HYDE PARK — Gov. Pat Quinn vetoed expanding gambling in Illinois Monday, but a University of Chicago researcher said the city will continue to deal with increased problems from excessive gambling even if a casino does not open in the city.
“Gambling is much bigger than casinos,” said Dr. Jon Grant, a psychiatrist and lead investigator of the addictive, compulsive and impulsive disorders research group at the Hyde Park university.
Grant is one of the few health professionals in the city treating gambling addiction.
“The other casinos are so close to Chicago anyway this isn't going to have a big impact,” Grant said. “It’s not clear that putting a casino in Chicago would make a big difference except for people who don’t have a car.”
Grant worries that as the expansion of gambling exits the conversation, the problems of gambling addicts will also fall by the wayside.
“If we have a casino in Chicago, people will ask what we do with people who develop a problem,” Grant said. “When it’s in Indiana, it’s out of sight, out of mind.”
Approximately 30 percent of American adults visited a casino in the last year, and 86 percent of Americans have gambled at least once in their lives, according to U. of C.'s National Opinion Research Center.
Grant came to Chicago from the University of Minnesota in July in part because there wasn't many good places for gambling addicts to go for help.
“It’s a huge city with really no gambling addiction treatment, which seemed kind of silly to me,” Grant said.
Personally, Grant does not eat fast food, doesn’t have a computer at home or own a cell phone to chronically check e-mail. He said the foreignness of the gambler’s mindset makes the subject fascinating to him, and his distance from the desire for immediate rewards makes him much more attentive to that compulsion in gambling addicts.
“Gambling addicts are wonderful people and they really are trying to understand why they’re doing it,” Grant said. “It is very moving, to see how long people have struggled.”
Grant said one patient told him he carried Grant’s number around with him for 10 years before getting the courage to seek treatment.
Gambling addiction afflicts 2 to 3 percent of the population. Someone with a gambling problem will affect up to eight other people, according to Grant. The effects can include absenteeism from work, domestic violence and bankruptcy.
There are enormously high rates of suicide among gambling addicts because they cannot bear “the financial devastation of where this was all going to lead,” Grant said.
The medical community is now starting to rethink the problem. For the first time gambling addiction will be grouped with alcohol and substance addictions in the American Psychiatric Association’s fifth edition of “Diagnostic and Statistical Manual of Mental Disorders,” to be released later this year.
“There is substantive research that supports the position that pathological gambling and substance use disorders are very similar in the way they affect the brain and neurological reward system,” Dr. Charles O’Brien, chairman of the association's substance-related disorders work group, said when the change was first suggested in 2010. “Both are related to poor impulse control and the brain’s system of reward and aggression.”
Grant suggested retraining substance abuse counselors to treat gambling addiction before any expansion of gaming in Illinois. He said on-site counseling in casinos has had positive outcomes overseas.
“Most of the people who gamble don’t have a problem,” Grant said. “It often takes a period of several years — it can be very subtle for many people.”
He said men tend to be drawn to strategic games of chance where they get an ego boost from the feeling that they can modify the odds with their ability to count cards or read other players’ faces in poker or blackjack.
Women, he said, are more often drawn to games such as slots that offer escapism.
“What I’m buying is that excitement — the feeling that I have possibilities in my life,” Grant said. “Basically, I’m paying for escape.”
Our brains react strongest when the rewards are frequent as they are in most games of chance — the brain gets a boost every few minutes from a win to counteract the string of losses, Grant said. Even when losing, the brain can push us forward by giving us a little jolt when we anticipate a reward, he said.
Eventually most people learn that their risk-reward behavior is off and will adjust, Grant said. Addicts do not learn that lesson and often feel it is only a matter of time before the risk will pay off, he said.
“People with a problem with gambling have won, so the system confuses them,” Grant said. “It’s ignoring probability and focusing on possibility.”
Gambling addiction disproportionately affects men and the poor. There is some research to suggest that Asians and African-Americans are more prone to suffering from gambling addiction.
The latest trend is a sharp rise in addiction among adolescents, many who have been introduced to gambling online and react strongly to immediate gratification.
Since less than 10 percent of gambling addicts seek treatment — with an unknown number successfully completing therapy — the public health problem is likely to be one society continues to grapple with, Grant said.
