Addiction is Addiction is Addiction

Addiction is Addiction is Addiction

The term “addiction” is defined as the state of being compulsively committed to a habit or practice or to something that is psychologically or physically habit-forming, such as narcotics, to such an extent that its cessation causes severe trauma.

Most of us are familiar with certain addictions, even if we may not completely understand them. For example, many of us know the person who can’t stop drinking, the person who can’t stop using prescription medications or the person who can’t stop using illicit drugs.

Yet there are many other addictions, ranging from food addiction to sex addiction to video game addiction. One addiction that’s as real as any but which is under reported in the media, and under recognized and under diagnosed by the treatment community and the general public, is gambling addiction.

This article will show how gambling addiction is essentially similar to other addictions and, indeed, merits the funding, attention and treatment that other, more commonly known, addictions do.

The Addicted Brain

While the range of addictions might seem different on the surface, there are certain fundamental things that they have in common. In particular, the processes that take place in the brain of a person with an addiction are quite similar.

When a person gambles for the first time, they might find it exciting. They might win money and feel on top of their world. This experience registers in their “reward hub” (ventral striatum), which acts like a gas pedal in their car to get them to where they want to go. The “control network” (pre-frontal cortex) works to stop or slow down what they’re doing. When these two areas are working together, the person is in control of their behavior and knows when to stop.

Addiction takes place when these two areas of the brain are not communicating properly. Continuing with the car analogy, an addict keeps pressing on the gas only to learn that the brakes may not work. By the time someone realizes they may have a problem with their gambling, it can be difficult to stop because it’s become a habit. Habits are developed when the brain no longer exercises conscious control. The person is essentially on autopilot. They become very aware of gambling cues and triggers, such as sporting events or casino or lottery advertisements.

At this point, gambling isn’t as fun as it was in the beginning. However, the addicted gambler continues gambling to escape the uncomfortable urges that the triggers create with the hope of recreating the high that they experienced early on in their gambling activities.

As the consequences of one’s gambling get worse, so does their mood. Whereas gambling once had a positive effect on their mood, it now cycles downward. Over time, they find gambling less pleasurable, and their mood continues to get worse, even when no longer gambling.

SEE ALSO  From MN DHS: As Sports Betting Goes Mainstream, So Must Problem Gambling Awareness

The brain processes that take place in people with addiction have been borne out by recent studies. Analyses of brain imaging of people with substance addictions and people with gambling problems show that both have less activity in the reward hub than people without addictions when it comes to anticipating rewards.

Over time, they find gambling less pleasurable, and their mood continues to get worse, even when no longer gamblingA person with an addictive brain is operating from the deep limbic brain (the place where emotion and survival are housed) and bypassing the frontal cortex (where logic and reason reside). People with addiction don’t choose for their brains to respond in this way, it’s the demand for dopamine that forges these distorted messages and strengthens these unhealthy pathways in the brain. An addicted brain is literally sending the message of survival when it is seeking another infusion of dopamine.

This means that people with addictions don’t process rewards in the same way. They may not be as excited by natural rewards. They might also have trouble learning how new experiences, such as taking up a hobby for the first time, can be enjoyable. That is why some people might seek out unnatural rewards (like gambling, alcohol, or drugs) just to feel pleasure or to escape.

Addictions hijack the attachment system, meaning that when a person is addicted to something, they gradually grow more detached from their personal relationships and responsibilities. They lose their true selves. Philips Flores, PhD., describes addiction as “a disease of isolation.” As the disease progresses, the gambler prefers to be alone, not wanting anyone to disrupt their “flow,” even if they are in the midst of chasing losses.

The good news is that brains are continually changing. Therefore, the processes that create addiction can be reversed to a varying degree over time. A study published in Neuropsychopharmacology showed that the brains of individuals with substance-based addictions changed in response to non-addiction cues. This means that individuals recovering from an addiction can start to enjoy natural rewards again. However, because these changes can take time to occur, it emphasizes the importance of continuing to practice previously enjoyable hobbies, to try out new activities in new settings, and to be around those who engage in positive behaviors. For those who choose recovery, it’s a journey that includes breaking from addictive habits and learning to reconnect to people and activities that will promote wellbeing, satisfaction, and joy.

Given the time it takes to build new brain processes—and a lasting recovery—individuals should consider the importance of cultivating healthy responses to non-gambling rewards. This can help protect them from the dangers of cross addiction and relapse, and create a rich, meaningful, and rewarding life over the long term.

Similar, But Not Equal

Given the similar processes involved with all addictions, it’s not surprising that some individuals “switch” from one type of addiction to another (also known as substitution or cross-addiction). For example, when a person stops drinking, he may find himself smoking more cigarettes, binging on certain foods, or gambling excessively. This unfortunate occurrence can occur because of reduced activity in the reward hub and their ability to “brake,” making a person vulnerable to other unhealthy rewards to satisfy urges. The result could be a new pattern of repeated rewarding behavior that steals one’s attention, opening the door to a new addiction.

With recent technological advancements, brain scans clearly show the commonalities of substance addiction and gambling addiction. In fact, it was in 2013 when the DSM-V (Diagnostic and Statistical Manual for Mental Health Disorders) finally recognized gambling as a peer addiction to substance addiction.

Given the similarity of the underlying process involved with all addictions, it’s logical and necessary for gambling addiction to be viewed through the same lens as substance use addiction. Fundamentally there should be appropriate and commensurate support in the form of funding. Unfortunately, funding for gambling treatment and prevention is a mere pittance of monies spent on treatment and prevention of alcohol and substance abuse.

In the U.S., substance use disorders are about seven times more common than gambling disorders, yet public funding for substance use treatment is about 338 times greater than public funding for problem gambling services. There are no federal funds for gambling disorder; all funds are provided by the states.

In Minnesota, there are no prevention materials on gambling addiction in the schools. While services offered to those seeking substance use treatment include opportunities to meet with certified peer recovery specialists, no such service is provided for problem gamblers. Minnesota has county-operated behavioral health clinics, yet they don’t offer services for problem gambling, nor is any screening for gambling addiction available. These clinics receive most of their funding from the federal government and adhere to federal regulations. While these clinics promote themselves as one-stop shops for all mental health and substance addictions, they do a significant disservice to those who may have gambling co-addictions by not screening for this disorder.

Reforms are needed for Minnesota’s approach to gambling addiction. Part of the mission of the Minnesota Alliance on Problem Gambling (MNAPG) is to advocate for parity of services and increased funding, along with educating the general public and treatment community that gambling addiction is very real.

An Equal Opportunity Addiction

Gambling addiction doesn’t discriminate by race, gender, socioeconomic status, culture, or age. Treatment for this often-devastating addiction is available — and it works. If you know of someone in your life who may be exhibiting signs of gambling addiction, let them know that help is available at no cost. Referrals are available through the Minnesota Problem Gambling Helpline at 1-800-333-HOPE (4673). MNAPG’s website has a wealth of information and resources on gambling addiction.

In Their Own Words – Danny’s Story

In Their Own Words – Danny’s Story

When you find yourself up at 2 a.m. betting on Chinese league basketball games, something you know nothing about, you have to realize that maybe you’ve got a gambling problem.

My relationship with gambling started when I was young. I remember playing cards with my uncle when I was nine or ten years old. At that time, poker was all over television, with ESPN broadcasting various poker tours. I found a website where I could play online for practice, and I spent many hours doing that.

By the time I was 14, I was staying up until four or five in the morning playing poker with my parent’s credit cards. My gambling progressed, and when I moved out on my own, I thought that maybe I could gamble all the time.

But by the time I was 18, I ended up in Gamblers Anonymous (GA). It was at a church and there were only two people there. At the time, it didn’t feel like the place for me. I had a full college scholarship for chess and figured I’d grow out of gambling. Unfortunately, I only lasted three months in college, and when I lost my scholarship, I lost some of my identity. I continued to gamble and also found substances as a way to try to keep gambling away.

There was a lot of pain and suffering between age 19 and 25. Although I visited GA again in 2013, I was very stubborn and didn’t stick with it. I got sober when I was 25 but didn’t give up gambling. By that time my income was substantially higher and my bets were larger. I also got involved in illegal activities to sustain my gambling.

In 2021, I had a substantial win and thought that would change everything. But, of course, it didn’t. I found myself sick and tired of being sick and tired. This time, my involvement with GA feels different. I’m more committed, have sponsors, chair meetings and go every week. While treatment centers may work for some (I went to the Vanguard Center for Gambling Recovery in Granite Falls as well as to a gambling treatment center in Florida), I’ve found that GA works best for me.

It’s now been eight months since I gambled. I’m very happy now. I have a great job and great friends. I’m back together with my girlfriend, who has been through a lot with me.

As someone who got into heroin at one point, I can honestly say that the high from gambling was greater than that of heroin. It is the hardest of the addictions. It’s easier to lie

to think you can win something. With drugs and alcohol, you won’t win anything, but with gambling, you can trick yourself.

To those who are struggling with gambling and wondering what to do, I would say this. Nobody accidentally finds their way into a GA meeting. If you think you’re having an issue, you more than likely do. But there’s help out there. There are a lot of different meetings and a lot of people are willing to help you. The environment is very welcoming and nonjudgmental. I realize now that the age factor — my being younger than many in GA — was simply a copout.

But I do think there’s a need for more GA meetings focused on young people, particularly now there are likely more younger people gambling because of the easy access. It can be difficult when you look around and see that most of the other meeting attendees are older. For this reason, I’ve worked to create a “young persons” GA meeting. My hope is that it will help others like myself.

iGaming:  the Next Frontier of Legalized Gambling

iGaming: the Next Frontier of Legalized Gambling

There has been increasing national attention on the recent push to legalize sports betting. (Minnesota has yet to pass a bill but look for action this legislative session.) However, another potentially lucrative expansion may be iGaming, defined as all forms of gambling games available through online apps. We were introduced to online gaming unknowingly through social casinos and “free-to-play” games on our phones. In a relatively short period of time (the iPhone came to market in 2007), gaming designers and gambling operators have exploited the tremendous opportunities to gain new customers and revenue through these relatively new venues.

At the Fall 2022 gathering of the Global Gaming Expo (G2E) in Las Vegas, a panel of gaming industry leaders discussed the opportunities afforded by legalizing iGaming. Currently, only six states allow iGaming: Pennsylvania, Michigan, Connecticut, New Jersey, West Virginia and Delaware. Leaders throughout the industry have asserted that the U.S. could gain $30 billion in annual revenue if iGaming were legalized in 42 states with commercial and/or tribal casinos and mobile sports betting. Some leaders expressed that iGaming would be quite competitive with commercial brick and mortar gambling. So, why aren’t more states jumping on this potential windfall?

Four reasons were cited by the panel.

1. Most states experienced a budget windfall due to COVID federal payments, reducing the need for additional revenue.

2. Lawmakers are concerned that adding iGaming will lower land-based revenue and cost jobs.

3. The risk that iGaming could lead to more gambling addiction.

4. iGaming doesn’t appear to have the same consumer interest as sports betting.

In addition to these four reasons, the panelists discussed the need for non-industry leaders to champion the cause. The tsunami-like approval by 35 states to legalize sports betting after the U.S. Supreme Court’s decision to overturn the ban in May 2018 was attributable in part to the number of consumers who were in favor of its passage. Currently, there doesn’t appear to be an equivalent level of enthusiasm for iGaming. In hindsight, the industry is thinking it may have moved too quickly to get sports betting through, when it should have paired the two in legislation, taking advantage of the pent-up demand for sports betting. Nor did it anticipate the level of federal COVID money going to the states, which has created at least a pause in lawmakers’ thinking about the benefits of expanding gambling again. Some lawmakers are considering that the expansion of slot machines and table games on a phone 24/7 may contribute to more gambling problems than sports betting.

(While it’s still early in the cycle and not a lot of data has been collected to measure the impacts of sports betting and iGaming, there are real concerns being raised about the level of advertising for sports betting and its influence over consumers, whether adequate consumer protections are in place in states that have passed sports betting and/or iGaming, and what states’ responses will be if addiction rates rise while minimal funds were set aside to address the issues.)

MNAPG will be watching this carefully and will continue to keep you informed of changes in the field.

Online Treatment Program Now Available At No Cost

Online Treatment Program Now Available At No Cost

Gambler Healing, an online gambling addiction recovery program offered through the state of North Dakota, is now available free for anyone — clients and counselors — to use.

While the program was unveiled just prior to the pandemic, it offers particular advantages in a post-pandemic world in which telehealth counseling figures to be a prominent and permanent feature.

“As we move into telehealth counseling becoming the normal, the Gambler Healing course can be a really beneficial resource for counselors who aren’t familiar with problem gambling and provide structure for individuals who live a distance from counselors,” says Lisa Vig, LAC, ICGC, program director for Gambler Healing.

Historically, there are many reasons why those with gambling addiction don’t always get the help they need. Some of these challenges include access to counselors, dealing with the burden of stigma and shame, concerns about privacy, and uncertainty about whether a problem really exists. With this online treatment program, it’s possible for more people to overcome these obstacles and access treatment.

Gambler Healing is an online course based on a 12-step recovery process that addresses the needs of gamblers with addiction. Details about the comprehensive program can be found on GamblerHealing.com. The program is the only one of its kind according to Lisa, who helped develop the curriculum. “The idea came to us when it became apparent that there were not a lot of relevant and educational resources about gambling addiction available,” says Lisa. “The original thought was to simply create updated educational DVDs, but the advent of e-campus modules made it possible and practical to create an actual class that would have greater impact.”

Program Components The program includes a variety of components considered critical for success. One key feature includes videos of recovering gamblers discussing their experiences. “We want people to know that they’re not alone and that others feel the same things that they might be feeling,” says Lisa. The program also includes a section for journaling. “Journaling is something we encourage in our own treatment program,” says Lisa. “It provides an opportunity for self-reflection and a chance to inventory one’s own behavior and thought processes.”

Enrollees also have the chance to read testimonials from those who have benefited from treatment. This helps to instill hope and remind participants that others have overcome similar challenges. There’s also an educational aspect of the curriculum to help gamblers understand how the process of addiction works.

Advantages of An Online Program As a program that’s administered online in the privacy of peoples’ homes, there are several advantages to Gambler Healing. Perhaps most important is the access to treatment it provides to those living in rural areas. “It can be particularly helpful for people living in places where there may be limited counselors or access to support groups and treatment,” says Lisa. The program is also convenient for the elderly or others who may have trouble traveling to treatment.

The privacy of the program may be useful for people who feel a sense of shame due to their gambling activity and would otherwise be reluctant to reach out for help. Similarly, the online aspect of the program can be attractive for high-profile individuals who don’t want to be seen around others who might recognize and judge them.

Gambler Healing also provides a way for people who might want to simply explore their gambling behavior and consequences to determine whether they have a problem. “In this respect, it can be used as an early intervention to stop a continued progression that might result in employment, family or marital problems,” says Lisa. People who choose to work the program on their own may also share their information with a counselor should they later decide to seek outside help.

Mental health professionals may find benefit in Gambler Healing as well. It allows those who are newer to the those addiction to gambling an insight into the addiction and possibly connecting to one of MN’s certified gambling counselors to coordinate a treatment plan.

In Their Own Words – Diane’s Story

In Their Own Words – Diane’s Story

Although Dianne is not a big football fan, she’ll never forget the Monday Night Football game between the Minnesota Vikings and Dallas Cowboys on January 3, 1983. It was the first major bet her husband, Don, placed on a football game. He bet a whopping $1,500 – an amount to cover accumulated gambling losses to date – and lost.

More than 25 years later, Dianne shudders at the memory of that night. She looks back on it as the beginning of a 14-year period in which her husband’s gambling took the family on a roller coaster ride it never wanted.

Shortly after that Vikings game, Don’s gambling losses began to mount. It soon led to another early memory that haunted the family: his young children watched in dismay as a stranger came into their house to remove a Betamax machine, the sales proceeds of which would be used to settle gambling debt. In the first of many gambling-related lies to his children, Don explained that the machine was broken.

In time, Don’s betting advanced from football to all other sports, and he soon had his own bookie. “I bet every day of the year except the Monday and Wednesday before and after the baseball all-star game, the only two days of the year when there was no sports betting,” says Don.

After Don’s bookie was the subject of a police raid, federal agents dressed in suits and badges came to the house. That development sent shock waves through the family. “That really scared the kids and I felt we couldn’t have that,” says Dianne. She subsequently packed up the kids and moved in hopes of finding a more stable home environment.

The sight of an empty house served as the first wakeup call for Don. He began attending Gambler’s Anonymous in 1986 and convinced Dianne he was ready to quit. Only he really wasn’t.

Shortly thereafter, Dianne came across a piece of paper with a list of football games while the couple was away at a cabin. “I was assured by Don that they were old games because he’d quit gambling.” She later confirmed the list was for current football games.

As a result, Don became increasingly sneaky in his dealings. He cancelled handball games with friends and rearranged work shifts so he could find more time for gambling at the casino. Don learned to kite checks from three checking accounts he created, and found himself visiting a banker every day. “I could at least relax on the weekends when the banks were closed,” recalls Don some 20 years later. He was working one job and half of another “to keep all the balls in the air.”

Don forged his wife’s signature a few times to take out loans to pay gambling debts. With a flexible work schedule, Don, who controlled the family’s finances, arranged to be home when he knew the mailman would arrive, meeting him several houses in advance. “The joke was that I was having an affair with the mailman,” says Don.

The cycle of lies and deceit – as well as a general absence from the family – continued through 1994, about eight years after Don first attended GA. On Tuesday, December 27, 1994, he called in sick to work and cancelled a handball match with a friend so that he could stay at a casino. When Don, who called his wife every afternoon like clockwork, didn’t call at the usual time, Dianne suspected the worst. Late that afternoon, a call finally came. “Would you mind if I cashed another $100 check,” Don asked? “Do whatever you want, stay as long as you want, I don’t care,” said his defeated wife of 16 years.

Don came home in the wee hours of the morning on Wednesday, but to a bedroom that was locked. He knew he’d hit rock bottom and had to stop gambling. He went to GA that night and has been attending religiously every since. That Tuesday night was the last time he’s every gambled.

Today, Don is well into his recovery and is a thriving member of society. He considers himself fortunate in that GA has helped him, and helped him at age where he can still repay his debts and hopefully accumulate something of a nest egg. Other gambling addicts require individual treatment and counseling to help in their recovery.

The road has been long and not without challenges. “It was particularly tough to quit at the beginning,” says Don. “Even several years into it, I remember seeing a list of football games and asking myself if the Packers would cover the spread, etc.” For her part, all these year’s later, Dianne’s stomach still turns when she sees her husband turn the channel from one football game to another, conditioned for so many years to think he’s checking on games he bet on.

Forgiveness, after so many years of deception, is difficult to grant. In Don and Dianne’s case, a more complete healing didn’t occur until well after Don had quit gambling and the couple had engaged in Retrouvaille, a type of marriage counseling that’s not unlike a 12-step program.

Thankfully, much of the damage caused by Don’s gambling has gradually healed. His daughter, who wouldn’t allow him to attend her high school graduation nor be part of her wedding, has reconciled with Don. “Our kids carried around a ton of hurt from what their father did,” says Dianne. “It seemed like every time we wanted to do something as a family, all the sudden he was gone. For the kids, it was one broken promise after another.”

Today, 17 years into his recovery, Don’s promises are as good as gold.

Reflections from Minnesota NCPG Conference Goers

Reflections from Minnesota NCPG Conference Goers

The annual conference of the National Council on Problem Gambling took place in July. Here are reflections from two Minnesotans who attended:

Jeff Hudson, MNAPG Board President, Person with Lived Experience

I am extremely grateful to have had the opportunity to attend. Ever since I made the commitment to ease gambling harm, I have thought the answer lies in all stakeholders being involved. Here are some of my observations:

· Networking. I had a list of specific people I wanted to meet in person, having either talked or followed on social media and it was a great networking experience.

· Critiquing research. I saw two panels where I had doubts about the thoroughness and accuracy of the research. Hearing the presenters talk about their methodologies helped me think critically about what they were measuring and the results they were claiming.

· Agility grants. I really enjoyed hearing the stories and seeing the videos that were created by participants.

· Veteran programs. The sheer number of veteran-related programs was telling, as was the convincing evidence. It is clear this is a very underserved community, and we have the potential to make some great strides in Minnesota.

· School boards. Someone said they are having more success reaching out to local school boards about gambling education than by going to individual schools. It makes sense, since the school board can influence many schools.

Katie Richards, MNAPG Board Vice President, Problem Gambling Counselor

One of my biggest takeaways from the conference is that sports betting will change a lot of things on many levels, not just on a state level but a national and individual level. There was a lot of education on what sports betting is, who is doing it, the companies that are promoting it, etc. However, one thing that could be done better is, once given that information (the multiple massive studies done), what should the person in the audience do with it? Example, I know the profile of a sports better, but what therapy techniques can I use with them? Or how do I advocate to the state of Minnesota to change the current legislative bills to make sure clients are being protected? On a federal level is there anything I can do? “

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