Maintaining Your Health on Mackinac
Casinos and Gambling Have Become a National Phenomenon
By Yvan Silva, M.D.

Ten years ago, surveys showed that 86% of the adult population said they had gambled sometime in their lives, compared to 68% in 1975. Placing bets on lotteries, in casinos, and horse races continues to increase, while in another growing dimension, the Internet, games, video poker, and other innovations in gambling technologies can become more exciting and habituating because of the rapidity of action and the ability of gamblers to bet in isolation.

To most people, gambling is acceptable. 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 that are available, and often the entertainment is affordable. Bets on sporting events are an important part of the lives of many. Their social 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 and interpersonal and financial relationships. 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, and loss of control and relinquishment of important activities.

Gambling can become an addiction, with many symptoms similar to that of drug abuse. They include intense preoccupation with gambling, repetitious discussions of gambling experiences, especially with winning, often exaggerating the experience and the amounts, planning the very 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 other people, 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. To start with, consultation with the family doctor and appropriate referral to specialists can be helpful. Consultation with a lawyer may also be relevant. It is important to realize that the gambling 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 - wanting a gain 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 widespread pain and suffering. As with other human challenges, it is important for us to learn about the possible consequences and work positively to help, if we can and when we can.

For those seeking help, Gamblers Anonymous meets every Tuesday at 7 p.m. in the basement of St. Ignatius Loyola Catholic Church in St. Ignace.

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