1. Problem Gambling: The Hidden Addiction J oanna Franklin MS NCGC II Maryland Center of Excellence on Problem Gambling University Of Maryland School of Medicine Jfranklin.ipg@gmail.com www.mdproblemgambling.com HELPLINE 1-800-522-4700 Funded by: Md. DHMH/ADAA

2. Problem Gambling: Just the Facts Gambling is older than alcohol. Before prehistoric people learned about rotten grapes turning into “joy juice” they were gambling. Gambling has historically been the way we communicated with the gods- a way to divine the future. The Bible has several references to gambling. Tossing of lots were how decisions were made. Roman soldiers gambled at the foot of the cross for Christ’s robe. Maryland Center of Excellence on Problem Gambling

3. Problem Gambling: Just the Facts Gambling games have been found in the ancient pyramids; the oldest game found is a stone game from Africa still played today. Dice were found in the ruins at Pompeii- loaded dice were found in Pompeii. The fathers of our nation used public lotteries to finance the building of institutions like Harvard and Yale, churches and hospitals. Maryland Center of Excellence on Problem Gambling

4. Problem Gambling: Just the Facts The US is going through the third wave of gambling now. The first was in colonial days when a lottery funded public projects. Cheating at such drawings ended the legality of the early lottery - they were all banned. Then pre-Civil War we see the Wild West, gambling halls, and riverboat gamblers plying their trade. More cheating and this, too, was banned. – About 11 gamblers who refused to stop gambling were hung in Vicksburg, Mississippi. Maryland Center of Excellence on Problem Gambling

5. Problem Gambling: Just the Facts The third, or current wave, began in the late 1930s in a desert town called Las Vegas. What makes the third wave different and likely “here to stay” is the strict regulation of gambling games today. States want/need the $. Cheating, though possible, is very difficult. Horse racing, lotteries, casinos, and the stock market are very strictly regulated, and those who play legally can be assured of a “fair game.” Today the gambling industry is part of corporate America. Maryland Center of Excellence on Problem Gambling

6. Problem Gambling: Just the Facts About 75-86% of all adults in the US gamble at one time or another. 90% of Maryland adults are gambling 2010 Prev. Study DHMH Legal gambling in the US is over a $90 billion dollar/year profit-making industry. (AGA 2008) Gambling is legal in all states but Hawaii and Utah. Gambling goes on in Hawaii and Utah via the stock market, internet gambling, cruise ship casinos, and with illegal gambling such as sports betting. At least 43 states have lotteries, six states have river boats, and 28 states have casino gambling. Maryland Center of Excellence on Problem Gambling

7. Problem Gambling: Just the Facts The Indian Gaming Act of 1988 now allows tribal casino gambling in 28 states, instead of what used to be limited to Nevada and New Jersey. According to the NGISC* people that live within 50 miles of a casino are at higher risk for developing a gambling problem. *National Gambling Impact Study Commission, 1999. State-funded gambling treatment is available in about 32 states. –APGSA ‘06 Maryland Center of Excellence on Problem Gambling

8. Problem Gambling: Terms Then and Now Problem Gambling- Problem Gambling- is a descriptive term used to define those individuals with problems in their lives due to gambling. Pathological Gambling- Pathological Gambling- is the clinical term for the Impulse Control Disorder defined in the DSM IV. (312.31) Gambling Disorder- Gambling Disorder- Is a new term in DSM V, under Behavioral Addictions with Substance Use Disorders Prevalence- Prevalence- estimates indicate that about 1-3% of the adult population of the US has a serious gambling problem. This may be 3-5 million people. An additional 3% are at risk for developing a serious gambling problem. Maryland Center of Excellence on Problem Gambling

9. Maryland Prevalence Study: 2010 Average amounts spent on gambling in Md. Per month spend Gambles 1x/yr. $45.79 “ 1x/mo $148.00 “ 1x/weekly $548.97 Adult Pathological Gamblers: 1.5% Adult Problem Gamblers: 1.9% Total Problem and Pathological: 3.4% or 150,000 adults in Md. Maryland Center of Excellence on Problem Gambling

10. Maryland Prevalence Study: 2010 Funded by DHMH/ADAA 89.7- or about 90% of Maryland adults have gambled in lifetime In past 12 mos. 21.9% play monthly 15.3% play weekly Preferred Gambling: Casino 67.5% Lottery 67.5% Sports 32.9% Priv. games 30.2% Horses 29.5% Maryland Center of Excellence on Problem Gambling

11. Problem Gambling: Criteria DSM V Researchers agree that enough has been learned about the biogenetics, brain scans, neurobiology, and pharmacotherapy responses, to support the move from “Impulse Control Disorder” to the “Addiction” family of disorders as they will be described in the DSM V. “Gambling Use Disorder” will be listed with Substance Use Disorders etc. Maryland Center of Excellence on Problem Gambling

12. Problem Gambling: Just the Facts Often compared to addictions- pathological gambling effects young and old, male and female, all cultures, faiths and economic groups alike. More common among males than females, it seems women are catching up to males in states with machine gambling, slots, VLT’s, poker machines etc. (Volberg ’99, ’03, Petry ‘05) The disorder seems to be more common among adolescents (at least double adult prevalence rates). (Volberg, Deverensky, Shaffer. Petry) Maryland Center of Excellence on Problem Gambling

13. In Maryland 2009 Recent and ongoing research by Silvia Martens MD of Johns Hopkins University indicates Baltimore City Youth experience an 11% prevalence rate for serious gambling problems. Teens nationally have a prevalence rate 2-3x’s higher than that of adults. Maryland Center of Excellence on Problem Gambling

14. Co-occurring disorders and cross addictions are high among pathological gamblers presenting for care. Affect disorders: depressions, anxiety and bipolar disorder are concerns. Substance Abuse Disorders seem unusually common to the problem gambling population. Suicide attempt rates have been reported as alarmingly high. Maryland Center of Excellence on Problem Gambling

15. Problem Gambling: High Risk Groups Growing numbers of gambling problems among: Adolescents Older Adults Women People of Color Lower Income populations Those with lower educations ( high school or less than high school) (Volberg 2000) Maryland Center of Excellence on Problem Gambling

16. Problem Gambling: Hiding the Facts Public Awareness messages, Prevention messages and Program Evaluation are areas still being developed in the problem gambling field. Though recognized by the NFL, NCAA, MLB, the Gaming Industry, Several Unions and large Businesses, the US has no coordinated or federally funded comprehensive leadership in addressing problem gambling. Maryland Center of Excellence on Problem Gambling

17. Problem Gambling: Hiding the Facts Without insurance parity gamblers with jobs and insurance are still refused coverage under their mental health benefits. Without federal protections gamblers with security clearances, licenses, bonds etc. stay quiet about a disorder that would cost them their jobs if acknowledged. Professional and college athletes stay quiet for fear of losing their careers. The secret stays hidden, services under utilized, and lives, careers, families, finances disrupted or lost. Maryland Center of Excellence on Problem Gambling

18. Problem Gambling: Funding in Maryland $425 per machine/yr. goes into the problem gambling fund. Legislation has ordered the state to provide: 1. A prevalence study prior to casino opening –completed 2010. 2. Treatment for problem gamblers and their families. 3. Helpline services for problem gamblers – 800-522-4700. www.MdProblemGambling.com 4. Public awareness programs 5. Prevention programs Maryland Center of Excellence on Problem Gambling

19. RESOURCES Md. Problem Gambling Helpline 800-522-4700 www.mdproblemgambling.com Joanna Franklin Jfranklin.ipg@gmail.com Evonne Gershon 410-328-4710 Egershon@psych.umaryland.eduEgershon@psych.umaryland.edu Gamblers Anonymous and GamAnon www.gamblersanonymous.org The National Council on Problem Gambling www.ncpgambling.org National Problem Gambling Awareness Week www.npgaw.org Assoc. of Prob. Gambling Serv. Admin. www.apgsa.org McGill University: www.youthgambling.com Maryland Center of Excellence on Problem Gambling