20 Questions of Addiction
Gamblers Anonymous offers these questions to anyone who may have a gambling problem.
For decades, researchers have said that alcoholism is more common in the U.S. adult population than compulsive gambling.
But last month the University of Buffalo’s Research Institute on Addictions published a surprising report concluding just the opposite.
After age 21, gambling problems are more common than booze dependence, the institute found in analyzing data from two national studies.
The study included all forms of gambling, such as lotteries, office pools, charity bingo, Internet gambling and raffles.
The results have drawn skepticism from some treatment experts in light of long accepted research that drinking problems are at least twice as common as gambling problems. Even the institute’s chief investigator, John Welte, was surprised by the results.
“I didn’t expect problem gambling to be more common than alcohol dependence for such a wide age range,” he said.
What might otherwise be an academic debate could have bigger consequences for the gaming industry, which has long fought criticism that gambling creates social ills that go unaccounted for in official statistics. Casinos are subject to high “sin” taxes in states where they are granted monopolies, with some tax money diverted to help problem gamblers. There’s still relatively little money for problem gambling treatment in the United States, in part because it has been viewed by academics and industry officials as rare.
Welte’s research found that the prevalence of alcohol problems peaks at a younger age and drops off significantly after age 21, a similar trend found elsewhere and possibly explained by the fact that young people tend to engage in risky behavior more than adults.
By contrast, the prevalence of gambling problems increases after 21, peaking at ages 31 through 40 and declining slowly until later adulthood, when it falls off significantly, the study found.
Welte’s findings show a significantly lower rate of alcohol dependence than previous studies, although his evidence that problem and pathological gamblers combined make up from 1 to 5 percent of the over-21 population is within the range of previously reported figures.
A state-funded study in 2002 found that from 2.1 to 6.4 percent of Nevada adults are problem gamblers or “probable” pathological gamblers likely to develop a problem — at least 75 percent higher than results for the rest of the country. That study hasn’t been replicated to determine whether the problem has worsened as the population and available gambling opportunities have grown, even as some locals with gambling problems stop or curb their gambling over time.
To compare gambling and drinking problems, Welte’s study ranked the percentage of survey respondents who answered “yes” to at least three questions on gambling addiction against the percentage who answered “yes” to at least three questions on alcohol dependence. The questions, which include whether a person has ever lied or stolen to feed his addiction, are taken from standard diagnostic manuals.
The study combined results from two national telephone polls conducted by the institute, including a survey of adults ages 18 and over in 1999 and 2000 and a survey of youth ages 14 to 21 from 2005 through 2007. All told, Welte’s group surveyed nearly 5,000 people in one of the largest research projects of its kind.
Welte found the greatest discrepancy between gambling and drinking problems from ages 31 to 40, with gambling problems peaking at about 5 percent of the population and at three times the rate of alcohol problems.
Robert Hunter runs the only nonprofit problem gambling treatment clinic serving the Las Vegas Valley. He’s one of the study’s skeptics.
Problem gambling is probably higher in Southern Nevada than it is elsewhere because of widespread gambling options, Hunter said. But drinking problems are believed to be more common because of the greater availability and consumption of alcohol, including in the home, he said.
That may be changing, Hunter said, as casino and Internet gambling spread nationwide.
“Conventional wisdom says you can get alcohol everywhere,” he said. “Theoretically, you can get gambling everywhere, too.”
Most of the Problem Gambling Center’s patients are 31 to 60, with the number of people in each decade about equally represented, he added.
Dr. Mel Pohl, medical director of the Las Vegas Recovery Center for the treatment of drug and alcohol addiction, is also not sold on the study’s findings.
Addiction experts generally believe that people who abuse alcohol make up 9 to 10 percent of the population, Pohl said. By contrast, Welte’s research found that up to 3 percent of adults have a drinking problem.
The study may be comparing apples and oranges by ranking people with both severe and less severe gambling problems against those with more severe drinking problems, said Christine Reilly, executive director of the Institute for Research on Gambling Disorders, the research arm of the National Center for Responsible Gaming.
People with three or more problematic symptoms related to gambling are believed to have a gambling problem, but drinkers who exhibit only one alcohol-related symptom could be quantified as having a problem, Reilly said. By including people who had three or more symptoms, the study could have underreported those with drinking problems, she said.
In contrast with many national studies on alcoholism, few have attempted to measure the rate of gambling addiction in the U.S. population. Welte has conducted two of only four such studies.
Researchers typically quantify compulsive gamblers in two ways — severely addicted “pathological gamblers” who experience tolerance or withdrawal symptoms similar to drug addicts, and a wider audience of “problem gamblers” who experience gambling-related problems such as money woes or strained marriages.
Casino industry representatives and treatment experts commonly cite only one of those figures when quantifying gambling problems. Pathological gamblers, they say, represent about 1 percent of U.S. adults — a figure taken from smaller, regional or statewide studies.
Critics say that figure minimizes what has become a bigger, nationwide problem. On the other hand, some experts say this more severely affected group is easier to quantify and study than the bigger, more loosely defined group of problem gamblers — people, they say, who don’t need as much help and often get better on their own.
Welte’s results are “out of the norm” yet indicate a need for further research, Reilly said.