John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Problem Gambling Training
1
John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
What is Gambling?
• Gambling is risking something of value on an event that is
determined mostly by chance.
• A person is gambling if he or she puts up something of
value, such as money or property
• The outcome has an element of chance beyond the
person’s control
• Once the bet is made, it’s not reversible
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Types of Gambling Activities
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•
•
•
•
•
•
•
•
•
•
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Lottery and lottery scratch offs
Pull-tabs and raffle tickets
Bingo
Sports betting
Slot machines/VLT’s
Card and table games
Internet/sweepstakes cafes
Horse betting
Internet gambling- poker, bingo sites
Stock market speculation
Betting on other games-pool, bowling etc.
Other?
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
How big is Gambling?
# ONE –Entertainment/ Leisure
activity in USA
Grosses $84,000,000,000
(84 BILLION)
How much profit was there on Bingo
in 2009?
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Bingo!
• $142,100,000 in profits
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Gambling behavior
Occurs on a continuum – is not static
No
Experimentation
Gambling
Level 1
Social
At-Risk
Problem
Pathological
Level 2
Level 3
John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Comparison of CD and Gambling
Tolerance
Chemical Dependency
Pathological Gambling
Tolerance, as defined by either of the needs to gamble with increasing amount of
money in order to achieve the desired
following:
excitement.
oa need for markedly increased
amounts of the substance to
achieve intoxication or desired
effect
omarkedly diminished effect with
continued use of the same amount
of substance.
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Comparison of CD and Gambling
Withdrawal
Chemical Dependency
withdrawal, as manifested by either of the
following:
othe characteristic withdrawal syndrome
for the substance
othe same (or closely related) substance
is taken to relieve or avoid withdrawal
symptoms.
Pathological Gambling
is restless or irritable when attempting
to cut down or stop gambling
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Comparison of CD and Gambling
Loss of control
Chemical Dependency
Pathological Gambling:
othe substance is often taken in larger repeated unsuccessful effort to control, cut
amounts or over a longer period than back, or stop gambling.
was intended
othere is a persistent desire or
unsuccessful efforts to cut down or
control substance use.
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Comparison of CD and Gambling
Preoccupation
Chemical Dependency
A great deal of time is spent in
activities necessary to obtain the
substance, use the substance, or
recover from its effects.
Pathological Gambling
is preoccupied with gambling …
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Co-Occuring
Among pathological gamblers, alcohol has been found
to be the most common substance of abuse. At
minimum, the rate of problem gambling among
people with substance use disorders is four to five
times that found in the general population.
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Screening and Treatment
• SOGS- South Oaks Gambling Screening
Widely used, available, easy to use
• NODS-based on DSM IV criteria
• Lie/Bet1) Have you ever felt the need to bet more and more money?
2) Have you ever had to lie to people important to you about how much you
gambled?
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Screening and Treatment
• Motivational Interviewing-meet client where they
are at.
• CBT-magical thinking, belief systems
• GA
• Harm Reduction
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Screening and Treatment
Currently listed as Impulse Control Disorder in DSM IV
The DSM V will move gambling to the addiction
section, it will be the only process disorder, (not
involving substance) in this section.
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Risk Factors
Significant financial loss
Higher rates of relationship
and family breakdown
Higher rates of emotional
and health problems
Work-related difficulties
Legal problems
Higher rates of suicide
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Risk Factors…suicide
Among those with gambling problems:
38% suicidal ideation (SI)
32% suicide attempt
SI leads to more gambling when
gambling
SI+ PG = 5x more likely to have
depression
PG + Drug history = 6x more likely
attempt
21% of attempters say it is gambling
related
Hodgins et al 2006
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Risk Factors…medication
Compulsive gambling
problems as side effect of
medication for Parkinson’s
& Restless Leg Syndrome
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Risk Factors…Mental Illness
•
•
•
•
Depression
PTSD/TBI
Mania
ObsessiveCompulsive Disorder
------------------------------also Grief/Loss
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
What to look and listen for
Listen:
• There goes the rent/car
payment’
• ‘If I go home my wife is going
to kill me’
• ‘I would be better off dead’
Look:
• Not eating
• Not going to the restroom
• Same clothes/grooming
Gut feeling
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Self Exclusion/Restriction
Some might not know about this option,
customer has ability to voluntarily exclude
themselves
• Urge to gamble significantly reduced
• Perception of control increased
• Intensity of negative consequences from
gambling decreased
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Self Exclusion/Restriction
Some might not know about
this option, customer has
ability to ask for restrictions
• Check cashing
• Credit
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Statewide Initiative
• Ohio Lottery Commission (OLC)
• Ohio Casino Control Commission (OCCC)
• Ohio State Racing Commission
• Ohio Department of Drug and Alcohol
Addiction Services (ODADAS)
www.org.ohio.gov
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Problem Gambling Helpline
1 800 589 9966
• Statewide Resource
• In operation since 1990
• Continuously Updated
• Printed on Ohio Lottery
tickets/materials
• Gaming Advertising
• Ohio for Responsible
Gambling website
www.org.ohio.gov
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John R. Kasich, Governor
Orman Hall, ODADAS Director
Tracy Plouk, ODMH Director
Questions?
Scott Anderson ODADAS (Treatment)
scott.anderson@ada.ohio.gov
614-466-8562
Melinda Norman ODADAS (Prevention)
melinda.norman@ada.ohio.gov
614-644-8318
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