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Conventional wisdom assumes that individuals with gambling problems must quit “cold turkey” and abstain from gambling in order to achieve recovery. However, a newarticle in the journalAddictionreports on individuals who are recovering from a gambling disorder without abstaining from all gambling activities (Slutske, Piasecki, Blaszczynski, & Martin, 2010). This study of Australian twins examined the behavior of a representative cross-section of the population, and not just people in treatment for gambling disorders. Population surveys like the one used in this study are useful for understanding how recovery occurs, as roughly 80 percent of people who recover from a gambling disorder do so without any kind of formal treatment (Slutske, 2006). This type of research is particularly noteworthy because much of what is known about people with gambling disorders has come from studies of people in formal treatment programs.

In the study sample of 4,764 people, 90 percent of the 44 recovered disordered gamblers had participated in some type of gambling during the past year. This finding is striking because it suggests that controlled gambling is not only possible for those with disordered gambling, but the norm for the majority of recovered pathological gamblers in this sample. The authors suggest that this finding may be good news for gambling treatment providers because programs that strive for “controlled gambling” instead of abstinence may attract people who otherwise would not consider attending more traditional, abstinence-based treatment programs. Also, once in treatment, a person may decide that abstinence really is the best choice, a conclusion that 39 percent of participants reached in a recent treatment study that offered controlled gambling as a starting goal(Ladouceur, Lachance, & Fournier, 2009).

More information on the article inAddictionis available onthe journal’s website. What are your thoughts about “warm turkey” versus “cold turkey”? Tell us in the Comments section below.

References

Ladouceur, R., Lachance, S., & Fournier, P. (2009). Is control a viable goal in the treatment of pathological gambling?Behaviour Research and Therapy,47(3), 189-197. doi:10.1016/j.brat.2008.11.004

Slutske, W. S. (2006). Natural recovery and treatment-seeking in pathological gambling: results of two U.S. national surveys.American Journal of Psychiatry,163(2), 297-302. doi:163/2/297 [pii] 10.1176/appi.ajp.163.2.297

Slutske, W. S., Piasecki, T. M., Blaszczynski, A., & Martin, N. G. (2010). Pathological gambling recovery in the absence of abstinence.Addiction. Advance online publication. doi:10.1111/j.1360-0443.2010.03080.x

NCRG staffResearch Updateabstinencegambling addictiongambling in Australiaproblem gambling

Scientists have identified many commonalities between people with gambling problems and those with substance use disorders. Are there similarities in brain function? A recent edition ofThe WAGER(Worldwide Addiction Gambling Education Report) reviews a study focused on this issue.

The most recent edition ofTheWAGER– Vol. 15(8)reviews a 2009 study published in the journalAddiction(Lawrence, Luty, Bogdan, Sahakian, & Clark, 2009) that compares decision-making and brain function in individuals with gambling disorders, alcohol dependant individuals, and healthy controls (participants without gambling or alcohol problems). The three groups were given a series of tests designed to evaluate traits such as impulsivity, decision-making on a gambling task and short-term recall. Individuals with gambling and alcohol problems showed significantly lower levels of impulse control than healthy controls. Only disordered gamblers went “bankrupt” significantly more often in the gambling task, and only alcohol dependant participants had significantly reduced short-term recall (possibly an effect of heavy alcohol use). For the full review or to access online reviews of research on other addictive disorders, visit The BASIS (Brief Addiction Science Information Source) athttp://www.basisonline.org.

As always, we welcome thoughts and questions in the comments section below.

References

Lawrence, A. J., Luty, J., Bogdan, N. A., Sahakian, B. J., & Clark, L. (2009). Problem gamblers share deficits in impulsive decision-making with alcohol-dependent individuals.Addiction,104(6), 1006-1015. doi: 10.1111/j.1360-0443.2009.02533.x

NCRG staffIn the NewsBASISdecision makingDivision on AddictionsHarvard Medical Schoolproblem gamblingThe WAGER

The National Center for Responsible Gaming (NCRG) recently released the fifth volume ofIncreasing the Odds: A Series Dedicated to Understanding Gambling Disorders,which is titled“Evaluating Self-Exclusion as an Intervention for Disordered Gambling.”The NCRG’s monograph series provides easy-to-understand summaries of seminal peer-reviewed research on gambling disorders, as well as implications for future research and prevention efforts.

Self-exclusion programs are a form of help-seeking behavior that provides gamblers an opportunity to voluntarily limit their access to gambling venues. The gamblers pledge to stay out of participating casinos for an agreed time period, often for the rest of their lives. The findings presented in this volume ofIncreasing the Oddscan be used by regulators, policymakers and gaming industry representatives to shape the development and implementation of new and existing programs, leading to more effective results that may help individuals who want to stop or reduce their gambling activities.

The publication includes research summaries from Helen Suurvali, B.A., on what motivates gamblers to seek help and change their behavior; Richard A. LaBrie, Ed.D., on how self-exclusion programs can inform public health strategies; Sarah E. Nelson, Ph.D., on the role of the Missouri Voluntary Exclusion Program in changing participants’ gambling behavior; and Robert Ladouceur, Ph.D., on early benefits to gamblers through self-exclusion and testing improvements in a self-exclusion program.

The publication also features commentary from Kevin Mullally, general counsel and director of government affairs at Gaming Laboratories International and the author of the first state self-exclusion program implemented in the United States, as well as an appendix outlining self-exclusion programs in the United States and in select international jurisdictions.

A downloadable copy ofIncreasing the Oddsis available in theMonographsection of the NCRG website. The first four volumes of the series, which address topics such as youth and gambling, the various aspects of gambling addition recovery and gambling and public health, are also available on the website.

As always, we welcome thoughts and questions in the comments section below.

NCRG staffResearch Updateinterventions for problem gamblingKevin MullallyMissouri Voluntary Exclusion Programresponsible gamingRobert Ladouceurself-exclusion

Removing barriers to treatment and recovery from addiction is one of the featured topics at the 11^thAnnual NCRG Conference on Gambling and Addiction, scheduled for Nov. 14-16, 2010, at the Mandalay Bay Resort & Casino and the Las Vegas Convention Center in Nev. Mark Vander Linden, coordinator of the Iowa Gambling Treatment Program, and Janet Zwick, a healthcare consultant withPrairielands A.T.T.C., will present on “Improving Access to and Retention in Treatment: The NIATx Program in Iowa.” Founded in 2003 as the Network for the Improvement of Addiction Treatment,NIATxis designed to help payers (e.g., health insurance and government) and behavioral treatment providers improve the quality of and access to treatment for clients with addiction.

Vander Linden and Zwick will discuss how NIATx is working to improve the Iowa Gambling Treatment Program and how treatment providers can become involved with the NIATx project.

The NIATx Model aims to improve a treatment program in four ways: reduce wait-time between first request for service and first treatment session, reduce no-shows for assessment, increase admissions to treatment and increase continuation from the first treatment to the fourth treatment.

“Like many states, Iowa has seen funding to gambling treatment services reduced the past few years,” said Vander Linden. “Despite this reduction, we have been able to provide more services to more people. NIATx has allowed us to examine our processes to look for efficient and effective ways to reach those who need help.”

For more information on the NIATx Model session at the 2010 NCRG conference, as well as other speakers and presentations, please download theNCRG Conference 2010 Brochure. To register for the conference, visit theConference linkon the NCRG website.

NCRG staffConference on Gambling and Addictionaddiction treatmentIowa Gambling Treatment ProgramNCRG ConferenceNIATxproblem gambling

The National Board for Certified Counselors(NBCC), the largest counselor credentialing body in the U.S., has designated the Institute for Research on Gambling Disorders as an approved provider of continuing education. The primary purpose of the NBCC is to certify masters-level professional counselors. This approval means that counselors participating in educational activities sponsored by the Institute and the NCRG will earn continuing education hours that can be applied to the National Certified Counselor (NCC) credential.

The Institute for Research on Gambling Disorders offers several approved educational opportunities for counselors throughout the year, including theNCRG Conference on Gambling and Addiction. This year’s conference is scheduled for Nov. 14-16, 2010, in Las Vegas, Nev., and counselors can earn up to 14 continuing education hours. The Institute and the NCRG also offer freewebinarsthroughout the year, which can be accessed from anywhere via the Internet. Watch for announcements about topics for the 2011 webinar series.

NCRG staffConference on Gambling and Addictioncontinuing education for health care providersNBCCproblem gambling