up in a family with: Alcohol abuse:38% Gambling problem:30% Drug Abuse:26% Abusive behavior:25% These rates far surpass the national average CCPG, 2006

Parental Influence Parents have critical impact on a child’s gambling.Parents have critical impact on a child’s gambling. Parent modeling and engagement in gambling with teens increases likelihood of teen gamblingParent modeling and engagement in gambling with teens increases likelihood of teen gambling duBay Horton, 2008

DSM-IV Criteria for Pathological Gambling Preoccupation with gambling. Needs to gamble more to get the same level of excitement. Repeated unsuccessful efforts to stop. Restlessness/irritability when attempting to cut down. Gambles as a way to escape problems or relieve other stresses (depression, guilt, anxiety, etc.).

DSM-IV Criteria con’t. After losing $ gambling, goes back to get even (“chasing one’s losses”). Lies to conceal extent of gambling. Has committed illegal acts to finance gambling (bad checks, stealing, forgery, embezzlement). Has jeopardized or lost significant relationship/job/education due to gambling. Reliance on others to provide money to relieve financial situation caused by gambling.

Why Integrating Problem Gambling Prevention in Education on Addictions Helps Identify PGs Now on “radar screen”. Awareness creates the opportunity to “have the discussion”. Information provides tools for assessment, referral, treatment. Caution: make note of school gambling policies (or lack thereof).

Holistic TX Model for Young Problem Gamblers Multi-faceted approach. Individual Therapy. Group: age-appropriate, psycho-ed. Essential Parental Involvement. Abstinence vs. Harm Reduction. Move along Stages of Change. Use of Motivational Interviewing, Motivational Enhancement Therapy, et al, to increase Protective Factors. G.A. ill-equipped for young people.

Youth Gambling Report Conclusions Growing body of scientific evidence that PG is an emerging societal issue requiring significant attention/response from families, schools, communities, state government & gambling industry. Form Youth Gambling Task Force empowered to advance Report recommendations.

Key Recommendations of Youth Gambling Report Increase gambling education at home & in schools. Develop and/or enforce school gambling policies. Reduce youth access to gambling sites, products & activities. Identify, refer, & treat youth problem gamblers. Conduct ongoing data collection & analysis on youth gambling. Embed gambling prevention in other state prevention policies, plans, programs.

Highlights from the 2009 CT Gambling Impact Study Although the State once contributed 78% of all casino $ to the 169 towns, this allocation has dropped to 21%. Influx of non-English speaking immigrants to casino jobs has had dramatic impact on housing and school systems in area; number of languages spoken in Norwich schools, for example, has increased from 3 to 30; ESOL $ demands drain resources from other academic programs. Towns surrounding the two casinos report DUI arrests have more than doubled since GICAESI, 2009 DMHAS Problem Gambling Services 2009

Links to the Full Reports Connecticut Youth Gambling Report Gambling in Connecticut: Analyzing the Economic and Social Impacts spectrum_final_final_report_to_the_state_ of_connecticut.pdf DMHAS Problem Gambling Services 2009

Additional factors to keep in mind Legal and illegal gambling opportunities are everywhere, and widely advertised/promoted. Casino visits now “rites of passage”. Most underage teens are introduced to gambling by a parent or adult close to them. Gambling can be a way to deal with pain, depression, or other problems involving low self- esteem, school, work, family, friends, and peer pressure. PG is easy to hide (often loved ones suspect “something is wrong”). Treatment can be successful---working with youth “a work in progress”.