A 2018 study from the National Institutes of Health suggests that casino workers may be twice as likely to develop gambling problems as those in the general populace. Studies before and since indicate the risk may be even higher—for example, an Australian report found that problem gambling rates among casino staff were 9.6 times higher than that in the general population.
Do casino workers gamble more because they’re closer to the action? Or do they choose casino careers because they already have a propensity for problem gambling? The answers may be as numerous as the people in the industry.
The ‘Whys’ of Gambling Disorder
“There’s lots of research that shows multiple reasons why casino workers tend to be at greater risk for gambling disorder than others,” said Kobie West, certified counselor at the Dr. Robert Hunter International Center for Problem Gambling (PGC) in Las Vegas. Among those reasons is the stress of shift work, which can isolate people from their social networks and family members. Gambling can also serve as a distraction from unpleasant feelings, like anxiety and depression.
And research from the University of Kentucky Center for Health Services confirms that casino workers are at special risk because of the unique stressors of the job such as “role conflict,” in which they encourage gambling and simultaneously screen for signs of problem gambling.
According to PGC Executive Director Stephanie Goodman, the problem was exacerbated by Covid-19, which sparked feelings of unease and anxiety in much of the population. “People who had been in recovery for five, 10, 20 years were all of a sudden having these little urges, and they were worried about it,” said Goodman.
While causation matters, a more practical question may be how casino workers can manage their condition—without changing careers.
It’s all about support, said West—the fellowship with others who have the same challenges, coupled with cognitive behavioral and mindfulness modalities. PGC offers a six-week intensive outpatient program: three-hours a day, four days a week, as well as a relapse prevention program and a program for family and “concerned others.”
“When they complete the (introductory) program, we don’t just throw them out,” added West. “You’re not just ‘cured’ because you completed our program. This is a lifelong chronic illness.” Alumni services include aftercare, ongoing meetings and one-on-one counseling sessions.
For casino workers who have a gambling problem, “It’s just a different type of recovery,” West added. “We came up with a specific relapse prevention program just for people who work in the industry. The program’s relatively new. It’s been less than a year, but the feedback has been wonderful.”
Early numbers suggest that following an initial intensive outpatient program, workers who “stay engaged in the relapse prevention” maintained a 91 percent abstinence rate after six months. “That’s about 45 percent higher than any other model out there.”
A Complex Disorder
Ted Hartwell, a recovering chronic gambler currently serving on the Nevada Council for Problem Gambling, estimates he lost $250,000 during his gambling years. “But people with a gambling problem are notorious at underestimating—both the amount of money they’ve lost and the amount of time they’ve spent,” he added. “I suspect that I’m no different.”
Hartwell was introduced to gambling by his father, a Texas Tech music professor who liked to take his kids to the racetrack. By age 10, Hartwell could read a racing form and place his own bets. As a teen, he was part of a weekly poker game with his dad’s friends. The compulsion grew, and as an adult, he risked his family and financial solvency in order to gamble. He finally made his last bet on September 14, 2007. Hartwell said he used gambling in part as a coping mechanism—the same reason some people ingest drugs or alcohol.
“The biochemistry of gambling disorder is nearly identical to substance use disorders, even though there’s no substance being ingested,” Hartwell observed. “So it’s not surprising that gambling is used for the same reasons, to deal with physical or emotional pain or avoid problems in one’s life. Just like people use substances to self-medicate.”
He pointed out that as many as 70 percent of people with a gambling addiction problem also have at least one co-occurring substance use disorder, making the search for sobriety even more complex.
“I can’t reach in and physically change the hard-wiring in my brain,” said Hartwell, “but I know my mind responds differently than most people’s to this activity. So teach me how to change my behaviors and thinking around this issue. Teach me how to deal with urges when they come, because even for people who are tremendously committed, we often experience strong urges or relapses before we get completely on the path.”
Above all, he added, don’t pile on the shame and blame. “There is a biological basis for this disorder. We would never stigmatize someone with cancer or heart disease or diabetes. We need to change the way we talk about this, especially during the largest expansion of legalized gambling in the history of this country.”
West agrees. “It’s not a personal weakness, it’s not a character flaw,” he said. “You didn’t wake up one morning and choose to be a problem gambler, choose to lose all your money and destroy your relationships and your marriage. This is a true disease, a complex disease, and a symptom of a greater problem.”
The stigma around the so-called “degenerate gambler” is “the No. 1 thing that causes people to avoid treatment,” West said. “They believe something’s wrong with them, that they have a character defect. And that’s why awareness is so important.
“If you look at the brain in an fMRI, you’ll see that whether someone is addicted to alcohol, heroin, or gambling, their brain lights up exactly the same way.” Gambling disorder “is characterized as a DSM-5 addiction. They keep playing, but they’re losing how come they can’t just stop. Right. And so that mentality, 92 percent of people just saying, well, why can’t they just stop leads? A large portion of the population doesn’t believe problem gambling is addiction, because you’re not necessarily putting something in your body like alcohol or drugs. So how could you possibly become addicted to it?”
Managing the Disorder
Addiction to any substance or behavior is often a way to distract from depression, boredom or other unwelcome emotions, West said. One key to sobriety is to understand the underlying factors that may propel a compulsive behavior. One of the first thing West may ask a gambler is, “Why did you gamble? What did you get out of it?”
“Say someone says, ‘Well, I was stressed and it gave me the ability to kind of just quiet my mind.’ That person needs to learn how to deal with stress, or they’re not going to stop gambling. When a client hears that, they shift their mindset away from the gambling itself and more about how they can live healthier and deal with stress better.
“Because if they deal with stress better, if they communicate better, if they deal with their anger better, they may not even want to gamble. So it’s really just shifting that mindset.”
He added that relapse typically begins “long before the bet. We help the client identify when they’re in stages of relapse—in the thinking phase, which can begin like a snowball rolling down the hill. So halfway down the hill, if they can identify the stage of relapse before they make the bet, that’s what prevention is all about. They can say, ‘I’m angry, I’m lonely, let me stop and consider what my tendency is at this moment.’”
In the absence of one-on-one counseling, West urges people to take advantage of Gamblers Anonymous meetings, which happen “pretty much 24 hours a day, all over the city on Zoom.”
Another management strategy that may work is to compartmentalize—to separate the task at hand (i.e., work) from ruminations about gambling.
Not that it’s easy, and the road to recovery seldom follows a straight line.
Like other addictions, this one doesn’t discriminate. The center’s clients have included dealers and buffet workers, pit bosses and casino executives. “All of them meet up at the same spot,” said West. “They’re all just one bet away from relapse, in that they find the fellowship and the will to not gamble anymore.”
According to the website CasinoCareers.com, when Mickey Brown was president of Foxwoods Casino in the 1990s, he urged staffers not to “become one of the people you’ve seen across the table.” Brown, who later became CEO of Seneca Gaming, estimated that 5 percent to 10 percent of Foxwoods employees “gambled more than they probably should … more than just recreationally.”