Compulsive Gambling:
The Invisible Addiction
June 24, 2010
Donald Weinbaum, MBA, LCADC, CCJP
Executive Director
The Council on Compulsive Gambling of NJ, Inc.
3635 Quakerbridge Rd, Suite 7
Hamilton, NJ 08619
609-588-5515 ext 17
1-800-GAMBLER ®
Don@800gambler.org
About CCGNJ
The Statewide ADVOCATE for problem gamblers and
their families.
Founded in 1982- Second State Council in US
NEUTRAL on legalized gambling.
Affiliated with NCPG, which has chapters in 35 of 50
states.
Work with government, gaming industry & community.
Legal Gaming in the U.S.
States 2007 Revenue
Casino 12 $35.5 billion
Indian 26 $26.0 billion
Charitable 47 $2.2 billion
Racing 33 $3.5 billion
Lotteries 47 $24.8 billion
$92.3 billion
(Data from NCPG)
Adult Rates of Smoking, Drinking &
Gambling
Past year Lifetime
Tobacco Use 35% 71%
Alcohol Use 64% 82%
Gambling 65% 85%
(Data from NCPG)
Who Gambles?
Adults: Youth:
Ever Gambled? 85% Ever Gambled? 85%
Past Year? 65% Past Year? 70%
At Least Weekly? 15% At Least 2x Wk.? 11%
Path. Past Year? 1% Prob. Past Year? 2%
Prob. Past Year? 2% At-Risk Past Year? 6%
(Data from NCPG)
LEGAL GAMBLING IN NJ
Pari-mutuel gambling at race tracks
New Jersey legalized Bingo (charitable wagering)
First Lottery (.50 ticket twice weekly) was approved by New
Jersey voters in 1970
Casino gambling was approved by New Jersey residents in
1976 and the first casino opened in 1978
OTHER FORMS OF LEGALIZED
GAMBLING
Spinning wheel type amusement game
Arcade type games
Chances for Fundraisers
Stock market gambling
Fantasy football?
Office pools?
Illegal Gambling
Sports Betting
Internet Gambling
First Internet Gambling site – 1995
Over 2,000 Gambling sites – 2005
1,100 Casino Gambling sites
700 Sports Gambling sites
200 + Poker Gambling sites
Estimated revenue – 2006 - $12 billion
Others
Types of Gamblers
Social (80%)
Problem (15%)
Compulsive (Pathological) (5%)
TYPES OF GAMBLERS
Social gamblers-80%
Enjoyable experience
Entertainment
Gamble with others
Limit amount of money spent
Stop after reaching limits
Gamble for short periods of time
No interference with other parts of life
TYPES OF GAMBLERS
Problem gamblers- 15%
Gambles longer than planned
Loses more than intended
Starts to borrow money for gambling
Prolonged losing episodes
Starts to lie about amount gambled
Returns to gamble to win back losses
Relationship problems begin
TYPES OF GAMBLERS
Compulsive (pathological) gamblers- 5%
Cannot pay household expenses and debts
Marked increase in gambling episodes
Gambling for larger amounts
Receives bailouts for gambling debt
Gambling alone
Alienation from significant others in life
Illegal acts to finance gambling
Unsuccessful attempts to stop
Helpless and suicidal
What is Pathological Gambling?
Enters DSM III in 1980
DSM IV (1994):
(312.31) Impulse Control Disorders, NEC
DSM5 (2013?) – Addictive disorder
DSM IV-TR
(312.31) Pathological Gambling
(Impulse-Control Disorders, NEC)
A. Must meet 5 out of 10 criteria:
1. Preoccupation
2. Tolerance (increasing amounts of $)
3. Inability to control, cut back or stop
4. Restless, irritable when not gambling
5. Escape or relief of dysphoric mood
DSM IV-TR
(312.31) Pathological Gambling
(Impulse-Control Disorders, NEC)
A. Must meet 5 out of 10 criteria (cont.):
6. “Chasing” –trying to win back losses
7. Lying to family members and others
8. Illegal acts to finance gambling
9. Jeopardized relationship, job, education, career
10. “Bail Outs” – relies on others to cover debts
B. Not better accounted for by a Manic Episode
Adult Problem Gambling Rates
(US) (per NCPG)
(Past year) – Approx. 1% (2.3 million) meet Pathological
Gambling criteria.
(Past year) – Approx. 2% (5 million) adults meet criteria
for Problem Gambling.
(Data from NCPG)
Bio-Psycho-Social Risk Factors
Male Low SES
Athlete Military Service
18-24 Yrs Racial/Ethnic minority
Substance use Gamble illegally
Substance abuse Early onset
Other MH problem Early big win
Family history of addiction Easy access to gambling
(Data courtesy of NCPG)
PHASES OF COMPULSIVE GAMBLING
Winning phase (1-2 years)
Early big win
Excitement prior and during gambling
Unreasonable optimism
Feel special
Euphoria and fantasy
Gifts for wife and children
Part -time activity
PHASES OF COMPULSIVE GAMBLING
Losing Phase
Prolonged losing and chasing losses
Lies about gambling
Personality changes
Starts to borrow
Home life begins to be unhappy
Conversion of assets to cash
Fearful
Bets impulsively
PHASES OF COMPULSIVE GAMBLING
Desperation Phase
Constant bailouts and increased debts
More time spent gambling
Remorse and isolation
Illegal activity
Thinking impaired
Physical symptoms of gambling
Helpless, hopeless, mental breakdown, divorce, substance
abuse, suicide
Subtypes
Action Escape
More likely to be male More likely to be female
• Prefer “skill” games Prefer “luck” forms of
(poker, sports betting, gambling - lottery, slots,
horses, casino table bingo
games) Gamble for relief, escape
Aroused euphoric state from stress or negative
affect
Seeking the rush
Narcissistic, fantasy
PREVALENCE - NJ
Compulsive and Problem Gamblers:
350,000
Substance Abusers:
806,000
PG in SA Populations
Rates are 2-10 times higher among substance
abusers than in general population
Substance abuse (overall) (5 studies): 12.2 % and 8%
Alcohol (5 studies): 14.5% and 5.0%
Cocaine: 8 to 15%
Methadone (3 studies): 30%
Cannabis found most related to gambling problems
Co-Occurring Disorders Among PGs
35-60% of PGs meet lifetime criteria for SA.
Alcohol: PGs average 4x higher lifetime abuse rate than non-
gamblers.
Drugs: PGs average 30% lifetime abuse/dependence (6% gen.
pop.)
Tobacco: PGs average 55% lifetime dependence.
SA associated with greater severity of PG.
GAMBLING AMONG SUBSTANCE ABUSE
TREATMENT POPULATION
30% of drug and alcohol clients in treatment likely have gambling
problem
50% of compulsive gamblers in treatment have substance abuse or
dependence
Prevalence of MH Disorders
Gen Pop PGs Tx Seeking
PGs
Any 8% 40% 60%
Disorder
Maj. 5% 20% 60%
Depression
Bipolar 1.5% 10% 15%
Suicidality 5% 20% 50%
(Data from NCPG)
ADOLESCENT PREVALENCE
2-4 times higher rate than among adults
Past year gambling problem: 1-6%
GAMBLING, DRUGS & ALCOHOL
Four (4) Similarities for all addictions
Preoccupation
Withdrawal
Progression
Tolerance
GAMBLING, DRUGS & ALCOHOL
Differences
Gambling connected to fantasy
Gamblers favor suicide, alcoholics hopeless and helpless
Gamblers fully functional until hitting bottom
Gambler sees money as drug and power.
Disease model harder for others to accept.
GAMBLING, DRUGS & ALCOHOL
Differences (cont.)
Cannot measure through blood, urine, hair
Gambling sponsored by religion and state
Bailout or big win can stop self destructive cycle
Gambling win seen as solution for problems
Gamblers do it alone, addicts often in groups
GAMBLING, DRUGS & ALCOHOL
Differences (cont.)
No saturation point for gamblers
Gamblers excel at math and/or superstitious
Gambler’s recovery requires financial restitution
Screening Tools
NODS (NORC Diagnostic Screen)
CPGI (Canadian Problem Gambling Index)
SOGS (South Oaks Gambling Screen)
GA 20 (Gamblers Anonymous 20 Questions)
Lie/Bet Screen
NJ-SAMS
All clients answer a 3-Question Screen. If “yes” is answered for any
question counselor will be directed automatically to Council’s web
site, where they can answer “20 Questions”.
If a problem or compulsive gambler, the client/counselor will be
referred to a page that lists professional help (free or low cost) and
12-step meetings.
Lie/Bet Screen
Have you ever felt the need to bet more and more
money?
Have you ever had to lie to people important to you
about how much you gambled?
Yes to one or both classifies respondent as a pathological
gambler (95% accuracy)
Johnson, et al, (1997) Psychological Reports
TREATMENT OPTIONS
Treatment Planning/Aftercare – Integrate Svcs
12 Treatment Providers in CCGNJ Network
Free or Low Cost Services for Gamblers and Significant Others
Funding Cutbacks limit network expansion at this time
12-Step Self Help Groups:
Gamblers Anonymous
Gam-Anon
MORE
TOOLS
TIP 42
“At a minimum, the rate of problem gambling among people with
substance use disorders is 4 to 5 times that found in the general
population.”
PGKIT (BKD 535) Includes:
excerpts from TIP 42
Problem Gamblers and Their Finances: A Guide for Treatment
Professionals
Personal Financial Strategies for Loved Ones of Problem
Gamblers
National Problem Gambling
Awareness Week ( March 6-
12, 2011)
In NJ, Month of March
www.800gambler.org/GAW
50+ free materials
Screening tools
Posters
Flyers
Brochures
Press releases
Stories
CCGNJ Programs and Services
Public Awareness Training & Workforce
Prevention and Education Development
(Schools & Colleges) Free 30 hr CCGC Workshops
Intervention Consultation on cases
1-800-GAMBLER® Helpline 28th Statewide Conference
Outreach to Seniors, (10/7/10)
Treatment , IDRCs and In-Service Trainings
Community Agencies
Criminal Justice Initiatives Advocacy & Collaboration
FOR MORE INFORMATION:
Contact us at: For Immediate Assistance 24
hours a day:
The Council on Compulsive
Gambling of NJ, Inc.
3635 Quakerbridge Rd 1-800-GAMBLER®
Suite 7
Hamilton, NJ 08619
609-588-5515
Don@800gambler.org
http://www.800gambler.org