Funds sought to fight problem gambling

David Strow

Wednesday, Dec. 5, 2001 | 10:44 a.m.

Scientists say they still have a long way to go in finding the causes of problem gambling -- and the most effective methods of treating it.

And the state of Nevada could help in that fight, researchers said at the conclusion of a three-day conference on problem gambling.

"As a political issue, (public funding in Nevada) seems logical," said Ken Winters, professor of psychiatry at the University of Minnesota Medical School. "It is not an indictment of the gaming system. It could advance the science. This would be an important behavioral laboratory."

Winters said his job as a researcher has been made easier by public dollars supplied by the state of Minnesota -- but in Nevada, no public dollars are made available for problem gambling research or treatment.

The Nevada Legislature considered a bill earlier this year that would provide $250,000 a year to combatting problem gambling. But the bill never came to the floor of the Legislature for a vote, and died when the legislature adjourned.

Howard Shaffer, director of Harvard Medical School's Division on Addictions, declined to criticize the state for failing to provide public funds.

"Nevada will do it. It's only a matter of time," Shaffer said. "I trust they know what they need to do. They need to do it, and they will."

Problem gambling has only been a recognized psychiatric disorder since 1980. As a result, therapists know how to identify it, but they know little about the nature of the disease itself. Often, it's unknown whether problem gambling is the true problem, or is a symptom of another, deeper issue.

And that means much more research is needed.

"While we think we know a lot, we're in a very undeveloped field, one that doesn't know very much," Shaffer said.

Currently, scientists can only identify problem gambling from the negative effects it has on a patient. By that time, the damage has been done.

"In science, that's not the way we do business," Shaffer said. "We're supposed to identify it before it becomes visible. I do have a vision that someday we will be able to identify the risk factors for this disorder."

Once scientists understand the disease better and have more accurate methods of diagnosis, treatment can be tailored for each individual patient.

Like AIDS, problem gambling needs to be treated with a "cocktail" of treatments, from medications and behavior therapy to financial and family counseling.

"If you think of this (problem gambling) as a syndrome, it probably won't respond to just one form of treatment," Shaffer said.

Syndromes have many causes -- and that means many more paths researchers must take. It also means much more involved studies -- studies that last three, four or five years, instead of just one year.

"If this field is going to advance, we're going to have to tackle some very ambitious studies," Winters said.

One of the most interesting areas of new research, Winters said, lies in the biological roots of problem gambling. Researchers at Massachusetts General Hospital in Boston, for example, have been studying the effects gambling has on the brain. By doing so, it is hoped, researchers can identify what short circuits in the brain for a problem gambler -- and begin searching for ways to prevent it.

The search can also turn to genetics, and the question of whether the roots of problem gambling are passed along in the genes.

"If we can identify this (biological causes and risk factors), we can engage in prevention," Shaffer said.

Another area that must advance, Winters said, is the science of how problem gambling occurs in different groups of people.

"We know a lot about what defines pathological gambling and what are the key factors among white males," Winters said. Far fewer studies have been conducted that focus on other groups, such as women, the young, the elderly and minorities.

That's changing -- Winters said the groundwork was laid for several new studies at this week's conference, including one that would look at problem gambling among young people.