1. GAMBLING PROBLEMS WHAT YOU NEED TO KNOW

2. INTRODUCTION TO GAMBLING DISORDERS: Gambling is defined as risking something of value, usually money, on the outcome of an event decided at least partially by chance. It can include such things as:  Lottery tickets  Bingo games  Blackjack at a casino  A Friday night poker game  The office sports pool  Gambling web sites  Horse and dog racing  Slot machines  Etc.

3. GAMBLING BY THE NUMBERS:  More than 75% of Americans ages 18 and older have gambled at least once (www.samhsa.gov) and many people view gambling as a harmless form of entertainment.www.samhsa.gov  Estimates from national surveys show that about 0.5% of Americans (1.5 million) have had a gambling use disorder sometime in their lives. Problem gambling is even more common and may affect 2 to 4 times as many Americans as gambling use disorders.  Gambling often co-occurs with substance use disorders and other behavioral health concerns. The National Epidemiologic Survey on Alcohol and Related Conditions of people diagnosed with “pathological gambling” estimates that 73.2% had an alcohol use disorder, 60.4% had nicotine dependence, and 49.6% had a mood disorder.  Only about 10% of people with a gambling problem seek treatment for the problem. When they do seek help for gambling, financial pressures are often the main reason, not a desire to abstain from gambling.

4. REASONS INDIVIDUALS MAY CHOOSE TO GAMBLE:  Some people who gamble are “action gamblers” who seek stimulation. These individuals tend to favor forms of gambling that have some skill or knowledge involved.  Some people gamble as a form of relief or escape from stress or negative emotions. They tend to prefer games of chance (e.g., bingo, lottery, slot machines).  Some people choose gambling to be more social, or to overcome shyness or isolation.  Some people choose gambling as an attempt to solve money problems.

5. LOW-RISK GAMBLING GUIDELINES: Making choices about gambling based on low-risk guidelines can help to prevent a future gambling problem. These low-risk guidelines can also be used as a basis for talking to someone whose gambling concerns you.

6. THE DECISION TO GAMBLE IS A PERSONAL CHOICE: No one should feel pressured to gamble. Many people will choose to gamble socially, for a limited period of time and with predetermined limits for losses. Others will simply have no desire to gamble. Some people with a family history of gambling problems or other addictions may choose not to risk gambling at all.

7. GAMBLING IS NOT ESSENTIAL FOR HAVING A GOOD TIME: The real value of social activities is being with friends and taking time out from the pressures of daily living. Gambling should not be seen as necessary for having fun and being with friends.

8. WHAT CONSTITUTES AN ACCEPTABLE LOSS NEEDS TO BE ESTABLISHED BEFORE STARTING TO GAMBLE: People need to expect that they will lose more often than they will win. The odds are always against winning. Any money spent on gambling needs to be considered the cost of entertainment. Money that is needed for basics such as food, clothing, shelter, education or child care should not be used for gambling. For those who choose to gamble, it is essential to know when to stop.

9. BORROWING MONEY TO GAMBLE SHOULD BE AVOIDED AND DISCOURAGED: Borrowing money from a friend or relative, writing bad checks, pawning personal possessions, taking out loans, or borrowing from any other source of funds with the intention of repaying with gambling winnings is always high-risk.

10. THERE ARE TIMES WHEN PEOPLE SHOULD NOT GAMBLE:  When under the legal gambling age  When the gambling interferes with one’s work or family responsibilities  When in recovery from compulsive/pathological gambling. And for many, when in recovery from chemical dependency or other addictions.  When in the early stages of recovery from other addictions such as chemical dependency.  When the form of gambling is illegal  When the gambling is prohibited by an organizational or employer policy  When trying to make up for a gambling loss or series of losses (chasing)

11. HIGH-RISK SITUATIONS DURING WHICH GAMBLING SHOULD BE AVOIDED:  When feeling lonely, angry, depressed or under stress  When coping with the death or loss of a loved one  When trying to solve any personal or family problems  When trying to impress others  When under the influence of alcohol or other drugs

12. WHO IS LIKELY TO DEVELOP A GAMBLING PROBLEM: Anyone can develop a gambling problem; however, men are more likely than women to have gambling problems. Other higher risk groups include adolescents and young adults, being a member of an ethnic minority, having low income and low- socioeconomic status, being unmarried, and having a high school education or less.

13. SIGNS OF PROBLEM GAMBLING: Common signs of problem gambling include:  Gambling longer than you intended  Betting “over your head” and then “chasing” losses  Lying to family or others about how much you are gambling  Missing work or family commitments because of gambling  Being distracted from other aspects of your life by time spent thinking about gambling As gambling problems grow, feelings of guilt, shame and depression can increase.

14. HOW DO I KNOW IF I HAVE A GAMBLING PROBLEM? Assessing a potential gambling problem can begin with answering two questions:  1. Have you ever felt the need to bet more and more money?  2. Have you ever had to lie to people important to you about how much you have gambled? - The Lie/Bet Screening Instrument A “yes” response to either of the questions noted above warrants further investigation into a potential problem with gambling.

15. POSSIBLE TREATMENT STRATEGIES:  Cognitive-Behavioral Therapy/Dialectical Behavioral Therapy: CBT and DBT focus on developing skills to assist with modifying negative or self-defeating thoughts and behaviors, including recognizing positive and negative consequences of gambling, reinforcement of non- gambling behaviors, and learning how to identify and avoid risky situations that can trigger or cue feelings or thoughts that can lead to relapse (MATRIX program).  Motivational Interviewing/Motivational Enhancement: MI seeks to help the individual address his/her ambivalence toward behavior change. Researchers have reported that even very brief motivational interventions have helped people with gambling problems.  Gambler’s Anonymous: GA is a 12-step recovery program patterned after Alcoholics Anonymous.

16. TOOLS FOR FAMILY MEMBERS OF PROBLEM GAMBLERS:  Start by helping yourself. You have a right to protect yourself emotionally and financially. Don’t blame yourself for the gambler’s problems. You can encourage your loved one to get help without losing yourself in the process.  Don’t go it alone. It can feel overwhelming when you are coping with someone else’s gambling. Reaching out for support will make you realize that many families have struggled with this problem. You might also consider therapy to help sort out the complicated feelings that can arise from coping with a problem gambler.  Set boundaries in managing money. You may have to consider taking over the family finances. However, this does not mean you are responsible for micromanaging the problem gambler’s impulses to gamble. Your responsibility is to ensure that your own finances and credit are not at risk.  Consider how you will handle requests for money. Problem gamblers may ask for money either directly or indirectly. They may use pleading, manipulation or even threats and blaming to get it. It takes time and practice to learn how to respond to these requests to ensure you are not enabling the problem gambler and are keeping your own dignity intact.