Gambling is part of American culture. For most, it is simply an enjoyable pastime. Based on a study by the National Council on Problem Gambling, for up to 3% of the population of the United States however, gambling is no longer hobby. The fun for these folks ended long ago. The NCPG estimates that for 7.5 million Americans, gambling has become problematic, perhaps a full-blown addiction, with an additional 5,000,000 Americans considered “at-risk” for addiction, as gambling continues to exist as part of mainstream American culture.
Gambling as an Addiction
Addiction is a word used liberally in today’s culture. The idea that one can be addicted to drugs or alcohol is nothing new, but in recent years, there have been a realization that it isn’t simply chemicals that cause addictive behaviors. Today, our understanding of compulsion and addiction extend to a variety of activities, such as overeating, sex, and of course, gambling. As our understanding of addictions has changed from a defect of character to that of an actual disease of mind and body, addiction medicine has moved out from behind the shadows, and into mainstream culture. New studies on addiction continue to offer insight as addiction is recognized as a brain disease, not simply a behavioral disorder. Clear differences can be seen when examining the addicted brain under Magnetic Resonance Imaging when compared to its non-addicted counterpart.
The Action Gambler
Experts in addiction have seen a dramatic increase in the number of gambling addicts since the advent of online gambling. Additionally, the face of gambling addiction is changing. Years ago, there was one profile of the gambling addict. The late middle aged man, domineering, controlling and extremely manipulative; often extremely charming. While this typical gambling addict saw himself as energetic, assertive and persuasive, his apparent confidence belied a deep insecurity and low self-esteem. Gambling seemed the perfect antidote. The composite gambling addict of yesteryear is now called the “Action Gambler”.
Action gamblers prefer games of “skill”; games that appear to have player influence, such as poker, blackjack, and other card games. These are games where the Action gambler can compete against other players or a “house” casino. Action gamblers, once they hit a problem stage, truly feel they can develop a system to beat the house, or their playing counterparts. Counting cards, reading of player “tells”, the action gambler feels everything is under his control. This helps build his self-esteem, and the daily issues of life that may seem overwhelming at times, simply melt away while he sits at the card table, or rolls the dice on a craps game.
Today, action gamblers are still most often men, but more and more, as casinos have increased in popularity, and gambling has become more mainstream, women are beginning to reach the same point of no return. Rehab centers and 12 step groups report dramatic increase in the number of women and teens seeking treatment as gambling has become interwoven into American culture, and the stigma of the seedy pool halls and back room card games has disappeared.
Stages of Addiction-Action gambler
With action gamblers, there are 4 stages of addiction. The first stage, or the Winning Stage, followed by the Losing Stage. Once the addiction grows more serious, the addict enters the Desperation stage, and then finally, tragically, the Hopeless stage. Typically, with action gamblers, it can take anywhere from 10 to 30 years to completely reach the point of hopelessness that defines the final stage of addiction. It’s a long, hard road, filled with many ups and downs, wins and losses, until finally the gambler loses almost everything.
The Winning Stage
The Winning Stage of addiction is at the beginning. The new gambler is enamored with his or her new pastime, is performing well, winning games, and appreciates those wins. He is able to walk away from the table ahead of the game, with more money than he started with. Gambling addicts often reminisce about this stage, when all was well and the games were excitable and enjoyable. The gambler feels powerful, a winner! Gambling becomes a way to ease the feelings of discontentment with themselves, their life. Unfortunately, this stage doesn’t last long, typically from 3-5 years. It is quickly and sometimes brutally followed by the Losing stage.
The Losing Stage
The Losing stage is the when the first inkling of a problem becomes evident. Often during this period, the gambler can’t seem to quit at the right time. The big win is right around the corner, the next hand, or the next roll of the dice. During each hand of cards, the gambler feels a rush of endorphins, similar to what a drug user may feel when snorting a line of cocaine. The heart rate increases, and the player may begin to sweat slightly. His head spins as he watches the cards intently. His world shrinks dramatically, to include only the cards on the table, and the other players. As he continues the game, his emotions change each time the cards are dealt. From the highest high, to despair, the gambler can feel both, and everywhere in between, during one game of cards. During the losing phase, the gamer may still have some control on occasion but more often will simply stay and play until his money is gone. Oblivious to the true nature of the problem, he feels his luck has changed, and if he simply gets the “right” cards, he will be back on top again.
Stage of Desperation
The addict then enters the Desperation stage. Now the gambler is regularly lying about the money and time spent gambling. Most of his playing is now done in secret. He may miss out on important family events, or days at work, due to his gambling. He makes promises and bargains with himself about his gambling, insisting he will only spent a set amount of money. Maybe he will attempt to quit playing altogether. Somehow, beyond his own understanding, and with all the best of intentions, he continues to play while losing more and more. He may begin to steal during this stage, or engage in illegal behavior to support his habit. He loves gambling, but hates it at the same time. Many addicts see the problem but are powerless to make a change at this point. Many gamblers may have issues maintaining employment. Others experience massive panic attacks, insomnia, and periods of great remorse. They are stuck in the cycle of abuse and can’t seem to do anything to help themselves.
The Stage of Hopelessness
Finally, the Hopeless stage, the final stage of addiction, become the gamblers reality. At this point, they no longer get any pleasure from gaming, but they don’t know what else to do. They know they are addicted and have spent years trying to stop, but to no avail. Once they reach this final stage, many gamblers consider suicide. Financial difficulties have become commonplace, and often the gambler sees no other way out. For those who don’t get help, death or jail seems to be the last stop on the pathway of addiction. Only when the gambler feels totally helpless, will he consider treatment.
The Escape Gambler
Image Via Flickr Images Of Money
Over the years, a new kind of gambler has emerged from the casinos, the bingo halls, and the lottery lines. The Escape gambler is a relatively new phenomenon in gambling addiction. Often they are women, or retirees. The primary motivation, unlike the Action gambler, is not to necessarily win money, but to have fun and escape from the pressures of daily life. Studies have shown that most often, escape gamblers report a sense of numbness when they gamble. Some describe the feeling as sedating, like having several alcoholic drinks in a row, or taking a Valium or other sedative. Winning, to these addicts, is unimportant. They are playing for the sense of relief from day to day boredom or pressure they may feel in their “normal” life. They are gambling for the feeling, not the money.
The stages of addiction – Escape gambler
The stages of addiction are similar, but rather than the Winning and Losing stages, Escape gamblers experience an Introductory stage, when they realize how playing makes them feel. They enjoy the escape and seek it out regularly. At first, they are responsible with finances, but as the draw of the games becomes too strong, they enter the Chasing stage. At this point, the escape gambler often loses more money they intend to. The relief they feel when engaging in gambling activities proves so appealing that money becomes secondary. When they realize the depth of their losses, they begin to gamble more, chasing their bets, trying to get their money back. As they continue to lose control, they too, reach the stages of Desperation and finally, Hopelessness.
Studies from various groups, such as Gamblers Anonymous and treatment centers state that Escape gamblers typically seek treatment earlier and are more responsive to treatment, but even so, the success rate is very low for all gambling addicts. Only 15% of all addicts will ever seek treatment, and the success rate for the first year after treatment is less than 10%, as indicated by a report by the United States Council on Problem gambling. Additionally, 80% of all gambling addicts consider suicide, and 2/3 commit crimes or engage in fraudulent activities.
Gambling and the brain
Why is gambling addiction so difficult to treat? As with other addictions, we are learning that there may be biologic factors at work in cases of addiction. A study performed at Mass General Hospital by Dr. Hans Breiter showed clear difference in the brain pattern of 12 men who were studied by Magnetic Resonance imaging. As the gamblers played, the brain release dopamine in larger and larger amounts as the players were winning. The blood flow in the brain was consistent with what one sees from a morphine or cocaine user. Chemicals such as serotonin and Dopamine become unbalanced in the brain, then stores of these “feel good” chemicals are depleted, causing depression and anxiety as the gambler’s brain fails to function normally.
Treating gambling addiction
As we continue to learn more about gambling addiction, and as addicts come into treatment at younger and younger ages, studies are being done on medications used to treat Alcoholics and Opiate addicts, such as Naltrexone, which may also benefit the gambling addict. While initial studies are promising, additional research is necessary before medication can become an approved treatment. The 12-step model of addiction treatment seems to be the most effective treatment plan available to gamblers today, though hardly perfect. Many people have difficulties with the spiritual concepts with the GA model and others simply cannot self-manage their behavior well enough over time to be successful.
As gambling becomes more and more a part of mainstream society, along with easier access through the internet, the popularity of gaming continues to increase, we as a society are going to be faced with higher numbers of gambling addicts, at younger and younger ages. Clearly, this has become an area of concern for addiction specialists across the country and around the world, and experts are continuing to search for better ways to manage the problem. As gambling continues to be a popular pastime, it appears that the problem of gambling addiction is here to stay.