Problem gambling: gender, treatment and the state

According to the National Council on Problem Gambling, nearly 3 million individuals in the United States (including just over 300,000 New Yorkers) are “pathological gamblers,” with another 4 million to 6 million individuals “problem gamblers.”

The latest edition of the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders” states that four of the following conditions must be met in a 12-month period for an individual to have a gambling disorder (formerly called pathological gambling):

1. Needs to gamble with increasing amounts of money in order to achieve the desired level of excitement

2. Is restless or irritable when attempting to cut down or stop gambling

3. Has made repeated, unsuccessful attempts to control, cut back or stop gambling

4. Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling experiences, handicapping or planning the next venture, thinking of ways to get money to gamble)

5. Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed). After losing money often returns another day to get even (“chasing” one’s losses)

6. Lies to conceal the extent of involvement with gambling

7. Has jeopardized or lost significant relationships, job or educational, or career opportunity because of gambling

8. Relies on others to provide money to relieve desperate financial situations caused by gambling.

Male and female gamblers

While there are more men than women with gambling problems, the gender gap is closing, with most experts of the opinion that wagering differs by gender. Men are more likely to be “action gamblers,” preferring games that involve skill such as poker, blackjack and sports betting. Women are more likely to be “escape gamblers” and play games governed by chance alone, such as the slots, bingo and lotteries.

Females with gambling disorders are often anxious and/or depressed, and wager to distract themselves from problems in their personal lives. Research indicates that lifestyle changes such as retirement, death of a loved one or divorce can lead to a transition from under-control social gambling to problem gambling.

The Council of Casinos’ “Why Casinos Matter” report states that for some slot machine players, the goal is not winning. Rather, it’s “staying in the zone.” The report states that to maintain this desirable psychological state, “players prolong their time on the machine until they run out the money – a phenomenon that people in the industry (gambling) call ‘playing to extinction.'”

Some studies indicate that women frequently report being “hypnotized” when playing slot machines. Anthropologist Natasha Schull, who has studied slot machine gambling extensively, notes that problem slots gamblers often get irritated when they hit a jackpot “because it stopped the flow of play.” One habitual slots player stated, “I was having a love affair with that machine. … If anybody came near it, touched it, ‘Back off. Don’t touch my machine.’ It was the same as a kiss from a lover,” she said. “It was sweet. Sweet.” Little wonder that slot machines are called the “crack cocaine” of gambling.

Males with gambling disorders typically began wagering as teenagers, with this behavior turning into a serious or compulsive disorder over a decade or more. Women who become compulsive gamblers generally begin wagering later in life than their male counterparts, usually in their 20s. However, once they become regular gamblers, female dependency can occur within five years.

Many problem gamblers fall victim to the “gambler’s fallacy,” the erroneous belief that in a game of pure chance, there is a relation between past events and future outcomes. For example, suppose that nine straight coin flips come up heads. What is the probability the 10th flip will be heads? If an individual says it’s more or much more likely the flip will be tails because tails is “due,” he or she has committed the gambler’s fallacy. The 10th coin toss is an independent event and, therefore, just as likely to come up heads as tails. The gambler’s fallacy can be disastrous when individuals confident a losing streak is about to end increase their bets to recoup losses.


Timothy Fong, professor of psychiatry at the University of California, Los Angeles, notes that only a small percentage of compulsive gamblers will seek treatment. Fong believes there is more shame associated with a gambling addiction then with a drug or alcohol addiction: “I think, for a lot of people, there’s something more disgraceful about losing your money while sober then you spending it on drugs.”

As there are no physical signs of problem gambling, this “silent addiction” is easier to hide. Compulsive gamblers, therefore, are less likely to be persuaded or cajoled into seeking treatment by their significant others or employers. As one gambling counselor noted, “You can’t smell blackjack on someone’s breath.”

Founded in 1957, Gamblers Anonymous “is a fellowship of men and women who share their experiences, strength and hope with each other that they may solve their common problem and help others to recover from a gambling problem.” Although anecdotal evidence indicates GA has helped some people, its overall effectiveness is questionable. A British study of 232 initial attendees of GA meetings found that after 10 meetings, only 71 individuals (30.6 percent of the original sample) remained in the program. Of this group, 7.5 percent had not gambled one year later, and 7.3 percent had not gambled two years later. Psychiatrists Sanju George and Vijaya Murali believe that although GA has a high attrition rate, those who regularly attend meetings benefit from this intervention.

Studies suggest some gambling disorders may be successfully treated with medication. Researchers at the University of Minnesota divided problem gamblers into two groups. The first group reported wagering when the urge to gamble became too strong to control. The second group had difficulty inhibiting even the slightest desire to gamble. Dr. Jon Grant stated that while a majority of gamblers in the study responded favorably to the medication, for some individuals the drugs did not work. Psychiatrists George and Murali note that preliminary findings offer promising trends in pharmacological treatments for gambling disorders.

Time to decide

Proponents of casino gambling typically consider compulsive gambling an individual or personal problem, much like drug addiction and alcoholism. However, this “individual” problem exists in a larger societal context wherein casino gambling is condoned – if not outright encouraged – by the state. Speaking of casino gambling, Les Bernal of the national organization Stop Predatory Gambling stated, “No one is saying that people can’t gamble. This is about government using gambling to prey on human weakness for profit.” While state governments have legalized casino gambling (and lotteries), they have shifted responsibility for any gambling problems they helped create onto individual gamblers.

Will additional casinos in New York create more jobs and revenue for the state, more problem gamblers, or both? Perhaps constructing up to seven new casinos is an expensive exercise in futility. Clyde Barrow, director of the Center for Policy Analysis at the University of Massachusetts, Dartmouth, stated, “The Mid Atlantic states – Maryland, Delaware, West Virginia, New Jersey, Pennsylvania and soon New York – have reached saturation,” meaning the number of slot machines and games currently available meet the existing demand.

Voters will have the opportunity to decide the future expansion of casino gambling in New York on Nov. 5.

George J. Bryjak lives in Bloomingdale, retired after 24 years of teaching sociology at the University of San Diego.


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