State-funded addiction programs evaluated

Monday, Dec. 15, 2003 | 10:47 a.m.

Two out of three compulsive gamblers who completed a Louisiana program to treat gambling addictions are less likely to ever wager again, the director of the program says.

Reece Middleton, executive director of the Louisiana Association on Compulsive Gambling, was among five panelists evaluating state-funded compulsive gambling treatment programs in a session last week of the National Center for Responsible Gaming's fourth annual conference on gambling and addiction.

The session was an important component of the conference, attended by gaming industry leaders, regulators and researchers of addictive behavior. Treatment outcomes and the success of clinical programs are important to industry leaders and state officials, who often are pressured by special interest groups to finance treatment programs.

Leaders from Louisiana, Iowa and Minnesota discussed their respective state-funded compulsive gambling treatment programs and generally came up with the same conclusions: that most gambling addicts can manage their excessive behavior if they complete their programs.

Middleton said most clients also were less likely to gamble again if they participated in his program's outpatient treatment, an option less demanding than the intensive treatment regimen, and participants also were more likely to improve their finances if they completed either program.

Louisiana's Center of Recovery helps problem gamblers assess the severity of their addictions, designs treatment plans, provides education on risk factors and warning signs for potential problem gamblers, develops financial restitution plans for gamblers who have debts, introduces the 12-step program commonly used by groups like Gamblers Anonymous and develops a relapse prevention plan for recovering gamblers.

States with treatment databases have been able to provide researchers, such as those from Harvard University's Medical School, with case studies from which success levels can be measured.

For example, since 1999, Louisiana has developed a summary of 626 valid client records to mine data. Middleton said the average age of his client is 46, that gambling addicts in treatment are evenly split between men and women, that 80 percent are white, 19 percent are black and 1 percent are of other ethnic groups and that the average client spends 30 days in treatment.

The Iowa Gambling Treatment Program (IGTP) also has a wealth of data and it worked directly with the Harvard Medical School's Division on Addictions to develop a report evaluating the program.

Using data from 1997 to 2001, the IGTP determined that gamblers seeking services were more likely to be male, older, single, less educated and unemployed compared with a sampling of all Iowans. At admission to treatment programs, IGTP gamblers had an average $14,000 in gambling debt and lost $522 a week playing.

Frank Biagioli, executive officer of the IGTP, said treatment seekers said slot machines accounted for 58 percent of their losses, video poker another 10 percent and casino table games 14 percent. He added that 23 percent of those treated by the IGTP had a history of some kind of substance abuse.

Tuesday's panel was moderated by Carol O'Hare, executive director of the Nevada Council on Problem Gambling, but she did not present statistics on Nevada gamblers.

The most recent report on problem gambling in Nevada was conducted in March 2002 by Gemini Research Ltd. for the Nevada Department of Human Resources.

That report said problem and probable pathological gambling is more prevalent in Nevada than any other state in the union. It also said problem gambling prevalence is highest among men, younger adults and minorities in Nevada. Rates also are high among those employed in the gaming industry, those with a high-school education or less and among those with a household income of less than $35,000 a year.

The report recommended working with insurance companies to obtain coverage for treatment services for those who need it, public education and prevention services targeting at-risk groups, development of government-industry programs to address problem gambling in Nevada, an increase in funding to support education, prevention and treatment of problem gambling through the Department of Human Resources and a monitoring and evaluation of services.

The Gemini report was presented a year after a failed attempt to approve legislation on problem gambling. When the Legislature convened earlier this year, a new proposal was presented and Michael Willden, director of the Department of Human Resources, lobbied for its passage.

Senate Bill 42 would have enabled the Department of Human Resources to administer a revolving account to support programs for the prevention and treatment of problem gambling.

Despite there being no opposition, the bill died when an alternative proposal was presented.

O'Hare explained that the bill that eventually was approved authorized the development of a certification program and expanded a drug and alcohol treatment certification board to include two gambling addiction treatment experts. The board expansion occurs Jan. 1.

After the expansion, the state will have gambling addiction treatment certification rules -- but still no funding.

Rachel Volberg, the author of the Gemini report, said because states have been insistent on regulating gaming, the federal government has stayed away from the treatment issue and has no grant money to offer for centers.

"Apart from the National Gambling Impact Study and a few research grants, there is very little that the federal government has done in this area," Volberg said.

O'Hare said with the certification criteria in place, health care professionals would be available to treat gambling addicts at private clinics.

As for public treatment centers, Nevada trails other states, primarily because no funding mechanism is in place.

William Eadington, director of the Institute for the Study of Gambling and Commercial Gaming at the University of Nevada, Reno, said the main reason other states got ahead of Nevada in the treatment of gambling addictions by public agencies is that problem gambling wasn't acknowledged as a health problem until the 1980s and '90s.

When other states and countries legalized gambling, many took a progressive stance and required the funding of gambling addiction treatment programs from lottery and casino proceeds.

"Nevada was in denial about problem gambling and when it moved outside to other jurisdictions the industry slowly started coming around," Eadington said.

Nevada did not build treatment centers, he said. O'Hare added that while policy leaders have avoided a knee-jerk reaction of forcing casino companies to finance public treatment centers, industry leaders are taking a role in helping solve the problem.