Gambling Addiction Treatment Sparse As Mass. Gears Up For Casinos

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"This time it's going to be different. I'm going to win. Or I'm going to lose less. I'm only going to the ATM once. If I win x dollars, I'm going to leave."

That's Andrew, a recovering gambling addict, describing his mindset when he was hooked on going to casinos.

More than eight years have passed since Andrew last placed any kind of bet. But for just as many years, starting as a 21-year-old college student and then as a working professional, he couldn't stay away from casinos. They were like a magnet pulling him in, he says. Whenever he had enough money on hand, he'd drive almost 100 miles from his home in Massachusetts to Foxwoods in Connecticut.

It's that addiction that experts in Massachusetts are hoping to prevent and treat as much as possible once casinos open here.

As the Massachusetts Gaming Commission gets closer to approving the first license for a full-service casino in the state, advocates are working to increase the number of compulsive gambling treatment programs. And gambling addicts are hoping to keep their temptation in check.

Andrew attends Gamblers Anonymous meetings to get and give support.

"For me, my job was the casino. Whatever I was doing in corporate America was just there to collect a paycheck for my bankroll," Andrew tells the other GA members at a meeting in Boston. "My job was to be a poker player. And I chased that dream deep, deep down a hole that I thought I would never get out of."

But he did get out of that hole.

Andrew won't publicly reveal his last name because 12-step programs, including GA, promote anonymity as one of their core principles. But he wants to speak out in hopes of helping other compulsive gamblers.

Gambling addiction counselor Dot Duda warns having casinos close to home will affect lots of people — those already overcome by compulsive gambling and some of those who haven't yet developed a problem.

"They're going to experiment," Duda predicts. "You know, it's a new place. It's an exciting place. 'We can take the T to it. We don't have to drive, we can go have a couple of drinks and gamble,' and then pretty soon it's like they're going more and more often."

Research backs up that idea. A 1998 national study by researchers at the University of Chicago found almost double the level of problem and pathological gambling within 50 miles of casinos.

In 2004, researchers at the University at Buffalo's Research Institute on Addictions discovered living within 10 miles of a casino increased the odds of becoming a compulsive gambler by 90 percent.

Duda, who recently retired as director of the addiction program at Mt. Auburn Hospital in Cambridge, says some problem gamblers worry about big changes coming to Massachusetts gambling culture.

"Some of them are very concerned they're going to be so close and the temptation is going to be there," she explains.

Unlike other states with casinos, Massachusetts is providing significant funding — $5 million a year — for research on the economic and social impact of expanded gambling. The state gaming commission and researchers at UMass Amherst are currently conducting a baseline study to determine the level of gambling addiction before casinos open.

Compulsive gambler Andrew says he tries not to dwell on casinos opening in his home state.

"I've got to deal with temptation and struggle every day," he reflects. "You can gamble online, there's convenience stores with lottery. There's fantasy football, there's gambling all around."

Gambling addiction treatment isn't nearly as easy to come by. There are a dozen outpatient counseling centers in Massachusetts that receive funding from the state Department of Public Health and have certified problem gambling specialists on site. But they're all located in cities, most in the eastern part of the state. Other than that, addicts have to search out private providers. About 100 people total in Massachusetts are trained to treat compulsive gamblers.

The numbers should increase faster once casinos open. Casino operators will have to pay a shared $5 million into a public health trust fund, which will also receive 5 percent of gaming revenue.

Victor Ortiz, a social worker who runs training programs for the Massachusetts Council on Compulsive Gambling, says he wishes he had more funding now to more quickly boost the number of specialists and awareness of the depth of gambling addiction.

"One in five individuals who has been identified who has a gambling disorder also attempts suicide. This is a very complicated disorder that's very interconnected to both mental health and substance abuse," Ortiz explains.

He and Dot Duda from Mt. Auburn Hospital say people in the throes of addiction need easy access to treatment.

"If they're driving a long distance and they don't have any money, they can start to rationalize, 'I can't afford it,' where they could be spending a lot of money gambling," says Duda.

Even finding a GA meeting isn't that easy. There are only 54 per week in all of Massachusetts. By contrast, there are 2,200 weekly Alcoholics Anonymous meetings just in the eastern part of the state.

Before Andrew sought out a meeting he went the distance to fuel his fantasy of winning big and becoming a professional poker player. It involved a lot of planning, stress and lies.

"It's the obsession, the, 'where am I going to get the money, who am I going to borrow from, how am I going to get this bill paid,' how long you're going to play for, what your thresholds are going to be, and how you're going to make excuses for the commitments, the jobs, the family stuff you're missing. It was a lot of work."

Knowing things had spiraled out of control, he eventually went to security officials at Foxwoods and Mohegan Sun to ask to exclude himself from the casinos — meaning he could be arrested if he returned. In Massachusetts, casinos will be required to have programs where gamblers can be excluded by themselves or others. But Andrew says he's proof such exclusion plans don't always work.

"[I] spent years, years going back, under the threat of arrest, knowing that I had a problem, knowing that I shouldn't be there, and that was not easy," Andrew recalls. "I felt stupid about it. But I kept going."

Massachusetts is going further than other states by drawing up what's called a Responsible Gaming Framework, which is currently in draft form. That includes the requirement that casinos have on-site centers where people concerned they have a gambling problem can go for advice and referrals.

Alan Feldman, executive vice president of global government and industry affairs at MGM Resorts International, says in places where those casino-based centers do exist — like Canada and Australia — word is gambling addicts don't use them.

"Chances are that while they're in the casino, they're still in some sort of a manic state, and that it's going to be when they're away from the casino that they have that moment where they're going to be open to information," Feldman says.

Still, Feldman, who also chairs the National Center for Responsible Gaming, says MGM supports having the center in its downtown Springfield casino if the gaming commission approves its license. Casino operators will also have to post signs promoting responsible gaming and train all employees to identify and intervene with problem gamblers. But Feldman stresses casino workers can't be psychologists.

"What they can be doing is looking for certain signs that things might be a bit amiss," he says. "If someone appears to not be having fun, if they're acting out or acting angry, or just acting antisocial, they may or may not have a gambling problem but something isn't right."

He acknowledges casinos are out to make lots of money, but insists the last thing they want to do is take advantage of a gambling addict.

"That is a person who is going to likely end up bankrupt or destitute, and is going to all but certainly end up with a trail of debts — one of which would be us," Feldman says.

Andrew has worked for years to pay back his trail of debts. He finally sought out help when he had a new job and a new girlfriend he really cared about. After his first GA meeting, he gambled just one more time.

And he was recently forced to test his recovery a little more than he would have liked. He had to attend a professional conference at a Las Vegas casino facility. He prepared by attending GA meetings, checked in with his sponsor every day, and only carried a small amount of cash. He says knew he couldn't even look as he walked by the gaming halls.

"It was great wake-up call for me to know that I'm not cured," he says. "But it was also empowering for me to know that, 'Hey, you know what, if they build a casino next to my house, maybe that's OK.' "

He'll always fight the battle one day at a time.

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Lynn Jolicoeur Producer/Reporter
Lynn Jolicoeur is the field producer for WBUR's All Things Considered. She also reports for the station's various local news broadcasts.



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