Professional Counselor Magazine
THE HIDDEN ADDICTION
By Arnie and Sheila Wexler
Tom, a 22 year old, calls the gamblers hot line from a telephone booth on the boardwalk in Atlantic City. He’s talking about killing himself because he believes he has no other options. He owes $75,000, has no job and just lost $4000 in stolen money. The hot line volunteer was took him to treatment in the only free standing in-patient facility in New Jersey, at that time. On admission he revealed that he had been in several alcohol and drug treatment centers for his drug addiction, but never was asked any questions about gambling.
Steve came to treatment after a gambling binge in the casinos in Atlantic City. He was experiencing what appeared to be, withdrawal symptoms. He had dilated pupils, sweats, shakes and extreme mood swings. The nursing staff reported that his blood pressure was elevated and that he was very hyper. He denied any use of alcohol or drugs. This was later confirmed through his lab results. He was placed in the detox unit until he was stabilized.
Michelle is clean and sober for 14 months. She never revealed to her addictions counselor, that gambling was her first love. During the 14 months in recovery she goes from occasional to daily attendance at the racetrack. One day she finds herself at the bar in the track, ready to order a drink. Fortunately, she panics and picks up a telephone, instead, and calls Gamblers Anonymous for help. Today she has 11 years of abstinence from gambling and 12 years from drugs and alcohol.
Over the past several years we have been doing workshops and seminars for alcohol and drug counselors from Canada to Mississippi; from Vermont to California, and even as far as Japan, on the subject of compulsive gambling. The most common thing we hear is that the calls for help from gamblers and their families are increasing, daily.
Compulsive gambling is a progressive disease in which an individual has an uncontrollable preoccupation and urge to gamble. This results in excessive gambling, the outcome of which is the loss of productive time and money. Eventually the gambling compromises, disrupts, and destroys the gambler’s personal life, family relationships and vocational pursuits. To the compulsive gambler the need to bet is no longer a little action or the illusion of a quick or easy profit. Placing the next bet becomes a matter of life and death.
For millions of people, gambling offers a harmless and entertaining diversion from everyday life. For others, however, the simple act of placing a bet is a very different experience, a moment in which they have lost the ability to control their gambling behavior. The compulsive gambler is driven to gamble in the same way an alcoholic needs a periodic drink or a drug addict needs a “fix”. However he or she does not reveal signs of their addiction on their breath nor by track marks on their arms. This addiction can remain hidden for a longer period of time and it is likely that the gambler will not seek help until it is in its advanced stages.
There are three phases of progression. The first is called the “Winning Phase”. Most compulsive gamblers report that they have either had one or more “big wins” or a series of winning streaks. This seems to be the “hook” that encourages the fantasy that they will continue to win and become wealthy from their gambling activity. This phase is usually over in a short period of time, but winning can occur in all phases.
The next phase is the “Losing Phase”. The gambler begins to chase their losses in this phase. Their bets get larger and they borrow money from friends, family, co-workers, credit cards, banks and eventually illegal sources. They often delay paying debts and will manipulate finances in order to continue their gambling. They cover up, lie to loved ones and they are often irritable, restless and argumentative. They may attempt to slow down or quit gambling, altogether, but they are unable to stay away for any substantial length of time.
The last phase of progression is appropriately referred to as the “Desperation Phase”. The gambler spends most of their waking hours in pursuit of the bet and/or the money to make the bet. By now the thrill ends when the bet is placed, not when the game is won or lost. The excitement of the win is only to obtain more money to place the next bet. They alienate themselves from family and friends. They may begin to be involved in illegal acts (i.e. bad checks, embezzlement, credit card fraud). They experience feelings of hopelessness and despair and suicidal thoughts and attempts can occur.
The gambling is so out of control that the gambler may destroy not only his or her life, but those of family members and significant others. They experience frequent arguments, feelings of rejection, fear, worry and anxiety as the spiral of progression continues. They tend to blame themselves and make vein attempts to gain control of the money and the gambler. Financial problems and pressures are overwhelming and they find themselves unable to cope with every day life. yet they may appear to function on their job or elsewhere because of the hidden nature of this addiction. Partners of gamblers will also experience feelings of hopelessness and will, at times, consider suicide as an option.
As was the case with alcoholism for many years, compulsive gambling is, for the most part, unrecognized and often misunderstood. Perhaps this is due to the fact that compulsive gambling is a “drugless” addiction. The gambler gets high without putting anything into their bodies. However, gamblers, themselves, describe sensations they experience as being quite similar to those experienced by chemically addicted individuals. When asked, a high percentage of dually addicted cocaine addicts/compulsive gamblers claim that gambling gives them the bigger high.
Many factors found in chemical addictions can also be found in the compulsive gambler. Some of these include: Preoccupation, denial, tolerance, loss of control, and legal problems. Gambling can elicit stimulating, tranquilizing, or pain -relieving responses. It is used as a way to escapes or to relieve a dysphonic mood.
It is estimated that 5% of the general population suffers from this addiction. However the numbers are much higher for alcoholics and drug addicts.In a survey of New Jersey treatment centers in the late 1980’s, 28% of patients receiving inpatient treatment and 22% in outpatient treatment for chemical dependency had gambling as a co-addiction. In some cases, gambling was the primary addiction. The potential for cross addiction or switching addictions is quite high in this population. Unfortunately, many cases slip through the cracks .
The treatment community needs to address this issue. One thing that can be done, fairly easily, is to add some questions about gambling to their intake forms. Another way would be to use the South Oaks Gambling Screen and / or the specific criteria listed in the DSM IV under Pathological Gambling (312.31). Educational lectures and films can be utilized to expand existing services. Finding the resources in the community and making proper referrals (including Gamblers Anonymous and Gamanon) is another way to assist. Facilities can train existing staff on the subject of compulsive gambling or hire specially trained or certified gambling counselors.
As gambling increases across this country, so does the need for help. Many people who are looking for help, naturally assume that they will be able to find it by reaching out to the addictions community. There are limited resources and funding for specific gambling treatment. Don’t let that stand in your way. Use some (or all) of the suggestions made above to expand your services to include the compulsive gambler and his or her family. You can make a difference. If you won’t – who will?
ARNIE AND SHEILA WEXLER
Arnie and Sheila Wexler Associates