Gambling is legal — and actually quite common — in Minnesota. In the last year, 75 percent of people in the state have participated in some form of gambling, according to the Northstar Problem Gambling Alliance. While most people can step away from the poker table or a slot machine, there is a relatively small percentage who cannot. Gambling addiction, once it takes hold, can create a swift downward slide into serious debt and strained personal relationships.
Since the mid-1980s, the state of Minnesota has trained and supported therapists to treat people with gambling addiction. One segment of the population that may be more vulnerable to problem gambling is veterans, especially those suffering from PTSD. They may be attracted to the temporary high that gambling creates, and more susceptible to falling into a vicious cycle of debt.
Roger Anton, MA, LSW, works as a consulting counselor/therapist at the Minneapolis VA Medical Center. His focus on veterans’ gambling addiction has been rewarding, he said, because he and his colleagues take a team approach to helping clients rebuild lives shattered by gambling addiction.
“I have been a provider of mental health services for people facing problem gambling since the year 2000,” Anton said. “With the right support, clients pull their lives back together.”
March is problem gambling awareness month in Minnesota. Anton and I talked earlier this week about the extent of the problem in the state, and about the ways he supports veterans committed to freeing themselves from gambling addiction.
MinnPost: How common is gambling addiction?
Roger Anton: The national statistic is that 1 to 3 percent of the population are problem gamblers. It’s really a very small percentage of people that actually get in trouble with gambling. But when a person does get in trouble with gambling, the impact can be pretty significant.
MP: How’s that?
RA: Problem gambling is known as the “silent addiction” because it can happen underground, before anyone can step in to help. A person can get in trouble with gambling addiction so much faster than a person can get in trouble with an alcohol or drug addiction. This is simply because a gambling addict can lose a lot of money in a relatively short time. Mounting gambling debt affects all aspects of a person’s life: their housing, their food, their family, their employment. Gambling can start off innocently enough and then escalate suddenly until it breaks through and impacts everything. A lot of times spouses don’t really know that their significant other has developed a serious gambling problem until there is a foreclosure on their house.
With alcohol addiction, it usually will take many years for an alcoholic to harm himself physically or negatively impact his family finances. And there are clear consequences, like DWIs, that develop over years. The negative impact of gambling addiction can be very rapid because if a person gets in deep enough, they can go through their life savings in a matter of months.
MP: How did you get involved in this line of work?
RA: I was a licensed social worker for about 30 years. I started out with drug and alcohol counseling, then I moved into working with clients who had a chemical dependency background and a psychiatric background. We call that a dual diagnosis. Back in the day, it was considered a niche specialty. When I found out that the state of Minnesota was offering a special training for mental health professionals interested in working with problem-gambling clients, I signed up for a 60-hour training. I found the topic very interesting. It felt like a refreshing career shift.
MP: Why was the state offering trainings for gambling-addiction counselors?
RA: This program comes out of legislation that was passed in the mid-1980s. Back then, the state Legislature was getting asked to approve gambling in the form of a state lottery and scratch-offs. The state decided that if we are going to allow gambling as a legal form of revenue, we also have to set aside funds to treat Minnesotans who may at some point in their life encounter difficulties with gambling addiction. Funding for my job comes out of those funds.
MP: You are based at the Minneapolis VA Medical Center. Do veterans experience gambling addiction at higher rates than the general population?
RA: I don’t know if there are any actual statistics on that. I would guess that the rate of gambling addiction among veterans is probably similar to that of the general public.
I do know, however, that young people away from home in military service are more vulnerable to a number of risk-taking behaviors, and gambling certainly can be a risk-taking behavior.
There was an interesting study that was conducted during the Vietnam War. When soldiers were serving in Vietnam, there was a lot of drug use and abuse. We are talking about 18- to 21-year-old people far away from home and under extreme stress with a lot of access to drugs. For most veterans, as soon as they got home to their loved ones, the vast majority stopped using illegal drugs. Today, when a young person is sent to a military base in Guam, say, where there have a paycheck but not much of a sense of a community, they probably will gamble more than they would if they were at home. My guess is once they get back to safe ground with community and family, most of these young people wouldn’t consider gambling anymore. But those with a general tendency toward gambling addiction might be more at risk of falling back into the habit.
MP: Are veterans struggling with PTSD at greater risk of gambling addiction?
RA: It makes them more susceptible to this addiction because when PTSD is active, an individual wants distraction and relief from their recurring memories. A veteran with PTSD may gravitate toward anything that will give him some kind of distraction. If there is a familial vulnerability around gambling, a person with PTSD might gamble to take their mind somewhere else. Or they might use drugs or alcohol, or drive fast. If a veteran’s distraction of choice is gambling, and there’s a casino down the street, it may feel like a good fit for a while, because when they are at the casino they are not thinking about what’s actually going on in their life.
MP: So gambling can help a person take their mind off their troubles?
RA: Yes. Sometimes I’ll ask a client, “How have you been dealing with your nightmares?” And they’ll say, “When I wake up at 2 in the morning, I’ll go online and start gambling.”
MP: You were just talking about how quickly the cost of gambling addiction can add up. This must get dangerous pretty quickly.
RA: It can. The mental health inpatient clinic at the VA deals with a lot of suicide attempts. I’ve worked with several clients there who’ve had serious suicide attempts. Their stated reason for the attempt was gambling.
MP: What happens at a typical therapy session for gambling addiction?
RA: At the first session, we usually talk about the client’s gambling habits and how they are impacting their life. I want to get a sense of the person: How are they connected in the community? Are they married? Do they have children? What is there income source? Are they collecting disability? We also talk about frequency of gambling: How much is being spent on each gambling episode? What kind of gambling are they doing? The majority of people I see do casino gambling. I’ve also talked with a number who have addictions to charitable bingo gambling. I’ve also seen a few people addicted to scratch-off and lottery tickets.
After the initial assessment, we try to look at what’s driving the behavior. Some of the possible drivers may be a stressful marriage or a lot of stress or grief related to death or divorce. Then we start going into those deeper issues. Maybe they’re not feeling a connection to their community or maybe they don’t have a community. And if they used to have a strong sense community, there is a good chance that they no longer have many friends or family contacts because of their gambling. Friends don’t want to return calls because they have a suspicion that the reason this person is calling is because they want to borrow more money. Family members also get really burned out with a person who has this addiction.
By the time they see me, my clients are usually pretty isolated. That isolation causes that much more stress. If they are using gambling as a way of managing their stress levels, it is a vicious cycle.
MP: How do you determine what direction your sessions will take?
RA: Sometimes when a client first shows up, they are just interested in determining what’s going on with their gambling addiction. They want to know, “What’s happening to me?” They’ll say something like, “I need to get more information about this. I don’t know if I am a problem gambler. I know I can quit any time.” Those folks are in the pre-contemplation stage of change. At that stage, they are looking for information. They are looking to ask an objective party, “Do I have a problem? Do I not have a problem? What’s going on in my life?” I might meet with a person at that stage once or twice.
From pre-contemplation, there is the contemplation stage of change. In this stage, a person has decided that they definitely have a problem. I may see a person in this stage more frequently — say for three to 10 sessions. Then you get into the other stages of change, like putting together an action plan and a maintenance plan, and then there is the acceptance phase, where people move on to make permanent change in their lives.
MP: How do your clients pay for your services?
RA: I am a certified problem gambling provider with the Minnesota Department of Human Services. The state of Minnesota will allow me to see a client for up to 24 sessions over a six-month period. Typically I don’t see a client for 24 sessions. If the client is a veteran, I waive all my co-pays so my services are 100 percent free. With other Minnesota residents, treatment can either be free or at a deeply discounted rate.
MP: Is this level of state coverage for gambling-addiction therapy typical?
RA: Very few states in America have the type of resources and support that the state of Minnesota is giving our residents when it comes to problem gambling. I think there are only three states that offer this kind of support to problem gamblers.
Most states have simply Gamblers’ Anonymous meetings, so when someone shows up for gambling treatment, a professional may say, “I can’t help you with your gambling. There are other issues we can work on together, but why don’t you go to a Gamblers’ Anonymous meeting for your gambling addiction?” Here there are therapists like me who are trained to help people fight their addiction.