Problem Gambling in Rhode Island:
Who, What, Where and How Much?
WITH
Recommendations for Public Policy
October 2, 2002
Bob Breen, Ph.D., NCGC
Licensed Clinical Psychologist
Director, Rhode Island Gambling Treatment Program
Rhode Island Hospital, Dept of Psychiatry
Rhode Island Gambling
Treatment Program (RIGTP)
• Located at RIH
• Psychiatric evaluation
• Individual psychotherapy for gamblers
or family members. Family therapy.
• Educational Support Group
• Outreach
Part 1: Problem Gamblers
Seeking Treatment in Rhode
Island 2001-2002
Clinical and Demographic
Characteristics
Demographics of 204 Problem Gamblers
Seeking Treatment in Rhode Island
• Male: 54%, Female 46%
• Caucasian: 92%
African American: 3%
Hispanic: 2%
Asian: 2%
Other: 3%
• Average Income: $42,157
Age of 189 Rhode Island
Problem Gamblers
Average Age: 45.5 (17 - 74)
60% 59%
50%
40%
30%
20% 18%
20%
10% 3%
0%
17-34 35-54 55-64 65+
Age and Gender in RI Problem
Gamblers (N=189)
60
50
40 Male
30 Female
20
10
0
17-34 35-54 55-64 65+
Psychiatric Disorders in Rhode
Island Problem Gamblers (%)
(Total number of patients is 136)
80%
70%
60%
50%
40%
30%
20%
10%
0%
Depression Current Past Anxiety
Substance Substance
Correcting a Common Misconception
about Problem Gamblers
• Problem gamblers generally concentrate
on one, and only one, primary form of
gambling.
• This is contrary to the popular notion
that a problem gambler will “bet on
anything”.
What Type of Gambling is the Biggest
Problem in RI? (treatment seeking)
70% 69%
60%
50%
40%
30%
20% 10% 8% 9% 4%
10%
0%
VLT's, Horses or Lottery Casino Sports
Slots Dogs Table
Where RI Problem Gamblers Lost Their
Money (Proportion of Losses in Previous
12 months)
70% 67%
60%
50% 39%
40%
28% 27%
30%
18%
20%
10%
0%
Lincoln Newport Foxwoods Mohegan RI Lottery
Park Jai Ali Sun Vendors
Financial Damages In RI Problem
Gamblers (RIGTP)
• Financial Damage includes:
1) Current, outstanding debt directly due
to gambling (credit cards, personal loans,
equity loans, etc..)
PLUS:
2) Value of assets sold to directly finance
gambling or pay gambling debts (E.G.:
stocks and bonds, IRA’s, jewelry, even
homes).
Financial Damages In RI Problem
Gamblers ($1000’s)
60 59
50 48
40 33 34
30
20
10
0
Outstanding Assets Sold Total Bankruptcy
Debts Financial
Damage
Problem Gambling Severity in RI
In the Previous 30 Days, Problem Gamblers had:
• Gambled on an average of 12 days
• Lost an average of $2,990.00
Average South Oaks Screen (SOGS) = 13.11
(range = 0 to 20, over “4” indicates pathological gambler)
Average Gambling Severity Index (GSI) =0.69
(range = 0 to 1, with 1= maximum severity)
Is Treatment Effective?
• At the RIGTP (RIH) we follow-up all
treatment seekers at 6-month intervals.
• Follow-ups are “blind” and are conducted
by a trained, independent interviewer by
telephone.
• Even treatment “drop-outs” and “refusers”
are followed up.
• We now have follow-up data on 66 patients
at 6-months, and 11patients at 12-months
Effectiveness of Therapy for
Gamblers (6-to-12 months)
10.3
12
10
8
Base
6
2.6 Last
4 Follow-Up
2
0
Days of Uncontrolled Gambling
(Previous 30 Days)
Effectiveness of Therapy for
Gamblers (6-to-12 months)
$3,000 $2,874
$2,500
$2,000
Base
$1,500
$645
$1,000 Last
Follow-Up
$500
$0
$$ Lost Last 30 Days
Effectiveness of Therapy for
Gamblers (6-to-12 months)
0.71
0.8
0.7
0.6
0.5 0.36
Base
0.4
Last
0.3 Follow-Up
0.2
0.1
0
GSI (30-Days)
Effectiveness of Therapy for
Gamblers (6-to-12 months)
16 13.73
14
12
10 7.32
Base
8
6 Last
4 Follow-Up
2
0
SOGS (6-Month)
% Abstinence from Gambling
(Prior 30 days at follow-up)
70% 65%
55%
60%
45%
50%
35%
40%
30% Yes
No
20%
10%
0%
ANY Gambling Gambling on Problem
Type
Part 2:
VLT’s: Are they “Addiction
Delivery Devices”?
Subjects
• 174 Problem Gamblers seeking treatment in
RI
• 62 developed problems through “traditional”
types of gambling, e.g.., cards, dice, horses &
dogs, sports.
• 112 developed problems through electronic
gambling machines (VLT’s).
Progression of Problem Gambling (cont.)
• The question: How long from initiation to
full-fledged DSM-IV diagnosed
pathological gambling?
Progression of Problem Gambling (cont)
• For VLT players it took an average of
1.27 years (15 months) to get from “social
gambling” to pathological gambling.
• For “traditional” gamblers it took about
4.16 years.
• The amount of financial damage between
the two groups isn’t different, meaning
that the VLT players did the same
financial damage in 1/4 the time.
Speed of Progression of
Problems in RI Gamblers (years)
7 6.3
6 5.1
5
4
2.8
3 1.9
1.3
2
1
0
VLT's Instant Tables Horses Sports
Lottery or Dogs
How Much of VLT Profits Come
from Problem Gamblers?
• 1998: Nova Scotia Dept. of Health Survey
– screened over 18,000 adults
– 16% of regular players were Problem Gamblers
– Problem Gamblers accounted for 53% of VLT
profits in Nova Scotia
– Problem Gamblers play average of 189 minutes
compared to 30-60 minutes for non-problem.
– Problem Gamblers make up 48-58% of those
playing the machines at any one time.
How Much of VLT Profits Come
from Problem Gamblers?
• 1999- Australian National Productivity
Commission Report
– random stratified sampling
– over 10,000 interviewed.
– 42% of VLT revenues were attributed to
problem gamblers.
– the average problem gambler lost 17 times
more on VLT's than non-problem patrons
Responsible Gambling Software
• Is on the market and has been for some
time.
• It can be easily loaded onto existing
VLT’s
• Features:
– players can set their own limits for losses,
time, or credits
– random time outs with messages,
quizzes and information
• Features are OPTIONAL!
Game Planit Interactive Corp.
Roger Horbay Ph.D., President
Toronto, CA
519-846-1905
www.gameplanit.com
Summary and
Recommendations
Current RI State Funding for
Treatment ($millions)
$160 $150
$140
$120
$100
$80
$60
$40 $10.6 $0.15
$20
$0
VLT Est. 2002 Losses of 180 Total State
Patients Funds for
Treatment
Recommendations
• Moratorium on ANY expansion of
gambling
– no additional VLT’s
– no new casinos
• Unless and Until:
1) Independent Regulatory Office is
funded, appointed and empowered.
Recommendations (cont.)
2) Player tracking technology enabled.
3) Players must be registered.
4) Professional Mental Health Liaison on-
site.
5) Responsible Gambling Software added
to all VLT’s.
Recommendations (cont.)
6) no gambling by employees
7) mandatory open-door for on-site
research.
8) Limit cash access.
9) Moratorium should continue until the
above recommendations are implemented
and the RESULTS EVALUATED - at
least several years.