A row of unattended slot machines in a casino.
Image Source: Linoleum Creative Collective / Unsplash

Battling America’s Rising Gambling Addiction

TW: This article mentions suicide and addiction.

“Most people don’t know when to stop. They take their last dime, they take their last twenty-five dollars,” Tony McDew says to the camera at the beginning of a video that condenses his decade of problematic gambling, from 2008 to 2019, into 30 minutes (YouTube). A moment later, he records himself pulling into a pawn shop to sell the video equipment he relies on for income, “One of these days, I am hoping that I will hit it big, that I will pay a lot of bills off, and then get back on track, but right now, it’s very difficult.” At this point in the video, McDew has already lost $35,000. By the end, he has lost his house and is living on the street in Las Vegas. 

KEY TAKEAWAYS

• The United States is in the midst of the largest expansion of legal gambling in history.

• Gambling addiction can be as severe as any substance-based addiction, with high rates of suicide, and disproportionately impacts people of color, particularly Black adults and Southeast Asian immigrant communities living in the United States.

• State-run lotteries and private gambling entities take advantage of the marginalized by generating the vast majority of their revenue from people with problem gambling, having little incentive or pressure to provide adequate treatment.

Why You Should Care

Gambling addiction and problematic gambling are largely invisible disorders, but the consequences can be as severe as those from any substance-based addiction, particularly for people of color. People living with gambling addiction have a higher suicide rate than any other addictive disorder — roughly one in five problem gamblers will attempt suicide (The Guardian). The disorder is also more common than you may think. As many as 1% of people living in the United States suffer from severe gambling addiction, a number that goes up to 7% for college-aged adults. Black young adults are 60% more likely to engage in frequent gambling than white young adults (National Center for Responsible Gambling, Pub Med). Race, along with gender, is among the strongest demographic predictors for gambling addictions.

Although research is limited, studies suggest that Black adults in the United States are twice as susceptible to gambling addiction as white adults (Gateway Foundation, Alegria et al., 2009). Southeast Asian refugees have some of the highest rates of problem gambling, with the rate of gambling disorder as high as 59% (PubMed), which may be caused in part by the stress of acculturation. 

According to Frankie DiFerdinando, the Director of Oregon’s Lewis & Clark Problem Gambling Services, the myth of the “American Dream” also contributes to problematic gambling in some immigrant communities. She said, “It’s an addiction of hope. Being able to gamble and win could catapult them into a comfortable place here in the United States.” DiFerdinando has worked with many Latinx immigrants through a program piloted by Alexia Deleon. They are not only trying to win money for themselves but also experience financial pressure to assist loved ones back home (OPB). A small study of Mexican immigrants in New York City found those who sent money home to their families were more likely to gamble than those who did not (Momper et al. 2009). Although some culturally-specific programs exist, underfunding and clinician turnover make it difficult for them to remain open.

Problem gambling also frequently co-occurs with mood and substance use disorders, such as anxiety and alcohol use, which Black and African American adults are at a higher risk of developing. It is no coincidence, according to DiFerdinando, that many slot machine companies capitalize on these vulnerabilities by placing more in lower-income and culturally-diverse neighborhoods.

Why This is Pressing Now

The United States is currently in the midst of “the largest and fastest expansion of legal gambling in the nation’s history” (NBC News). A 2018 Supreme Court decision legalized sports betting in states beyond Nevada. This, along with the COVID-19 pandemic, created a perfect storm that allowed online gambling to sky-rocket — a “ticking time bomb” that has very few guardrails (NBC News).

But this isn’t only the fault of private ventures. Between the 1980s and 1990s, pressure to jump-start the United States economy resulted in an explosion of state-supposed lotteries and the Indian Gaming Regulatory Act (1988), both of which made gambling significantly more accessible. In the 1970s, gambling was only legal in Nevada and Atlantic City, New Jersey. Today, some form of legalized gambling is available in every state except Hawaii and Utah (Encylopedia.com, Play It Safe Ohio).

Many politicians and lawmakers support state-sponsored gambling as a way to fund public programs, including education and parks, without raising taxes. Just last month, the Oregon Lottery Commission boasted a “milestone of sales,” hitting a record-breaking one billion dollars in revenue by mid-February (Oregon Lottery Commission Meeting). Oregon revenue from Super Bowl bets were also up 60% year over year, and in January, New York legalized online sports betting (Gotham), which contributed to a staggering 270% increase in national sports betting in the first quarter of this year over last (American Gaming Association). 

The problem is that this “revenue” comes at an enormous literal cost for people who struggle with gambling addiction. In 2013, most of the revenue from the Oregon Lottery came from 4% of the players, which translates to 80% of all gambling revenue coming from compulsive gamblers (The Oregonian, Inaba & Cohen, 2014). It’s what gambling researcher Earl L. Grinols refers to as “cannibalized dollars,” a system that preys on the vulnerable and underrepresented (Gambling in America). 

Inadequate Care

People who suffer from problem gambling rarely seek treatment. This is due in part to cognitive distortions like the “gambler’s fallacy,” which leads the person who gambles to feel sure they’re “due” for a big win. But failure to get treatment also stems from the stigmatization of problem gambling (Psychiatry Online). People living with gambling addiction often experience an enormous amount of shame and fear around the debt they have accrued. This can lead to isolation, which in turn creates a self-perpetuating cycle of addiction. This is complicated by the fact that many people do not view gambling as a “real addiction.” This even includes some in recovery communities themselves, leaving those who suffer from the disease with fewer options when it comes to reaching out for help.

This inadequate treatment is compounded in Black communities by a distrust of the medical system and by a lack of “back doorways” for undocumented Latinx folks to receive services, according to DiFerdinando. Although most states offer state-sponsored treatment for problem gambling treatment, many of these services are underfunded, have prohibitive barriers to those in need of treatment, and are not culturally specific or even able to offer counseling in the client’s language. A disproportionate number of white mental health counselors also means that even when organizations offer culturally responsive programs, Black, Latinx, and Asian populations are often seeing a white counselor, which adds another barrier for many (Insight Into Diversity).

Advances in gambling technology and loosened regulations put the financial security and physical safety of people like Tony McDew and some of our most vulnerable communities at direct risk. It is only by holding lawmakers responsible, destigmatizing the disease, and demanding treatment options that we can put the odds back in their favor.


KEY TAKEAWAYS
• The United States is in the midst of the largest expansion of legal gambling in history.

• Gambling addiction can be as severe as any substance-based addiction, with high rates of suicide, and disproportionately impacts people of color, particularly Black adults and Southeast Asian immigrant communities living in the United States.

• State-run lotteries and private gambling entities take advantage of the marginalized by generating the vast majority of their revenue from people with problem gambling, having little incentive or pressure to provide adequate treatment.

If you or someone you know has a gambling problem, call the National Problem Gambling Helpline at 1-800-522-4700, or go online at ncpgambling.org/chat. If you or someone you know is considering suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-8255. Or you can contact the Crisis Text Line for emotional crisis support by texting HELLO to 741741. It is free, available 24/7, and confidential.

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