GAMBLING:Guest Lecture for SAPP 407Addictive Behaviors
The complete slide deck & print-friendly handouts are posted at:
www.preventionlane.org/SAPP
1:07 PM
Define trends in gambling & defineproblem/disordered gambling.
Talk about how people get help.
1:09 PM
Understand substance abuse & mental health connections.
DEFINITION:
______ something of valuein the _________________
something of greater value.hopes of obtaining
RISKING
Source: American Psychiatric Association - DSM-5 (2013).
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Presentation Notes
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, D.C.: Author.
Image sources: Oregon Lottery, Hynes
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Presentation Notes
Oregon Lottery 2009: $1.24 billion (Oregon Lottery, 2009) Oregonians spent $1.6 billion on all forms of gambling in 2007 (EcoNW, 2007) Lane County citizens spent an average of $330 per capita on lottery games in 2009 (Oregon Health Authority, 2010) About $7 out of every $10 was spent on video lottery games (video poker & slots)
Video poker and other computerized gambling develop gambling disorders “faster” – 15 months can be average to addictions – 4x as fast as horse/dog betting More problem gamblers with a preference for video lottery than any other form of gambling Provide a mechanism for escape, relieve boredom, promote fantasy, stimulate neurological systems Deceptively expensive to play You can bet $4.50 every five seconds on a five cent machine, $54 for each minute of play
Photo: Hynes
Photo: Daniel Berman
THE GAMIFICATION
DAILY FANTASY SPORTS
Image source: FX Network Image sources: FanDuel.com
Season → Day
problem
NOT ALL GAMBLING IS PROBLEM GAMBLING. IT’S A CONTINUUM.
No Gambling Experimentation
Recreational Problem Pathological
Sources: 1. Moore (2016). 2. Volberg, Hedberg, & Moore (2008). 3. Shaffer & Hall (2001). 4. Northwest Survey & Data Services (2007). 5. Moore (2001).
Between 2-3% adults 18+ problem gamblers (2.6%) Teens (13-17 y.o.): 6% at risk or problem gamblers 2College age (18-24): 5.6% 3
At-Risk“GAMBLING DISORDER”
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DiClemente, 2003: Addiction & Change: Self-regulated engagement: Balanced view of pros and cons and acknowledgement of the potential for negative consequences Action stage abuse & dependence: decisions focus on the positive end of the behavior; support repeated engagement Normalize & minimize problems associated with it Relationships, beliefs, attitudes, social systems are modified to support repeated engagement Quantity and frequency Own definition or pattern of what they consider “out of control” (gambling only on weekends, certain types of gambling, etc.)
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Pathological gambling is characterized by a number of phenomenon, including: A preoccupation with gambling “Magical” thinking - control the uncontrollable Total loss of control Chasing losses Lying and cheating Illegal acts Family bailouts Family disruption Basically, there is a continuation of the behavior despite the adverse consequences Gambling is no longer a form of recreation - it evolves - into the center of the individual’s life. Flip the coin
“reflects the increasing and consistent evidence that some behaviors, such as gambling, activate the brain reward system with effects similar to those of drugs of abuse.”
Source: American Psychiatric Association, 2013. http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf
According to the American Psychiatric Association (APA), this change to an addiction:
Information source: Custer, R. (1982); Lesieur, H. & Rosenthal, M. (1991)
WINNING
LOSING
DESPERATION
HOPELESSNESS
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Winning Phase Fun, Excitement Big Wins Feeling on top of the world Gambling is everything Losing Phase Large loses Using Credit to bet Borrowing Money Selling Possessions Arguing Missing school or work Desperation Phase Obsessed with Next Win/next game Lying Depressed
These comparisons are of course generalizations & do not by any means reflect all male & female gamblers.
Comparison by Start gambling at older age
Get addicted fasterMore likely to be “escape” gamblers (slots)
More likely to seek help
Start gambling fairly young (teens, 20s)
Tend to like games of strategy & “action” (poker, sports bets)
Less likely to seek help
Source: Brain Briefings (2007, October), Society for Neuroscience, Washington, DC
Gambling & Dopamine
Dopamine not released when expecting a loss.Flooded with dopamine when expecting a win!
It’s not about the money –it’s about the ACTION of the game and the HOPE of winning.
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Presentation Notes
http://www.youtube.com/watch?v=7A4Qxx7j63Y studies have found that when we anticipate financial gains - whether at the gaming tables or on the stock market - an area of our brain known as the ventral striatum becomes activated and flooded with dopamine, a brain chemical linked to pleasurable sensations. The release of this chemical also occurs during physically rewarding activities such as eating, sex and taking drugs, and is a key factor behind our desire to repeat these activities. When we start to consider the possibility of losing money, however, the same brain areas become less active. In fact, most people's brains show more negative sensitivity to losses than positive sensitivity to gains - neural evidence of our tendency toward risk aversion. Once considered a character defect, gambling is now known to be a highly addictive disorder with neurological causes. Thanks to new advances in brain imaging, scientists are beginning to identify the neural mechanisms that go awry in the brains of pathological and problem gamblers. What they're learning from such research is also shedding light on how these same mechanisms determine individual risk tolerance – and influence the financial choices we all make throughout our lives. You hold your breath as the wheel spins on the roulette table. You briefly close your eyes as the croupier deals you another card at the blackjack table. You stand frozen in place as the horse you bet on lunges toward the finish line. At such moments – when you're anticipating the possibility of a financial reward – certain areas of your brain jump into action. The particular pattern of that activity, neuroscientists are now discovering, helps identify how risk-averse you are – not only when you're at the gambling table or the racetrack – but when you ponder any decision that involves some financial risk. Should you take a new job? Should you invest in a new business? Should you put your savings in potentially volatile stocks or in the “sure thing” of a bank certificate of deposit? Those same neural patterns may also reveal whether you're at risk of becoming a pathological gambler, someone so addicted to gambling that you continue the activity even while mounting losses ruin your personal finances and relationships. Recent studies have found that when we anticipate financial gains – whether at the gaming tables or on the stock market – an area of our brain known as the ventral striatum becomes activated and flooded with dopamine, a brain chemical linked to pleasurable sensations. The release of this chemical also occurs during physically rewarding activities such as eating, sex and taking drugs, and is a key factor behind our desire to repeat these activities. When we start to consider the possibility of losing money, however, the same brain areas become less active. In fact, most people's brains show more negative sensitivity to losses than positive sensitivity to gains – neural evidence of our tendency toward risk aversion. In one study, researchers could predict how tolerant individuals were to risk by analyzing how their brains responded to potential gains versus potential losses. Those whose brains were less turned off by the possibility of increasing their losses tended to be more eager gamblers. In pathological gamblers, neural activity in the ventral striatum remains remarkably unreactive – even during winning streaks. Their brains also show decreased activation in the ventrolateral prefrontal cortex – the brain's “superego” – which, when functioning normally, keeps people from acting impulsively. This finding may explain why pathological gamblers keep betting despite the havoc it inflicts on their lives. To maintain even a normal level of dopamine in their brains, they must gamble with increasing frequency – and often for greater and greater stakes. And the impulse control in their brain is not functioning properly. Drug addicts show a similar brain pattern – and a similar need to keep feeding their addiction. Recently, pathological gambling has been found to be a rare side effect of specific types of dopamine agonists, drugs used to treat the tremors and balance problems associated with Parkinson's disease. The dopamine boost from these drugs appears to overload receptors in the ventral striatum, causing an irresistible urge to gamble. The effect does not occur in everybody who takes dopamine agonists and it dissipates once the medication is discontinued. Source: http://www.sfn. Good introductory video on dopamine & dopamine receptors: http://www.youtube.com/watch?v=7A4Qxx7j63Y
connections
(Poole et al. 2017; Hodgins et al. 2010; Najavits et al. 2010; Petry and Steinberg 2005; Kraus et al. 2003; Taber et al. 1987)
Exposure to early childhood trauma has consistently been associated with
Because of our time limitations, we’re focusing today on the services oftreatment & recovery.
It often takes years for someone to
1) admit they have a problem2) seek help, and then3) continue in recovery
First Steps to getting help could be…
24/7 Helpline: 1.877.MY.LIMIT
Referral to provider for assessment
Often family members come in; later bring gambler in
This is an actual helpline counselor. Everyone who answers the phone is a Certified Gambling Addictions Counselor (CGAC).
Treatment is free.The Oregon legislature requires that 1% OF LOTTERY PROFITS go to a Problem Gambling Treatment Fund.
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Presentation Notes
Paid through Lottery funds Gambling Evaluation and Reduction Program (GEAR) Corrections Program 27 outpatient treatment centers (Emergence Program in Lane County) 3 crisis-respite programs 1 residential treatment program
HAVE COMMITTED CRIMES TO FINANCE THEIR GAMBLING. Most crimes are “white collar” (forgery, check fraud, embezzlement.)
IS THE AVERAGE INDIVIDUAL GAMBLING DEBT.
Oregonians in gambling treatment (2016):
WHAT OUTPATIENT Tx IS LIKE: (SPOTLIGHT: EMERGENCE IN LANE COUNTY)
Treatment free for gamblers and loved ones- Over 250 problem gamblers and family members treated last year- Gender-specific
Many different things happen in treatment:- Individual sessions - Family therapy- Group sessions - Recreational counseling- Class type lectures - TV/internet/Skype
55 % male 45 % female
IN OREGON GAMBLING TREATMENT:
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Presentation Notes
1,754 Gamblers in Traditional Outpatient 214 Family Enrollments in Traditional Outpatient 85 Gamblers in Residential Treatment 99 Gamblers in Prison Based Minimal Intervention 38 Family in Prison Based Minimal Intervention 59 Gamblers in Home-Based Minimal Intervention 1 Family in Home-Based Minimal Intervention 15 Gamblers in Respite Care
gambler.IT’S NOT ALL JUST ABOUT THE
NEED HELP TOO!
Learning.Education about problem gambling as an addiction. What to watch out for. Gaining tools for financial/legal/other issues.
Dealing with trust issues. Being allowed to vent rage and betrayal. Healing from more “unfolding truths.” No more secrets. No more bailouts!
Getting continued support. Renew sense of hope & empowerment. Determining future of relationship.
Healing.
Growing.
FOR MORE INFO ON Tx OPTIONS IN OREGON:OPGR.ORG (Oregon Problem Gambling Resource)
PART 1: New apps and types of gambling come about almost continuously. Keeping up with digital gaming/gambling trends can be overwhelming and exhausting for many—including parents, educators, and those in behavioral health professions. In this workshop, we look at an overview and key concerns of some of the latest trends in the online gaming world (including daily fantasy sports and esports), and how the lines often are blurry between what is gaming and what is gambling. PART 2: As parents, educators and behavioral health providers, we have come to understand the importance of prevention of problem gambling, gaming and substance abuse. We are often left wondering about the best ways to break down barriers and apply principles of prevention and risk reduction to our communities and clients. In this section of the program we will discuss the similarities of risk factors in youth gaming, gambling, and substance abuse. We will identify various at risk communities and populations and examine readiness to address these issues, and how to plan and implement prevention strategies. WARNING: You will leave this workshop with practical tools to help make a positive difference in your community and at work.
