At the Dr. Robert Hunter International Problem Gambling Center (PGC), the largest treatment center in Nevada, we believe responsible gaming is an important part of gaming education. The casino industry provides responsible gambling tools aimed at helping gamblers avoid gambling-related harms, including self-limiting wagering. In turn, there is an expectation for gamblers to behave responsibly. Here at PGC, we see on a daily basis the devastation experienced by the approximate 6 percent to 8 percent of our population who have a problem gambling. So the question is: how can the gaming industry help individuals who are not capable of gambling responsibly?
Problem gambling is often called the “secret addiction” because most gamblers can hide the scope of their devastation from friends until it is too late. Problem gambling includes all gambling behavior patterns that compromise, disrupt, or damage personal, family, or vocational pursuits. The negative consequences of problem gambling include lying, cheating, stealing and the individual’s psychological well-being. Research shows gambling addicts have a lower measured quality of life with a marked increase in depression and anxiety. That depression accounted for 46 percent of patients seeking treatment for problem gambling reporting current suicidal ideation.
The societal cost of problem gambling can be compared to other addictive public health issues such as smoking or alcoholism. However, it is grossly under-diagnosed, with some studies showing that as low as 1 percent of problem gamblers seek treatment. Researchers concluded that the low participation rate could be attributed to denial, minimization of the need for treatment, limited treatment options, and the stigma of having an addiction.
Some occupations have been linked to increased gambling addiction. For example, casino workers are three times more likely to become problem gamblers than non-casino workers but less likely to seek treatment. The most common reason given for not seeking treatment for casino workers is retaliation or fear of losing their job. At our center, casino workers make up about 25 percent of our clients.
Problem gambling is the first behavioral addiction recognized in the DSM-5 under Substance-Related and Addictive Disorders. Previously it was classified as an impulse control disorder. However, it was learned that patients who struggle with impulse control disorders such as pyromania or kleptomania are overwhelmed by their impulses and only get a sense of relief after acting on their urges. Problem gamblers find gambling pleasant and only feel distressed after losing or after they stop, which is more in line with substance abuse. Therefore, the American Psychiatric Association concluded that the pathogenic mechanisms behind gambling were more aligned with substance abuse disorders than impulse control.
It is not known why some people are more susceptible to addiction than others. The American Society of Addiction Medicine notes that addiction is a multifactorial process involving genetics, complex interactions among brain circuits, the environment, and individual life experiences. However, it is believed that heritability and genetics account for 40 percent – 60 percent of individual variability in developing an addiction. At our center, 52 percent of the clients report a problem gambler in their family.
When treatment for problem gambling is sought, it can effectively reduce gambling symptoms. Current research confirmed that the higher number of treatment sessions a problem gambler attended, the more long-term success the client benefited from treatment. Positive outcomes are directly related to the number of group treatment sessions. Our center uses effective, evidence-based cognitive-behavioral therapy to reduce problem gambling symptoms. With an increase in accessible gambling methods, such as online and mobile gambling, it has become increasingly important to have effective treatment for individuals afflicted with the addiction.
So how can the gaming industry help individuals who are not capable of gambling responsibly? We have had great success working with varied gaming properties. For the most part, the industry is open to listen and often amazed by how our program can provide positive change for our clients. We would suggest that the gaming industry include problem gambling education and awareness as part of their corporate culture. Provide the tools needed to ambassadors on the floor so they may give those with a problem the information they need to get help.
Here at the Dr. Robert Hunter International Problem Gambling Center, we are state-funded and supported by gaming properties and manufacturers through fundraising and other varied grants. There is no cost to the client and we are willing to work with industry human resource departments to educate gaming employees about gambling addiction. We are grateful for the responsible gaming programs adopted by most properties, yet we implore the industry to work with us to ensure that those who have a gambling problem find the help they need.