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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 ® [email protected] About CCGNJ.

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Compulsive Gambling:The Invisible AddictionJune 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 ®

[email protected]


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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.


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Legal Gaming in the U.S.

(Data from NCPG)



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Who Gambles?

Adults:

  • Ever Gambled? 85%

  • Past Year? 65%

  • At Least Weekly? 15%

  • Path. Past Year? 1%

  • Prob. Past Year? 2%

Youth:

  • Ever Gambled? 85%

  • Past Year? 70%

  • At Least 2x Wk.? 11%

  • Prob. Past Year? 2%

  • At-Risk Past Year? 6%

(Data from NCPG)


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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


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OTHER FORMS OF LEGALIZED GAMBLING

  • Spinning wheel type amusement game

  • Arcade type games

  • Chances for Fundraisers

  • Stock market gambling

  • Fantasy football?

  • Office pools?


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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


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Types of Gamblers

  • Social (80%)

  • Problem (15%)

  • Compulsive (Pathological) (5%)


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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


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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


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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


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What is Pathological Gambling?

  • Enters DSM III in 1980

  • DSM IV (1994):

    (312.31) Impulse Control Disorders, NEC

  • DSM5 (2013?) – Addictive disorder


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DSM IV-TR(312.31) Pathological Gambling(Impulse-Control Disorders, NEC)

A. Must meet 5 out of 10 criteria:

  • Preoccupation

  • Tolerance (increasing amounts of $)

  • Inability to control, cut back or stop

  • Restless, irritable when not gambling

  • Escape or relief of dysphoric mood


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DSM IV-TR(312.31) Pathological Gambling (Impulse-Control Disorders, NEC)

A. Must meet 5 out of 10 criteria (cont.):

  • “Chasing” –trying to win back losses

  • Lying to family members and others

  • Illegal acts to finance gambling

  • Jeopardized relationship, job, education, career

  • “Bail Outs” – relies on others to cover debts

    B. Not better accounted for by a Manic Episode


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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)


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Bio-Psycho-Social Risk Factors

  • Male

  • Athlete

  • 18-24 Yrs

  • Substance use

  • Substance abuse

  • Other MH problem

  • Family history of addiction

    (Data courtesy of NCPG)

  • Low SES

  • Military Service

  • Racial/Ethnic minority

  • Gamble illegally

  • Early onset

  • Early big win

  • Easy access to gambling


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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


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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


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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


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Subtypes

Action

  • More likely to be male

    • Prefer “skill” games (poker, sports betting, horses, casino table games)

  • Aroused euphoric state

  • Seeking the rush

  • Narcissistic, fantasy

Escape

  • More likely to be female

  • Prefer “luck” forms of gambling - lottery, slots, bingo

  • Gamble for relief, escape from stress or negative affect


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PREVALENCE - NJ

Compulsive and Problem Gamblers:

350,000

Substance Abusers:

806,000


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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


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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.


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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



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ADOLESCENT PREVALENCE

  • 2-4 times higher rate than among adults

  • Past year gambling problem: 1-6%


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GAMBLING, DRUGS & ALCOHOL

Four (4) Similarities for all addictions

  • Preoccupation

  • Withdrawal

  • Progression

  • Tolerance


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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.


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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


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GAMBLING, DRUGS & ALCOHOL

Differences (cont.)

  • No saturation point for gamblers

  • Gamblers excel at math and/or superstitious

  • Gambler’s recovery requires financial restitution


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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


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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.


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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


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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


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MORE

TOOLS


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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


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CCGNJ Programs and Services

  • Public Awareness

  • Prevention and Education (Schools & Colleges)

  • Intervention

    • 1-800-GAMBLER® Helpline

    • Outreach to Seniors, Treatment , IDRCs and Community Agencies

    • Criminal Justice Initiatives

  • Training & Workforce Development

    • Free 30 hr CCGC Workshops

    • Consultation on cases

    • 28th Statewide Conference (10/7/10)

    • In-Service Trainings

  • Advocacy & Collaboration


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FOR MORE INFORMATION:

Contact us at:

The Council on Compulsive Gambling of NJ, Inc.

3635 Quakerbridge Rd

Suite 7

Hamilton, NJ 08619

609-588-5515

[email protected]

http://www.800gambler.org

For Immediate Assistance 24 hours a day:

1-800-GAMBLER®


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