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How to beat an online gambling addiction

Earlier this week, it was revealed that a 23-year old accountant who plunged to his death from a London skyscraper last summer “died of shame” from his online gambling addiction.

Joshua Jones, a Surrey University graduate, saw no way out after the debts and loans he had taken out to feed his habit rose uncontrollably, and took his own life in July 2015. His father, speaking at an inquest at Southwark Coroner’s Court, revealed how his son had lived a “double life” and how despite having a “good job, he was addicted to gambling.”

“He took his life because of gambling,” Mr Jones added. “We miss him terribly.”

Unlike substance abuse, there are no immediate physical effects of problem gambling. However, as the Joshua Jones suicide proves, the repercussions can be just as grave.

“For gambling addicts – around 0.1 per cent of the population – gambling completely takes over their lives and compromises their relationships, jobs or education, and social activities,” says Dr Mark Griffiths, Professor of Behavioural Addiction at Nottingham Trent University. “They experience the same things other addicts experience – including withdrawal symptoms, relapse, mood modification, cravings and loss of control.

“Brain imaging studies have shown that individuals with gambling addictions have diminished ventral striatial activation,” Griffiths adds, “the part of the brain involved in both emotional and motivation aspects of behaviour.

“Thus, gambling becomes the most important thing in an addict’s life and becomes an activity that they will do to the neglect of everything else. They will become totally preoccupied with gambling and, even when they are not gambling, they are always thinking about the next time they will be.”

Liz Karter, an addiction therapist, gambling addiction expert and author of Problem Gambling has seen many individual’s lives ruined by online gambling. She shares her tips on how to combat the problem.

“Ever since online gambling began to get more and more prevalent,” says Karter, “gambling addiction has leaped the social divide. Now, over 50 per cent of my clients, both male and female, are from a middle-class, professional background.

“Online gambling has given this type of higher earner private access to a product and service that they may not have previously been comfortable trying in public or person. You no longer have to leave your home to gamble – you can do it in the office, on the commute home or anywhere you have an internet connection. And that is what makes it dangerous.”

1. Admit you have a problem

“Like any addiction, the first step on the road to recovery is accepting that you have a problem,” says Karter. “You need to face up to the fact that your gambling habit has got out of control and, by realising that you need to return to some sense of normality, you will be better prepared to put in the work and effort to get there.

“Emotional confusion is very common at this point – with one side of your personality acting rationally and acknowledging that gambling is destroying your life whilst the other is craving the practice with an increased intensity.

“The next step is to rally the right support around you that will help reinforce and strengthen the rational part of you and ease your cravings.”

2. Confide in a trusted individual

“Next, you should confide in a supportive friend or family member,” advises the addiction therapist. “This tends to be one of the first steps before seeking professional support, as they will likely encourage you to capitalise on your rationality. However, the act of telling a friend or family member is often the most worrying part of the entire process.

“Unlike other addictions, such as with drugs or alcohol, there are no immediate physical signs that an individual may be suffering. Because of this, it is an addiction that is easily hidden and your confidant may have not picked up on your problem. Instead, the indications will have been subtler – you may have started withdrawing from social interactions, been exhibiting mood swings or been unenthused by previously enjoyable activities.

“The general behaviour of a gambling addict is such that partners frequently believe them to be having an affair,” reveals Karter.

“But both you and your confidant will feel better once the problem is out in the open,” she adds. “It is likely that they suspected something was wrong due to your changing behaviour, and this way they will be relieved that you have finally revealed what it is – despite still being worried for you.”

3. Block your access to gambling

“The third step is to block your access to the type of gambling you are addicted to. Then, to all and any forms of gambling.

“This will put an end to your habit and – with the help of your confidant – you will be more likely to stay away from the gambling websites and apps than had you attempted to quit by yourself. This way, you will be letting someone down if you relapse into your gambling ways.

“This step will allow you to realise that gambling is not the escape you believed it to be,” says the addiction expert. “People use online gambling as an escape – something to distract them from the stresses and pressure of juggling what they feel are overwhelming work and home commitments. However, eventually, you will realise that it is not a solution, and that the inevitable losses begin a cycle of problems, and the issues from which you were initially trying to run are intensified.”

4. Relinquish control of your finances

“Another common problem that only serves to exacerbate the secrecy of the habit is that the gambler is afraid that their addiction will be misunderstood and viewed as greed,” Karter reveals. “Many also simply can’t comprehend the actual odds of them winning, and this drives the problem deeper underground.

“Therefore, the next step is to overcome this shame and embarrassment, realise that your confidant will not think that it is greed, and ask them if they will help you manage your finances for a short period of time – four weeks is a good start.

“By giving someone else control of your money,” Karter continues, “be this a bank account or credit cards, you will have the burden lifted from your shoulders momentarily, and this will make it easier to move on. During this time, it is advisable to seek debt management – as unmanageable debt simply drives the addictive cycle of loss chasing. Loss chasing, when you keep gambling to win back money you’ve already lost, is one of the hardest habits to break.”

5. Stay busy to overcome withdrawal

“Taking away your access to gambling will not take away your cravings to gamble,” warns the addiction therapist. “So – as is the case with beating any addiction – you will experience a withdrawal period. This tends to feel the worst for the first week or so after quitting gambling, so it is imperative to stay busy during this time – preferably in the company of others to distract yourself.

“It is of paramount importance that you don’t think about how one more gamble could give you the big win that would sort out all of your problems – this is a fantasy. When you are addicted to gambling you are in a no win situation.

“But, if this withdrawal becomes unbearable and you begin to feel stressed, depressed or anxious, talk to your GP.”

6. Look to others who have successfully stopped

“After four weeks free from gambling, you should begin to feel better,” Karter forecasts. “The cravings should have lessened and, if you sought out a friend to help you with your debt, your finances should also be on the path to recovery. This month can also be made a lot easier if professional help is sought.

“However, this time can also be uncertain – it hasn’t been that long since you gave up the force that was driving your life. As a result, you should focus on how everyone who has successfully given up online gambling and is now leading a rewarding and wholesome life once felt as you do now. Simply keep telling yourself that you are not the first person to be going through this process, and that it is entirely possible for you – like others have before – to free yourself of addictive online gambling.”

Telegraph

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Gambling addiction in Hong Kong: as World Cup kicks off betting surge, we look at the addicts and victims

With the Fifa World Cup in the news, we talk to a reformed gambler, social workers and a gambler’s former wife about the vicious cycle of addiction and the impact it can have on physical and mental health as well as finances and property.

“When I started gambling I had no idea I’d end up like this,” says 29-year-old reformed gambler Wah, who does not want to disclose his full name. “I thought I’d be able to control it.”

We’re in a room at Wan Chai’s Tung Wah Even Centre, a counselling and treatment service for problem and pathological gamblers, where Wah is talking about his 11-year struggle with gambling addiction that started when he was a 16-year-old high school student. Under the legal age of 18, Wah had to ask older friends to place bets for him.

Tung Wah Even Centre counsellor Joseph Fung Ka-pan feels sorry for young people such as Wah. “Many young people think they’re equipped with the knowledge about soccer,” he says. “I’ve analysed the mentality of young soccer gamblers and they think they know more than other people.” That is why they expect to win.

With the 2018 Fifa World Cup underway in Russia, there’s good reason for concern that football gambling could increase in the city. A 2014 study jointly conducted by Shue Yan University and the Society for Truth and Light found that young adults are particularly vulnerable when World Cup fever spreads, with one in four involved in gambling activities during the last World Cup in Brazil in 2014.

“Young people also have a higher tendency to submit to their failure in gambling,” Fung adds.

For Wah, it was curiosity that lured him into gambling. His “just-for-fun” bets started small – HK$10 (US$1.30) and HK$20. But as with so many gambling tales, the stakes increased, with Wah’s bets gradually rising to between HK$1,000 and HK$2,000. His biggest bet was HK$20,000 on a single game. When his addiction peaked, he was in debt to the tune of almost HK$500,000.

Fung says the biggest problem is that many gamblers don’t think they have a problem. If they lose money, they can get it back by winning the next bet.

Stuck in a vicious cycle, Wah sought help from Tung Wah Even Centre in 2011. “I’d lost everything,” he says in a low voice. “I’d borrow money from people and lose it. Would borrow again and lose it again. I couldn’t see a way out.”

But six years on he did find a way out, shaking his addiction. Earlier this year he finally cleared his debts.

Today he has advice for those tempted to place bets. “If you’ve never touched football gambling, don’t try it.”

Also wanting to protect her identity is Aunty Kwan who has felt the pain of gambling addiction for more than 40 years. But it’s her husband who has the problem.

“I don’t know whether he still gambles, but two months ago I got a letter from some creditors,” says Kwan. Over the past 40 years she has witnessed every trick in the creditors’ book. They even visited her home, shouting obscenities and posted fliers around the building informing neighbours about her husband’s gambling debts.

The situation and her depression got so bad, that in 2006 she contemplated suicide after a creditor came to her door with luggage, telling her that he now owned half the house. She and her newly married son and daughter-in-law were evicted, forced to live in a relative’s small room.

After five years on medication, Kwan’s mental state began to stabilise but she still carries her “getaway backpack” containing vital medical statements, banking papers and other important documents.

“In many cases, families are more severely affected by gambling than the gamblers themselves,” says Alfred Chan Chi-wah, senior social work supervisor at Caritas Addicted Gamblers Counselling Centre in Tsuen Wan.

Every week the centre holds sharing sessions for gamblers’ family members, teaching them how to deal with creditors and carry on with their lives instead of taking responsibility for gamblers. A similar practice takes place in the Tung Wah Even Centre.

“It happens a lot that when the family of our clients gets invited here, we need to provide counselling for them, to help them sort out their emotions,” says Daphne Yeung Nam-ying from Tung Wah Even Centre. “Sometimes family members are so angry and shocked and start yelling at our clients, and we have to take them out of the room to calm them down before they continue the session.”

Wah also recalls how shocked and sad his mother was when she found out about his debts. He was asked to bring his mother to one of his counselling sessions and list his debts.

“I kept listing the debts, as I finished and the number ended up in the hundreds of thousands of dollars, she was astonished,” Wah said. Before that, his family were aware of his gambling problem but had no idea of the size of his debt load.

Fung says it’s common practice for gamblers to conceal their addiction from their families. “They want to handle it by themselves, but it usually leads to more gambling so they can pay off their debts.”

There are symptoms to look out for if people are worried a family member or friend has a gambling problem, Fung says. Gamblers may appear absent-minded or to be in a trance, their moods fluctuate, and they are often broke.

Fung says those who have not gambled in the past should not get swept up in World Cup fever: “You don’t need to place bets to show you support the game. Young people especially need to learn to say no to anyone who invites them to gamble.”

SCMP

Gambling addiction facts

Gambling addiction facts

  • Compulsive gambling affects 2%-3% of Americans, can involve a variety of ways and places to bet, and symptoms may differ somewhat between males and females, as well as teenagers versus adults.
  • Although men tend to develop a gambling addiction at a higher rate and at younger ages than women, women now make up more than one-quarter of all compulsive gamblers, and women’s symptoms tend to worsen faster once compulsive gambling develops.
  • As opposed to pathological gambling, problem gambling involves more than one but less than five symptoms of compulsive gambling.
  • Although direct causes of compulsive gambling are unusual, the manic episodes associated with bipolar disorder and some medications that treat Parkinson’s disease and restless leg syndrome have been associated with the development of this disorder.
  • Risk factors for pathological gambling include schizophrenia, mood problems, antisocial personality disorder, alcohol, or cocaine addiction.
  • The diagnosis of compulsive gambling involves identifying at least five symptoms that indicate poor impulse control when it comes to gambling, as well as ruling out other potential causes of the behaviors.
  • As with any mental-health condition, accurate diagnosis of gambling addiction requires a complete physical and psychological evaluation, including a mental-status examination and appropriate laboratory tests to rule out other possible causes of the symptoms that are being observed.
  • The treatment of compulsive gambling usually uses more than one approach, including psychotherapy, medication, financial counseling, support groups, 12-step programs, and self-help techniques.
  • The prognosis of recovery from compulsive gambling is encouraging with treatment.
  • Although pathological gambling may resolve with time on its own in many individuals, the devastating effects it usually has on the person’s financial, family, legal, and mental-health status indicates that treatment should be attempted by anyone who is motivated to get help for this disorder.
  • Prevention of compulsive gambling usually involves addressing risk factors and educating the public about the warning signs of this disorder.

What is a gambling addiction?

Gambling addiction is a mental-health problem that is understood to be one of many kinds of impulse-control problems and having many similarities to obsessive compulsive disorder. However, it is now understood to be more similar to other addictive disorders. The types of gambling that people with this disorder might engage in are as variable as the games available. Betting on sports, buying lottery tickets, playing poker, slot machines, or roulette are only a few of the activities in which compulsive gamblers engage. The venue of choice for individuals with gambling addiction varies as well. While many prefer gambling in a casino, the rate of online/Internet gambling addiction continues to increase with increased use of the Internet. Alternatively, some compulsive gamblers may also engage in risky stock market investments. Gambling addiction is also called compulsive gambling or pathological gambling.

Estimates of the number of people who gamble socially and qualify for being diagnosed with a gambling addiction range from 2%-3%, thereby affecting millions of people in the United States alone. Other important statistics on problem gambling include that it tends to affect at least 1% of people internationally. Teens actually tend to suffer from this disorder at a rate that is twice that of adults.

Although more men than women are thought to suffer from pathological gambling, women are developing this disorder at higher rates, now making up as much as 25% of individuals with pathological gambling. Other facts about compulsive gambling are that men tend to develop this disorder during their early teenage years while women tend to develop it later. However, the disorder in women then tends to get worse at a much faster rate than in men. Other apparently gender-based differences in gambling addiction include the tendencies for men to become addicted to more interpersonal forms of gaming, like blackjack, craps, or poker, whereas women tend to engage in less interpersonally based betting, like slot machines or bingo. Men with pathological gambling tend to receive counseling about issues other than gambling less often than their female counterparts.

Problem gambling generally means gambling that involves more than one symptom but fewer than the at least five symptoms required to qualify for the diagnosis of compulsive or pathological gambling. Binge gambling is a subtype of compulsive gambling that involves problem gambling but only during discrete periods of time. That is different from a general gambling addiction, which tends to involve excessive gambling behavior on an ongoing basis and to include persistent thoughts (preoccupation) about gambling even during times when the person is not engaged in gambling.

What are causes and risk factors for gambling addiction?

When contemplating why people gamble, it is important to understand that there is usually no one specific cause for pathological gambling. Some potential exceptions include the observation that some individuals who are given medications that treat Parkinson’s disease or restless leg syndrome (including pramipexole [Mirapex]) have been observed to develop impulse-control disorders like compulsive gambling, shopping, or compulsive sexual behaviors. The theory about that connection involves the increased activity of the chemical messenger dopamine in the brain. Another example where compulsive gambling may have a single cause is in bipolar disorder since exorbitant spending, including compulsive gambling, may be a symptom of the mania that is part of bipolar disorder.

Much more commonly, gambling addiction, like most other emotional conditions, is understood to be the result of a combination of biological vulnerabilities, ways of thinking, and social stressors (biopsychosocial model). There are, however, elements that increase the likelihood that the individual will develop a gambling addiction. Risk factors for developing pathological gambling include schizophrenia, mood problems, antisocial personality disorder, and alcohol or cocaine addiction. Individuals who have a low level of serotonin in the brain are also thought to be at higher risk for developing pathological gambling compared to others.

People who suffer from compulsive gambling have a tendency to be novelty seekers, feel disconnected (dissociated), relaxed, or aroused while gambling or playing video games. Research also shows that individuals who have money problems, win a large amount of money early into gambling, suffer a recent loss (like divorce, job loss), or are lonely increases the risk of developing compulsive gambling. Easy access to gambling (for example, living near towns with many gambling resources, such as Las Vegas or Atlantic City), belief that they’ve discovered a system to winning at gambling and failing to keep track of money won and lost gambling are more risk factors for engaging in compulsive gambling.

What are symptoms and signs of a gambling addiction?

Pathological gambling involves persistent and recurring problem gambling that includes several of the following symptoms that are not the result of another mental-health problem, like during a manic episode:

  • A preoccupation with gambling, either by reliving past gambling, planning for future gambling experiences, and/or thinking of ways to secure money to finance gambling
  • Needing more and more money for gambling in order to achieve the desired level of gambling enjoyment
  • Repeated unsuccessful attempts to stop or reduce betting behaviors
  • Becoming uneasy or easily irritated when trying to reduce or stop gambling
  • Gambling for the purpose of escaping problems or to relieve depression or anxiety
  • Returning to gambling after losing money in an effort to recoup losses
  • Lying to family or other loved ones, mental-health professionals, or others in an effort to hide the extent of the gambling behavior
  • Committing crimes (for example, stealing, fraud, or forgery) or securing illegal loans to finance gambling
  • Risking important relationships, employment, or other opportunities due to gambling
  • Depending on others for money to resolve dire financial situations that are the result of gambling

How do health-care professionals diagnose a gambling addiction? What specialists diagnose and treat this illness?

The first step to obtaining appropriate treatment is accurate diagnosis, which requires a complete physical and psychological evaluation to determine whether the person may have a gambling addiction. Since some medical conditions can cause an individual to develop erratic, impulsive behaviors, including problem gambling, the examining physician should rule out (exclude) these possibilities through an interview, physical examination, and applicable laboratory tests, as well as implementing a full mental-health evaluation. A thorough diagnostic evaluation includes a complete history of the patient’s symptoms, during which time the practitioner might ask the following questions:

  1. How old were you when you gambled for the first time?
  2. How much time (how often and for how long each time) do you spend gambling or thinking about gambling?
  3. How much money do you lose/spend gambling?
  4. What kinds of things do you do to finance gambling?
  5. Do you have irresistible urges to gamble?

The doctor usually asks about alcohol and drug use and whether the patient has had thoughts about death or suicide. Further, the history often includes questions about whether other family members have had a gambling problem or other mental-health problems, and if treated, what treatments they received and which were effective versus ineffective.

A diagnostic evaluation also includes a mental-status examination to determine if the patient’s speech, thought pattern, mood, or memory has been affected, as often happens in the case of a many forms of mental illness. As of today, there is no laboratory test, blood test, or X-ray that can diagnose this mental disorder.

What is the treatment for gambling addiction?

Although there is no standardized treatment for pathological gambling, many people participate in Gamblers’ Anonymous (GA) or learn how to stop engaging in gambling behaviors. The approximately 8% one-year abstinence rate that intervention tends to produce is often improved when GA is combined with psychotherapy that is administered by a trained professional. That seems to be particularly true when cognitive behavioral treatment is the psychotherapy approach that is used by the practitioner. Medications that have been found to be helpful in decreasing either the urge to gamble or the thrill involved in doing so include antiseizure medications like carbamazepine (Tegretol) and topiramate (Topamax), mood stabilizers like lithium (Eskalith, Lithobid), medications used to address addictions like naltrexone (ReVia), and antidepressants like clomipramine (Anafranil) and fluvoxamine (Luvox). Psychotherapy appears to be more effective than any of the medications used to treat this disorder so far. Financial/debt counseling and self-help interventions may also be important aspects of the care provided to individuals with gambling addiction.

Individuals who engaged in illegal behavior in the year prior to treatment tend to have more severe symptoms of this disorder, have more gambling-related debt compared to people who have not engaged in illegal activity during that time period. It is therefore thought that people who engage in breaking laws in the year before treatment begins need more intensive treatment for a longer period of time, sometimes even requiring inpatient or residential treatment, often referred to as rehab. Another important fact to consider in treatment for a gambling addiction is that up to 70% of people with this disorder also have another psychiatric problem. Therefore, it is not enough to just treat the gambling problem but any coexisting mental-health condition (such as alcoholism or other substance abuse problem, mood disorder, or personality disorder) should be addressed as well in order to give the person with a gambling addiction his or her best chance for recovery from both conditions. There is also a need for research about how a person’s culture can play a role in the development and treatment of problem gambling.

Some studies have explored the possibility that so-called home remedies may help treat gambling addiction. Some remedies being explored to address this disorder include glutamate, diet, and aromatherapies.

What is the prognosis for gambling addiction?

With treatment, the prognosis of compulsive gambling can be quite encouraging. More than two-thirds of people with this disorder tend to abstain from problem gambling a year after receiving six weeks of treatment. After treatment has ended, less than one-fifth of those who receive follow-up for relapse prevention tend to relapse into gambling addiction behavior after one year compared to half of those who do not receive follow-up.

What are complications and negative effects of gambling addiction?

Although as many as one-third of individuals who suffer from pathological gambling may recover from the disease without receiving any treatment, the potential devastation that compulsive gambling can wreak on the life of the suffer and those around him or her clearly indicate that the potential positive aspects outweigh the possible complications that result from an intervention. As much as $5 billion is spent on gambling in the United States every year, with people who are addicted to gambling accruing tens to hundreds of thousands of dollars in debt. Harmful effects that compulsive gambling can have on the individual include financial problems ranging from high debt, bankruptcy or poverty, to legal problems resulting from theft to prostitution, to wanting, attempting, or completing suicide. Many compulsive gambling sufferers experience stress-associated medical problems like insomnia, stomach ulcers and other gastrointestinal problems, headaches, and muscle aches. Gambling addiction can have a multitude of negative effects on the family. Statistics indicate that families of people with compulsive gambling are more likely to experience domestic violence and child abuse. Children of problem gamblers are at significantly higher risk of suffering from depression, behavior problems, and substance abuse. One of the challenges of treatment of compulsive gambling is that as many as two-thirds of people who begin treatment for this disorder discontinue treatment prematurely, whether treatment involves medication, therapy, or both.

Is it possible to prevent gambling addiction?

In addition to alleviating risk factors for compulsive gambling, educating the public about the warning signs for this disorder are key components to prevention. Some warning signs include often talking about gambling, bragging about gambling wins, poor performance and unexplained absences from work or school, mood swings, stealing, or excessive borrowing.

Where can people get support for gambling addiction?

Compulsive Gamblers Hub
http://www.cghub.homestead.com

Compulsive Gambling Center
924 East Baltimore St.
Baltimore, MD 21202
1-800-LOST-BET (1-800-567-8238)
http://www.lostbet.com

Debtors Anonymous
General Service Office
P.O. Box 920888
Needham, MA 02492-0009
Phone: 781-453-2743
Fax: 781-453-2745

Debtors Anonymous | Official Website

Gam-Anon International Service Office, Inc.
P.O. Box 157
Whitestone, NY 11357
718-352-1671

Gamblers Anonymous (GA) International Service Office
P.O. Box 17173
Los Angeles, CA 90017
213-386-8789
isomain@gamblersanonymous.org

GamBlock
http://www.gamblock.com

Problem Gambling.com
24 Hours a Day
7 Days a Week
U.S. Gambling Hotline: 1-800-522-4700
Canadian Gambling Hotline: 1-888-391-1111

United States National Gambling Help Line
1-800-522-4700

Where can people find more information about how to overcome gambling addiction?

NAADAC – The Association for Addiction Professionals
1001 N. Fairfax St., Suite 201
Alexandria, VA 22314
Phone: 1-800-548-0497
Fax: 1-800-377-1136

UCLA Gambling Studies Program
http://www.uclagamblingprogram.org

Massachusetts Council on Compulsive Gambling
1-800-426-1234

homepage

Original

How the Brain Gets Addicted to Gambling

Addictive drugs and gambling rewire neural circuits in similar ways:

When Shirley was in her mid-20s she and some friends road-tripped to Las Vegas on a lark. That was the first time she gambled. Around a decade later, while working as an attorney on the East Coast, she would occasionally sojourn in Atlantic City. By her late 40s, however, she was skipping work four times a week to visit newly opened casinos in Connecticut. She played blackjack almost exclusively, often risking thousands of dollars each round—then scrounging under her car seat for 35 cents to pay the toll on the way home. Ultimately, Shirley bet every dime she earned and maxed out multiple credit cards. “I wanted to gamble all the time,” she says. “I loved it—I loved that high I felt.”

In 2001 the law intervened. Shirley was convicted of stealing a great deal of money from her clients and spent two years in prison. Along the way she started attending Gamblers Anonymous meetings, seeing a therapist and remaking her life. “I realized I had become addicted,” she says. “It took me a long time to say I was an addict, but I was, just like any other.”

Ten years ago the idea that someone could become addicted to a habit like gambling the way a person gets hooked on a drug was controversial. Back then, Shirley’s counselors never told her she was an addict; she decided that for herself. Now researchers agree that in some cases gambling is a true addiction.

In the past, the psychiatric community generally regarded pathological gambling as more of a compulsion than an addiction—a behavior primarily motivated by the need to relieve anxiety rather than a craving for intense pleasure. In the 1980s, while updating the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association (APA) officially classified pathological gambling as an impulse-control disorder—a fuzzy label for a group of somewhat related illnesses that, at the time, included kleptomania, pyromania and trichotillomania (hairpulling). In what has come to be regarded as a landmark decision, the association moved pathological gambling to the addictions chapter in the manual’s latest edition, the DSM-5, published this past May. The decision, which followed 15 years of deliberation, reflects a new understanding of the biology underlying addiction and has already changed the way psychiatrists help people who cannot stop gambling.

More effective treatment is increasingly necessary because gambling is more acceptable and accessible than ever before. Four in five Americans say they have gambled at least once in their lives. With the exception of Hawaii and Utah, every state in the country offers some form of legalized gambling. And today you do not even need to leave your house to gamble—all you need is an Internet connection or a phone. Various surveys have determined that around two million people in the U.S. are addicted to gambling, and for as many as 20 million citizens the habit seriously interferes with work and social life.

Two of a Kind

The APA based its decision on numerous recent studies in psychology, neuroscience and genetics demonstrating that gambling and drug addiction are far more similar than previously realized. Research in the past two decades has dramatically improved neuroscientists’ working model of how the brain changes as an addiction develops. In the middle of our cranium, a series of circuits known as the reward system links various scattered brain regions involved in memory, movement, pleasure and motivation. When we engage in an activity that keeps us alive or helps us pass on our genes, neurons in the reward system squirt out a chemical messenger called dopamine, giving us a little wave of satisfaction and encouraging us to make a habit of enjoying hearty meals and romps in the sack. When stimulated by amphetamine, cocaine or other addictive drugs, the reward system disperses up to 10 times more dopamine than usual.

Continuous use of such drugs robs them of their power to induce euphoria. Addictive substances keep the brain so awash in dopamine that it eventually adapts by producing less of the molecule and becoming less responsive to its effects. As a consequence, addicts build up a tolerance to a drug, needing larger and larger amounts to get high. In severe addiction, people also go through withdrawal—they feel physically ill, cannot sleep and shake uncontrollably—if their brain is deprived of a dopamine-stimulating substance for too long. At the same time, neural pathways connecting the reward circuit to the prefrontal cortex weaken. Resting just above and behind the eyes, the prefrontal cortex helps people tame impulses. In other words, the more an addict uses a drug, the harder it becomes to stop.

Research to date shows that pathological gamblers and drug addicts share many of the same genetic predispositions for impulsivity and reward seeking. Just as substance addicts require increasingly strong hits to get high, compulsive gamblers pursue ever riskier ventures. Likewise, both drug addicts and problem gamblers endure symptoms of withdrawal when separated from the chemical or thrill they desire. And a few studies suggest that some people are especially vulnerable to both drug addiction and compulsive gambling because their reward circuitry is inherently underactive—which may partially explain why they seek big thrills in the first place.

Even more compelling, neuroscientists have learned that drugs and gambling alter many of the same brain circuits in similar ways. These insights come from studies of blood flow and electrical activity in people’s brains as they complete various tasks on computers that either mimic casino games or test their impulse control. In some experiments, virtual cards selected from different decks earn or lose a player money; other tasks challenge someone to respond quickly to certain images that flash on a screen but not to react to others.

A 2005 German study using such a card game suggests problem gamblers—like drug addicts—have lost sensitivity to their high: when winning, subjects had lower than typical electrical activity in a key region of the brain’s reward system. In a 2003 study at Yale University and a 2012 study at the University of Amsterdam, pathological gamblers taking tests that measured their impulsivity had unusually low levels of electrical activity in prefrontal brain regions that help people assess risks and suppress instincts. Drug addicts also often have a listless prefrontal cortex.

Further evidence that gambling and drugs change the brain in similar ways surfaced in an unexpected group of people: those with the neurodegenerative disorder Parkinson’s disease. Characterized by muscle stiffness and tremors, Parkinson’s is caused by the death of dopamine-producing neurons in a section of the midbrain. Over the decades researchers noticed that a remarkably high number of Parkinson’s patients—between 2 and 7 percent—are compulsive gamblers. Treatment for one disorder most likely contributes to another. To ease symptoms of Parkinson’s, some patients take levodopa and other drugs that increase dopamine levels. Researchers think that in some cases the resulting chemical influx modifies the brain in a way that makes risks and rewards—say, those in a game of poker—more appealing and rash decisions more difficult to resist.

A new understanding of compulsive gambling has also helped scientists redefine addiction itself. Whereas experts used to think of addiction as dependency on a chemical, they now define it as repeatedly pursuing a rewarding experience despite serious repercussions. That experience could be the high of cocaine or heroin or the thrill of doubling one’s money at the casino. “The past idea was that you need to ingest a drug that changes neurochemistry in the brain to get addicted, but we now know that just about anything we do alters the brain,” says Timothy Fong, a psychiatrist and addiction expert at the University of California, Los Angeles. “It makes sense that some highly rewarding behaviors, like gambling, can cause dramatic [physical] changes, too.”

Gaming the System

Redefining compulsive gambling as an addiction is not mere semantics: therapists have already found that pathological gamblers respond much better to medication and therapy typically used for addictions rather than strategies for taming compulsions such as trichotillomania. For reasons that remain unclear, certain antidepressants alleviate the symptoms of some impulse-control disorders; they have never worked as well for pathological gambling, however. Medications used to treat substance addictions have proved much more effective. Opioid antagonists, such as naltrexone, indirectly inhibit brain cells from producing dopamine, thereby reducing cravings.

Dozens of studies confirm that another effective treatment for addiction is cognitive-behavior therapy, which teaches people to resist unwanted thoughts and habits. Gambling addicts may, for example, learn to confront irrational beliefs, namely the notion that a string of losses or a near miss—such as two out of three cherries on a slot machine—signals an imminent win.

Unfortunately, researchers estimate that more than 80 percent of gambling addicts never seek treatment in the first place. And of those who do, up to 75 percent return to the gaming halls, making prevention all the more important. Around the U.S.—particularly in California—casinos are taking gambling addiction seriously. Marc Lefkowitz of the California Council on Problem Gambling regularly trains casino managers and employees to keep an eye out for worrisome trends, such as customers who spend increasing amounts of time and money gambling. He urges casinos to give gamblers the option to voluntarily ban themselves and to prominently display brochures about Gamblers Anonymous and other treatment options near ATM machines and pay phones. A gambling addict may be a huge source of revenue for a casino at first, but many end up owing massive debts they cannot pay.

Shirley, now 60, currently works as a peer counselor in a treatment program for gambling addicts. “I’m not against gambling,” she says. “For most people it’s expensive entertainment. But for some people it’s a dangerous product. I want people to understand that you really can get addicted. I’d like to see every casino out there take responsibility.”

This article was originally published with the title “Gambling on the Brain

VLT Addiction – Video Lottery Terminal Addiction

Why Video Lottery Terminals Are So Addictive VLT

Called the crack cocaine of gambling for good reason, video lottery terminals (VLTs) seem uniquely addictive – and VLT addiction happens fast.

While gamblers betting on sports, horses, or on perceived games of skill (such as poker) may take decades to progress to pathological gambling; VLT players can make this tragic journey in under a year.

Completely unregulated in most states, no one was prepared for the social devastation unleashed by the proliferation of VLT gaming. Countless stories of tragedy, financial ruin and suicide linked to VLT have made their very existence controversial, yet they remain widely available for play in many jurisdictions.

Why Are VLTs So Addictive?

Escape Gambling

VLT gamers play for an analgesic escape. They play to forget about problems, anxieties or any other negative emotions – They play VLT’s in the same way an alcoholic drinks to forget. By contrast, action gamblers (those who play games such as poker or bet on sports) chase the thrill and excitement of the wager.

This seeking of escape through gaming induces an almost narcotic and trance-like state, and this hypnotic and narcotic trance is very addictive to the escape gambler.

More women than men gamble to escape, and all escape gamblers play fairly mindless and repetitious games, such as those offered on VLTs.

Fast Action

VLT gamers may bet 10 or more games per minute; VLT machines offering unparalleled speed of play and quickness of reward – and this rapidity of bet/reward increases the addictive properties of VLT play.

The quicker the pleasurable stimulus after an action, the more habit forming or addictive that action can become. Just as crack is more addictive than cocaine partially due to it’s speed of onset, VLT gaming is more addictive than other forms of gambling due to this speed of play.

Access

The more time spent gaming, the quicker the progression of addiction.

Gamblers preferring to play live poker can only play when they can get to a casino, and

only while the casino remains open for business. Additionally, gambling regulations in most jurisdictions limits the time any one player may game in succession.

VLT gaming offers round-the-clock access, usually only minutes from the home – 24 hour a day play, with no limitations set on duration of gaming and with machines in hundreds of easy to access locations throughout most towns.

The Hypnotic Nature of VLT Play

The lights and sounds of a VLT can induce a trance-like state, particularly for someone playing over long periods of time. This trance-like state increases the analgesic effects sought by the escape gambler – increasing the addiction.

Although now widely recognized as socially destructive, VLTs generate enormous taxation revenues for local and state governments, governments now too reliant on these revenues to seriously limit access to play.

Play VLTs only with extreme caution and awareness, if at all.

The video lottery terminal is an insidious trap for the addictive personality. The machine invites the gambler to insert money, select a combination of numbers, push a button and hope that a series of randomly generated numbers will match his. Seconds later, he (or she) can do it all again. He may use a debit card rather than actual cash to keep playing, and the machine may keep track of his losing streak in credits rather than dollar amounts so as not to spook him.

It’s by definition a losing game; the house keeps a percentage of the total dollars bet. Many people lose more than the gamble; they lose their houses, their families and, for the few each year driven to suicide, their lives. Those are the problem gamblers, the ones who disproportionately pay the toll for the existence of VLTs in bars, casinos and other “gaming” establishments in most provinces. And they are the ones who have province after province suffering qualms about their role in encouraging people to throw their money away on a machine that has been called the most addictive form of gambling, and described as electronic crack cocaine.

In Nova Scotia, where the Conservative government recently announced a strategy to cut back on VLTs, the opposition NDP wants a vote in the next provincial election on whether the machines should be banned entirely. In a poll commissioned earlier this year by the Nova Scotia Gaming Corp., 54 per cent of Nova Scotians said they wanted the number of VLTs reduced or eliminated even if it meant higher taxes. Liberal Leader Francis MacKenzie has said he no longer supports VLTs, which Nova Scotia introduced in 1991, and will seek to eliminate every machine from the province.

The debate has grown so heated that Conservative MLA Gary Hines, upset that aboriginal bands were demanding compensation before they would remove any of the 600 VLTs on the reserves, said, “They’re willing to prostitute themselves at the expense of having a social conscience.” Justice Minister Michael Baker distanced the government from that statement, which was only prudent, since even its own new strategy will eliminate only 1,000 of the 3,234 VLTs under its control.

Newfoundland, which has almost 2,700 VLTs, last month announced that the number would be reduced by 15 per cent over the next five years. Saskatchewan has capped its number of VLTs at 4,000, in 691 sites. New Brunswick talks of the “responsible gaming features” built into the new generation of VLTs, including a mandatory cash-out period and a window that records the amounts players have spent in dollars, not credits. The machines accounted for $135.8-million of that province’s net revenue in 2003-04.

Manitoba brags that it is the only jurisdiction in North America so far to havea “Responsible Gaming Information Centre, with on-site Addictions Foundation experts,” to counsel problem gamblers — a lead that Ontario, which has no VLTs, plans to follow in its casinos. But there’s no talk of getting rid of them all. In 2003-04, Manitoba’s net income from VLTs was $126.2-million. Since then, the government has purchased new VLTs and ended the rule that prevented their use on Sundays — this, in a province identified by Statistics Canada as one of two provinces with the highest proportion of problem gamblers in the country and the highest VLT participation rate. (The other is Saskatchewan.)

Alberta, which has a “minister of gaming,” estimates that its VLTs will bring in $575-million in 2005-06 (with an additional $575-million from other slot machines). It continues despite opposition that led it to reduce the number of locations with VLTs to 1,139 in 2003-04 from 1,179 the year before. Seven communities had voted by plebiscite to kick the machines out of town. Alberta Premier Ralph Klein initially threatened to deny those communities the fruits of any VLT revenues, but changed his mind.

Quebec, which has more than 14,000 VLTs in close to 4,000 bars and restaurants, took in net income of $706-million from them in 2003. But it is suffering from sinner’s remorse. A Quebec study found that 8 per cent of those who gamble on VLTs are pathological gamblers, and account for 59 per cent of all VLT revenues. After Richard Cassista killed himself last summer, leaving a note for his wife saying he couldn’t live with his VLT addiction, his wife went public with this chilling indication of what governments who tax the ill — problem gamblers — must have on their conscience. Loto-Québec, the provincial lottery, announced last year that it would remove VLTs from low-income neighbourhoods where the ratio was higher than two per 1,000 residents, and would move machines from the heart of Quebec’s four main cities to the outskirts.

VLTs are not alone in ruining the lives of problem gamblers and those around them. The burgeoning field of Internet gambling has horrors all its own to offer. Both Nova Scotia and Quebec have worried about a rise in illegal gambling machines if legal ones are removed. But the existence of legal VLTs is something each province can control, and even the enormous revenue the machines produce must be put in perspective. A 1997 study by the Canada West Foundation warned that VLTs might be causing more problems than their revenues could fix. It’s a losing game for more than the addicts who play it.

Governments did without their VLT fix before 1985, when the Criminal Code was amended to make it legal for them to operate electronic gambling machines. They can learn to do without it again. The sooner they phase out the video lottery terminals, the better.

Fruit machine addiction in adolescence: A case study

A majority of the research on adolescent fruit machine gambling has been survey type studies concentrating on incidence, demographics and quantitative analysis of motivations, subjective feelings and negative consequences of fruit machine addiction. The data from this study are reported as a case study of an 18 year old former adolescent fruit machine addict with additional information from the addict’s mother. The study examines a number of distinct stages and circumstances in the development of the addiction including die discovery of the problem, the motivations to constantly gamble, the role of family distress, loss chasing, excitement and skill in maintenance of problem gambling, in addition to a personal examination of the problem’s confrontation and eventual recovery. These personal insights are discussed with relation to the contemporary literature. It is shown that previous speculations on some issues arising from quantitative analysis may have to be re-evaluated in the light of more detailed qualitative accounts such as this study.

Keywords

Quantitative Analysis Problem Gambling Type Study Distinct Stage Subjective Feeling 

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

A mother-of-three who lost her home and her family after gambling away £250,000 on fruit machines has finally managed to beat her addiction.

Tara Mooney, 46, who lives in Frome, Somerset, spent up to 12 hours a day putting every penny she earned as a bus driver into the slots.

However she says she was only able to quit her decade-long habit when she was sacked from her job after missing too many shifts.

She said: ‘It was dreadful. I spent all my wages on those machines, and I did it for ten years. When you add it all up it comes to about £250,000.

‘It’s ridiculous when you think of it but I was in the grip of a fierce addiction.’

Speaking in a video to the Press and Journal, Tara explained how she first got into gambling by playing bingo.

She said: ‘I was in denial for many years and lost almost everything. I actually started off by playing bingo, going to Gala, and when you have a win you feel all excited and when they have the intervals – they tend to have breaks – so you go and play on the slot machines or party bingo.

‘And I started enjoying the fruit machines but I didn’t realise how it was affecting me. And when I was bus driving every dinner break I had I was going into Corals, any kind of bookies that was nearby so I could get back to work on time.’

However the bus driver, who was paid weekly, quickly became hooked and ended up wasting her entire £500 after-tax wages on the habit.

She would spend all day on the machines at work or at her local pub, and even started playing online slot machines in a bid to feed her addiction.

She said: ‘There was one in the canteen at work, so I would just put a couple of quid in.

‘But that was never enough and it quickly snowballed into a full-blown addiction. It was all I could think about.

‘I’d have good days, where I won money, but it all went back into the machines. Every penny I had went on those damned things.

‘I was so hooked that if I pulled over at a motorway service station, I would end up playing the machines there for hours – it tore my family apart.’

Tara admits she was ‘selfish’ and that it eventually led to the breakdown of her marriage. She was so out of control with her habit she got behind on her mortgage and lost her house.

Her sons Gary, now 24, and Daniel, 21, chose to move to Peterborough in the midst of her problems.

While her son Alfie, 26, hated her gambling problem he has since forgiven her and the pair now live together.

She said: ‘I was hooked. All I could think about was putting more money down the slots.

‘My husband at the time realised I had a problem, but he was so stuck working to pay for everything else in our life that he couldn’t help me. He couldn’t keep up with the bills and we rowed and he left.

‘Sadly, I’m not surprised. I realise now what a selfish person I was and I know I’ve ruined my life.

‘I wish I could take it all back. I must have spent about £250,000 on those things.’

At one point Tara admits she took a float of money from work to fund her habit, but she quickly went to her boss and told him everything.

According to Tara, he was initially ‘very understanding’ and did not want to let her go because she was a good worker. However she eventually got the sack after missing too many shifts.

Speaking about how she felt at her lowest, she said: It affects you and it gets you depressed. It isolates you, you’re stuck in that circle.’

Eventually Tara found a hobby and started self-publishing books in a bid to overcome her addiction. She also went out more and socialised with friends, but admits she was ashamed of her problem.

She said: ‘The hardest thing was telling my loved ones about being addicted to gambling because I thought they were going to be very judgmental.’

Tara claims that parts of her family were ‘not understanding at all’ but she was determined to turn her life around.

The mother-of-three has finally managed to kick her habit and get her life back on track, although she allows herself to play the lottery every week.

She said: ‘I feel guilty about what I did, but these things are so addictive, it took over my life.

‘Getting sacked was the best thing that happened to me, it meant I couldn’t gamble. I don’t gamble any more, apart from playing the lottery.’

Casino Addiction Stories

How Casinos Enable Gambling Addicts Modern slot machines develop an unbreakable hold on many players—some of whom wind up losing their jobs, their families, and even, as in the case of Scott Stevens, their lives.

On the morning of Monday, August 13, 2012, Scott Stevens loaded a brown hunting bag into his Jeep Grand Cherokee, then went to the master bedroom, where he hugged Stacy, his wife of 23 years. “I love you,” he told her.

Stacy thought that her husband was off to a job interview followed by an appointment with his therapist. Instead, he drove the 22 miles from their home in Steubenville, Ohio, to the Mountaineer Casino, just outside New Cumberland, West Virginia. He used the casino ATM to check his bank-account balance: $13,400. He walked across the casino floor to his favorite slot machine in the high-limit area: Triple Stars, a three-reel game that cost $10 a spin. Maybe this time it would pay out enough to save him.

It didn’t. He spent the next four hours burning through $13,000 from the account, plugging any winnings back into the machine, until he had only $4,000 left. Around noon, he gave up.

Stevens, 52, left the casino and wrote a five-page letter to Stacy. A former chief operating officer at Louis Berkman Investment, he gave her careful financial instructions that would enable her to avoid responsibility for his losses and keep her credit intact: She was to deposit the enclosed check for $4,000; move her funds into a new checking account; decline to pay the money he owed the Bellagio casino in Las Vegas; disregard his credit-card debt (it was in his name alone); file her tax returns; and sign up for Social Security survivor benefits. He asked that she have him cremated.

He wrote that he was “crying like a baby” as he thought about how much he loved her and their three daughters. “Our family only has a chance if I’m not around to bring us down any further,” he wrote. “I’m so sorry that I’m putting you through this.”

He placed the letter and the check in an envelope, drove to the Steubenville post office, and mailed it. Then he headed to the Jefferson Kiwanis Youth Soccer Club. He had raised funds for these green fields, tended them with his lawn mower, and watched his daughters play on them.Stevens parked his Jeep in the gravel lot and called Ricky Gurbst, a Cleveland attorney whose firm, Squire Patton Boggs, represented Berkman, where Stevens had worked for 14 years—until six and a half months earlier, when the firm discovered that he had been stealing company funds to feed his gambling habit and fired him.

Stevens had a request: “Please ask the company to continue to pay my daughters’ college tuition.” He had received notification that the tuition benefit the company had provided would be discontinued for the fall semester. Failing his daughters had been the final blow.

Gurbst said he would pass along the request.

Then Stevens told Gurbst that he was going to kill himself.

“What? Wait.”

“That’s what I’m going to do,” Stevens said, and promptly hung up.

He next called J. Timothy Bender, a Cleveland tax attorney who had been advising him on the IRS’s investigation into his embezzlement. Up until that point, he had put on a brave face for Bender, saying he would accept responsibility and serve his time. Now he told Bender what he was about to do. Alarmed, Bender tried to talk him out of it. “Look, this is hard enough,” Stevens said. “I’m going to do it.” Click.

At 4:01 p.m., Stevens texted Stacy. “I love you.” He then texted the same message to each of his three daughters in succession.He took off his glasses, his glucose monitor, and his insulin pump—Stevens was a diabetic—and tucked them neatly into his blue thermal lunch bag with the sandwich and apple he hadn’t touched.

He unpacked his Browning semiautomatic 12-gauge shotgun, loaded it, and sat on one of the railroad ties that rimmed the parking lot.

Then he dialed 911 and told the dispatcher his plan.

Scott Stevens hadn’t always been a gambler. A native of Rochester, New York, he earned a master’s degree in business and finance at the University of Rochester and built a successful career. He won the trust of the steel magnate Louis Berkman and worked his way up to the position of COO in Berkman’s company. He was meticulous about finances, both professionally and personally. When he first met Stacy, in 1988, he insisted that she pay off her credit-card debt immediately. “Your credit is all you have,” he told her.

They married the following year, had three daughters, and settled into a comfortable life in Steubenville thanks to his position with Berkman’s company: a six-figure salary, three cars, two country-club memberships, vacations to Mexico. Stevens doted on his girls and threw himself into causes that benefited them. In addition to the soccer fields, he raised money to renovate the middle school, to build a new science lab, and to support the French Club’s trip to France. He spent time on weekends painting the high-school cafeteria and stripping the hallway floors.

Stevens got his first taste of casino gambling while attending a 2006 trade show in Las Vegas. On a subsequent trip, he hit a jackpot on a slot machine and was hooked.Scott and Stacy soon began making several trips a year to Vegas. She liked shopping, sitting by the pool, even occasionally playing the slots with her husband. They brought the kids in the summer and made a family vacation of it by visiting the Grand Canyon, the Hoover Dam, and Disneyland. Back home, Stevens became a regular at the Mountaineer Casino. Over the next six years, his gambling hobby became an addiction. Though he won occasional jackpots, some of them six figures, he lost far more—as much as $4.8 million in a single year.

Stevens methodically concealed his addiction from his wife. He handled all the couple’s finances. He kept separate bank accounts. He used his work address for his gambling correspondence: W-2Gs (the IRS form used to report gambling winnings), wire transfers, casino mailings. Even his best friend and brother-in-law, Carl Nelson, who occasionally gambled alongside Stevens, had no inkling of his problem. “I was shocked when I found out afterwards,” he says. “There was a whole Scott I didn’t know.”

When Stevens ran out of money at the casino, he would leave, write a company check on one of the Berkman accounts for which he had check-cashing privileges, and return to the casino with more cash. He sometimes did this three or four times in a single day. His colleagues did not question his absences from the office, because his job involved overseeing various companies in different locations. By the time the firm detected irregularities and he admitted the extent of his embezzlement, Stevens—the likable, responsible, trustworthy company man—had stolen nearly $4 million.

Stacy had no idea. In Vegas, Stevens had always kept plans to join her and the girls for lunch. At home, he was always on time for dinner. Saturday mornings, when he told her he was headed into the office, she didn’t question him—she knew he had a lot of responsibilities. So she was stunned when he called her with bad news on January 30, 2012. She was on the stairs with a load of laundry when the phone rang.“Stace, I have something to tell you.”

She heard the burden in his voice. “Who died?”

“It’s something I have to tell you on the phone, because I can’t look in your eyes.”

He paused. She waited.

“I might be coming home without a job today. I’ve taken some money.”

“For what?”

“That doesn’t matter.”

“How much? Ten thousand dollars?”

“No.”

“More? One hundred thousand?”

“Stace, it’s enough.”

Stevens never did come clean with her about how much he had stolen or about how often he had been gambling. Even after he was fired, Stevens kept gambling as often as five or six times a week. He gambled on his wedding anniversary and on his daughters’ birthdays. Stacy noticed that he was irritable more frequently than usual and that he sometimes snapped at the girls, but she figured that it was the fallout of his unemployment. When he headed to the casino, he told her he was going to see his therapist, that he was networking, that he had other appointments. When money appeared from his occasional wins, he claimed that he had been doing some online trading. While they lived off $50,000 that Stacy had in a separate savings account, he drained their 401(k) of $150,000, emptied $50,000 out of his wife’s and daughters’ ETrade accounts, maxed out his credit card, and lost all of a $110,000 personal loan he’d taken out from PNC Bank.

Stacy did not truly understand the extent of her husband’s addiction until the afternoon three police officers showed up at her front door with the news of his death.Afterward, Stacy studied gambling addiction and the ways slot machines entice customers to part with their money. In 2014, she filed a lawsuit against both Mountaineer Casino and International Game Technology, the manufacturer of the slot machines her husband played. At issue was the fundamental question of who killed Scott Stevens. Did he die because he was unable to rein in his own addictive need to gamble? Or was he the victim—as the suit alleged—of a system carefully calibrated to prey upon his weakness, one that robbed him of his money, his hope, and ultimately his life?

Less than 40 years ago, casino gambling was illegal everywhere in the United States outside of Nevada and Atlantic City, New Jersey. But since Congress passed the Indian Gaming Regulatory Act in 1988, tribal and commercial casinos have rapidly proliferated across the country, with some 1,000 now operating in 40 states. Casino patrons bet more than $37 billion annually—more than Americans spend to attend sporting events ($17.8 billion), go to the movies ($10.7 billion), and buy music ($6.8 billion) combined.

The preferred mode of gambling these days is electronic gaming machines, of which there are now almost 1 million nationwide, offering variations on slots and video poker. Their prevalence has accelerated addiction and reaped huge profits for casino operators. A significant portion of casino revenue now comes from a small percentage of customers, most of them likely addicts, playing machines that are designed explicitly to lull them into a trancelike state that the industry refers to as “continuous gaming productivity.” (In a 2010 report, the American Gaming Association, an industry trade group, claimed that “the prevalence of pathological gambling … is no higher today than it was in 1976, when Nevada was the only state with legal slot machines. And, despite the popularity of slot machines and the decades of innovation surrounding them, when adjusted for inflation, there has not been a significant increase in the amount spent by customers on slot-machine gambling during an average casino visit.”)

“The manufacturers know these machines are addictive and do their best to make them addictive so they can make more money,” says Terry Noffsinger, the lead attorney on the Stevens suit. “This isn’t negligence. It’s intentional.”Noffsinger, 72, has been here before. A soft-spoken personal-injury attorney based in Indiana, he has filed two previous lawsuits against casinos. In 2001, he sued Aztar Indiana Gaming, of Evansville, on behalf of David Williams, then 51 years old, who had been an auditor for the State of Indiana. Williams began gambling after he received a $20 voucher in the mail from Casino Aztar. He developed a gambling addiction that cost him everything, which in his case amounted to about $175,000. Noffsinger alleged that Aztar had violated the 1970 Racketeer Influenced and Corrupt Organizations Act by engaging in a “pattern of racketeering activity”—using the mail to defraud Williams with continued enticements to return to the casino. But the U.S. District Court for the Southern District of Indiana granted summary judgment in favor of Aztar, and the U.S. Court of Appeals for the Seventh Circuit instructed the district court to dismiss the case, declaring, “Even if the statements in these communications could be considered ‘false’ or ‘misrepresentations,’ it is clear that they are nothing more than sales puffery on which no person of ordinary prudence and comprehension would rely.”

Four years later, Noffsinger filed a suit on behalf of Jenny Kephart, then 52 years old, against Caesars Riverboat Casino, in Elizabeth, Indiana, alleging that the casino, aware that Kephart was a pathological gambler, knowingly enticed her into gambling in order to profit from her addiction. Kephart had filed for bankruptcy after going broke gambling in Iowa, and moved to Tennessee. But after she inherited close to $1 million, Caesars began inviting her to the Indiana riverboat casino, where she gambled away that inheritance and more. When the casino sued her for damages on the money she owed, Kephart countersued. She denied the basis of the Caesars suit on numerous grounds, including that by giving her “excessive amounts of alcohol … and then claiming that it was injured by her actions or inactions,” Caesars waived any claim it might have had for damages under Indiana law. Although Kephart ultimately lost her countersuit, the case went all the way to the Indiana Supreme Court, which ruled in 2010 that the trial court had been mistaken in denying Caesars’s motion to dismiss her counterclaim. “The existence of the voluntary exclusion program,” the judge wrote, referring to the option Indiana offers people to ban themselves from casinos in the state, “suggests the legislature intended pathological gamblers to take personal responsibility to prevent and protect themselves against compulsive gambling.” (Caesars did not respond to repeated requests for comment.)
Noffsinger had been planning to retire before he received Stacy Stevens’s phone call. But after hearing the details of Scott Stevens’s situation—which had far more serious consequences than his previous two cases—he eventually changed his mind. Unlike in his earlier gambling cases, however, he decided to include a products-liability claim in this one, essentially arguing that slot machines are knowingly designed to deceive players so that when they are used as intended, they cause harm.In focusing on the question of product liability, Noffsinger was borrowing from the rule book of early antitobacco litigation strategy, which, over the course of several decades and countless lawsuits, ultimately succeeded in getting courts to hold the industry liable for the damage it wrought on public health. Noffsinger’s hope was to do the same with the gambling industry. When Noffsinger filed the Stevens lawsuit, John W. Kindt, a professor of business and legal policy at the University of Illinois at Urbana-Champaign, described it as a potential “blockbuster case.”

Even by the estimates of the National Center for Responsible Gaming, which was founded by industry members, 1.1 to 1.6 percent of the adult population in the United States—approximately 3 million to 4 million Americans—has a gambling disorder. That is more than the number of women living in the U.S. with a history of breast cancer. The center estimates that another 2 to 3 percent of adults, or an additional 5 million to 8 million Americans, meets some of the American Psychiatric Association’s criteria for addiction but have not yet progressed to the pathological, or disordered, stage. Others outside the industry estimate the number of gambling addicts in the country to be higher.

Such addicts simply cannot stop themselves, regardless of the consequences. “When you’re dealing with an addict active in their addiction, they’ve lost all judgment,” says Valerie Lorenz, the author of Compulsive Gambling: What’s It All About? “They can’t control their behavior.”Gambling is a drug-free addiction. Yet despite the fact that there is no external chemical at work on the brain, the neurological and physiological reactions to the stimulus are similar to those of drug or alcohol addicts. Some gambling addicts report that they experience a high resembling that produced by a powerful drug. Like drug addicts, they develop a tolerance, and when they cannot gamble, they show signs of withdrawal such as panic attacks, anxiety, insomnia, headaches, and heart palpitations.

Neuroscientists have discovered characteristics that appear to be unique to the brains of addicts, particularly in the dopaminergic system, which includes reward pathways, and in the prefrontal cortex, which exerts executive control over impulses. “We’ve seen a disregulated reward system,” says Jon Grant, a professor in the department of psychiatry and behavioral neuroscience at the University of Chicago. “The frontal parts of the brain that tell us ‘Hey, stop!’ are less active, and parts that anticipate rewards tend to be stronger.”

Gambling addicts may have a genetic predisposition, though a specific marker has not yet been uncovered. Environmental factors and personality traits—a big gambling win within the past year, companions who gamble regularly, impulsivity, depression—may also contribute to the development of a gambling problem. Whatever the causes, there’s widespread agreement that certain segments of the population are simply more vulnerable to addiction. “You can’t turn on and turn off certain activities of the brain,” says Reza Habib, a psychology professor at Southern Illinois University. “It’s an automatic physiological response.”Scott Stevens’s story is not anomalous. Given the guilt and shame involved, gambling addiction frequently progresses to a profound despair. The National Council on Problem Gambling estimates that one in five gambling addicts attempts suicide—the highest rate among addicts of any kind. There are no accurate figures for suicides related to gambling problems, but there are ample anecdotes: the police officer who shot himself in the head at a Detroit casino; the accountant who jumped to his death from a London skyscraper in despair over his online-gambling addiction; the 24-year-old student who killed himself in Las Vegas after losing his financial-aid money to gambling; and, of course, Stevens himself.

Problem gamblers are worth a lot of money to casinos. According to some research, 20 percent of regular gamblers are problem or pathological gamblers. Moreover, when they gamble, they spend—which is to say, lose—more than other players. At least nine independent studies demonstrate that problem gamblers generate anywhere from 30 to 60 percent of total gambling revenues.

Casinos know exactly who their biggest spenders are. According to a 2001 article in Time magazine, back in the 1990s casino operators bought records from credit-card companies and mailing lists from direct-mail marketers. One of the latter, titled the “Compulsive Gamblers Special,” promised to deliver the names of 200,000 people with “unquenchable appetites for all forms of gambling.” The casinos used these records and lists to target compulsive gamblers—as Caesars was alleged to have done with Jenny Kephart.These days, the casinos have their own internal methods for determining who their most attractive customers are. According to Natasha Dow Schüll, an NYU professor who spent more than 15 years researching the industry, culminating in her 2012 book, Addiction by Design: Machine Gambling in Las Vegas, 70 percent of patrons now use loyalty cards, which allow the casinos to track such data points as how frequently they play electronic gaming machines, how long they play, how much they bet, how often they win and lose, what times of day they visit, and so on. Each time a patron hits the Spin or the Deal button, which can be as frequently as 900 to 1,200 times an hour, the casino registers the data. Even gamblers who choose to forgo loyalty cards do not necessarily escape the casino’s watchful eye. In some machines, miniature cameras watch their faces and track their playing behavior.

Several companies supply casinos with ATMs that allow patrons to withdraw funds through both debit and cash-advance functions, in some cases without ever leaving the machines they are playing. (Some of the companies also sell information on their ATM customers to the casinos.) “The whole premise of the casino is to get people to exceed their limits,” says Les Bernal, the national director of the advocacy organization Stop Predatory Gambling. “If you’re using the casino ATM, it’s like painting yourself orange.”All of these data have enabled casinos to specifically target their most reliable spenders, primarily problem gamblers and outright addicts. Despite those customers’ big losses—or rather, because of their losses—the casinos lure them to return with perks that include complimentary drinks and meals, limo service, freebies from the casino gift shop, golf excursions for their nongambling spouses, and in some cases even first-class airfare and suites in five-star hotels. They also employ hosts who befriend large spenders and use special offers to encourage them to stay longer or return soon. Some hosts receive bonuses that are tied to the amount customers spend beyond their expected losses, which are calculated using the data gathered from previous visits. As Richard Daynard, a law professor at Northeastern University and the president of the Public Health Advocacy Institute, explained at the group’s forum on casino gambling in the fall of 2014, “The business plan for casinos is not based on the occasional gambler. The business plan for casinos is based on the addicted gambler.”

Casinos have developed formulas to calculate the “predicted lifetime value” of any given individual gambler. Gamblers are assigned value rankings based on this amount; the biggest losers are referred to as “whales.” These gamblers become the casinos’ most sought-after repeat customers, the ones to whom they market most aggressively with customized perks and VIP treatment.Caroline Richardson, for example, became a whale for the Ameristar Casino in Council Bluffs, Iowa. In 2011 alone, she lost nearly $2 million, primarily on the casino’s slot machines. The casino allegedly allowed her to go behind the cashier’s “cage,” an area normally off-limits to patrons, to collect cash to gamble. It increased the limits on some slot machines so that she could spend more on single games. It also made a new machine off-limits to other customers so that Richardson could be the first to play it. Management assigned Richardson an executive host, who offered her free drinks, meals, hotel stays, and tickets to entertainment events.

So claimed a suit brought against the casino by Richardson’s employer, Colombo Candy & Tobacco Wholesale. Richardson, the company’s controller, embezzled $4.1 million over the course of two years to support her gambling addiction. (In 2014, Richardson, then 54, was sentenced to 14 to 20 years in prison for the crime.) The thefts ultimately put the company out of business. The suit claimed that the casino had ample reason to presume that Richardson, who earned about $62,000 a year, had come into the money she gambled by fraudulent means. (A representative for Ameristar Casino declined to comment on the lawsuit.)

The U.S. District Court for Nebraska agreed that Colombo had sufficiently proved its initial claim of unjust enrichment, which the casino would have to defend itself against. The suit, however, stalled when Colombo’s president and CEO, Monte Brown, and his wife, Jenise, ran out of money to pay their attorneys and had to file for personal bankruptcy. “They found someone who had the addiction and the ability to steal, and they exploited it,” Monte Brown says. “The casino embezzled from us through an employee.” Jenise adds, “For people to do that to other people, it’s evil.”

Walk into the Mountaineer Casino in West Virginia, and the slot machines overwhelm you—more than 1,500 of them, lights blinking, animated screens flashing, the simulated sound of clinking coins blaring across the floor. The machines have names such as King Midas, Rich Devil, Cash Illusions, Titanic, and Wizard of Oz. It’s a Tuesday afternoon, and here inside the windowless, clockless, cavernous space, a few patrons are clustered around a craps table, a roulette table, and a handful of card tables. But the vast majority sit at the slot machines. Slots and video poker have become the lifeblood of the American casino. They generate nearly 70 percent of casino revenues, according to a 2010 American Gaming Association report, up from 45 percent four decades ago. Three out of five casino visitors say their favorite activity is playing electronic gaming machines. Their popularity spells profits not only for casinos but for manufacturers as well. International Game Technology, which, as the world’s largest manufacturer of slot machines, has made many of the 900,000-plus slot machines in the U.S., earned $2.1 billion in revenues in fiscal year 2014. (That year, Gtech, an Italian lottery company, acquired IGT and adopted its name in a $6.4 billion deal.)

These are not your grandma’s one-armed bandits. Today’s electronic gaming machines, or EGMs, feature highly sophisticated computers driven by complex algorithms. Old-fashioned three-reel slot machines consisted of physical reels that were set spinning by the pull of a lever. Each reel would have, for example, 22 “stops”: 11 different symbols, and 11 blank spaces between the symbols, for a total of 10,648 possible combinations. If the same symbol aligned on the payline on all three reels when they stopped spinning, the player would win a jackpot that varied in size depending on the symbol. The odds were straightforward and not terribly hard to calculate.The big breakthrough in slots technology was the invention of “virtual reel mapping” in 1982. According to NYU’s Schüll, about 20 to 30 percent of slot machines today resemble the old-fashioned ones, with physical spinning reels. But where each reel stops is no longer determined by the force of a good pull of the lever. Rather, a computer chip within the machine chooses an outcome using “virtual reels,” which may include different quantities of the various symbols—more blank spaces, for instance, and fewer symbols for big jackpots. The physical reels are not spinning until they run out of momentum, as it might appear. Rather, the chips “tell” them where to stop the moment a customer pulls the lever or pushes the button. Thus it is possible for game designers to reduce the odds of hitting a big jackpot from 1 in 10,648 to 1 in 137 million. Moreover, it is almost impossible for a slots player to have any idea of the actual odds of winning any jackpot, however large or small.

Virtual reel mapping has also enabled a deliberately misleading feature, the “near miss.” That’s when a jackpot symbol appears directly above or below the payline. The intent is to give the player the impression of having almost won—when, in fact, he or she is no closer to having won than if the symbol had not appeared on the reel at all. Some slot machines are specifically programmed to offer up this near-miss result far more often than they would if they operated by sheer chance, and the psychological impact can be powerful, leading players to think, I was so close. Maybe next time. (As I. Nelson Rose, a professor at Whittier Law School and the author of Gambling and the Law, has written, Nevada regulations operate on the theory that a sophisticated player would be able to tell the real odds of winning by playing a machine long enough. The gambling industry maintains that deceptive near misses do not occur in North American gaming machines, but as Schüll has noted, it has developed a more narrow definition of deceptive near misses, which still allows for “subliminal inducements.”)

Research has shown that an elevated number of near-miss results does increase playing time. Indeed, as early as 1953, B. F. Skinner, the godfather of modern behaviorism, noted, “ ‘Almost hitting the jack pot’ increases the probability that the individual will play the machine.” This effect is even stronger for gambling addicts, whose brains respond to near misses more like wins than like losses. “The near misses [trigger] the same brain response as a win,” says Reza Habib, the Southern Illinois University psychology professor.

Yet another feature made possible by virtual reel mapping is the uneven distribution of winning symbols among virtual reels, known as “starving reels.” For instance, a 7 may come up four times on the first virtual reel and five times on the second but only once on the third. The first two reels are thus much more likely to hit a 7 than the last one, but you wouldn’t know this by looking at the physical reels. Just as the craps player expects the dice to be numbered 1 to 6 and the blackjack player expects the dealer to use conventional decks of 52 cards, it’s natural for the slot-machine player to expect equal odds on each of the reels, says Roger Horbay, a former gambling-addiction therapist and an expert on electronic gaming machines. “Unbalanced reel design enables EGMs to present to the player screens which are rich in symbols but which are designed to limit winning combinations in a manner incommensurate with the appearance of the screen,” Horbay writes in “Unbalanced Reel Gaming Machines,” a paper he co-authored with Tim Falkiner in 2006.Astonishingly, the patent application for virtual reel mapping, the technology that made all these deceptive practices possible, was straightforward about its intended use: “It is important,” the application stated, “to make a machine that is perceived to present greater chances of payoff than it actually has within the legal limitations that games of chance must operate.” Countries such as Australia and New Zealand have outlawed virtual reel mapping because of the harm the inherent deception inflicts upon players.

In the United States, by contrast, the federal government granted the patent for virtual reel mapping in 1984. IGT purchased the rights to it in 1989 and later licensed the patent to other companies. “Imagine sitting around a boardroom table, thinking of what’s fair, and coming up with this,” says Kevin Harrigan, a co-director of a gambling-research lab at the University of Waterloo, in Ontario. “It just seems wrong to me.”The Nevada State Gaming Control Board approved virtual-reel slot machines in 1983. Interestingly, during hearings on the subject, Ray Pike, the attorney representing IGT—the very company that would subsequently buy the rights to the patent for virtual reel mapping and manufacture hundreds of thousands of slot machines—called these overrepresented near misses “false advertising,” adding, “There is a deception involved with this kind of a machine.” Yet he also stated that if the board approved virtual reel mapping, “certainly we would like to be able to do that”—create the appearance of near misses above and below the payline—“because I think that is a competitive advantage.”

Of course, classic, spinning-reel slot machines make up only a fraction of the electronic gaming machines available at most casinos. Technology has evolved such that many machines lack physical reels altogether, instead merely projecting the likenesses of spinning symbols onto a video screen. These machines allow “multiline” play, an innovation that became common in the 1990s. Instead of betting on one simple payline, players are able to bet on multiple patterns of paylines—as many as 200 on some machines. This allows for more opportunities to win, but the results are often deceptive. For instance, if you bet $1 on each of five different patterns and then get a $3 payout on one pattern, the machine will treat you like a winner, with flashing lights and congratulatory videos and the requisite clinking of virtual coins. The reality, of course, is that you have lost $2.

“The brain somehow registers a win,” Kevin Harrigan says. “No matter what you think, physically you’re being affected by these things—the lights, the sounds, the graphics—as a win. You can get 150 to 200 of these false wins, which we also call losses, an hour. That’s a lot of positive reinforcement.”Losses disguised as wins also create a “smoother ride,” as some within the industry call it, allowing a machine to slowly deplete a player’s cash reserves, rather than taking them in a few large swipes. Because the machine is telling the player he or she is winning, the gradual siphoning is less noticeable.

Related to the video slot machines are video-poker terminals, which IGT began popularizing in 1979. The standard five-card-draw game shows five cards, each offering players the option to hold or replace by drawing a card from the 47 remaining in the virtual deck. The games require more skill—or at least a basic understanding of probabilities—than the slot machines do. As such, they appeal to people who want to have some sense of exerting control over the outcome.

But over time, designers of video-poker machines discovered that they could influence gamblers’ behavior by manipulating game details. They saw, for instance, patrons going more often for four of a kind than the royal flush, a rarer but more lucrative hand, and they adjusted the machines accordingly. Video poker also offers its own version of losses disguised as wins. Today’s “multihand” video-poker machines—triple-play, 10-play, and even 100-play—allow patrons to play multiple hands simultaneously. This creates an experience similar to multiline slots, in which players are likely to “win back” a portion of each bet by frequently hitting small pots even as they are steadily losing money overall.

Regardless of the machine—slots, video poker—casinos’ ultimate goal is to maximize players’ “time on device.” This is crucial for casinos, because given enough time, the house always wins. Local regulations typically stipulate that machines must pay out 85 to 95 percent of the bets placed on them—which means that for every $100 inserted into the machine, on average, the player will lose $5 to $15. Whatever the exact figure, the house odds make it such that if a player plays long enough, she will eventually lose her money.

Technological innovations have not only rendered electronic gaming machines wildly profitable; they have also, according to experts, made them more addictive. “They’re creating problem gamblers as much as they are preying upon problem gamblers,” says Natasha Schüll.

A crucial element in modern gambling machines is speed. Individual hands or spins can be completed in just three or four seconds. Wander through a casino at almost any hour, and you’ll see people transfixed before the machines, their fingers poised over the buttons, jabbing at them like rats in cages. The ability to immediately access additional cash at many machines “shrink[s] the time that transpires between a player’s impulse to continue gambling and the means to continue gambling, thus minimizing the possibility for reflection and self-stopping that might arise in that pause,” Schüll writes in Addiction by Design. They’re lulled into a “state of suspended animation that gamblers call the zone.”

For many gambling addicts, the zone itself becomes more desirable even than winning. Schüll describes it as “a state of ongoing, undiminished possibility that came to trump the finite reward of a win.” The zone provides an escape from life’s daily troubles, from past trauma, and even from the gambling debt accumulating with each spin. Players have gone for 14, 15, 16 hours or more playing continuously. They have become so absorbed in the machines that they left their young children unattended in cars, wet themselves without noticing, and neglected to eat for hours.

Casinos and game designers have come up with many ways to keep patrons at their machines and playing rapidly. The chairs are ergonomically designed so that someone can sit comfortably for long stretches. Winnings can be converted back to credits or printed on vouchers to be redeemed later. Waitresses come by to take drink orders, obviating the need for players to get up at all.

The all-consuming nature of electronic gaming machines also speeds up the onset of addiction, which has earned slot machines descriptions such as “electronic morphine” and the “crack cocaine of gambling.” Schüll notes that a 2002 study showed that “individuals who regularly played video gambling devices became addicted three to four times more rapidly than other gamblers (in one year, versus three and a half years), even if they had regularly engaged in other forms of gambling in the past without problems.”

Public-policy advocates compare slot machines to cigarettes. Both, they claim, are products specifically and deliberately engineered to have addictive properties that are known to hook users. “The EGM and tobacco industries intend users to consume their products in precisely the ways that directly, and without further mediation, initiate the [causal] chain that results in known harms,” writes James Doughney, a professorial fellow in economics at Victoria University, in Melbourne, in a 2007 paper published in the International Journal of Mental Health and Addiction.

Regardless of whatever “pleasures” smoking and EGMs may provide, it is true that both products also cause death … Almost all smokers will smoke potentially lethal amounts. The EGM product, used precisely as intended, will cause users to lose control of time and money in sufficient numbers for the industry to flourish.Cigarette manufacturers were held accountable for the health problems caused by their product after Jeffrey Wigand, a former executive at the tobacco company Brown & Williamson, spoke out in the mid-1990s about the way his firm had manipulated the levels of nicotine to make cigarettes more addictive.

Terry Noffsinger’s legal team grasped the similarities, going so far as to bring on board Sharon Y. Eubanks, an attorney with the West Virginia law firm Bordas & Bordas. Eubanks was the lead counsel for the Justice Department in successful federal litigation against the tobacco industry between 2000 and 2005. She joined Noffsinger in representing Stacy Stevens after he convinced her that the deception used by the gambling industry paralleled that of the tobacco industry. “The tobacco and gambling industries are basically working from the same playbook, using highly engineered products to hook consumers,” Eubanks says.

Casinos are highly attentive to their patrons’ “pain points”—the moments when they are getting close to giving up. The data they track in real time on player cards alert them to these pain points: a big loss, for instance, or when credits start to run low after a dry run. Hosts are also on the lookout for telling behavior, such as someone striking a machine in frustration or slumping over it in discouragement. When hosts spot someone in a state like this, they may swoop in and offer a voucher for some free credits, a drink, or perhaps a meal in the restaurant, where the player can take a break until the resistance passes and he can resume gambling. The hosts may also offer encouraging words such as You’ll win it back. “To me, that is the most vile and venal example of the casino’s intention to trap and keep captive problem and addictive gamblers,” Lissy Friedman, a senior staff attorney at the Public Health Advocacy Institute, said at the group’s 2014 forum.

When players do exhaust all their funds, casinos will sometimes loan them additional money. This is what happened to Noffsinger’s former client Jenny Kephart. In 2006, she spent an entire night gambling at Caesars Riverboat Casino, drinking strong alcoholic beverages provided for free. When she eventually came to the end of her money playing blackjack, the casino offered her a counter check, basically a promissory note, to enable her to keep playing. She signed the check and gambled away the money. That happened five more times. By the end of the night, she had racked up $125,000 in debt owed to the casino. When she couldn’t repay it, the casino sued her. Noffsinger countersued on her behalf. After Kephart’s suit was dismissed, the casino’s original suit was settled confidentially.

Experts say casinos should be aware that when they extend credit to losing patrons, they are by definition enabling problem gamblers. “Any gambler who seeks credit for continued gambling has automatically fulfilled one (and perhaps three) of the ten diagnostic criteria established by the American Psychiatric Association for a ‘pathological gambler’ (as well as for a ‘problem gambler’),” wrote the University of Illinois’ Kindt in the Mercer Law Review. “Theoretically, any gambling facility granting credit (particularly over $200) to a [gambler] has actual or constructive knowledge that the gambler is problematic.”

Bars that serve alcohol to inebriated customers who then injure someone, say by striking that person with their vehicle, can be held liable according to “dramshop” laws. Casinos might similarly be held liable for the financial consequences suffered by gamblers to whom they extend credit beyond a certain limit. In 1994, the widow of a man who killed himself after racking up insurmountable debt at a Mississippi casino sued the casino under an extrapolation of dramshop laws. As her attorney told the Chicago Tribune, “Feeding Eric Kimbrow credit was the equivalent of giving him alcohol.” But her $50 million lawsuit became moot when the casino went bankrupt. So far, no U.S. court has ruled on such a case against a casino and no state legislature has enacted comparable laws that apply to casinos.

Nor should they, according to the gambling industry. “There is no liability to the casino,” says Geoff Freeman, the president and CEO of the American Gaming Association. “There is a set standard to determine inebriation. Nothing of that sort exists to measure what the level is to have gambled too much.”

Stacy Stevens’s suit charged that the Mountaineer Casino, knowing what it knew about her husband and knowing about the harm that can befall gambling addicts, “had a duty to protect Scott Stevens from itself.” She claimed that his suicide was foreseeable by the casino, “yet no attempts were made to intervene.”

Drawing on the research of NYU’s Schüll, the Stevens suit charged that Mountaineer Casino and IGT “have knowingly and intentionally taken advantage of casino patrons, exploiting and causing harm to them, by employing and concealing the present state of gambling with slot machines.” It further claimed that “modern slot machines create, encourage, sustain, and exploit behaviors associated with addiction (e.g., longer, faster, more intensive play)” and that “even when played as intended, slot machines cause users to suffer losses and other detrimental effects.” This formed the foundation of Stacy Stevens’s complaint as a products-liability case: The design of the machines itself, the suit alleged, was responsible for her husband’s addiction and eventual death.

Mountaineer Casino and IGT both declined repeated requests for comment. The casino’s attorneys did maintain the industry position, however, in a motion to dismiss the Stevens complaint, asserting that “nationally utilized and government approved slot machines cannot be found defectively designed or lacking proper warning because of a plaintiff’s unreasonable misuse.”

Mountaineer Casino further maintained the party line that the duty to protect problem gamblers from gambling “belongs to the individual gambler.” As the American Gaming Association’s Freeman argues, “They should have the responsibility to put themselves on a list not to be there.” He is referring to the option states offer residents to voluntarily place themselves on a self-exclusion list, which bans them from gambling activities in that state, and from collecting winnings if they violate the ban. (It does not, however, prevent them from losing money if they visit a casino despite the restriction.) Some experts believe self-exclusion lists are not effective, because they seem to be erratically enforced. Despite the presence of sophisticated surveillance technology, patrons are not routinely screened for their self-exclusion status. “If a self-excluded gambler goes to a casino, it’s okay for them to lose money, but once they start winning, a worker taps the gambler on the shoulder and says, ‘You’re being arrested for trespassing,’ ” says Lorenz, the author of Compulsive Gambling. “Go to any casino, and the gamblers will tell you this is happening with regularity.”

Given that casino operators and slot-machine manufacturers are adamant that the blame for gambling addiction resides with the individual, it is not surprising that research by the industry-funded National Center for Responsible Gaming favors studies directed toward confirming this conclusion. Of the approximately $17 million that the NCRG has allotted for research since its inception in 1996, it has not spent a nickel studying slot machines and the impact they have on those who play them. (According to Chris Reilly, a senior research director at the NCRG, though the majority of the group’s funding comes from commercial casinos and manufacturers, the center maintains a firewall between its contributors and its researchers. Members of the board of directors, she asserts, do not make research decisions, and the center has a separate scientific advisory board.)

“It’s a mistake to focus on the machine, because it’s just this thing,” Reilly says. She says that the problem is rooted in the individual. “We don’t know why the gambler has cognitive disorders” or other issues. “That’s what feeds their addiction.”

That’s not right, says Roger Horbay, the EGM expert and former gambling-addiction therapist. Independent research not funded by the NCRG has shown how false wins, near misses, and other such features influence gamblers, especially the way they perceive expected outcomes. “We’ve been treating these people like they’re messed up, but it’s the machines that are messing them up,” he says. “A lot of the so-called cognitive distortions were actually caused by the machines, not [because the users] were making errors in thinking. Most of them are making correct conclusions based on deceptive information. It’s the lie of the technology that’s the problem.”

Keith Whyte, the executive director of the National Council on Problem Gambling, says that although the industry should have a role in research and public-education efforts, it cannot be effective on its own. (The group, which maintains a neutral stance toward legal gambling, receives a large share of its funding from the industry.) “We can’t rely on the people who provide the product and profit from it to educate the public on the risks,” he says. “It needs to be a broad-based public-health effort.”

Almost a decade after the 1988 Indian Gaming Regulatory Act launched the dramatic expansion of casino gambling into new jurisdictions, the federal government appointed a commission to study the impact of the proliferation. Based on findings that suggested the rate of problem gambling could be twice as high within a 50-mile radius of a gambling facility, the National Gambling Impact Study Commission in 1999 recommended “a pause in the expansion of gambling in order to allow time for an assessment of the costs and benefits already visible, as well as those which remain to be identified.”

Despite that warning, states have been unable to resist the continued expansion of casino gambling. One reason for the ongoing growth is the financial clout of the industry itself. In 2008, when nine states were considering gambling measures, gambling proponents raised more than $167 million, compared with about $106 million by gambling opponents, according to a report by the National Institute on Money in State Politics. “Predatory gambling interests are now the most powerful lobby in the country on the state level because government is a partner with them,” says Les Bernal of Stop Predatory Gambling. “They are literally going out and buying the political process.”

Indeed, experts argue that many states have created a government-gambling complex that implicates them in the casinos’ practices. Many states provide tribal casinos with regional monopolies in exchange for revenues skimmed off the top of casino profits—as much as 30 to 40 percent in some places. West Virginia has a proprietary interest in the slot machines’ software. Kansas actually owns the games and operations of nontribal casinos. New Jersey, Delaware, and Rhode Island have all provided financial bailouts to faltering casinos. “It’s a pretty sleazy way to fund state government,” says Peter Franchot, the comptroller of Maryland. “We have set ourselves up in partnership with a predatory industry … The profits come mainly from a group of addicts that are recruited and nurtured by casinos until they’re out of money.”

Communities typically build casinos based on a mirage of false promises: that they will provide jobs, fund schools, and boost the local economy. But Earl Grinols, an economics professor at Baylor University, in Texas, and the author of Gambling in America: Costs and Benefits, has estimated that every dollar of benefit a casino brings to a community entails about $3 in social costs—whether it’s increased crime, or declining productivity, or more spending on services such as unemployment payments. “It’s a social negative,” Grinols told me. “Casino gambling is bad for the economy. It should not be allowed by anyone, anywhere, anytime.”

In defense of its products and practices, the gambling industry insists that it is heavily regulated and therefore safe. As the attorneys for Mountaineer Casino argued in their motion to dismiss the Stevens suit, “Gaming is highly regulated in each state where it is legalized … If gambling were deemed unsafe or to pose unreasonable harm to citizens … it would not have been legalized.” But this “if it’s legal, it must be safe” argument fails to acknowledge the inadequacies of existing regulations. “Regulators are supposed to protect players and the industry,” says I. Nelson Rose, the author of Gambling and the Law. “But it’s just not at the top of the government’s or industry’s priorities to be thinking about how to protect players.”

Each state in which gambling is legal has set up its own commission to regulate the industry, but there seems to be a symbiotic relationship between regulators and the industry. There are numerous instances of former regulators’ being hired by casinos or other gambling interests. Many gaming-commission members—including those who approve applications for casino licenses—are advised by consultants for private companies also on casino payrolls. “I think society in general has been led to believe that this is a highly regulated and fair industry because the regulators test everything,” Roger Horbay says. “But they would be shocked if they knew even slot machines don’t have to comply with consumer-protection laws.”

Horbay points to informed choice as the central tenet of consumer protection, which is why when you apply for a loan, the bank has to tell you the interest rate and how it’s calculated. It’s why many state lotteries have to disclose their odds, and it’s why even the contests on the backs of cereal boxes list the chances of winning a prize. Yet such essential disclosure is not required of electronic gaming machines. “These machines present all sorts of deceptive trade practices that wouldn’t be allowed in any other industry, not even in other gambling games,” he says. “The standard for game fairness is nonexistent on slots.”

As it happens, the Nevada State Gaming Control Board addressed exactly this question during its 1983 hearings on virtual-reel technology. As Richard Hyte, then a Nevada commissioner, explained, if slot machines were to disclose a player’s odds of winning a payout, that would “take away the mystery, the excitement and entertainment and risk of playing those machines.”

In June, the West Virginia Supreme Court of Appeals ruled on Stacy Stevens’s suit, determining that “no duty of care under West Virginia law exists on the part of manufacturers of video lottery terminals, or the casinos in which the terminals are located, to protect users from compulsively gambling.” The opinion, written by Justice Brent Benjamin, declared that electronic gaming machines exist in West Virginia for the express purpose of providing an economic boon to the State and its political subdivisions in the form of increased public revenues, to the citizenry in the form of enhanced employment opportunities, and to the racetrack industry for the additional benefit of the dependent local economies.

West Virginia might have been a difficult venue in which to make Stevens’s case. The state has a proprietary interest in the slot machines’ software, and legalized gambling provided more than $550 million in fiscal year 2014, according to the Rockefeller Institute of Government. (For the sake of comparison, the state’s total tax revenues were only about $5 billion.) Little wonder that the court’s ruling focused on the “economic boon,” “increased public revenues,” and “enhanced employment opportunities” provided by gambling, as opposed to the state’s responsibilities to problem gamblers. As Sharon Eubanks, Noffsinger’s co-counsel on the Stevens suit, notes: “What this tells us is the states are addicted to gambling themselves. They seem unwilling to deal with the social costs.”

Les Bernal of Stop Predatory Gambling agrees that the close relationship between the state and its gambling interests was crucial: “I don’t think it has something to do with it; I think it has everything to do with it. Essentially what the West Virginia Supreme Court has said is that gambling interests in West Virginia are immune from liability.”

In West Virginia, Indiana, and other states, the courts have deferred to the state legislatures’ intentions in their decisions, but the legislators don’t always know better—in part because they may have been informed principally by gambling interests. Former West Virginia House Majority Leader Rick Staton has expressed regret over his role in expanding legalized gambling in the state. “I think we got, no pun intended, played,” he told the Charleston Gazette. He’s not alone. Stan Rosenberg, the president of the Massachusetts Senate, helped lead his state’s drive to legalize casinos in 2014 despite being unaware of near misses, false wins, and other EGM practices. “I don’t know the engineering and science of it,” he admits.

Noffsinger concludes that this “is basically the end of our efforts in West Virginia.” But he believes the movement to hold casinos liable for problem gambling is only building momentum: “One of the things that has happened is that the public is learning more about it. There have been more people who have lost a lot of money, there have been more people who have had to file bankruptcy, there have been more people who have embezzled, there have been more people who have committed suicide. What’s amazing to me is that not one time has the evidence that we alleged in our complaint been tested in a court of law with sworn testimony and a trial and a ruling.”

And that, according to several experts, is what it will probably take—a court trial, which would open access to private industry documents. “The industry knows if any court gets to the point of discovery, they’re in real trouble,” says Kindt, from the University of Illinois at Urbana-Champaign. “They know what they’ve got in their marketing plans and their documents. They cannot afford to have that made public, because it would confirm what everybody knows: that one- to two-thirds of their income comes from the roughly 10 to 20 percent of their customers who are pathological and problem gamblers.” Kindt continued, “The Stevens case is getting good publicity and national recognition. The more lawyers read about it, the more they are going to start smelling blood in the water. It just takes for a case to be brought up in the right jurisdiction.”

On his last Christmas, shortly before he lost his job, Scott Stevens did not buy his wife or three daughters any presents, and he couldn’t bring himself to open the presents they had bought him. He didn’t feel that he deserved them, and he gave in only after his daughters begged him. A photograph of him later that week, when he was deep-sea fishing in Cabo San Lucas, a place that usually brought him happiness, reveals the heaviness in his expression—his eyes defeated, his smile gone.

In the months after he was fired, Stevens tried taking the antidepressant Paxil and saw a therapist, but he did not admit to Stacy that he was still gambling almost every day. As spring turned into summer, he knew that charges from the IRS were forthcoming following its investigation into his embezzlement and that even after serving time in prison, he would likely still be on the hook for the hundreds of thousands of dollars he owed in back taxes and penalties. His former employer seemed close to pressing charges, having put the police on notice. He would never be able to work in the financial sector again. Once the affair hit the papers, his family would be dragged through the gantlet of small-town gossip and censure. He could see no way to spare them other than to sacrifice himself.

By mid-afternoon on August 13, 2012, Stacy had started to worry. Why hadn’t Stevens responded to her texts? That wasn’t like him. She texted him that they would eat dinner early to accommodate the girls’ evening activities. “Why aren’t you answering me?” she texted. But she got no response until about an hour later, when he sent his last text to her: “I love you.”

Distressed, Stacy responded, “Honey, I love you. Please come home.” She telephoned his therapist to ask whether she had seen him, but to no avail.

Shortly after that, Stacy’s phone rang. It was Tim Bender, the Cleveland tax attorney helping Stevens with his IRS troubles. Stevens had just called him. Bender had tried to talk him out of killing himself, but Stevens had hung up. Bender said he would call 911.

All Stacy could do was pray: “Please, God. Please, please, please. Let things be okay.”

Then she heard sirens. Lots of them.

Police officers from the neighboring town of Wintersville arrived at the soccer fields within six minutes of Stevens’s own 911 call. They found Stevens sitting on the railroad tie by his Jeep. Two sheriff’s deputies and an Ohio highway patrolman also pulled into the complex.

They spoke to Stevens across the gravel parking lot.

“Stand up. Show us your hands.”

But Stevens was not going to back down. This was his family’s only chance, his final gamble.

He raised the muzzle of the shotgun to his chest, reached for the trigger, and squeezed.

How do I overcome a slot machine addiction (on my own)?

This addiction does not discriminate. If the propensity is there, and the gambler crosses over that invisible line into problem gambling, addiction can occur in anyoneas life. It does not matter whether the person is rich or poor, educated or uneducated. An addiction like this can send people to jail, cause major social and occupational problems, mental instability, and financial devastation that can last for years.

It is important to get help as soon as possible. It isnat easy to quit gambling, but there are ways you can help yourself before you get to the point of no return. Here are twelve strategies to use to stop gambling and reclaim your life!

Remember the feeling when you lose a lot of money at the casino, online, or through sports betting. Allow yourself to feel that despondency when you are having thoughts about gambling again.

Find something to replace your gambling. Exercise, go shopping, go out with friends, or do some cooking. You can also rent a movie, listen to some music, or do some reading a do whatever it takes to keep yourself busy. You could pick up a new, exciting hobby, like bike racing or climbing or welding.

Your goal is to stop gambling, and it is not easy when you get such a high from it. Finding replacements, however, can help. Try and see how it goes.

Attend a Gamblers Anonymous meeting for group support. If you do not want to do a 12-Step program, there is an online program called Smart Recovery. Having support from other gamblers who also want to quit is an important piece of your recovery. Just talking about gambling with other people who understand what you’re going through can be really helpful.

Make a list about how your gambling problem has affected your life in a negative way. Write as much as you can. Make the list on the left side of a sheet of paper so you have room on the right side. On the right side, write about how your life will change for the better when you stop gambling.

See a counselor that specializes in addictions, especially gambling, and talk to this person about your problem. If your addiction is severe, you will need as much support as you can get to stop gambling now.

Surround yourself with people that you trust who want to see you recover and avoid any kind of environment where you might be tempted to gamble, which could be anything from a casino, to being at home alone with your smartphone. Delete gambling apps from your phone and tell casinos that you have a problem and that you want them to block you from entering.

Just because you have a problem with gambling does not mean you are a weak-willed, irresponsible person. Strong-willed or responsible people are just as likely to develop a gambling disorder as anyone else.

How to overcome slot machine addiction is for someone else to say. But I can tell you this.

A) I love the thrill of going to the casino and playing slot machines. B) I know over time I am going to lose money, I’ve proved to my own satisfaction its true and C) I hate to lose any amount of money that is painful to lose.

Solution? Remove any financial impact a trip to the casino had on me. That way I could have my cake (experience the thrill of playing) and eat it too (not have to lose any money that really matters).

How?

I found playing penny machines one penny at a time was exactly the best thing to do. I cant get rich doing it but that’s not the point (remember, I realized the odds were stacked against me). Hours of entertainment and fun and keeping a trip as inexpensive as possible are the point. This makes every little hit you get very exciting because each one makes the trip just that much cheaper. Keeping a trip to the casino as low cost as possible becomes the game, and it’s tons of fun. I can honestly say I win EVERY SINGLE TIME playing slot machines. What I pay for in losses is merely the cost of entertainment, and it’s way cheaper than the cost of the entertainment I get.

When you say “slot machine addiction” I automatically think “financial problems” and I understand how difficult it must be to break that addiction. I’m not saying not to try to break the addiction, but if you try to do it and it’s just far too difficult, then what I’m saying is, at least try to eliminate the financial problems your gambling causes. If you can do at least that much, then you can re-evaluate at that point how really bad the addiction is for you.

Realize how badly the odds are stacked against you and then turn the idea of “slot machine gambling” into one of “slot machine entertainment” and I’m confident, if you can’t break the addiction completely, you will have at least made a very valuable stride.

Ask yourself that if you are addicted to slot machine or gambling, if it is slot machine Peter’s advice should help, you may find it is really boring without money involved. If it is gambling, you may want to consult a psychologist.

How I became addicted to the ‘crack cocaine of gambling’

When I came out recently about my gambling past, one of the most common responses I got from people is, “you don’t look like a gambling addict!”

What does that even mean? What does a gambling addict look like? Well, in my case a gambling addict looks like a 36-year-old mother of six.
I guess from an early age I had a fascination with winning money and I thought that it was somehow the answer to life’s struggles. I would hear family members talking about lotto, I would get “Scratchies” (lottery scratch cards) in birthday cards and of course, if we ever went to a club I would walk past the “Pokies” (slot machines) and think “Wow! I would love to be able to play them!”
The subtle and not so subtle ways in which gambling is almost intrinsically woven into Australian culture is appalling.
As a teen, my boyfriend at the time loved gambling in all its forms and because I wanted to be around him I quickly joined in. I will never forget that first win. I put in $20 and won $100. ‘Wow!” I thought, why would anyone do anything else?
I was in awe of this amazing machine that I thought had the capacity to make all my desires come true. Slowly, I began to gamble more and more and sit there longer and longer in order to replicate that rush I got from turning the money I had into more.

The “crack cocaine” of gambling

This behavior continued. I would go before work, after work, in lunch breaks, on nights out and days off. It’s easy to see now why some people call Pokies the “crack cocaine” of gambling. I was hooked.
At the time I don’t think I realized the devastating financial effect it was having on me. I was still living at home and mum and dad were supporting me, so I looked at the money I was getting from my receptionist job as disposable income I could do whatever I wanted with.
The threat of homelessness or starvation was never a reality for me. I got paid $1,500 a month and some months that would be gone by close of business on payday. Then I would borrow money from mum or one of my siblings to get by for the month.
I should have gotten help then, but I didn’t even know there was help for that kind of thing. I didn’t know that, left untreated, my addiction would worsen and even linger dormant for periods of time, waiting to resurface when money, time and opportunity aligned.
My life had started to spiral in a very bad direction and I was too afraid to tell my family just how bad it was. All of a sudden, my world took a very sudden turn in the other direction when I met a young guy who was unlike anyone I had ever known. I broke up with my gambling boyfriend and after a few months Phil and I started dating. We got engaged and married within a year.
We were 20 when we got married and had our first baby at 21. When we were expecting our second child at 23 and building our own home, the stress and pressure on me rose to boiling point; I buckled, and old ways of coping resurfaced — and then what also returned was the shame, guilt and regret.

Dreaming of the ‘Pokies’

My husband’s depression that he had also struggled with in his youth made its way into our marriage and from that point forward we were both dealing with pain.
He could never understand the hold and pull the machines had over me and I thought that because he withdrew and kept piling all the stress on me that he didn’t care about me.
The horrible roller coaster of self loathing and disappointment continued for 12 years until I was so completely exhausted from trying to keep up the facade that I was fine and I wasn’t an addict.
I struggled for such a long time with that word and what nearly killed me was the phrase “once an addict always an addict.”
I had wished so many times that it had been a drug or an alcohol issue because then people would have seen and I wouldn’t have been able to hide for so long.
Even the people that I did let in didn’t know how to help me. People thought that if I wasn’t in a venue then it wasn’t affecting me, but it was. I could see the Pokies in my dreams, hear the sounds that they played and there was the grip of fear and anxiety every time the phone rang, worrying if I was about to be discovered.
I was so afraid of people finding out, I told my husband that if anyone did I would kill myself.
I got to the point that I could no longer bear the thought of living the rest of my life perpetually disappointing all who loved me.
In 2012 aged 32, I almost took my life. I sat for 8 hours crying on the stool, the sounds of other machines all around me, just staring at the machine that had just swallowed the last money I had access to. The nil balance on the screen was too much for me to bare. Completely alone and feeling like there was nowhere to turn, my brain was trying desperately to figure out how to kill myself in such a way that my body could be kept alive in order to let my unborn baby be delivered to term. I loved her so much that I didn’t want anything to happen to her.
I actually loved my life on every level, except that I thought I had made mistakes too huge, that I could never come back from them. I thought that they would all be better off without me, without an addict. After all, “What would people think?”

The importance of self esteem

I had tried to seek help over and over and it had failed, so I lost hope. I lost sight of a future. All I could see was pain — the pain I was in and the pain I could cause.
Uncovering hope was not easy. It started with one simple question: “Name 10 things you like about yourself.” My counselor at the time asked me this question as she could see what no one else had, probably because I hadn’t let anyone else in. She saw a woman who was destroyed in every way, physically — weight gain and strokes, emotionally — no self esteem, and of course financially. When you are emotionally destroyed, that question was the hardest question of my life, but it was also the most vital. I didn’t know it then but rebuilding of one’s self esteem is the cornerstone through which all successful recovery can be built.
Resources for Gambling Addiction

Impact Your World is CNN’s network-wide initiative which informs and empowers those who ask: “What can I do?”

The biggest reason why I came out this year about my addiction was because I wanted to shatter the stigmas and judgments that exist and simply step forward as an example of someone who failed, fell, but then stood up and kept going, with a focus to be present in my life to my family and friends and help others in their humanness.
I protected this secret almost to my grave and it would have destroyed all the people around me had I robbed them of the chance to love me through it.
I’m so grateful that I allowed them into my pain and didn’t keep deciding for them what they could and couldn’t handle. I realize now that people will love you or judge you no matter what you do or who you are, and if they choose to judge you, it is their stuff not yours.
Admitting and acknowledging one’s weaknesses should be met with support, compassion and encouragement only. Never judgment.
So what does a gambling addict look like? I guess I very proudly look like a human being.
Kate Seselja is founder of the HOPE Project.

Who does problem gambling affect?

Problem gambling can affect anyone. It can happen at any age, to males or females, and to people from any ethnic background. Studies have shown that you are more likely to develop a problem if you have a family history of problem gambling and if you started gambling at an early age. Find out more about young people and problem gambling here.

Problem gambling has been called the ‘hidden addiction’, meaning that unlike other addictions such as alcohol or drug addiction, the physical effects of the problem are very difficult to see. You are unlikely to know that someone has a gambling problem unless they tell you.

The impact of someone else’s gambling problem can be very stressful for friends and family members. GambleAware® offer support to anyone struggling with a loved one’s gambling problem. Find out how to talk to someone about their gambling here, or call the National Gambling Helpline to receive support and access free, confidential counselling.

Signs to look out for

Is your gambling causing problems for you or others around you? The following signs may indicate a problem:

  • Spending more money and time on gambling than you can afford.
  • Finding it hard to manage or stop your gambling.
  • Having arguments with family or friends about money and gambling.
  • Losing interest in usual activities or hobbies like going out with friends or spending time with family.
  • Always thinking or talking about gambling.
  • Lying about your gambling or hiding it from other people.
  • Chasing losses or gambling to get out of financial trouble.
  • Gambling until all of your money is gone.
  • Borrowing money, selling possessions or not paying bills in order to pay for gambling.
  • Needing to gamble with larger amounts of money or for a longer time to get the same feeling of excitement or buzz.
  • Neglecting work, school, family, personal needs or household responsibilities because of gambling.
  • Feeling anxious, worried, guilty, depressed or irritable.

Remember, problem gambling behaviour is often hidden

It can be difficult to know if someone has a problem with gambling. Initially we may not want to believe that someone we know or love has a problem with gambling. It can also be difficult to detect a gambling problem, because many people who gamble do not show their feelings and may lie or get angry if questioned about their behaviour.

People sometimes say they feel that they should have noticed sooner, but remember the person gambling may have gone to great lengths to hide it from you.

Read more about how to help a problem gambler, and yourself, here.

Once you have noticed there are many ways we can help you and the person gambling. Whether or not you think any of these points apply to you, if you think you, or someone close to you may have a gambling problem, and you would like help and support, visit our Confidential Help page or contact the National Gambling Helpline on freephone 0808 8020 133.

Engineers of addiction: Slot machines perfected addictive gaming. Now, tech wants their tricks

Engineers of addiction

Slot machines perfected addictive gaming. Now, tech wants their tricks

 You can play a slot machine in Las Vegas before you’ve even reached baggage claim: there are tiny slots parlors in every terminal of McCarran International Airport. Once you pick up your rental car, you can stop for gas and play slots at a convenience store. And that’s all before you’ve even reached your hotel-casino, which — if it follows the modern standard — dedicates roughly 80 percent of its gaming floor to slots, and only 20 percent to table games.

“The room was silent apart from the soothing hum of two dozen hibernating consoles”

Bally Technologies, one of the world’s largest manufacturers of slot machines, is headquartered 3 miles south of the Strip. When I visited Bally in mid-March, Mike Trask, the company’s senior marketing manager, walked me into the company’s showroom to play some games. Compared to the cacophony of a casino floor, Bally’s showroom was practically monastic, the lights low and the room silent apart from the soothing hum of two dozen hibernating consoles.

Trask, a tall man in his 30s with dirty-blond hair, showed me the company’s new Friends-themed game, installed on Bally’s ProWave cabinet, a slick, 42-inch curved console. Friends celebrated its 20th anniversary last year, and the company hopes to tap some of that nostalgia. “That person, that girl who watched every episode of Friends when it came out, is our demographic,” Trask said, standing alongside the cabinet.

I took a seat in front of the unit, and Trask touched a logo on the display’s upper corner, selected a box on the display that ensured I would get a bonus round, and told me to hit the spin button. I did, and a pared down version of the show’s theme song played, the NBC sextet smiled at me from the prime of their youth, and five reels of symbols — a Central Perk decal, a guitar, screenshots of characters — scrolled down the screen. The Wheel of Fortune-style bonus round featured a clip of Rachel saying, “Happy birthday, Grandma!” wearing a wedding dress.
Slots floater

Bally assembles all of its machines in a factory warehouse next to its game studios and tucked behind its Vegas corporate headquarters. Last year, Scientific Games, Bally’s parent company, shipped out more than 17,000 new units. On my visit, hundreds of freshly assembled slot machine shells, featuring the industry standard black exterior and jutting dashboards, lined the warehouse walls.

A tag attached to each cabinet indicated its destination: Oklahoma, Washington, Michigan, Canada. Only a handful were destined for Vegas casinos, a sign of gaming’s national and international expansion. Scientific Games acquired Bally last year for $5 billion. At the time, 23 states had legalized gambling, a heavily taxable industry, to quickly infuse deficient coffers.
“Technology built for slot machines has found admirers in Silicon Valley”

But the expansion of gaming generally is the expansion of slot machines specifically — the modern casino typically earns 70 to 80 percent of its revenue from slots, a stratospheric rise from the 1970s when slots comprised 50 percent or less. New York, the latest state to introduce gaming, doesn’t even allow table games, and Pennsylvania, now the third-largest gaming state in the country after Nevada and New Jersey, only later allowed table games in an amendment to its legislation. And increasingly, the psychological and technical systems originally built for slot machines — including reward schedules and tracking systems — have found admirers in Silicon Valley.

In the factory, Trask and I passed a ProWave cabinet, a design released by Bally in mid-2014 that features a 32-inch concave screen, like an even more curved Samsung TV. Trask claimed that putting the same exact games on curved screens increased gameplay 30-80 percent. I asked him why that was. “It looks cool; it’s incredibly clear,” he said in a tone suggesting a guess as good as any. Game designers are charged with somehow summoning the ineffable allure of electronic spectacle — developing a system that is both simple and endlessly engaging, a machine to pull and trap players into a finely tuned cycle of risk and reward that keeps them glued to the seat for hours, their pockets slowly but inevitably emptying. As we stood over the gaming cabinet, Trask told me about the floor of the MGM, home to 2,500 machines and hundreds of different games. Trask’s mission, as he saw it, was simple: “Our job is to get you to choose our game.”
Bally Factory Wide

The prototypical slot machine was invented in Brooklyn in the mid-1800s — it was a cash register-sized contraption and used actual playing cards. Inserting a nickel and pressing a lever randomized the cards in the small display window, and depending on the poker hand that appeared, a player could win items from the establishment that housed the machine. In 1898, Charles Fey developed the poker machine into the Liberty Bell machine, the first true slot with three reels and a coin payout. Each reel had 10 symbols, giving players a 1-in-1,000 chance of hitting the 50-cent jackpot if three Liberty Bells lined up. The three-reel design was a hit in bars and became a casino standard, but for decades gaming houses considered them little more than a frivolity — distractions for the wives of table-game players. Accordingly, casinos were dense with table games, and slots were relegated to the periphery.

That began to change in the 1960s, when Bally introduced the electromechanical slot machine. The new rig let players insert multiple coins on a single bet, and machines could multiply jackpots as well as offer up smaller, but more frequent wins. Multi-line play was introduced: alongside the classic horizontal lineup, players could now win with diagonal and zig-zagged combinations. The new designs sped up gameplay and breathed life into the stagnating industry.

William “Si” Redd, the bolo tie-wearing Mississippi native who oversaw some of Bally’s new projects during the era, was instrumental to that renaissance. “The player came to win,” he said, “he didn’t come to lose, [so] speed it up, give him more, be more liberal. Let him win more, but then [you make money] still with the speeding up, because it was extra liberal.” In other words, the new machines lowered slots’ volatility — gaming parlance for the frequency at which a player experiences big wins and losses.
Casino Color

The casino floor of the Boulder Club, early 1950s. Image courtesy of the University of Nevada, Las Vegas
“Video poker gained a reputation as the “crack cocaine” of gambling”

In the 1970s, Redd left Bally and founded another gaming manufacturer that was later renamed IGT. IGT specialized in video gambling machines, or video poker. Video poker machines could be designed to have even lower volatility, paying players back small amounts on more hands. And video poker’s interactive elements made them extra engrossing, turning them into an enormous success: people lined up to play the first machines, and the game’s ability to command a player’s complete concentration for hours gave it a reputation as the “crack cocaine” of gambling.

“If you were to take $100 and play slots, you’d get about an hour of play, but video poker was designed to give you two hours of play for that same $100,” Redd said at the time, instructing game designers to lengthen the time it took a poker machine to consume a player’s money.

Redd also acquired the patent for the newly created Random Number Generator, which computerized the odds-calculator behind the spinning reels and allowed game makers to control volatility. A modern slot machine, at its core, is nothing more than an RNG going through millions or billions of numbers at all times. When a player hits a spin button, they are simply stopping the RNG at a particular moment. Everything beyond that — the music, the mini-games, the actual appearance of spinning reels, Rachel, Monica, and the rest of the gang keeping you company — is window dressing to keep you hitting spin.
Slot Factory Floor

IGT now makes 93 percent of the world’s video poker machines and is the largest manufacturer of video slots in the world. Its Wheel of Fortune franchise spans every kind of slot machine — reels, curved screens, and massive installations with enormous physical flourishes. On my visit to their Las Vegas offices, I asked Jacob Lanning, IGT’s vice president of product management, what makes a good game. “If you can figure that out, you’ve got a job,” he said. Trask had told me something similar: “If we knew what the perfect game was, we’d just keep making that game over and over.”

Perhaps no one has uncovered the Platonic ideal of the slot machine, but certain principles undergird most games. First, there’s a vague aesthetic uniformity: colors tend toward the primary or pastel, franchise tie-ins are a must, and the game soundtracks are typically in a major key. Meanwhile, the multi-line wins introduced by Bally have become an unintelligible tangle: modern slots offer players upwards of 50 and sometimes 100 different winning combinations — so many that without the corresponding lights, sounds, and celebration, most casual and even advanced players would have trouble recognizing whether they’d won or lost.
“”If we knew what the perfect game was, we’d just keep making that game over and over.””

To keep players gambling, all slots rely on the same basic psychological principles discovered by B.F. Skinner in the 1960s. Skinner is famous for an experiment in which he put pigeons in a box that gave them a pellet of food when they pressed a lever. But when Skinner altered the box so that pellets came out on random presses — a system dubbed variable ratio enforcement — the pigeons pressed the lever more often. Thus was born the Skinner box, which Skinner himself likened to a slot machine.

The Skinner box works by blending tension and release — the absence of a pellet after the lever is pressed creates expectation that finds release via reward. Too little reward and the animal becomes frustrated and stops trying; too much and it won’t push the lever as often.

Like video poker, most multi-line slots rarely pay large jackpots, instead doling out smaller wins frequently. “They’re imitating the formula of video poker, but they’re doing it in a slot formula,” Natasha Schüll, an associate professor at MIT who has researched slots for 15 years, says. In 2012, Princeton University Press published Addiction by Design: Machine Gaming in Las Vegas, the culmination of her research and a deconstruction of the slot machine.
“Too little reward and the animal becomes frustrated and stops trying; too much and it won’t push the lever as often”

Schüll says modern slot machines essentially continued the trend started by Redd so as not to jolt players too intensely in the form of losses — or wins. “Too-big wins have been shown to stop play because it’s such an intense shift in the situation that you’ll kind of pause, you’ll stop, you’ll take your money and leave,” says Schüll. Stretching out gameplay with minor rewards, Schüll says, “allows you to get in the flow of, another little win, another little win.”

As a result, modern slots pay out on approximately 45 percent of all spins, instead of the 3 percent of traditional slots. “The sense of risk is completely dampened,” Schüll says. “Designers call them drip feed games.”

That analysis is supported by a 2010 American Gaming Association white paper. “Lower-volatility games often have greater appeal in ‘locals markets’ than in destination resort markets like Las Vegas or Atlantic City…Customers tend to play these games for longer periods of time…” In other words, lower volatility games paved the way for gaming’s wild expansion nationwide.

The advent of bonus games has also helped bolster slot machines’ popularity: instead of just winning money, certain combinations can trigger mini games. In the IGT showroom, Lanning showed me the company’s forthcoming Entourage game, in which a bonus game has the player match portraits of characters. In the industry, it’s called a pick-em bonus. “Those are the most popular features,” Melissa Price, the senior vice president of gaming for Caesar’s Entertainment, told me. “Customers enjoy ‘perceived skill’ experience.”

And then, there’s the emotional appeal: Price told me the company commissioned a study to find out why people love the Wheel of Fortune line so much. “People said it was as much about the brand as anything,” she said. “People said, ‘That brand — I used to hear it in the living room at my grandma’s house, I’d hear that wheel spinning because my grandma watched it. It reminds me of my grandma.’ I mean, how can you compete with that?”
Slots Pink Glasses

Price and I spoke on the floor of Harrah’s Las Vegas at 9:00AM — the slots players were already at their machines, or perhaps they’d been there all night. Last year, Harrah’s parent company, Caesar’s Entertainment, declared bankruptcy as a consequence of overextension and growing competition. During proceedings, creditors appraised Caesar’s vast store of customer data as the company’s most valuable asset, worth about $1 billion.

Harrah’s pioneered the now industry standard Total Rewards player tracking system, first with a punchcard program introduced in 1985, then with a digital program and magnetic cards in the 1990s. Slots were easy to track, and stood at the very center of the program. The system grew even more sophisticated under the auspices of former CEO Gary Loveman. Loveman arrived at Harrah’s fresh from teaching at Harvard Business School, and he brought a methodical business savvy to an industry that, in many ways, had spent decades winging it.
“Caesar’s vast store of customer data has been valued at about $1 billion”

Before the tracking system, the player management was as sophisticated as watching which players spent a lot of money and comping amenities to encourage them to spend more. “We all looked around and said, there’s got to be a more automated way to do that,” said Price.

Price and I stood behind a woman playing IGT’s Ellen Degeneres game. Ellen’s head whizzed down the reels on the parabolic display in high definition. As long as the player had her Total Rewards card inserted in the machine, every time she hit the spin button the system recorded the size of her bet, what game it was spent on, at what time, how long she’d been playing for, and so on, until she hits the “Cash Out” button on the machine, at which point all the data is encapsulated in her file, along with all the other games she has ever played at a Caesar’s casino.

Player tracking systems revealed more than a pit boss ever could: over time, Harrah’s can create a portrait of the person’s risk profile, including how much money a player typically loses before they stop playing and what kinds of gifts to give them to keep them on the gaming floor. Sometimes, that can be a penthouse suite; other times, it can be as little as giving a player $15 in cash. In 2012, This American Life charted the lurid and unsettling extreme of how these systems can be used in a story about a Harrah’s in Indiana that enticed a woman to keep playing with unlimited hotel suites, diamond jewelry, and free trips to the Kentucky Derby. The perks fueled her gaming habit until she was $125,000 in debt.
“”We are the envy of probably every consumer products industry out there.””

Every casino today has a form of the data system invented at Harrah’s — most of them are now built by Bally. “We are the envy of probably every consumer products industry out there because of the amount of data that we really have on our players,” said Price. Newer systems can even visualize heat maps of casino activity — an operator can see precisely how much is being spent in a specific time period in localized areas.

The data also vindicates Redd’s approach: the small slots customer, over a lifetime of spending, is just as valuable as the high roller. “The slot player was the forgotten customer,” Loveman told Bloomberg BusinessWeek in 2010. “I had to be willing to be unsexy in this,” Loveman added. “I can take you to a casino that would have a lot of young beautiful people in there and you would say, ‘Man, this is a happening place.’ I could take you to another place where there are a lot of people who look like your parents. The latter would be a lot more profitable than the former. My job is to make the latter.”
Slots Devil

After my trip to Vegas, I visited the Sugarhouse casino in Philadelphia, on the bank of the Delaware River. Sugarhouse opened in 2010 and is one of 12 casinos that turned Pennsylvania into a gaming powerhouse after legalization in 2004. The casino’s interior — clear passageways, a clean line of sight from the eastern to western walls — brimmed with activity on a Tuesday evening. Sugarhouse squealed with the cacophony of slots and the saccharine melodies sounded like a thousand robots blowing bubbles. (The slot manufacturer Silicon Gaming decided at one point that soundtracks in the key of C were the most agreeable.)

In 11 years of legalized gaming, the state has earned $3 billion from table games and $17 billion from slots. Table players at Sugarhouse made their wagers at an island amidst an ocean of slots. As I made my way through the casino, I struck up a conversation with two slot players: Diane Singleton, a 45-year-old retiree; and Jack, who refused have his last name published. The two were playing Fu Dao Le, whose theme can only be described as Cherubic Chinese Babies. The game was loaded onto a ProWave cabinet, and a red cursive Bally logo hung in the upper right corner of the screen.
“Singleton says she threw her rewards card away because it reminded her of how much money she’d spent”

I asked what they enjoyed about the game. Jack said that unlike other games, Fu Dao Le is “highly interactive.” He likes the game’s “kooky stuff; you can touch the display,” he said, touching the image of cherubic babies above the reels, causing them to laugh with a Pillsbury Doughboy-like giggle.

Jack and Singleton say they’ve both earned “Black Cards” through Sugarhouse’s player tracking system, meaning they’ve each spent more than $10,000 here. Jack says the casino has comped them four cruises so far; Singleton says she threw her card away because it reminded her of how much money she’d spent. I had more questions, but at a certain point it became apparent that Singleton was no longer listening.

“She’s in the zone right now,” said Jack.

The “zone” is at the core of Schüll’s theory about the success and proliferation of slot machines. She heard the term over and over again in her 15 years of research — the players repeatedly told her that they played to zone out, to escape thought.

To understand the zone, you first have to understand “flow,” the concept developed by Hungarian psychologist Mihaly Csikszentmihalyi to describe a hyperfocused state of absorption. During “flow,” time speeds up (hours feel like minutes) or slows down (reactions can be made instantly) and the mind reaches a state of almost euphoric equilibrium. Schüll, in her book, describes Csikszentmihaly’s four criteria of flow: “[F]irst, each moment of the activity must have a little goal; second, the rules for attaining that goal must be clear; third, the activity must give immediate feedback; fourth, the tasks of the activity must be matched with challenge.” For most of their history, slots easily fulfilled the first two criteria; after lowering volatility, they fulfilled the third criterion, and with the introduction of multiple lines, endless bonus rounds, and the occasional mini-game, they finally fulfilled the four criteria.
“The “zone” is hyperfocused, neurotransmitters abuzz, but directed toward a numbness with no goal in particular”

The “zone” is flow through a lens darkly: hyperfocused, neurotransmitters abuzz, but directed toward a numbness with no goal in particular. When Singleton emerged from the zone, I asked her again why she found the slots so compelling. “I lost my husband two years ago to throat cancer,” she explained. “He was the love of my life, and I started doing this just to — I was out of my mind and spent a lot of time at the cancer center.” Jack had lost his son to pancreatic cancer. As they told their stories, Jack and Singleton hit the spin buttons and the machines blared so loudly that their words were lost in the noise.

Singleton says she never recovered from the pain of her loss, and that’s why she keeps coming back to the slots. Jack echoed that sentiment: “I don’t have to think. And I know I can’t win.”

“Right, so you know that,” said Singleton.

“Every now and then…you get something,” Jack agreed.

“But it’s never what you lost.”

“Because I don’t care whether I win 38 cents or 600 dollars.”

“You just want to see them again.”

Singleton rifled through her wallet filled with $100 bills. “I’ll be right back, guys,” she said, and went off to get change.
Slot Zone

Back at the Bally showroom, Trask and I had sat in front of the company’s new Duck Dynasty game. “There’s never been more slot machines in the world than there are today,” he said. “And that’s proliferation not just in the US, but abroad.” His hand rested on the game’s display, his index finger next to a reel symbol of a cast member sticking his tongue out and playing air guitar. Scientific Games’ market now includes 50 countries on six continents. This spring, the company announced it was planning on providing 5,000 of the 16,500 machines recently authorized in Greece.

The industry is also preparing for the eventual deterioration of its key middle-aged demographic and competition from free-to-play mobile games. “People only have so much leisure time and there’s a lot of activity on iPhones,” Price told me. At one point in the Bally’s warehouse, Trask said, “You know how you get people younger to gamble? Hand them a fucking telephone.”
“”You know how you get people younger to gamble? Hand them a fucking telephone.””

The industry seems to be working on the same hunch. In 2011, Caesar’s acquired Playtika, an online casino games company that offers free and paid mobile games. A year later, IGT acquired the free casino games app DoubleDown, which runs as both a stand-alone mobile app and through Facebook. The company now offers online table games and a good sample of its portfolio of slots, including Wheel of Fortune, to mobile players. Earlier this year, the gaming giant appointed former Zynga studio manager Jim Veevart as DoubleDown’s vice president of games. And last year, Churchill Downs Incorporated, which runs seven casinos in addition to its Kentucky Derby racetrack, acquired the free games company Big Fish Games.

Meanwhile, the tech sector is adopting the principles of slot design for its own purposes. In the early aughts, the tech writer Julian Dibbell devised the concept of ludocapitalism, a term inspired by watching World of Warcraft players mine gold in the game to making a living in real life. Ludocapitalism was an attempt to explain the growing gamification of society through technology. Dibbell admits the concept’s parameters are vague, but at its most basic it identifies that capitalism can harness the human play drive for better or worse — and that increasingly, games aren’t allegories that say something about our lives; they are our lives. As people move toward more data-driven existences where points are accumulated from health apps (the subject of Schüll’s latest research) and status is accumulated in identifiable quantities on social media, gamification becomes so total that it can sometimes mask whether what we’re doing has any inherent utility outside the game that surrounds it.

Within gamification, Schüll also identifies slotification: we slay an endless procession of monsters with no progress of narrative, mine endless digital coins for no other reason than their aggregation, hit spin on the slot machine with no big payoff. “It’s this ludic loop of, open and close, open and close; you win, you lose, nothing changes,” Schüll says. Writing in The Atlantic, Alexis Madrigal tapped Schüll’s concept of the ludic loop to explain the inextricable entrancement of flipping through Facebook photos: you push a button over and over, primed for an eternally fleeting informational reward.
Slot Winners

A more exact replica of a slot may be Tinder. The mechanics of the dating app mirror the experience of playing slots: the quick swiping results in an intermittent reward of connection, followed by the option to either message your potential date or “Keep playing.” Tinder recently launched a premium version that allows the user to undo an accidental “not interested” swipe, essentially monetizing mistakes made while in the automatic rhythm of the zone.

“I can’t tell you how often I’ve been approached since the publication of my book by Silicon Valley types who say things like, ‘Wow, the gambling industry really seems to have a handle on this attention retention problem that we’re all facing,'” Schüll told me. “‘Will you come tell our designers how to do a better job?’”

Last year, Schüll heard from Nir Eyal, a tech entrepreneur who founded and sold two startup companies that produce advertisements in free-to-play games. “[Eyal] showed me his copy of my book, and it had, like, hundreds of hot pink sticky notes coming out of it,” she told me. In his 2014 book Hooked: How to Build Habit Forming Products, Eyal laid out his “Hook Model” of product development that works on basic behaviorist principles: a trigger turns into an action turns into a variable reward turns into a further personal investment back into the product. Last year, he invited Schüll to speak at his Habit Summit, hosted at Stanford. Schüll gave a talk on the “dark side of habits,” placing slot machines on the undesirable end of the habit spectrum.
“”Everything that engages us, all pieces of content are engineered to be interesting.””

Eyal told me he invited Schüll to offer a less self-congratulatory, “rah-rah” voice to the conference. Although the conference focused on how to build habit-forming tech products, “These techniques — they have a dark side,” he said. “If not used appropriately, or if used for nefarious purposes, then they don’t always benefit the user.”

Still, it was difficult to determine whether Schüll’s slot research has been received as a warning or a how-to guide within tech. Eyal criticized slot machines for what he said was a business model dependent on addicted players — “that industry, I have a problem with,” he said. But Hooked is in many ways tech’s version of Addiction by Design: his model of successful product design is a loop going from “trigger” to “action” to “variable reward” to “investment” and back again. In his trigger section, Eyal uses Instagram to illustrate how emotional pain can be a powerful motivator to use a product — in that app’s case, the mostly insubstantial pain of lost memories. He writes, “As product designers it is our goal to solve these problems and eliminate pain…users who find a product that alleviates their pain will form strong, positive associations with the product over time.”

I asked Eyal what distinguishes mobile games or dating apps from slot machines. He gave a range of answers that sounded at once comprehensive and somewhat defensive — that tech addictions never really plummet to the league of gambling addiction; that people prone to addiction will be addicted no matter what — before finally admitting that, in a sense, everything functions like a slot machine.

“All content needs to be made interesting. What you’re doing as a writer is introducing variable rewards into your story. Everything that engages us, all pieces of content are engineered to be interesting,” he said. “Movies aren’t real life, books aren’t real life, your article isn’t real life. It’s manufactured to pull us one sentence after another through mystery, through the unknown. It’s a slot machine. Your article is a slot machine. It has to be variable. So just because an experience introduces variability and mystery — that’s good!”

“I think the answer is, it’s okay to addict people as long as your business model doesn’t depend on it,” he said, as if finally finding the answer to a problem that had long seemed without a solution. “That’s the answer,” he added. “That’s the answer.”

Correction: a previous version of this article stated that modern slots have a 45 percent payback rate. In fact, they pay out on approximately 45 percent of all spins. In addition Nir Eyal’s Hooked was published in 2014, not 2003.

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