uo addictive-behaviors-2016june

Julie Hynes, Sr. Community Health AnalystLane County Public Health,

National Council on Problem GamblingSAPP 407 | University of Oregon | 6/13/16

GAMBLING

THIS AFTERNOON:• Gambling trends & definitions

• Issues with problem gambling

• Gambling & the brain

• Addressing the issue

These slides are at:

REAL GAMBLING…

FREE*

GAMESAPPS…

6

And this is where lines in 2016 are blurring…..

Gaming or Gambling?7

DEFINITION:

______ something of valuein the _________________

something of greater value.

hopes of obtainingRISKING

Source: American Psychiatric Association - DSM-5 (2013).

A longhistory

NEWER TYPES: CONSTANTLY EVOLVING.

Images: pinnacle.com, unikrn.com, fanduel.com, abcnews.go.com, espn.com, propbets.com, bovada.lv

Image sources: Oregon Lottery, Hynes

2,400 retailers in Oregon

ELECTRONIC GAMBLING:“Video Poker/Slots/Line Games”

Data source: Oregon LotteryPhoto: Daniel Berman.

$8.60out of

every $10 Lottery dollars

Photo: Daniel Berman.

ELECTRONIC GAMBLING:“Video Poker/Slots/Line Games”

Data source: Oregon Lottery

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Let’s play “GUESS THE SPORT!”

Answer: League of Legends Pro League.Source: http://espn.go.com/esports/story/_/id/14555655/latest-league-legends-news-esports

E-SPORTS BETTING:REAL MONEY FOR VIRTUAL STUFF.

E-sports, professional video gaming, is becoming huge. (If you think I’m exaggerating, please visit: www.espn.com/esports)

Source: http://www.bloomberg.com/features/2016-virtual-guns-counterstrike-gambling/

BETTING ON ESPORTS HAS ALSO BECOME HUGE. $2.3 BILLION HUGE.

E-SPORTS BETTING. HUH? HOW?By buying this weapon skin with real money.

Then using it to bet on a game outcome (in this case, CounterStrike).

Image source: csgostash.com

World Series of Poker (image source: cbssports.com)

…And more of THIS

Less of THIS

E-sports (image source: www.esportsearnings.com)

THE FUTURE

1 in 1751 in 175,000

1 in 175 million1 in 175 billion

1 in 175 Million(175,233,510)

Odds of getting struck by lightning: 1 in 280,000

Let’s say there is 1 RED popcorn kernel in this bag of

10,000 pieces of popcorn

….you’d have a better chance of reaching in and grabbing the one red kernel of popcorn in this bag than you would of winning $100 on a powerball ticket

So…if your lucky numbers have “almost” come up in the

last 5 drawings, are your chances better, worse, or the

same?

Sports betsLottery ticketsVideo & onlineBingo & raffles

Video lottery

& online gambling

Electronic Gambling

89% Cards6%

Other5%

Gambling Treatment ClientsGamblers' Preferences

0.1%11.2%

1.2%2.7%

Research shows about what percentage of Oregon adults have a gambling problem?

2.7% of Oregon adults

(1 in 37 people)

have a gambling problem.

“Last Week Tonight with John Oliver” –11/9/14

https://www.youtube.com/watch?v=9PK-netuhHA

disordered

PATHOLOGICAL:Persistent and recurrent maladaptive gambling behavior...results in the LOSS OF CONTROL over gambling. (DSM-IV )

Definitions

New language

It’s a“Continuum”

No Gambling Experimentation

Recreational Problem Pathological

Sources: 1. Moore (2006). 2. Volberg, Hedberg, & Moore (2008). 3. Shaffer & Hall (2001). 4. Northwest Survey & Data Services (2007). 5. Moore (2001).

At-Risk“GAMBLING DISORDER”

2.7% of the adult population in OR(1 in every 37 Oregonians)

5.6% college age (18-24)

2½ % all adults (18+)

4% teens (13-17)

Younger People, Higher Rates

Source: http://www.oregonlive.com/politics/index.ssf/2015/04/oregon_lottery_amid_difficult.html

>70%are current

tobacco users

24%have current

alcohol problems

5%actually attempt

suicide

Source: Oregon Health Authority, 2014

27%experience

suicidal ideation

Use illicit drugs

AND IT’S NOT A SOLITARY PROBLEM.

Each problem gambler affects anaverage of 6-12 others.

Other addiction

issues

Starting early in life

Parental attitudes & behaviors

Community laws & norms

Mental health issues

54

Watch the next fewslides & think aboutwhat you are watching.

What Comes Next?

For good or bad, we are wired to see patterns in things.

This can be “gambler’s fallacy” in the sense of a cognitive distortion.

THIS was supposed to be “next.”

Sources: Tonneato, T. (1999). Cognitive psychopathology of problem gambling. Subst Use Misuse. Sep;34(11):159Anecdotal reports from problem gamblers in treatment and recovery.

18

25

21

16

At what age is the brain considered

fully developed?

The PREFRONTAL CORTEX is the LAST PART to develop.

The brain is still

developinguntil

Source: Brain Briefings (2007, October), Society for Neuroscience, Washington, DC

Gambling & Dopamine

Dopamine not released when expecting a loss.Flooded with dopamine when expecting a win!

It’s not about the money – it’s about the action of the game and the hope of winning.

It’s about the action!

THE CONNECTIONS MAKE SENSE.

“ALMOST WINNING”: dopamine is activated the same as ACTUALLY winning.

Problem gamblers are more likely to see their near misses as “NEAR WINS”

People play LONGER when machines give them NEAR MISSES.

89

addressing the issue

It often takes

years for someone to

1) admit they have a problem

2) seek help, and then

3) continue in recovery

Check out the following chartto see some of the steps from problem gambling to recovery…

Like other addictions, some people relapse and may need help several times before maintaining recovery.

contribute

Addressing Risks -- the “A’s”

IS IT “SOCIAL” OR PROBLEM GAMBLING?

Social GamblerOccasional

Sticks w/ limits

Hopes to win, expects to lose

Can take it or leave it

Problem GamblerFrequent, preoccupied

Plays w/needed $, borrows

Hopes & expects to WIN

Primary source of “fun”

Intervention

Helpline emergence

24/7: 1.877.MY.LIMIT

Referred to provider for assessment

Family members come in; later bring gambler in

TREATMENT IS FREE.

24 hrs: 1877-my-limitOnline: 1877mylimit.org

Minimal intervention: GEAR (Gambling Education and Reduction)Outpatient treatment Crisis respite Residential treatment

TREATMENT OPTIONS IN OREGON

EMERGENCE GAMBLING TREATMENT PROGRAM

Treatment free for gamblers and loved ones- >200 problem gamblers and family members treated last

year- Gender-specific

Multimodal treatment - Individual sessions - Family therapy- Group sessions - Recreational counseling- Didactic lectures - Audiovisual educ.

Suggest to explore 12-step program as additional help

MANAGING KEY TRIGGERS

Even just driving down the street can be a trigger.

https://www.flickr.com/photos/drbethsnow/5995618252/in/photostream/

ON THE RIGHT PATH

Last chance!

Under $100$100-$1,000

$1,000-$2,500More than $2,500

Problem gambling treatment is ‘free’ in Oregon for gamblers AND loved ones.

preventionlane.org

facebook.com/preventionlane

@HynesUO@preventionlane