Problem Gambling: The Hidden Addiction 2.27.07 problem gambling: the hidden addiction Presented By: Gulf Shores High School Peer Helpers ‘Know the Rules of the Game’ Julie Hynes, Lane County H&HS

Problem Gambling: The Hidden Addiction 2.27.07 Gambling To risk money or something of value on the outcome of an unpredictable event or contest. Gambling - is UNPREDICTABLE. For example - you flip a coin and 20 timed in a row it comes up heads. Julie Hynes, Lane County H&HS

Problem Gambling: The Hidden Addiction 2.27.07 Trends Greater Access + Greater Acceptance = More Gamblers Many “A’s” for concern: Availability: more types of gambling than ever Access: video poker: 763 bars, taverns & delis; online gambling everywhere Acceptability: social; “benign” form of entertainment, perception of harmlessness “victimless” habit (More accepted than ever among adults & peers; viewed as “cool” , now considered a rite of passage) Advertising: media hype, tv shows, commercials, etc. Attractiveness: types of gambling more attractive than ever (video games, 1st generation to use video games; branded slots, etc.) Adrenaline: Loma Linda University researcher Durand Jacobs: “Young males seek excitement from pervasive boredom. Gambling is like an upper drug, such as cocaine. It produces abnormal arousal levels.” Neuron study: gambling affects the brain in the same way as cocaine. Areas of the brain stimulated by anticipation & experience of gambling are similar to those stimulated by euphoria-inducing drugs. Why people gamble: Money 42.7% Enjoyment/Fun 23.0% Social Reasons 11.2% Excitement 7.3% Winning 3.9% Source: Neighbors, Lostustter, Cronce, & Larimer, 2002) Julie Hynes, Lane County H&HS

Cell Phone Gambling: Next Wave? Problem Gambling: The Hidden Addiction 2.27.07 Cell Phone Gambling: Next Wave? Cell phone gambling is still getting off the ground but, thanks to its convenience and a receptive 20 to 35 year-old age bracket, the sector is primed for growth. Global revenues from cell phone based casino games will grow at an accelerated pace through 2008, expanding by nearly 50% from 2006 to 2007, and will likely total over $2.2 billion by 2010 (more than five times the revenues generated in 2004). Cell phone users in the UK who were surveyed regarding the appeal of cell phone gambling overwhelmingly cited convenience as a benefit (70%), with smaller numbers saying that it was less intimidating and allowed for more discretion. Julie Hynes, Lane County H&HS

“so what?” stats & effects

Gambling behavior which causes disruptions in any major area of life. problem gambling Gambling behavior which causes disruptions in any major area of life.

pathological gambling More serious form of problem gambling; loss of control; often called “gambling addiction”.

Problem Gambling: The Hidden Addiction 2.27.07 Video Gambling = Crack?? Video poker/slots 7 in 10 Mississippi problem gambling treatment clients say video poker is their game of choice Internet Click & Play Lottery games 15 months – 4x as fast as horse/dog betting ‘Crack cocaine’ of gambling... Julie Hynes, Lane County H&HS

Problem Gambling: The Hidden Addiction 2.27.07 College: Quick Facts 50.4%: Male college students who gamble on cards at least once a month Female college students who gamble on cards at least once a month Internet gambling revenue in 2001 Internet gambling revenue in 2006 (even after new anti-Internet gambling law passed) 26.6%: $3.1 billion: $15 billion: Julie Hynes, Lane County H&HS

Most Common Effects of Problem Gambling Problem Gambling: The Hidden Addiction 2.27.07 Most Common Effects of Problem Gambling Debt Crime Depression/Suicide Relationship problems Employment problems Concurrent alcohol and/or drug problems 1 in 10 attempted 1 in 4 1 in 7 Behavioral, psychological, physical A correlation between gambling and all forms of substance abuse exists. Gamblers are more likely to… Lose their jobs, be demoted Fall deeply into debt and file for bankruptcy Lose their homes and personal property Accumulate legal fees due to divorce, criminal activities Run up medical, mental health bills Well-demonstrated relationship of problem gambling with other risky behaviors Excessive alcohol use & binge drinking Regular tobacco use Illicit drug use Overeating/binge eating Source: Engwall & Steinberg, 2003; Ladouceur, Dube, &^ Bujold, 1994; Lesieur, et al., 1991 1 in 3 alcohol problems 1 in 10 drug problems Julie Hynes, Lane County H&HS

Economic/Financial Impact Problem Gambling: The Hidden Addiction 2.27.07 Economic/Financial Impact By one estimate, the social-economic cost for each pathological gambler is in excess of $11,000 and over $3,000 for each sub-clinical pathological gambler. If those figures generalized to Mississippi then the annualized socioeconomic costs of problem gambling to Mississippi approximates $449 million. Julie Hynes, Lane County H&HS 11

“how do you tell?” signs & diagnosis of the problem

Pathological Gambling: DSM-IV Diagnostic Criteria Problem Gambling: The Hidden Addiction 2.27.07 Pathological Gambling: DSM-IV Diagnostic Criteria Preoccupation with gambling Increases amount of money gambled Unsuccessfully tries to quit Restless or irritable when trying to cut down/stop Gambles as an escape “Chases” losses Lies to others to conceal gambling Has committed illegal acts Has jeopardized relationships Relies on others to bail him/her out Other impulse control disorders: Kleptomania Compulsive sexual behavior Compulsive buying Pyromania Compulsive Internet use Trichotillomania Pathological Gambling is defined in DSM-IV as an “Impulse Control Disorder” Julie Hynes, Lane County H&HS

Problem Gambling: The Hidden Addiction 2.27.07 discussion Given all the characteristics of problem gambling we’ve shared, how would you identify “responsible” gambling? Try to come up with 5 signs. Loss of control - Repeated attempts to stop/cut back fail Denial - Not always a conscious act Progressive - between first-time use and addiction Chasing - throwing good money after bad Blackouts - not too common, but called “going on tilt” Escape - think valium Use of rituals - ever seen a serious bingo player? Similar highs - speaking physiologically Hidden - quite easy to hide from friends and family Overdose - can’t do it in the conventional sense Financial - Average debt called into the OR hotline is 20 - 40 thousand dollars Work - can function at work, usually can gamble in short bursts Tests - no UA for gambling Resources - more than 13,000 in U.S. providing substance abuse tx… Perception - where alcoholism was about 40 years ago. Just stop! Gambling questions added to a student survey in of Connecticut St. Univ. students in 2000 (n=1,348) Problem & pathological gamblers compared with social gamblers had significantly: Greater tobacco, alcohol, and marijuana use Greater binge drinking Greater number of negative outcomes from drug and alcohol use Greater binge eating and efforts at weight control Julie Hynes, Lane County H&HS

the addiction connection

Problem Gambling & Alcohol Abuse Problem Gambling: The Hidden Addiction 2.27.07 Problem Gambling & Alcohol Abuse Problem drinkers are 23 times more likely to have a gambling problem than persons without an alcohol problem Problem gamblers had 7 times the rate of alcohol dependence than nongamblers and low-risk gamblers (Welte J, Barnes G, Wieczorek W, Tidwell, MC, Parker J. (2001). A 1999 study revealed that almost one in every three persons with a gambling problem also abused alcohol--compared to about one in ten without gambling problems (Pasternak & Fleming, 1999) The same study showed almost twice as many problem gambler used tobacco compared with those without gambling problems; another study also showed strong associations (Crockford & el-Guebaly, 1998) 1.       Pasternak, A.V., Fleming M.F. (1999). Prevalence of gambling disorders in a primary care setting [Electronic version]. Archives of Family Medicine, 8, 515-520. Available online: http://archfami.ama-assn.org/issues/v8n6/ffull/foc8086.html   Crockford, D.N. and el-Guebaly, N. (1998, February). Psychiatric comorbidity in pathological gambling: A Critical Review. Canadian Journal of Psychiatry, 43, 43-50. Julie Hynes, Lane County H&HS

Problem Gambling & Substance Abuse Problem Gambling: The Hidden Addiction 2.27.07 Problem Gambling & Substance Abuse Between 25-65% PGs report substance abuse at some point 9-16% of those with substance abuse issues also found to be PGs (Welte J, Barnes G, Wieczorek W, Tidwell, MC, Parker J. (2001). A 1999 study revealed that almost one in every three persons with a gambling problem also abused alcohol--compared to about one in ten without gambling problems (Pasternak & Fleming, 1999) The same study showed almost twice as many problem gambler used tobacco compared with those without gambling problems; another study also showed strong associations (Crockford & el-Guebaly, 1998) Shaffer: Road less traveled 1.       Pasternak, A.V., Fleming M.F. (1999). Prevalence of gambling disorders in a primary care setting [Electronic version]. Archives of Family Medicine, 8, 515-520. Available online: http://archfami.ama-assn.org/issues/v8n6/ffull/foc8086.html   Crockford, D.N. and el-Guebaly, N. (1998, February). Psychiatric comorbidity in pathological gambling: A Critical Review. Canadian Journal of Psychiatry, 43, 43-50. Julie Hynes, Lane County H&HS

Problem Gambling & Mental Health: Mood Disorders Problem Gambling: The Hidden Addiction 2.27.07 Problem Gambling & Mental Health: Mood Disorders A major depressive disorder: likely to occur in 76 percent of pathologic gamblers Higher suicide rates 6% of problem gamblers made suicide attempt within six months prior to entering treatment , with recurrent depressive episodes likely to occur in 28 percent of pathologic gamblers Julie Hynes, Lane County H&HS

“ADDICTION” CONNECTION: Gambling & Substances Problem Gambling: The Hidden Addiction 2.27.07 “ADDICTION” CONNECTION: Gambling & Substances DIFFERENCES SIMILARITIES Loss of control Denial Depression & mood swings Progressive First win (high) remembered Use as an escape Preoccupation Similar “highs” Hidden addiction Can’t overdose-no “saturation point” Can’t be tested Doesn’t require ingestion Fewer resources available Societal perceptions Loss of control - Repeated attempts to stop/cut back fail Denial - Not always a conscious act Progressive - between first-time use and addiction Chasing - throwing good money after bad Blackouts - not too common, but called “going on tilt” Escape - think valium Use of rituals - ever seen a serious bingo player? Similar highs - speaking physiologically Hidden - quite easy to hide from friends and family Overdose - can’t do it in the conventional sense Financial - Average debt called into the OR hotline is 20 - 40 thousand dollars Work - can function at work, usually can gamble in short bursts Tests - no UA for gambling Resources - more than 13,000 in U.S. providing substance abuse tx… Perception - where alcoholism was about 40 years ago. Just stop! Gambling questions added to a student survey in of Connecticut St. Univ. students in 2000 (n=1,348) Problem & pathological gamblers compared with social gamblers had significantly: Greater tobacco, alcohol, and marijuana use Greater binge drinking Greater number of negative outcomes from drug and alcohol use Greater binge eating and efforts at weight control Julie Hynes, Lane County H&HS

Playing the Cards Right: addressing the issue

Problem Gambling: The Hidden Addiction 2.27.07 Helpful Links www.friends4friends.ca (Responsible Gambling Council -- good link for students) www.npgaw.org (Problem Gambling Awareness Week – good for you; further tools) Julie Hynes, Lane County H&HS

Problem Gambling: The Hidden Addiction 2.27.07 Who’s in Treatment? Mississippi Gambling Treatment Clients: Males 47% | Females 52% Average age: 45 years Average household income: $36,495 Race/Ethnicity: White 87% Marital status: Married 36% - Divorced 25% Average gambling-related debt: $23,331 Julie Hynes, Lane County H&HS