1. New Trends in Gambling Research Christine Reilly Institute for Research on Pathological Gambling and Related Disorders Division on Addictions Cambridge Health Alliance, affiliate of Harvard Medical School This presentation will probably involve audience discussion, which will create action items. Use PowerPoint to keep track of these action items during your presentation In Slide Show, click on the right mouse button Select “Meeting Minder” Select the “Action Items” tab Type in action items as they come up Click OK to dismiss this box This will automatically create an Action Item slide at the end of your presentation with your points entered.

2. Explosion of Knowledge 1/3 of all knowledge about gambling published 1999-2003 1/3 of all knowledge about gambling published 1999-2003 Much of what we know has been learned only in the past few years Much of what we know has been learned only in the past few years Findings have challenged conventional wisdom Findings have challenged conventional wisdom

3. Research Trends Population Studies Population Studies –Trajectory dynamic, not static –Transition to adulthood –Natural recovery –Similarity of international prevalence rates Genetics Genetics Drug Treatments Drug Treatments

4. Trajectory of gambling disorders Conventional wisdom –G–G–G–Gambling addiction chronic, progressive Research indicates –D–D–D–Dynamic –E–E–E–Episodic rather than chronic –M–M–M–Moving toward health

5. From adolescence to adulthood Longitudinal study by Winters, Stinchfield, Botzet, & Slutske (2005) Gambling problem progression during adolescence dynamic No evidence of automatic progression to most disordered state No evidence that increased gambling in Minnesota triggered increase in PG among youth Demonstrates importance of longitudinal studies

6. Natural Recovery Conventional wisdom –P–P–P–People with gambling addiction need treatment or self-help groups to recover New Research – University of Missouri (Slutske, 2006) –F–F–F–First empirical evidence for natural recovery –A–A–A–Analysis of 2 national community surveys –A–A–A–Approximately 1/3 got well on their own –S–S–S–Similar to other addictive disorders

7. International Prevalence Rates

8. Role of Genetics Conventional wisdom –C–C–C–Clinicians have suspected genetic link Research now provides evidence for genetic role –U–U–U–University of Iowa study (funded by NCRG) –N–N–N–National Institutes of Health

9. Treatment No treatment standard yet No treatment standard yet Promising strategies: Promising strategies: –Pharmacological interventions –Cognitive Behavioral Therapy –Brief interventions

10. Drug Treatments Nalmefene study released in 2006 –U–U–U–Used for alcohol disorders –L–L–L–Largest randomized pharmacotherapy trial for PG –N–N–N–Nalmefene effective for reducing PG symptoms –P–P–P–Published in American Journal of Psychiatry (Grant, JE, et al., 2006)

11. Implications for Gaming Regulations Understanding of PG shifting constantly It’s not about the game Responsible gaming policies should be based on empirical not anecdotal evidence Prevalence does not = treatment-seeking Educational materials must be updated periodically –E–E–E–EMERGE: Executive, Management and Employee Responsible Gaming Education Evaluation of prevention and intervention programs essential

12. How to keep up with research Subscribe to the BASIS Subscribe to the BASIS –Monthly research report on gambling research – The WAGER Contact the Institute (781-306-8604); christine_reilly@hms.harvard.edu Contact the Institute (781-306-8604); christine_reilly@hms.harvard.edu christine_reilly@hms.harvard.edu Attend Annual NCRG Conference on Gambling and Addiction Attend Annual NCRG Conference on Gambling and Addiction

13. 7th Annual NCRG Conference on Gambling & Addiction Lost in Translation? The Challenge of Turning Good Research into Best Practices November 12-14, 2006 Las Vegas