Q. Is pathological gambling similar to chemical dependency?

Yes and no. Similarities between pathological gambling and chemical dependency include an inability to stop/control the addiction, denial, severe depression, and mood swings. Pathological gambling and chemical dependency are both progressive diseases with similar phases. These include “chasing” the first win/high, experiencing blackouts and using the object of addiction to escape pain. Both pathological gamblers and persons addicted to alcohol or drugs are preoccupied with their addiction, experience low self-esteem, use rituals, and seek immediate gratification.

Q.Unlike chemical addiction, pathological gambling is a hidden disease ­ gamblers do not stumble, have needles in their arm, or smell of cards and dice.

Pathological gamblers cannot overdose in the conventional sense, but they experience tremendous financial problems that require immediate attention. More resources are available to chemical dependency than gambling addiction, in part because most people do not perceive gambling as potentially addicting. It is very important that pathological gamblers receive crisis stabilization at the beginning of their treatment, because pathological gamblers have a much higher suicide rate than persons addicted to alcohol or drugs.

Q. How are children affected by pathological gambling?

Children may be affected in several ways. They may be physically and/or emotionally abandoned by their parents, who are unable to provide their children with needed attention and nurturing because of the time spent gambling. “Casino kids” have been left by themselves at the outer rim of casinos while their parents gamble, according to some casino security officers. In some extreme cases, children are left in the family car in the casino parking lot for hours at a time while their parents gamble inside. Less obviously, children may also spend several hours each week with babysitters while their parents gamble in casinos, bingo halls or card rooms. All of these scenarios may lead a child to feel physically and emotionally abandoned.

In addition, the dysfunction that pathological gambling creates in a home often includes spouse and child abuse. Children are abused verbally, mentally and physically by the gambler, and often even more so by the co-dependent spouse. This devastating abuse frequently goes unnoticed or is denied by others as the child suffers in silence.

Another way children are affected by pathological gambling is when they become pathological gamblers themselves. Today, teens are approximately three times more likely than adults to become problem and pathological gamblers. It is imperative that we educate young people about the dangers of pathological gambling and the importance of seeking help if gambling becomes a problem. The rate of problem gambling among high school students is more than twice the rate of adults, 11.3% of High school students qualified as problem gamblers in contrast to that of adults 5.4%. Interestingly 87% of High school students reported that they have done some sort of gambling in their lives.

Given these statistics concerning gambling amongst high school students-governing bodies of schools should implement awareness in their curricula concerning the ramifications of gambling amongst teenagers. To conclude the bottom line in gambling addiction amongst children 9 out of 10 times could be ascribed to the parents involvement in gambling.

Q. Are gamblers addicted to money?

Pathological gamblers are addicted to action, not money. Many pathological gamblers will gamble to lose in the desperation phase of their addiction, because it is the action they seek, not the money. For a gambler, being in action is similar to being high on cocaine for the person addicted to cocaine. Both describe their “drug of choice” as seductive and ultimately destructive.

Q.What is the physician’s role in treating pathological gambling at the Illinois Institute for Addiction Recovery?

Pathological gambling has been recognized as a major addiction illness, similar in many ways to the chemical dependency of cocaine. It is characterized by the sudden euphoria of winning and the marked dysphasia, depression and frustration of repeated losing.

The physician is needed to assess these patients for the frequent incidence of cross addiction to drugs and alcohol, for potential drug withdrawal, and for potential suicidal tendencies associated with the depression that most patients experience. Underlying medical problems are often neglected while patients are in a gambling frenzy, leading to symptoms of illness and health deterioration. Laboratory tests and physical examinations can often uncover unexpected medical problems. The most important medical contribution the physician makes is to assist patients who are experiencing withdrawal by supporting their need for group therapy, assessing for possible antidepressant medication, and making referrals for appropriate psychological help. The use of sedative medication is avoided, as these drugs may lead to a deepening of the depression and may actually exacerbate suicidal behavior.

Q.What is the financial counselor’s role in treating pathological gambling at the Illinois Institute for Addiction Recovery?

Pathological gamblers often find themselves in a devastating financial position by the time they reach treatment. Helping them become financially stable goes a long way in supporting their recovery and the well-being of their families.

It is the responsibility of the financial counselor first to determine the extent of the gambler’s debt, and then to help guide them out of their financial problems through debt management, budgeting and restitution.

Gamblers in treatment work extensively with the financial counselor, through every level of care, to achieve financial stability.

Q. Is there one type of gambling that is more addictive than others?

Video poker and slot machines have been referred to as the “crack cocaine of gambling.” Because of their immediate and effective reinforcement schedules, problem gamblers who regularly play these machines appear to progress into pathological gambling much faster than problem gamblers who only gamble at horse races, or other games that do not have such an immediate rate of gratification.

Just as crack cocaine ­ referred to as the “great precipitator” ­ shortened the length of time between first use of cocaine and chronic addiction, so too have video poker and slot machines apparently reduced the length of time between first wager and pathological gambling. In the past, a gambler would experience 15 to 25 years of “sick” gambling at the horse track before he or she reached the desperation phase. Today, it is not uncommon for a gambler addicted to slot or video-poker machines to progress into the desperation phase in two or three years.

Q. Is there a biological basis for pathological gambling?

Biological findings from a recent study indicate that pathological gambling is an addiction similar to chemical addiction.

A study conducted by Alec Roy, M.D., a psychiatrist formerly at the National Institute on Alcohol Abuse and Alcoholism, showed that some pathological gamblers have lower levels of norepinephrine than normal gamblers. This brain chemical is secreted under stress, arousal, thrill and excitement, so pathological gamblers may engage in activities such as gambling to increase their levels of norepinephrine.

This evidence supports the assertion made by Dr. Henry Lesieur, among others, that some pathological gamblers are “action seekers” who gamble, not for money, but for the excitement.