Nigel E. Turner is an Independent Scientist with the Institute for Mental Health Policy Research at Centre for Addiction and Mental Health (CAMH). He is also Assistant Professor in the Dalla Lana School of Public Health at the University of Toronto and he has a PhD in psychology from the University of Western Ontario.
This week Milénio Stadium interviewed Turner, a well-published researcher in the field of gambling studies.
Milénio Stadium: How can we identify gambling addiction?
Nigel E. Turner: Gambling addition is considered a hidden disorder because there often are no overt symptoms (not smell on the breath, no public inebriation etc.). The main sign is financial because its financial harm that really defines gambling addiction. So the only way to really uncover is to track spending. However, stories from the person about winning all the time (which is impossible), frequency of gambling or lies about the extent of gambling are symptoms as well. Taking out a second mortgage or third mortgage is not uncommon. Gambling late or all night is another good sign of excessive involvement.
For more signs and symptoms go to CAMH webpage.
MS: What are the numbers in Canada/Ontario?
NET: The latest data indicates that approximately 0.5% of the adult population has a gambling problem… that translates into a bit more than 50000 people. Another 2% have some degree of problem which translates into about 200,000 adults. The case load in Ontario is about 5000 patients per year, though I don’t have the most recent case load numbers.
MS: How can this be treated?
NET: Mostly through group or individual counselling. Cognitive Behavioral Theory is considered the gold standard for psychotherapy and even for depression is as effective as medication with no side effects. Some medication is used but mostly to deal with co-occuring disorders such as anxiety, depression or hyperactivity.
MS: What are the programs that CAMH provides?
NET: CAMH has a full range of treatment options for problem gambling and problem video game addicts as well. Skills for Change is an introductory program to help people get started. Cognitive Behavioral Theory is also available. Relapse prevention and mindfulness meditation are programs that help people who have gained control, stay in control. There is also family counselling and couples counselling.
MS: What is usually the profile of the victim?
NET: About 60% of disordered gambler are male. Young people report higher rates of problems, but the treatment facilities are mostly made up of middle-aged men and women. This may be because it takes a few years and some good credit scores to ruin your life with gambling. Young people may gamble excessively, but lack the means to dig a really deep hole.
MS: The World Health Organization (WHO) included this addiction in the international list of diseases in 2018. Why did it take so long?
NET: The WHO has recognized gambling addiction for several years. The American Psychiatric Association have included gambling disorder called “pathological gambling” since 1980 and classified it as an impulse control disorder. In 2015, they renamed it gambling addiction and identified it as a behavioral addiction. The International Classification of Diseases added gaming (as in video gaming) as a disease last year.
MS: Is gambling addiction genetic?
NET: Yes and no… some genes make some people more vulnerable to an addiction (any) and there are personalities that seem to be particularly attracted to gambling (impulsive, neurotic, narcissistic). But it also takes gambling and winning (positive reinforcement) enough to convince a person that winning is possible, so it’s an interaction of predispositions, random events like winning. Mood disorders can also lead to gambling problems and they are somewhat genetic, but also depend on miserable life experiences. Some people, especially women, gamble to emotionally escape from miserable life experiences (childhood trauma, spousal abuse, stress at work, the death of a dog, etc.). Gambling provides a dream that allows people to cope with negative emotions. Gambling provides powerful positive reinforcement (wins) and negative reinforcement (dreams of escape) and in my opinion anyone can become a problem gambler, but some people are more likely to get hooked if they have strong predispositions or negative life experiences.
MS: Is most gambling online?
NET: No, most gambling occurs in casinos and most problem gamblers gamble online. Internet gambling is creeping up. I believe the help line now gets about 8% of calls regarding online gambling.
MS: Technology is everywhere nowadays. This phenomenon increases the possibilities to have this addiction?
NET: Online gambling is definitely on the increase, but keep in mind that it’s bricks and mortar casinos where most problem gamblers lose their money. We are monitoring the situation. Gambling on the internet is associated with more serious problems, but it’s not clear if the internet causes problems or if the internet is a last resort for desperate gamblers who can no longer afford the casino (I can bet as little as $1 (or even less) per spin on internet roulette, or $10 per spin at the local casino).
MS: Parents have to control the time that teenagers spend on internet?
NET: More of an issue with problem video gaming which is mainly defined in terms of time spend on device, but yes, monitor the sorts of web sites that teenagers go to, but keep in mind that most teenagers know more about the internet than parents. The most important thing is to limit their access to credit cards because without credit cards or some other way to get money online, they can’t gamble online. In my studies of youth gambling, I found that most youth gambling was in private bets on sports and card games, so monitor how much money they have. Gambling is associated with having more cash.
MS: Where can victims get help?
NET: It’s a treatable disorder and in Ontario treatment is available and free. Option 1: You can call CAMH if you are in Toronto area, 416 535-8501 or 1 800 463-2338 toll-free, staffed 24/7. Option 2: If you are outside of Toronto, call the Ontario problem gambling helpline, they will direct you to one of the 52 designated treatment services in the province, 1-866-531-2600, or go to the Connex Ontario website.
Option 3: If you are in a casino go to their Play Smart Centre, Most casinos in Ontario have staff Play Smart Centers but some have self-serve kiosks, either way you can get information on treatment and recovery.