As sports betting expands, gambling addiction services fall behind

After the Supreme Court's decision earlier this week permitting sports betting, those involved in gambling addiction recovery are worried that without robust support systems problem gambling will only increase. The national average, among the 40 states that spend on gambling addiction help, is 37 cents per capita.

First Look

Oklahoma’s 128 tribal casinos host 46 million visits and rake in $4.5 billion a year – but there isn’t a single billboard in the state that tells problem gamblers where they can find help.

“We can’t afford it. It costs $1,200 to $1,400 a month for a billboard,” said Wiley D. Harwell, executive director of the Oklahoma Association for Problem and Compulsive Gambling.

With $186,000 from the state and about $100,000 from Indian tribes and other donations annually, Mr. Harwell’s group operates a hotline, trains counselors, and gives public education talks. Billboards won’t fit into the budget – which might explain why the hotline received just 1,020 calls in 2016, even though an estimated 65,000 Oklahoma adults have a gambling problem.

Overall, the Sooner State dedicates $1 million a year – 25 cents per capita – to help problem gamblers. The national average, among the 40 states that spend anything at all, is 37 cents per capita.

By clearing the path for all states to permit sports betting, the Supreme Court earlier this week set the stage for “the largest potential expansion of gambling in our nation’s history,” said Marlene Warner, executive director of the Massachusetts Council on Compulsive Gambling and current board president of the nonprofit National Council on Problem Gambling. She predicted that problem gambling will increase, too, “unless steps are taken to minimize harm.”

Ms. Warner would like to see any state that permits sports betting dedicate a percentage of revenues to prevention and treatment. In many states, that is unlikely to happen.

The federal government mostly leaves gambling regulation, and gambling addiction programs, up to the states. Only 17 states pay for one or more full-time staff positions to help problem gamblers, according to a 2016 survey of problem gambling services by the National Council on Problem Gambling and the Association of Problem Gambling Service Administrators. Others operate on a shoestring with half-time positions and volunteers.

Seven states with at least some legal gambling – Alabama, Arkansas, Idaho, Kentucky, Montana, New Hampshire, and Texas – spend no state money at all to combat problem gambling. Arkansas, for example, stopped spending state money on problem gambling in 2015, redirecting the $200,000, which came from the state lottery, to scholarships.

Alaska, Hawaii, and Utah are the other three states that don’t spend state money on problem gambling services, but those states have limited gambling opportunities within their borders.

Financial ruin

Gambling disorder, as the addiction is classified medically, is believed to affect about 2.2 percent of US adults. Unlike those who abuse alcohol or drugs, problem gamblers may not show signs of their addiction until financial ruin is upon them, experts say.

Brad Martin, a former school superintendent in Springfield, Ohio, illustrates the problem.

“I didn’t know I had an issue until I got caught,” he said.

Mr. Martin admitted in 2015 to skipping more than 300 hours of work to gamble at casinos, enabling his truancy by falsifying mileage reports, sick leave requests, and other documents over a two-year period. He was sentenced to six months in jail, five years of probation, and 500 hours of community service. He repaid the school district more than $46,000.

Fortunately for Martin, Ohio is one of 13 states that offer free or low-cost inpatient residential treatment for problem gamblers. Ohio voters approved a constitutional amendment in 2009 authorizing casinos in four cities – Cincinnati, Cleveland, Columbus, and Toledo. The amendment also required a 2 percent tax on casinos’ gross revenue to be dedicated to a problem gambling fund.

Martin was able to leave jail twice a week for counseling sessions. He now has a job he likes managing a warehouse, where he supervises about 130 people.

“No one is ever turned away” from counseling for problem gambling in Ohio, said Stacey Frohnapfel-Hasson, Ohio’s bureau chief for gambling services.

The state screened more than 68,000 Ohio residents for gambling disorder in 2017, a 35 percent increase from the year before, and increased the number being diagnosed or treated for gambling disorder by 11 percent to 1,159, Ms. Frohnapfel-Hasson said.

Massachusetts increased its funding for problem gambling by enacting a gaming expansion law that includes addiction services. The 2011 law not only allows construction of up to three destination resort casinos but also calls for addiction services and public health research into problem gambling. Unclaimed state lottery prize money pays for the addiction services, and 5 percent of gross gaming revenues go into a public health trust fund to support the problem gambling research.

Plainridge Park, a racetrack with 1,250 slots as well as electronic game tables 35 miles southwest of Boston, opened in 2015 with the nation’s first GameSense information center. GameSense advisers greet customers as they enter and are available to explain the odds of winning before patrons play. They also offer suggestions for voluntary spending, time limits, and other tips.

“Everybody else is there to push gaming, to push the casino. We’re there to meet the customer wherever they are,” said Warner of the Massachusetts Council on Compulsive Gambling, which operates the GameSense Center at Plainridge.

“We’re never going to interrupt someone’s play or touch someone,” but if a customer wants to talk, staffers are ready, she said. Also available is Play My Way, a budgeting program that tracks an individual’s spending at the casino. A customer can set a limit for himself for a day, week, or month.

“I had very low expectations for this, but 14,000 have enrolled,” said Warner, who likens Play My Way to wearing an exercise monitor or seeing the calorie count at McDonald’s.

“Gamblers often don’t know how much they’re gambling. Now people are making a choice. They can decide whether they want to stay longer or come back tomorrow,” she said.

'I thought I was lucky'

Karen, a recovering gambling addict in Massachusetts who asked that her last name not be used, was single and in her 40s, living far from her family, when she met a charming man who liked to bet on horseraces. Karen started to play blackjack and slots on her own.

“I thought I was lucky,” she said, but her gambling got out of hand. She stole hundreds of thousands of dollars from her employer, a charitable foundation, and pled guilty in 2007 to 26 counts of forgery, theft , and income tax evasion.

“I lost everything – my friends, my whole family, my good job, all my belongings,” she said. She declared bankruptcy. “Gambling literally ruined my life.”

Now in her mid-50s, Karen has a counselor she trusts, a job at a recovery center, and an apartment.

“A lot of times I struggle with money,” she said. “I wonder: Should I play the lottery? Can I do that? I know the answer. No.”

Self-exclusion programs can be an answer for gamblers who can’t stay away from casinos. A customer fills out paperwork, gets the form notarized, and presents a photo ID to ban herself from casinos’ premises for a year, five years, or life.

But the process can be cumbersome. In Washington State, a gambler must notify every single venue – all 24 tribal casinos and 30-some card rooms. But in Oklahoma, New Mexico, and other states, a gambler can file a single request to be excluded from all the casinos in the state.

Terry, who lives in Albuquerque, never imagined she’d need to ban herself from casinos for the rest of her life.

Terry, who also asked that her last name not be used, was always the good daughter, wife and mother. But her first afternoon playing slots in 1995, she turned $40 into $1,300.

Over time, seeking an escape from family- and work-related problems, her pastime became an obsession. Before Terry banned herself two years ago, hardly a day passed that she didn’t go to the casino.

Terry’s marriage of nearly 33 years fell apart, and she spent her alimony on gambling. Deep in debt, she took out new credit cards, wrote bad checks, and pawned what she could. She was caught attempting to shoplift silver jewelry and spent a night in jail.

Terry lived in her truck for 11 months and sold her blood plasma to survive. Her house, “yellow tagged” by the city for its run-down condition, is headed for auction this summer unless she can somehow pay the back real estate taxes.

Now things are looking up for Terry. Her church helped her find temporary lodging, she qualified for Social Security, food stamps and Medicaid, and she’s looking for a full-time job.

But self-exclusion isn’t fool-proof. No one checks IDs at the casino door, and Terry has been back to gamble a few times since she banned herself. Once she even won a jackpot of $2,100, but under the rules, she couldn’t keep the winnings; the casino did. She was escorted out and could have gone to jail for trespassing.

Terry decided to tell her story to Stateline after a good friend who was also fighting gambling addiction took his own life last month. They had texted each other encouraging words morning and night for seven months.

“He couldn’t see any light at the end of the tunnel,” she said. “People don’t realize how horrible this addiction can be. If it can do it to him, it can do it to anyone.”

Not OK in Oklahoma

Oklahoma, with just under 4 million residents, is tied with Nevada and South Dakota for the most casinos per capita, and is second to Nevada in gaming machines per capita, a recent WalletHub survey found.

And more gambling is on the way. Last month Gov. Mary Fallin (R) signed a law allowing games with a ball or dice, effective in November. Tribal gaming operations will be adding craps and roulette to their more than 73,000 electronic games and 5,300 bingo seats.

So how will Oklahoma’s small problem gambling council cope with widespread betting windows as well as new craps and roulette games – without additional state funds?

“We’re going to pray,” Harwell of the Association for Problem and Compulsive Gambling said.

This article was reported by Stateline, an initiative of the Pew Charitable Trusts.