Gambling addictions on the rise
It seems you can’t watch a professional sports game without also viewing a barrage of commercials enticing you to place a wager on your team.
On-line gambling, including betting on sports, casino-type games, poker, or lotteries, has taken off in the past decade and so has the associated rise of problem gambling and addiction. And, while it’s become easier to take a chance or two, admitting to a problem can be a lot more difficult.
In 2011, the Department of Justice ruled that only sports gambling was restricted under the Wire Act. Then, in 2018, the U.S. Supreme Court struck down laws restricting online sports betting too.
Today, 38 states, including all six in New England, have legalized various forms of sports betting. Online casinos are legal in Connecticut as is online poker there and in Rhode Island.
Gambling is a multi-billion dollar industry. States often partner with private companies and use gambling as a revenue source, touted as a way to “cheaply” raise funds for tax relief and various programs.
The cost in dollars and in human potential, however, raises concerns from experts.
The National Council on Problem Gambling (NCPG) puts the annual cost of gambling addiction at $14 billion as of December 2023. Across all venues, nearly 2.5 million U.S. adults struggle with a gambling disorder while up to six million more deal with problem gambling behaviors.
“In our facility, we see about 20% of our population with a gambling use disorder,” said Greg Bacos, LMHC, director of clinical operations at Atlantic Behavioral Health, a psychiatric day program offering gambling addiction treatment in Wilmington, Mass.
He said it may not be the reason a client seeks treatment. It can be stand alone or co-occurring.
“It is hard to know what came first,” Bacos said. “Did excessive gambling cause the depression or was the person depressed and gambling relieves the symptoms?”
Gambling may be more socially acceptable than other substances, like drugs or alcohol. And, like other additive behaviors, gambling can start out as a fun activity, a way to be entertained, and then can grow into a crutch to boost mood and avoid negative feelings. This is all intentional.
“The allure of a casino with all the bells and whistles are all meant to jack dopamine receptors,” said Bacos. “Even scratch tickets are designed so that just the look of them releases dopamine.”
While only 4% of gamblers come out on top, that knowledge may not be enough to turn people away. In many cases, the potential loss of money can bring an even bigger surge of dopamine.
“It’s the process and the risk itself, not just the winning and losing,” Bacos said.
Gambling is not a new problem, but the ease of access for online betting, most of which is sports-related, may contribute to higher participation and more problem gambling in the future.
Bacos, who has been working in addiction for 15 years, said sports betting is the most difficult to treat. “It is always accessible, done in isolation, and anonymous, all of which makes controlling impulses a lot harder.”
According to the NCPG, treatment rates for those struggling with gambling issues are far lower (8%) than for those with other addictions.
Shame, stigma, and barriers to care can keep many from seeking help. Programs to address the issue will need to be amped up to address the problem.
Bacos said education is needed as well as marketing like what was done to make smoking cigarettes look unattractive.
That effort would improve statistics and normalize seeking help so people “do not feel shame walking in to the therapist’s office.”
The gold standard for treatment, Bacos said, includes CBT, family therapy, pharmacological treatments, and 12-step programs that include a reliance on a “higher power.”
“An addiction is such a powerful release of dopamine so you need to help them find something as powerful to replace that,” Bacos said.
He added Carl Jung was a proponent of having a “spiritual moment,” to aid with recovery.
“It is not the only way for treatment but one of a few methods that we find key,” Bacos said.
It is important to accept that recidivism rates are high for gambling and to encourage clients to keep working through the program, he added.
Having a therapist who is understanding and non-judgmental about relapses is important, Bacos said.
The biggest challenge is initially getting clients in the door and helping them overcome shame.
“It really is a big barrier to treatment,” he said.