Recognizing Problem
Gambling
Developed by Nicole Corbin, LPC, CADC I
Presented by Richard Johnson, MA, CGAC II, CADC III,
NCGC II
Gambling Outreach/Prevention
Goals for presentation
 Understand gambling in Oregon;
prevalence among youth
 Differences/similarities with substance
abuse
 Indicators and impact of problem
gambling on youth and families
 Assessment
 Become familiar with resources to
address problem gambling
Gambling in Oregon is
Growing
Spirit Mt. Casino has replaced
Multnomah Falls as our #1 tourist
attraction
Societal Acceptance = More
Gamblers
 Industry perpetuates a vision of gambling as entertaining,
glamorous and as a means of achieving financial freedom.
 Recent surge in reality TV gambling shows
 High use of internet gaming sites among those under 18
Oregon Numbers
 2002
Oregonians spent $1.18 billion on all
forms of gambling, $447 per adult
25% more than the national average*
 2003
Legislation made way for a 20% increase
in Video Lottery Terminals
 2004
A ninth tribal casino opened in Oregon
 2005
The Lottery expanded into video slots
 2006
Lottery exceeds $1 billion in sales, video
lottery sales up 24% over previous year
Source: * Eco Northwest, 2005
Affected Oregonians
 More than 74,000 Oregon adults (2.7% of all
adults in the state) are believed to meet the
criteria for being current problem or
pathological gamblers (Moore, 2007)
 1.3% of Oregon youth are problem
gamblers, and an additional 4.6% are at-risk
gamblers. That means there are between
1,100 and 6,300 adolescents with severe
gambling-related difficulties (Volberg, 2007)
More Casinos?
Oregon Gambling: Summarized
Oregon has more forms of legalized
gambling and offers easier access to
gambling than almost any other state
- AND Oregon is a nationally recognized leader
in prevention, harm reduction and
treatment for gambling problems
Source: National Ctr for the Study of Gambling, 2006
What is Gambling?
(G.A. Definition)
Any betting or wagering, for self or others
whether for money or not, no matter how
slight or insignificant, where the outcome is
uncertain or depends upon chance or “skill”
constitutes gambling.
What is Gambling?
(A definition for clients)
Playing a game of chance or “skill” where
money, or something of value, is placed at
risk based on the uncertain outcome of a
future event
Chance, Skill, Money, Risk, Uncertain
Future?
What is Problem Gambling?
 All patterns of gambling behavior that
compromise, disrupt, or damage personal,
family, educational or vocational pursuits
 Pathological gambling is the most severe
pattern of excessive or destructive
gambling
Pathological gambling
 Synonymous with “compulsive”, “addicted”,
“clinical”, “diagnosable” and “Level 3”
 Classified in DSM-IV as an Impulse Control
Disorder
 Diagnostic criteria is similar to that of
Substance Abuse/Dependence
DSM-IV Diagnostic Criteria for
Pathological Gambling

Persistent and recurrent maladaptive
gambling behavior as indicated by five or
more of the following:
1)
2)
3)
4)
5)
Is preoccupied with gambling
Needs to gamble with increasing amounts of money
in order to achieve the desired excitement
Has repeated unsuccessful efforts to control, cut
down, or stop gambling
Is restless or irritable when attempting to cut down
or stop gambling
Gambles as a way of escaping a problem or of
relieving a dysphoric mood
DSM-IV Diagnostic Criteria for
Pathological Gambling cont.
6) After losing money gambling, often returns
another day to get even (“chasing” after one’s
loses)
7) Lies to family members, therapist, or others to
conceal the extent of involvement with gambling
8) Has committed illegal acts, such as forgery,
fraud, theft, or embezzlement to finance gambling
9) Has jeopardized or lost a significant relationship,
job, or educational or career opportunity because
of gambling
10) Relies on others to provide money to relieve a
desperate financial situation caused by gambling
Pathological Gambling: Comparison
to Substance Abuse
–Similarities
 Loss of Control
 Preoccupation
 Negative impact on major life areas
 Tolerance
 Immediate gratification
 Agent used as avoidance tool (e.g.,
pain)
Pathological Gambling: Comparison
to Substance Abuse
–Similarities
 Withdrawal Symptoms
 Self-help groups
 Biopsychosocial/spiritual disorders
 Family involvement
 Use of rituals
Pathological Gambling: Comparison
to Substance Abuse
–Differences
 Gambling is not self-limiting
 Behavior not attributable to
intoxication / chemical
ingestion
 More intense sense of shame
and guilt
 Greater denial and stronger
defenses
Pathological Gambling: Comparison
to Substance Abuse
–Differences
 Unpredictable outcome
 Fantasies of success /quitting is
giving up hope
 No biological test
 Easier to hide
Indicators of problem
gambling
 Increase in gambling time and places
 Increase in size of bets
 Increase in intensity of interest in gambling
 Working up special occasions for gambling
 Boasting about wins; not talking about losses
 Exaggerated display of money and other
possessions
 With teens, increase in computer use
More Indicators

Gambling when there is a crisis

Drop off in other activities/interests

Frequent absences from school, work and home

Diversion of funds earmarked for other purposes

Hidden Funds

Personality changes (irritability/hostility/moodiness)

Withdrawal from family

Decline in school performance

New friends; isolation from old friends

Missing possessions (may have been pawned)
Costs of problem gambling
 25 - 50 percent of spouses abused
 10 to 17 percent of children neglected or
abused
 FY 07-08 of 2,012 receiving treatment in
Oregon:
average gambling debt was $22,000 (underestimated)
combined debt from gambling over $37 million; 99
clients had debts of over $100,000
57% jeopardized or lost a significant relationship or job
21% committed illegal acts to obtain gambling money
28% had alcohol problems; 12% drug problems
21% reported suicidal thoughts and 7% reported having
made an attempt
The More Problem Gamblers, the
More Gambling Related Crimes
 Moore & Marotta ( 2006).
– 43% of women and 38% of men entering gambling
treatment reported to have committed an illegal act related
to their gambling.
 National Gambling Impact Study Commission (1999).
– A third of problem and pathological gamblers had been
arrested, compared to 10% of low-risk gamblers and 4% of
non-gamblers
Samuel Hopkins, Pastor of First
Congregational Church, Montpelier
Vermont on April 19, 1835
 “Let the gambler suffer this persecution. Lay upon
him the biting lash of public odium. Let him be
conscious that… he must bear the superadded
curse of unrestrained abhorrence; that whatever
else may be tolerated, there can be no tolerance
and no courtesy for a vice so foul as his” (Hopkins
1835:15).
 Stigma of PG remains today – a clinician
needs to understand the social stigma that
remains with this disorder. We are not far
removed from Pastor Hopkins.
Co-occurring Disorders
 Substance use disorders: About 30% of
problem gamblers report a current
substance use disorder at intake.
 Mood disorders: About 50% of problem
gamblers report significant depression
symptoms at intake.
 Suicide: About 10 percent of pathological
gamblers report frequent suicidal ideation at
intake.
Co-occurring Disorders (Continued)
 Personality Disorders: Problem gamblers
in the general population were over 6 times
more likely to meet criteria for ASPD than
non-gamblers. Youth have a higher
incidence of ODD
 Anxiety disorders: 12 - 28% of treatment
seekers met criteria for an anxiety disorder.
Irrational Ideas about Gambling
Held by Some Gamblers.
1.
2.
3.
4.
5.
6.
Gambling is an important human activity
Gambling is an easy way to earn money
Those who do not gamble are stupid, slow or frightened
Dedicated gamblers are usually bright and creative
Gambling is healthy recreation
My gambling is under control, or can be controlled with
some effort
7. I do not have to quit; I can just cut down and ration my
gambling
8. I can win it back
9. I’m smart; I have a system to beat the odds
10. People respect a heavy bettor
Irrational Ideas about Gambling
Held by Some Gamblers.
11. Someday I’ll score a really big win and quit with honor
12. Gambling will be the solution to my problems
13. Expensive presents will make up for past disappointments
14. Gambling makes me feel better
15. Money is my problem
16. I will pay it back
17. Borrowing to gamble is okay
18. Stealing to gamble isn’t really stealing
19. The more money I have to gamble with the more I can win
20. Even if I only have a few bucks, I’m better off taking a
shot at winning
Irrational Ideas about Gambling
Held by Some Gamblers.
21. Somebody will be there to bail me out if things go really
wrong
22. If only I knew why I gamble, I could stop
23. Will power is the answer
24. I always win in the long run
25. I’m just a lucky person when I win and really just
unlucky when I lose
26. What’s the use, I can’t stop
27. Sometimes I think I am really two personalities, a
gambler and a non-gambler
28. Suicide would solve all my gambling problems
29. I can’t afford to pay for treatment or take time off
from work to get help
Irrational Ideas about Gambling
Held by Some Gamblers.
30. I have to make as much money as I can as quickly
as I can
31. I am luckier than most people.
32. Gambling is a good way to forget about my
problems.
33.My gambling isn’t hurting anybody
34.Gambling will solve my family’s problems

[Adapted from “In the Shadow of Chance,” and Internet book by
Julian I. Taber, 1998.]
Problem Gambling
Screening Procedures

The Lie-Bet Questions:
1) Have you ever felt the need to bet more and
more money?
2) Have you ever had to lie to people important
to you about how much you gambled?
If yes to one or both, further assessment
is indicated
Screening techniques
 Ask on intake about gambling
– Also ask during collateral contacts
 Assess financial issues in family
 Ask “How often…” and “How much…”
 Ask about Leisure and recreational interests
 Ask if parents or siblings gamble
Gambling Treatment in Oregon
 Oregon has 27 outpatient gambling
treatment programs
 3 crisis-respite programs
 1 residential treatment program
 Free Treatment for gamblers and
family members
Problem Gambling Help Line:
Free and confidential; staffed by professional counselors
Phone: 1 (877) MY LIMIT (1-877-695-4648)
1(877)-2-STOP-NOW (1-877-278-6766)
Online: 1877mylimit.org (chat, IM, email)
Conclusions
 Problem gambling is a real and growing
concern
 Affects about 1 in 37 adults and 1 in 45
youth
 Help is available for gamblers and family
members
 81% of clients reported either no gambling
or reduced gambling at 6-months posttreatment
 Treatment is free, confidential and effective