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Answers to your questions on gambling disorder

Two LI experts describe markers of the powerful thrill-seeking compulsion and its damaging effects on addicts’ emotions, families and finances.

Licensed clinical social workers Cheryl Hecht, left, of

Licensed clinical social workers Cheryl Hecht, left, of Bohemia, and Renae Tramonte, of Bellmore, counsel patients who are addicted to gambling. Photo Credit: Cheryl Hecht / Renae Tramonte

About 2 million people in the United States meet the diagnostic criteria for gambling disorder, compulsive behavior that experts define as being as powerful as drug or alcohol addictions.

Cheryl Hecht, a board member of the New York Council On Problem Gamblers and a licensed clinical social worker in Bohemia, and Renae Tramonte, a licensed clinical social worker in Bellmore, both counsel problem gamblers. After the U.S. Supreme Court ruling Monday regarding sports betting, they answered the following questions.

Q: Is gambling addiction a recognized psychological problem?

A: Yes. Gambling disorder is listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. The DSM-5 criteria describes it as “persistent and recurrent problematic gambling behavior” leading to clinically significant impairment or distress over a period of at least 12 months.

Q: How many criteria does the DSM-5 list?

A: Nine, including a need to gamble with increasing amounts of money to achieve the desired excitement; having jeopardized or lost a significant relationship, job or career opportunity because of the behavior; and/or often gambling when feeling distressed, helpless, guilty, anxious or depressed. Also, having a preoccupation with gambling, such as having persistent thoughts about it and planning the next gambling venture, as well as thinking about ways to obtain money to pursue gambling. Additional criteria include having made repeated unsuccessful efforts to control, cut down or stop gambling.

Q: Is there a neurological/psychological component to gambling?

A: Yes. Instant gratification — compulsion — and thrill-seeking behavior are the underlying drivers of gambling disorder. There also is a growing body of scientific evidence suggesting the possibility of fewer dopamine receptors in the brain, which are designated D2 for dopamine-2. The brain’s dopamine centers are associated with pleasure and reward.

Q: Are there different forms of the addiction?

A: Yes. In past years, most addicts were defined as action gamblers — that is, people who had skills, such as those who know how to play poker, blackjack and other casino table games. Now, there is an increasing number of “escape gamblers,” people who play video lottery terminals and lottery scratch-off games. These are gamblers without special skills, who seek to escape their problems through chronic gambling.

Q: What does the new U.S. Supreme Court decision mean in terms of the type of gambler who may emerge now that the judges have signed off on sports betting?

A: There’s a possibility of a hybrid gambler, a composite of the active, skilled gambler and the escape gambler. For certain, it will mean more people willing to take risks.

Q: Does gambling addiction tend to run in families?

A: Yes, it’s split between genetic predisposition and environmental exposure in the home.

Q: What are chronic gamblers willing to risk?

A: Everything, as they seek the thrill of winning: marriage, family, home, job, bank accounts. On Long Island, there are numerous cases of people who are hundreds of thousands of dollars in debt because of their gambling addiction. Some people embezzle money, take second mortgages on their homes, or borrow huge sums to feed their addiction.

Q: Does a gambling addiction cause problems in families on a scale with alcohol and drug addiction?

A: Yes. It starts with the preoccupation of addicted individuals becoming riveted on their gambling activity. This leads to friction within families. The effects of gambling on a family are emotional, financial and sometimes physical because of domestic violence.

Q: What are some of the activities in which gamblers participate that cause problems?

A: These are varied and numerous. Some people spend large sums on lottery tickets, risking entire paychecks week after week, and/or on illegal poker games, placing bets on horses or routinely betting on the outcomes of professional sports. There’s a strong psychological lure to what is considered easy money.

Q: What is the difference between gambling and blowing money for fun and entertainment?

A: Gambling is risking something of value with the hope of obtaining even greater value. Many people can and do gamble socially for entertainment, not risking more than they intend. Someone with a gambling disorder will risk paychecks, retirement accounts and children’s college savings to come up with money to gamble. Still others borrow or risk imprisonment because of theft and embezzlement.

Q: Do most people seek out treatment at the beginning of a gambling problem?

A: No. As Hecht noted, “It is a hidden addiction.” Many individuals with gambling disorder seek treatment only after a crisis: a marriage dissolves, theft is caught, a family’s financial reserves are depleted. In such instances, treatment usually starts with crisis management because there are emotional, family, financial, legal and other concerns that first have to be resolved.

Q: Can a gambling addiction be successfully treated?

A: Absolutely. Group and individual therapy sessions are available on Long Island and throughout the greater metropolitan area. Anyone interested in dealing with gambling issues is encouraged to reach out to the New York State Hopeline 1-877-8-HOPENY, which directs individuals to credentialed therapists. Another avenue is the New York Council on Problem Gambling at nyproblemgambling.org. The not-for-profit is dedicated to increasing public awareness about problem gambling and gambling disorder. For general information for difficulties with gambling behavior, the council offers Know the Odds, knowtheodds.org.

Q: Is there an organization for gamblers equivalent to Alcoholics Anonymous?

A: Yes. Gamblers Anonymous at nyproblemgambling.org/support/gamblers-anonymous, which provides peer support. There are no dues or fees.

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