2005-05-20 / Columnists

Gambling Addiction — A Growing Phenomenon

Maintaining Your Health on Mackinac
By Yvan Silva, M.D.

Maintaining Your Health
on Mackinac


The phenomenon of casino gambling is exploding all over the United States, in addition to the many forms of legal and illegal gambling that have existed for a long time. There are several campaigns to expand in the latest trend on the growth of Indian tribal gambling. Revenues for tribal casinos amounted to about $18.5 billion in 2004, according to the National Indian Gaming Association, up from $5.4 billion in 1995. There are 411 tribes operating casinos that employ 533,000 people. The trend for expansion continues.

This is adding to the otherwise extant expansion of legalized gambling throughout the United States, increasing the prevalence of gambling and, consequently, the prevalence of problems resulting from excessive gambling. In 1998, it is estimated that legalized gambling grossed more than $50 billion, more than the entertainment industries, music, theme parks, and motion pictures, combined. The amount of money changing hands, with all of the peripheral ramifications, is an important socioeconomic factor.

In 1998, surveys showed that 86 percent of the adult population admitted having gambled sometime in their lives, compared to 68 percent in 1975. Placing bets on lotteries, in casinos, and at horse races continues to increase while Internet gambling, video poker, and other innovations in gambling technologies can become more habituating because of the rapidity of action and the ability of gamblers to bet in isolation.

To most people, gambling is accepted as normal. Nowadays, many people buy lottery tickets and thrill to the possibility that they will win. They know the odds, they accept the loss, and yet the excitement of hearing how someone won another big one keeps them buying. Many enjoy going to the casinos with the variety of games available, and affordable entertainment. Bets on sporting events are an important part of the lives of many. Their lifestyles remain unimpaired and gambling can be fun, if not always painless.

Gambling involves the challenge of risking something of value to gain something of greater value. Gambling becomes a problem when it interferes significantly with the gambler’s occupation, interpersonal, and financial functioning. The most severe form of gambling, defined as pathological gambling, was included in the Diagnostic and Statistical Manual of Mental Disorders as far back as 1980. Interestingly, the criteria are remarkably similar to those for drug dependence, including increasing tolerance, withdrawal, loss of control, and relinquishment of important activities.

Gambling can become an addiction with symptoms similar to that of drug abuse. They include intense preoccupation with gambling, repetitious discussions of gambling experiences, especially with winning, often exaggerating the amounts; planning the next opportunity to gamble; and expectantly working out ways to get more money for gambling. Tolerance leads to needing more frequent and bigger bets to keep up the level of excitement; lying to family members, friends, and others to conceal the problem and especially lying to self; inability to stop gambling, in spite of several attempts to stop; trying to win back losses and getting farther behind; restlessness, frustration, and inability to stop; and finally, breaking the law to finance the gambling habit.

The consequences of pathological gambling that ensue include financial problems that increase with magnitude over time, loss of job and job opportunities, problems with marriage, long-term friendships, and relationships, and withdrawal from society. Legal problems arise, with widespread ramifications including family members, friends, and caring individuals. Pathological gamblers are known to have high suicide rates and tend to abuse alcohol and other drugs more than other people.

For the pathological gambler, the first step in getting help is to admit that it is a problem. This is often very difficult, as is well known with alcoholism and other forms of drug abuse. Denial can become so entrenched, that people around the gambler become frustrated and feel helpless. A consultation with the family doctor can be helpful. Consultation with a lawyer may also be relevant. It is important to realize that the gambling, per se , is part of a complex picture of psychological and physical problems, and that treatment must be directed to all these elements.

The significant adverse consequences that accompany gambling problems, for individuals as well as for society, clearly point to the need to identify the spectrum, do research and develop effective treatments for individuals with gambling problems. Today, almost everyone knows someone who indulges in some form of gambling in its simplest definition, gaining value while risking something of value. Fortunately, for most it remains a game, take it or leave it. Unfortunately, as the opportunities for legalized gambling continue to increase, more people will fall victim to the pathology of gambling with its potential for pain and suffering. As with other human frailties, it is important for us to learn about it and work positively to help, if we can and when we can.

Dr. Silva is a professor of surgery at Wayne State University and a resident of Woodbluff on Mackinac Island.

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