The invisible social cost of problem gambling

Denise Jewell
CNHI News Service

May 17, 2006 02:26 pm

— Clutching a handful of scratch-off lottery tickets, Sandy Bartholomew stares at the blue keno screen mounted on the corner wall at Ted’s Stateline Mobil in Methuen, Mass., and waits for the winning numbers to light up.
Anticipation of a match with her picks excites the 52-year-old nurse, who thinks nothing of driving an hour from her home in New Hampshire three times a week to get her gambling fix with instant-result lottery tickets and the video keno game.
"I see a lot of people do it that shouldn't be doing it," said Bartholomew. "But I don't spend what I can't afford to lose anymore."
That's not the case with medical clerk Jonathon Mitnick, 30, of Owings Mills, Md. Impulse gambling cost him everything. His home, his wife, his job, his savings, his self-esteem. Then he sought help.
"I spent so much time trying to cover myself that eventually I had trouble keeping my lies straight," said Mitnick. "I was in that dream world of the compulsive gambler."
It is a world several million people live in since the rapid expansion of legal gambling in America, a phenomenon driven by get-rich-quick fantasies and the allure of easy money to stimulate economic development and pay for state and local government.
The social stigma once connected to gambling has vanished, an indepth study of the subject by CNHI News Service shows. It is now seen by public officials as a panacea to hold the line on traditional taxes and help depressed communities get jobs - and worry about the social consequences later.
Only two states - Utah and Hawaii - remain off limits to gamblers. A dozen states are considering proposals to expand from lotteries to racinos (race tracks with slot machines), slot machine and video poker parlors, or fullfledged casinos. States that already have casinos want more. Without exception, gambling revenue has become an important stream of government income.
The result is one of the fastest growing and largest businesses in the United States, an industry that takes in billions in profits and lays out millions to lobby legislatures and city councils and Congress to keep the momentum going. But, by comparison, it's an industry that spends a trifling sum helping problem gamblers, many of whom are poor to start with, overcome their destructive habit, the CNHI News Service study found.
The American Psychiatric Association, the National Center on Addiction and Substance Abuse at Columbia University, U.S. Rep. Frank Wolfe of Virginia and others warn the spread of legal gambling - without a concomitant pledge to address the consequences - may end up costing the states as much or more in social service dollars than they rake in from gambling revenue.
That's borne out by a federal study of the social and economic implications of gambling in the United States, an analysis conducted by a special commission in the late 1990s under authority of Congress. To wit, problem gamblers:
-- Steal property for money or commit crimes such as forgery, credit card fraud and embezzlement, adding significantly to the nation's prison population.
-- End up homeless. One in five, according to a national survey by the Association of Gospel Rescue Missions in Kansas City, Mo. It is even higher in cities and towns with or near casinos.
-- Engage in other addictive behavior, including abuse of alcohol and drugs.
-- Suffer from mental disorders, including abusive behavior. Studies by the National Research Council estimated between one-quarter and one-half of the spouses of compulsive gamblers have been abused.
-- Commit or attempt suicide. One in five, according to the National Council on Problem Gambling, a rate experts say is higher than for any other addictive disorder.
-- Declare bankruptcy. One in five, according to a National Opinion Research Center survey included in the commission study.
-- Divorce their spouses. More than 53 percent reported having been divorced in the National Opinion Research Center survey. Multiple failed marriages also are higher among gamblers than the population in general.
-- Rely on the myth that "lady luck" will improve a person's lot in life rather than hard work, education and perseverance.
"Despite the lack of basic research and consensus among scholars," the National Gambling Impact Study Commission said in 1999, "the incidence of problem and pathological gambling is of sufficient severity to warrant immediate and enhanced attention on the part of the public officials and others in the private and nonprofit sectors."
Since then, little has been done about it, the CNHI News Service study found. Congressional Rep. Wolfe at the federal level, and Sen. Susan Tucker of Massachsuetts at the state level, say that's because the financial benefactors of gambling - state and local governments, Indian tribes and the gambling industry - do not want to kill the golden goose. Critics also blame less hidebound social attitudes toward gambling. It is now accepted as a way of everyday life in America.
For whatever reason, the gambling commission's recommendations to deal with the issue of addiction and other concerns got short shrift. They included:
-- A federal and state moratorium on the expansion of gambling to allow time for an assessment of the longterm costs and benefits.
-- Cease and roll back "convenience gambling" locations like neighborhood lottery outlets that sell scratch tickets and feature video keno and other fast-play games that appeal to low-income people looking to get rich quick.
-- Earmark a specific tax on gambling revenues for research, prevention, education and treatment programs.
-- Require gambling operators and agents to refuse to serve customers whose behavior "convincingly exhibits indications of problem or pathological gambling."
-- Mandate public and private insurance companies to cover gambling treatment programs.
-- Initiate public awareness, education and prevention programs aimed at low-income, ethnic and other populations vulnerable to problem and compulsive gambling.
-- Ban "aggressive advertising strategies," especially those that target impoverished neighborhoods and young gamblers.
In response, state officials and the gambling industry point to evidence that the vast majority of gamblers do it for fun and bet their money responsibly; that lottery tickets carry hotline numbers for problem gamblers to seek help, and that the industry is funding research into compulsive gambling at, among other places, the Harvard Medical School.
The National Center for Responsible Gaming, the industry's research arm, sponsors an annual convention to counter negative publicity. Last year, a discussion about "Junk Science and Conventional Wisdom" concluded that "it's a myth problem gambling is widespread. It's a myth stats on problem gambling are readily available. It's a myth the known number of problem gamblers is just the tip of the iceberg."
But there was no talk about the problems created by encouraging gambling through casino atmospherics, neighborhood lottery outlets, slick TV and Internet advertising, and other types of promotion. “All you need is a dollar and a dream .... Hey, you never know,” goes the jingle in New York.
Casinos thrive on frequent gamblers and they use sophisticated technogy to identify them, tracking transactions in much the same way retail outlets detect shopping preferences. They issue special credit cards and monitor the use of those cards at slot and video poker machines. If you play often and fast, you are considered a high roller, entitled to enticements such as free dining, hotel rooms and other largess.
They also want gamblers to lose track of time and reality. That's why there are no windows or clocks in most casinos, and why drinks are free 24 hours a day from cocktail waitresses who flit about the gaming tables and slot machines.
Bartholomew, the New Hampshire nurse, remembers a time when the excitement of gambling drew her into a dark cycle. She found herself playing keno and buying scratch tickets six days a week, lying to her husband about what she had been doing, and losing too much money. But it wasn't until she dropped $4,000 in one sitting at the slot machines at Connecticut's Foxwoods Casino that she finally realized she had a problem.
"It was so addicting," she said.
Researchers are still studying why people are compelled to gamble to the point that it disrupts their lives, but they see similarities to drug addiction, including the need to increase the risk through larger bets to get high.
Dr. Jon Grant, a psychiatrist at the University of Minnesota who studies addictive behaviors, said brain images of compulsive gamblers revved up to bet have shown activity similar to that of cocaine users - receptors in the brain looking for reward.
“These give us bits of information that this is not simply an issue with people with poor moral character, but that this is an addiction,” said Grant.
The American Psychiatric Association classifies pathological gambling as a “social impulse disorder,” a category of disease that also includes kleptomania and pyromania. And the impulse is not always about the cash payoff.
“Compulsive gamblers do not gamble for the money. They gamble to get the adrenaline rush - it’s about reaching that high,” said Jim Chesser, a Louisville, Ky., businessman who has spent eight years recovering from the addiction. “You might as well grind the money up and put it in a syringe and put it in our arm. It has the same effect.”
Realtor Michael Osborne of Baltimore is an example of that rush - and the consequence. He tapped into a client’s escrow account to bet $25,000 that the New York Mets and the Atlanta Braves would score more than seven runs in a National League Championship series game in October 1999, and lost.
Osborne, 34, had no reason to make the bet. He was happily married with three children and earning a decent salary in a legitimate business. But there was something else driving him to gamble - a conviction that he could always win the next bet.
“I went to get help a lot of times. It just was never for me. It was for her and the kids. It was for my grandmother who was dying of cancer,” said Osborne, who estimated he lost more than $3 million in two years of gambling. “In my mind I couldn’t come to fathom that something was beating me. I had to get it back.”
Osborne said he was arrested 12 times and went through four unsuccessful rehabilitation programs before he got the will to change. Even after a stint in prison, he said, he continued to gamble.
“The gambler is not going to realize or accept or even want to ask others around him for help until every last bit of his resources are tapped out,” said Osborne, now executive director of the Habour Pointe Center for Compulsive Gambling in Baltimore. “As long as a gambler has a dollar in his pocket, there is a flicker of hope he can either hit the big lottery, hit the 16 parlay that will pay $1,200 or some other fantasy illusion.”
After hitting bottom and working his way back, Osborne has been pushing to change the way people perceive the disorder.
“I’m not against gambling. I’m here to say society, unfortunately, ignores the other side of the coin: prevention and treatment,” Osborne said. “When you live in a society where most states are balancing their budgets off legalized gambling revenue, they’re not addressing this adequately because they’d look like hypocrites.”
Instead, states are spending liberally to promote gambling and grow state revenue. Gambling addicts are not deliberate targets, but they are the class of gamblers most seduced by the message, addiction experts report.
New York state is a good example. It spent nearly $71 million on advertising state lottery games in the fiscal year ended June 30, 2005. That yielded $6.27 billion in lottery sales, the highest in the nation. Addictive gambling, which is rising exponentially with revenue, got only $3 million for prevention and treatment.
Credit counselor Thomas Coates of Des Moines, Iowa, said an often overlooked aspect of problem gambling is the easy availability of money at gambling outlets. In addition to issuing special credit cards, casinos and race tracks install ATM machines and often provide check-cashing services. Some extend generous lines of credit to regular customers.
Coates said gamblers who seek help from his company, Consumer Credit of Des Moines, have 50 percent more unsecured debt than the average customer. He said they also have higher rates of bankruptcy - a problem he says will only get worse without more dollars going to prevention and treatment.
Coates said Iowa takes in $1 billion a year in gambling revenue and "we give back five-tenths of 1 percent for a problem that we created. We're going to make ourselves feel better by giving a pittance back?"
In testimony before the national gambling commission, Coates shared an insightful suicide note from a gambler who ran up $60,000 in credit card debt at a local casino. The note read:
"I never thought of gambling prior to two or three years ago. I really can't blame anyone but myself but I sincerely hope that restrictions are placed upon credit card cash availability at casinos. The money is too easy to access and goes in no time. My situation is now one of complete despair, isolation and constant anxiety."
Denise Jewell is a CNHI News Service Elite Reporting Program fellow. She writes for the Niagara Gazette in Niagara Falls, N.Y.

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