M.A.P.P.A 2012 Annual Conference Ocean City, Maryland “Gambling Prevalence and Prevention Strategies” Presenter Carl E. Robertson, Prevention Manager November, 2012

Funded by DHMH/ADAA

Maryland Center of Excellence on Problem Gambling Partnership of Maryland Council on Problem Gambling and the University of Maryland School of Medicine Funded with a 3 year grant (2012-2015 ) from State Health Department

Purpose:  Identify and promote problem gambling treatment resources  Provide Maryland based prevention and research initiatives  Establish problem gambling lending library resources  Conduct Public and Professional Awareness Outreach Campaigns  Manage Maryland Problem Gambling Hotline: 1-800-522-4700 Funded by DHMH/ADAA

• If you bet on a horse, that’s gambling. • If you bet you can make three spades, that’s entertainment. • If you bet cotton will go up three points, that’s business. • What’s the difference?

• Gambling is any activity or game where you risk something of value or money on an outcome that is not guaranteed. Funded by DHMH/ADAA

History of US Gambling Evidence suggests that the expansion of gambling has been at times both evolutionary and revolutionary. •

First Wave

Begins during the colonial period and extends to the mid-nineteenth century. •

Second Wave

Begins after the conclusion of the Civil War and continued to the early years of the twentieth century. •

Third Wave

Begins during the Great Depression. By the close of the 1930s, 21 states had legalized race-tracks, low stakes charity bingo. By the late 1990s, 25 states legalized casino gambling •

Fourth Wave

Begins in the late 1990s and is defined by the increase growth of commercial casinos, rapid expansion of tribally controlled gambling and the explosion of gambling on the Internet. Presently some form of legalized gambling is available in 48 states plus the District of Columbia. The two states without legalized gambling are Hawaii and Utah. (I. Nelson Rose, as cited in Dunstan, 1997)

Problem and Pathological Gambling Definitions Problem Gambling – is a descriptive term used to define those individuals with problems in their lives due to gambling. Pathological/Compulsive Gambling- is the clinical term for the Impulsive Control Disorder defined in DSM IV312.31 (failure to resist the impulse to gamble) Funded by DHMH/ADAA

Why do people gamble? What are the perceived benefits? • Money: the possibility of earning extra money is very appealing • Excitement: a major motivating factor • Enjoyment: this was described as an “entertainment value” and was more often reported by the girls • Social: Again, most often reported by girls. Gambling is viewed as a way to promote relationships with friends and family

Why do they gamble? What are the perceived benefits? • Independence: Boys often reported gambling to assert their sense of importance and to feel older, since gambling is viewed as an “adult activity • Competition: Gambling presents as a challenge to compete with and win against others. This was more true for the younger teens. • Escape: This was not a common motivator listed by participants. The few who referred to it also reported recent problems with gambling experiences.

What do we know about Adult and Adolescent Problem Gambling? Actually, quite a lot, there is data from sources such as:

• • • •

National Research Council – 1999 McGill University – 1998/Present National Council on Compulsive Gambling Gambling Prevalence in Maryland: A Baseline Analysis – 2010 • Johns Hopkins Longitudinal Study

Who Are Adult Problem Gamblers based on National Research Council Survey 1999 • About 1-3% of the Adult Population of the U.S. has a Gambling Problem • Estimated to be over 4-6 million adults in the United States(combination of pathological/problem gamblers) • Estimated to be over 128,670 adults in Maryland (based on 2011 census projections)

Who Are Adult Problem Gamblers based on Maryland Baseline Survey 2010 • Survey indicated 3.4 % of the Adult Population in Maryland are problem/pathological gamblers •

(1.5% pathological/1.9% are problem gamblers)

• Estimated to be over 154,400 adults in Maryland(based on Maryland Baseline projections) • Range: 128,670 – 154,400 Adult Marylanders

Youth Prevalence Findings • 4-8 % Level III, Probable Pathological gambler (NRC, 1999)

• 1.1 million youth 12-17 exhibit pathological gambling behavior (NGISC, 1999) • 10-15% at-risk for Problem Gambling (Shaffer & Hall, 1996; Winters, Stinchfielf, & Fulkerson, 1991; Wiebe, 1999; Wynne, Smith, & Jacobs, 1996)

• Youth Gambling 4 to 6 % (problem/pathological)

• Maryland Youth Estimated: 47,000-50,000 (problem/pathological based on 2011 census projections)

Johns Hopkins survey Study began in 1993 in 27 1st Grade Classrooms in Baltimore City public schools Data Sources utilized: Teacher ratings Parent ratings Self-reports: 90 minute self-administered compter interview Gambling data collected via age appropriate scales SOGS-RA in 2004, 2006-07 and SOGS 2008-2011 Funded by DHMH/ADAA

Prevalence of Baltimore Inner-City Youth

• Found that 11-15% of adolescents/adults have some form of problem gambling from the groups studied since 2004 • (when gambling questions were added to the study.)

Youth Problem Gambling Health and Social Correlates

• About 4.2% of 12-17 yr. olds have an alcohol abuse problem. • About 2.3% have an illicit drug abuse problem (NHS-DA 01). • Both are lower than the 4-6% of youth with severe gambling problems (Gupta & Derevensky 98a). • Problem and pathological gambling result in: – increased delinquency and crime – disruption of familial relationships – decreased academic performance, higher truancy, poor grades – higher rates of depression – higher rates of suicidal ideation and suicide attempts

Data from the 2006 Oregon Healthy Teens Survey Jeff Marotta PhD Problem Gambling Solutions Inc

Have you had beer or wine or hard liquor to drink during the past 30 days? 70 60

Percent

50 40 30 20 10 0

Drank alcohol

Nongambler, grade 8

Gambler, grade 8

26

48.7

Nongambler, grade Gambler, grade 11 11 41.3

60.3

Have you carried a handgun during the past 12 months? 25

Percent

20 15 10 5 0

Carried a handgun

Nongambler, grade 8

Gambler, grade 8

Nongambler, grade 11

Gambler, grade 11

7.1

23.2

5.2

16.8

Implications Gambling is one of many activities that carry risk and should be addressed as such in school and community prevention efforts

Gambling should be a signal to parents that they ought to be talking to teens about risky behaviors including gambling

• There are more adolescents engaged in gambling than other potentially addictive behaviors. • Past Year Use % Weekly Use % • Gr 7 Gr 9 Gr 11 Gr 7 Gr 9 Gr 11 •Alcohol 36.8 62.2 79.8 7.4 14.0 20.2 •Drugs 3.5 13.4 26.5 2.7 2.1 9.0 •Cigarettes 18.2 34.5 48.4 7.0 16.1 31.4 •Gambling

79.1

78.9

83.4 30.4

37.4

37.1

• Grade 7 (12-13 yrs.) Grade 9 (14-15) Grade 11 (16-17) •

(Gupta & Derevensky, 1998a)

Prevalence Rates in College Students Shaffer et al., 2003

• • • • •

4-8% of college students are problem gamblers 10-14% are at-risk for developing a gambling problem 85% have been involved in various forms of gambling 23% involved in weekly forms of gambling Problem Gamblers age 18-25 lose an average of $30,000 per yr.

Adapted from Understanding Substance Abuse Prevention: Toward 21st Century Primer on Effective Programs (P. Brounstein & J. Zweig, 1999). Center for Substance Abuse Prevention (CSAP) & Substance Abuse and Mental Health Services Administration (SAMHSA). Dickson, Derevensky, & Gupta (2002).

Gambling Prevention No one product can serve as a complete prevention strategy. Prevention should take place, repeatedly, over time, via different mediums and modalities.

Trends: emphasizes the need for prevention • Gambling as a primary form of entertainment. Even being televised. • Gambling promoted as a sport. Players gaining celebrity status.

• Gambling online (increases accessibility). Training on practice sites. • Gambling as a career option. • Gambling being normalized, and no longer being viewed as risky.

Best options protecting our youth • Prevention is key, as knowledge is power

• The school system is an ideal venue for administration of prevention programs. In the process, teachers are sensitized as well. • Prevention of gambling problems also translates into prevention of other high-risk behaviours. • Prevention is a proactive and necessary approach

Prevention Programs: McGill University

Carl Robertson [email protected] •Maryland Problem Gambling Helpline 800-522-4700 •Center: www.mdproblemgambling.com •National Council on Problem Gambling www.ncpgambling.org

• McGill University Youth Gambling Research and Treatment Clinic www.education.mcgill.ca/gambling www.youthgambling.com