Donald Weinbaum, MBA, LCADC, CCJPExecutive Director

The Council on Compulsive Gambling of NJ, Inc.

3635 Quakerbridge Rd, Suite 7Hamilton, NJ 08619609-588-5515 ext 171-800-GAMBLER ®

Don@800gambler.org

Compulsive Gambling:The Invisible Addiction

June 24, 2010

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.

Legal Gaming in the U.S.

States

2007 Revenue

Casino 12 $35.5 billion

Indian 26 $26.0 billion

Charitable 47 $2.2 billion

Racing 33 $3.5 billion

Lotteries 47 $24.8 billion

$92.3 billion

(Data from NCPG)

Adult Rates of Smoking, Drinking & Gambling

Past year Lifetime

Tobacco Use

35% 71%

Alcohol Use 64% 82%

Gambling 65% 85%

(Data from NCPG)

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)

LEGAL GAMBLING IN NJ

Pari-mutuel gambling at race tracksNew Jersey legalized Bingo (charitable

wagering)First Lottery (.50 ticket twice weekly) was

approved by New Jersey voters in 1970Casino gambling was approved by New

Jersey residents in 1976 and the first casino opened in 1978

OTHER FORMS OF LEGALIZED GAMBLING

Spinning wheel type amusement gameArcade type gamesChances for FundraisersStock market gamblingFantasy football?Office pools?

Illegal GamblingSports BettingInternet Gambling

First Internet Gambling site – 1995Over 2,000 Gambling sites – 20051,100 Casino Gambling sites700 Sports Gambling sites200 + Poker Gambling sitesEstimated revenue – 2006 - $12 billion

Others

Types of Gamblers

Social (80%)

Problem (15%)

Compulsive (Pathological) (5%)

TYPES OF GAMBLERS

Social gamblers-80%Enjoyable experienceEntertainmentGamble with othersLimit amount of money spentStop after reaching limitsGamble for short periods of timeNo interference with other parts of life

TYPES OF GAMBLERSProblem gamblers- 15%

Gambles longer than plannedLoses more than intendedStarts to borrow money for gamblingProlonged losing episodesStarts to lie about amount gambledReturns to gamble to win back lossesRelationship problems begin

TYPES OF GAMBLERSCompulsive (pathological)

gamblers- 5%Cannot pay household expenses and debtsMarked increase in gambling episodesGambling for larger amountsReceives bailouts for gambling debtGambling aloneAlienation from significant others in lifeIllegal acts to finance gamblingUnsuccessful attempts to stopHelpless and suicidal

What is Pathological Gambling?

Enters DSM III in 1980DSM IV (1994):

(312.31) Impulse Control Disorders, NECDSM5 (2013?) – Addictive disorder

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

A. Must meet 5 out of 10 criteria: 1. Preoccupation2. Tolerance (increasing amounts of $)3. Inability to control, cut back or stop4. Restless, irritable when not

gambling5. Escape or relief of dysphoric mood

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

A. Must meet 5 out of 10 criteria (cont.): 6. “Chasing” –trying to win back losses7. Lying to family members and others8. Illegal acts to finance gambling9. Jeopardized relationship, job, education,

career10.“Bail Outs” – relies on others to cover debts

B. Not better accounted for by a Manic Episode

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)

Bio-Psycho-Social Risk Factors

MaleAthlete18-24 YrsSubstance useSubstance abuseOther MH problemFamily history of

addiction

(Data courtesy of NCPG)

Low SESMilitary ServiceRacial/Ethnic

minorityGamble illegallyEarly onsetEarly big winEasy access to

gambling

PHASES OF COMPULSIVE GAMBLING

Winning phase (1-2 years)Early big winExcitement prior and during gamblingUnreasonable optimismFeel specialEuphoria and fantasyGifts for wife and childrenPart -time activity

PHASES OF COMPULSIVE GAMBLING

Losing PhaseProlonged losing and chasing lossesLies about gamblingPersonality changesStarts to borrowHome life begins to be unhappyConversion of assets to cashFearfulBets impulsively

PHASES OF COMPULSIVE GAMBLING

Desperation PhaseConstant bailouts and increased debtsMore time spent gamblingRemorse and isolationIllegal activityThinking impairedPhysical symptoms of gamblingHelpless, hopeless, mental breakdown,

divorce, substance abuse, suicide

SubtypesActionMore likely to be male• Prefer “skill” games

(poker, sports betting, horses, casino table games)

Aroused euphoric state

Seeking the rushNarcissistic, fantasy

EscapeMore likely to be

femalePrefer “luck” forms

of gambling - lottery, slots, bingo

Gamble for relief, escape from stress or negative affect

PREVALENCE - NJ

Compulsive and Problem Gamblers: 350,000

Substance Abusers: 806,000

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

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.

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

Prevalence of MH Disorders

Gen Pop PGs Tx Seeking PGs

Any Disorder

8% 40% 60%

Maj. Depression

5% 20% 60%

Bipolar 1.5% 10% 15%

Suicidality

5% 20% 50%(Data from NCPG)

ADOLESCENT PREVALENCE

2-4 times higher rate than among adults

Past year gambling problem: 1-6%

GAMBLING, DRUGS & ALCOHOL

Four (4) Similarities for all addictions

Preoccupation

Withdrawal

Progression

Tolerance

GAMBLING, DRUGS & ALCOHOLDifferencesGambling connected to fantasyGamblers favor suicide, alcoholics hopeless

and helplessGamblers fully functional until hitting

bottomGambler sees money as drug and power.Disease model harder for others to accept.

GAMBLING, DRUGS & ALCOHOLDifferences (cont.)Cannot measure through blood, urine, hairGambling sponsored by religion and stateBailout or big win can stop self destructive

cycleGambling win seen as solution for problemsGamblers do it alone, addicts often in

groups

GAMBLING, DRUGS & ALCOHOL

Differences (cont.)No saturation point for gamblersGamblers excel at math and/or

superstitiousGambler’s recovery requires financial

restitution

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

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.

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

TREATMENT OPTIONSTreatment Planning/Aftercare – Integrate

Svcs12 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 AnonymousGam-Anon

MORE TOOLS

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 42Problem Gamblers and Their Finances: A

Guide for Treatment ProfessionalsPersonal Financial Strategies for Loved Ones

of Problem Gamblers

National Problem Gambling Awareness Week ( March 6-12, 2011)

In NJ, Month of March

www.800gambler.org/GAW

50+ free materialsScreening toolsPostersFlyersBrochuresPress releasesStories

CCGNJ Programs and ServicesPublic AwarenessPrevention and

Education (Schools & Colleges)

Intervention1-800-GAMBLER®

HelplineOutreach to Seniors,

Treatment , IDRCs and Community Agencies

Criminal Justice Initiatives

Training & Workforce DevelopmentFree 30 hr CCGC

WorkshopsConsultation on cases28th Statewide

Conference (10/7/10)In-Service Trainings

Advocacy & Collaboration

FOR MORE INFORMATION:

Contact us at:

The Council on Compulsive Gambling of NJ, Inc.

3635 Quakerbridge RdSuite 7Hamilton, NJ 08619609-588-5515Don@800gambler.orghttp://www.800gambler.org

For Immediate Assistance 24 hours

a day:

1-800-GAMBLER®