Column: What’s become of gambling?

How quaint it used to be. When I was a kid there was just Las Vegas. Grownups could go out there and play blackjack or craps and gape at the high rollers and the women with high hair. Then they could go see Wayne Newton perform at one of the hotels.  When did all of that change?

Of course, there was always horse racing, but did anyone actually consider that to be gambling? What about the stock market? Never!

Gambling started to expand in the 1960’s. Here is an abbreviated chronology: In 1964 New Hampshire introduced a state lottery. Other states followed. In 1976 New Jersey voters passed a referendum legalizing gambling. Thus, Atlantic City was reborn. Then the Indian Gaming Regulatory Act of 1988 was passed at the federal level opening the door to casino gambling on Native American lands. Foxwoods in Connecticut became the first casino to open its doors in 1992. Also, in the late 1980’s riverboat gambling became legal, leading to more popularity on the Midwestern rivers.

But the gambling explosion took off in 2018 with a Supreme Court decision to legalize wagers on live sports games. According to Eric Lipton of the New York Times, professional sports betting soon became a multibillion-dollar corporate gambling enterprise. Anyone can now go on their phone and place a bet. Sites such as DraftKings make it simple — just download the app and start betting. Age requirements vary from state to state, the youngest being 18. Yikes.

And this leads to the latest form of gambling known as prediction markets. If you’ve never heard of Kalshi and Polymarket, you will soon. These companies provide platforms where users can bet on almost anything in the future — sports, politics, the war, or the weather. They claim that they are not gambling companies, but more like modern versions of commodities futures. Most people would disagree. In a recent expose, John Oliver explained that users are easy prey; of the 2 million current users, most lose money. And while the Biden administration tried to regulate these companies, all bets (no pun intended) are now off. In fact, Don Trump, Jr. is involved in both companies.

As with alcohol, most people can gamble in moderation and enjoy it. Take for example my son, a modest gambler who says he enjoys sitting down at a poker table having no illusion of getting rich. He just likes the game and is comfortable losing a non-meaningful amount of money. When he bets on sports, it is about validating a prediction he has about a certain team, more than actually cashing in.

For him and for all those non-problem gamblers, it’s a sport that is often social with a built-in understanding that generally money will be lost. And if instead, money is won, that just makes it more fun.

Problems begin when a person can’t step away from the table and instead tries to recoup losses with bigger bets. If only it were as simple as “knowing when to hold ‘em and knowing when to fold ‘em.” According to the World Health Organization, about 1.2% of the world’s population has a gambling disorder. Not surprisingly, in the U.S. with all these new gambling opportunities, the numbers are even higher. 

The disorder is defined as repeated and ongoing betting and wagering that continues despite creating multiple problems in several areas of an individual’s life. For these people, gambling activates the same reward centers in the brain as alcohol and drugs. The high of winning releases dopamine, just like a drug. Then chasing the win makes it almost impossible to stop. It can take over a person’s life, becoming devastating to that person and all those around them.

Along with the obvious problem of financial depletion, problem gambling can lead to terrible family problems including violence, child neglect, and illegal activities. And it can be deadly. A Swedish study estimated that those with a gambling disorder were 15 times more likely to die by suicide than the general population.

Risk factors include people experiencing significant life events such as separation, retirement, injury, or the loss of a loved one. Poverty is also a risk factor. While many people dream about winning the lottery, it’s generally lower income people who bet heavily on it.

And now, with these easily accessible gambling platforms, younger people (particularly men) are at greater risk. In fact, according to the American Psychological Association, men in their early 20’s are the fastest growing group of gamblers. In addition, nearly 60% of adolescents said they had gambled in the last year.

Gambling, per se, will not necessarily lead to addiction, so researchers are trying to understand what factors make someone most vulnerable. Unlike an opioid addiction that often begins with physical pain or an injury, it’s thought that areas in the brain related to learning, stress management, and reward processing might contribute to problematic gambling.

Those with a gambling disorder often require professional help or a support group.  Gamblers Anonymous, a 12-step program modeled on Alcoholics Anonymous, has existed for decades and has helped many. Should a person seek therapy, they may learn about the underlying causes that have led to this behavior and look to make changes. Cognitive behavioral therapy, a therapy based on the here-and-now, looks at behavioral change and is often effective.

Helpguide.org, an online therapy referral service, has offered some basic strategies to help:

1. Acknowledge and understand the problem. Like any addiction, breaking through denial and facing up to the reality is always the first step. Helpguide says, “Many others have been in your shoes and have been able to break the habit and rebuild their lives. You can too.”

2. Recognize triggers. This is difficult, because it requires making conscious what is often impulse driven. For example, if someone grabs their phone to place a bet, it requires them to stop and ask themselves what caused the behavior. The idea is to attempt to understand and head off what was previously an impulsive act.

3. List the reasons why change is necessary. Think about the financial toll gambling has taken. Examine the relationship difficulties that have arisen from gambling. Let these be front and center to help fight the urge.

4. Establish barriers. Separate yourself from gambling buddies. Since most gambling centers around sports, it may mean not watching “the game.” Or it may require separating oneself from the phone or removing gambling apps from the phone. For some people giving up credit cards entirely removes the ability to “auto fill” financial information.

5. There is also a national helpline —1-800-426-2537 or (1-800-GAMBLER) or a website 1-800-GAMBLER.net. This is often a first step for a person to initially and privately assess the problem.

In the movie “Casino,” Robert De Niro says, “In the casino, the cardinal rule is to keep them playing and to keep them coming back. The longer they play, the more they lose and in the end, we get it all.” Whether you are in Las Vegas or sports betting on your phone, this is the reality that the problem gambler may know intellectually, but somehow thinks does not apply to him. And if by chance, he does hit it big, can he then walk away? I’d place a large bet that he cannot.

Nancy Green is the Co-Chair of the Shelter Island Health and Wellness Committee.