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A new study from the Research Institute on Addictions at the University of Buffalo published in theJournal of Gambling Studiescombined two national surveys to examine gambling and gambling problems across the lifespan, from the teenage years to retirement-age. The authors found that gambling involvement, frequent gambling (defined as gambling 52 times per year or more) and problem gambling increased during the teens, peaked in the 20s and 30s, and then declined in adults older than 40.

The authors noted that these findings do not support the notion that gambling involvement and problem gambling are most prevalent among adolescents, a pattern observed with alcohol involvement. In fact, this study showed that alcohol use and gambling followed distinctly different patterns. Alcohol dependence peaked between 18 and 22 and fell off rapidly after that, while problem gambling remained relatively stable between 18 and 60, peaking between 31 and 40.

To access this article visit the website of theJournal of Gambling Studies. As always we welcome your thoughts and questions in the comments section below.

NCRG staffResearch Updatedisordered gamblinggambling across the lifespangambling involvementnew research

This is the first of several of our reports from the7th Annual Midwest Conference on Problem Gambling & Substance Abusein Kansas City, Mo. Dr. H. Westley Clark, director of theCenter for Substance Abuse Treatment(CSAT), opened the conference with a keynote address on the challenges and opportunities for addressing gambling disorders. CSAT promotes community-based substance abuse treatment services as part of the Substance Abuse Mental Health Services Administration (SAMHSA), within the U.S. Department of Health and Human Services.

Dr. Clark identified several developments that will affect how disordered gambling is treated in the future. For example, he noted the the proposed reclassification of “Pathological Gambling” in thenext edition of theDiagnostic and Statistical Manual of Mental Disordersas a behavioral addiction within the larger category of Addiction and Related Disorders. Dr. Clark predicted this would have great impact on the perception of the disorder. By recognizing the commonalities between gambling disorders and substance use disorders, Dr. Clark observed that the new definition of disordered gambling could expand insurance coverage for the disorder and reduce the stigma reflected in the public perception of problem gambling as an eccentric behavior rather than a mental health problem.

Dr. Clark also predicted the recent trend toward an integrated approach to addiction treatment will benefit those seeking help for gambling disorders.“Recovery Oriented Systems of Care,”(ROSC) a priority at SAMHSA, supplants the old one-size fits all model with an individualized, holistic and comprehensive approach to addiction. The ROSC model is focused on providing person-centered, comprehensive services across the lifespan that address not only the psychological dimension but other health problems and social needs. Continuity of care–not the old 28-days of treatment model–is the hallmark of ROSC.

Dr. Clark concluded by identifying the following public health needs for adequately addressing disordered gambling:

• More qualified treatment providers;
• Consensus on minimum competency requirements for treatment providers;
• Specialized financial management training for clinicians;
• Treatment programs that are sensitive to cultural differences; and
• Reduction of the stigma associated with pathological gambling through greater public awareness and education

The PowerPoint presentations from the Midwest Conference on Problem Gambling and Substance Abuse, including Dr. Clark’s, will be posted on the Conference on Problem Gambling & Substance Abusewebsite.

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

Christine Reilly Executive Director, Institute for Research on Gambling DisordersIn the NewsCenter for Substance Abuse TreatmentH. Westley Clarktreatment for pathological gambling

What if the director of a treatment organization is approached by researchers interested in testing an intervention for gambling disorders? That director is then confronted with a decision that involves weighing the risks of a clinical trial against the potential benefits for the clients who participate in the trial and the larger society. How can treatment providers ensure that such research would be conducted ethically? In this dispatch from theMidwest Conference on Problem Gambling & Substance Abuse, I report on Dr. Catherine Striley’s workshop on “Research & Practice Ethics: What You Need to Know.”

According to Dr. Striley, research assistant professor of psychiatry at Washington University in St. Louis, ethical research ensures rigorous research, and rigor ensures benefits from the research. Research investigations always involve a level of risk, and there must be a corollary benefit – in the form of a more effective treatment or a better understanding of the disorder–if the investigation places people at risk. Therefore it is vital for treatment organizations to be fully aware of the ethical issues involved so that informed decisions can be made about participating in research investigations. The following are examples of the types of questions that should be asked of the researchers:

• Has your Institutional Review Board (IRB) approved the research investigation? IRBs are committees at universities and research centers that review all proposed research by the institution’s faculty to ensure that human subjects and animals are protected.
• How do you plan to protect the confidentiality of the research participants?
• What are the risks of the research, and how do you plan to mitigate these risks? The most obvious example of a risk would be participant’s adverse reaction to medication in a drug trial.
• What is your hypothesis based on? In other words, does the scientific literature support the testing of the proposed intervention?

Dr. Striley offered case studies to spark audience discussion. One conversation focused on the incentives offered to individuals involved in gambling research. Recruiting and retaining participants in research projects on gambling has been challenging. I raised the question of whether increasing incentives or switching to cash payments would make a difference and, if so, what are the ethical implications. It appears that most IRBs prefer gift certificates as opposed to cash payments in research focused on gambling, alcohol and drugs out of a desire to prevent the participants from using the cash to gamble or buy alcohol and drugs. The group discussed whether this approach is an example of protection or paternalism. The clinicians in the session also observed that gift certificates can be easily sold on the street for cash, rendering this approach ineffective for some research participants.

What do you think about the issue of providing incentives for gambling research participants? We welcome your thoughts and questions in the comments section below.

Christine ReillyIn the Newsgambling researchInstitutional Review Boardresearch ethics

In recent years, reports about Parkinson’s disease patients engaging in excessive gambling have cropped up in the news. Several lawsuits against pharmaceutical companies have been filed by individuals claiming that the drug treatments for Parkinson’s disease caused them to develop gambling disorders, sex addiction and other impulse control disorders. So, what is the connection between disordered gambling behavior and a degenerative disorder of the central nervous system that often impairs the sufferer’s motor skills and speech? We asked Dr. Marc Potenza, a professor of psychiatry, child study and neurobiology at Yale University School of Medicine, to shed light on this research in the July edition ofIssues & Insights. Dr. Potenza, a co-author of thelargest studyto date on Parkinson’s disease and impulse control disorders, explains that the relationship between these disorders is more complex than may be suggested by some news accounts. You can read the summary of this study inJuly’s Issues and Insights. As always we welcome your thoughts and questions in the comments section below.

NCRG staffResearch Updatecomorbidity of pathological gamblingnew researchParkinson’s Disease

TheNational Center for Responsible Gamingrecently announced the formation of an advisory committee to guide the development of a new website to help colleges and universities address gambling and gambling problems among students. Scheduled to launch in 2011, collegegambling.org will provide a host of free, science-based resources to administrators, student health and life professionals, current and prospective college students and parents. The new website answers the call issued by theTask Force on College Gambling Policiesto disseminate research-based harm reduction strategies and programs to U.S. colleges and universities. Because only about one-fifth of U.S. colleges and universities have a gambling policy, the task force identified the need to provide science-based, accessible resources to schools interested in addressing gambling on their campuses.

A distinguished group of educators, scientists and health professionals will serve on the advisory committee for collegegambling.org. Chaired by Dr. Patricia Ketcham, associate director of health promotion at Oregon State University, the advisory committee includes representatives from Columbia University, Rensselaer Polytechnic Institute, Harvard University, Boston University School of Public Health, McGill University, Monmouth University, the American College Health Association’s Mental Health Best Practices Task Force and the Alcohol and Other Drugs National Knowledge Community of NASPA – Student Affairs Administrators in Higher Education. The Advisory Committee held its first meeting this month to review preliminary plans for the website.

For a full list of Advisory Committee members, please see thepress releaseon the NCRG website. More information on college gambling is available from theTask Force on College Gambling Policiespage, including thefull reportavailable for download in PDF format. As always, we welcome your thoughts and questions in the comment section below.

NCRG staffICRG Newscollege gamblingcollegegambling.orgTask Force on College Gambling Policies